A nurse is mixing regular insulin and NPH insulin in the same syringe prior to administering it to a client who has diabetes mellitus.
Which of the following actions should the nurse take first?

Inject air into the NPH vial.

Withdraw the NPH insulin from the vial.

Withdraw the regular insulin from the vial.

Inject air into the regular insulin vial.

Answer and Explanation

The Correct Answer is A

The correct sequence for mixing regular insulin and NPH insulin in the same syringe is important to ensure proper dosing. The nurse should follow these steps:

Inject air into the NPH (intermediate-acting) insulin vial: Injecting air into the NPH vial first helps to equalize the pressure in the vial, making it easier to withdraw the insulin later. This step is done first to avoid contaminating the regular insulin vial with NPH insulin.
Inject air into the regular insulin vial: Next, inject an amount of air equal to the intended regular insulin dose into the regular insulin vial.This also helps to equalize the pressure and makes it easier to withdraw the insulin.
Withdraw the regular insulin from the vial : The nurse should withdraw the regular insulin first because it is clear and not contaminated. This prevents any NPH insulin from mixing into the regular insulin vial.
Withdraw the regular insulin from the vial: Finally, the nurse withdraws the NPH insulin. Since the regular insulin has already been drawn up, there is no risk of contaminating the regular insulin with NPH insulin.

This sequence ensures that you don't contaminate the vials, and you accurately withdraw the appropriate doses of each insulin type.

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Correct Answer is D

Explanation

Metformin is a medication used to lower blood glucose levels in people with type 2 diabetes. Metoprolol is a beta-blocker used to treat high blood pressure and heart problems. If the nurse accidentally gives metformin instead of metoprolol, the client may experience hypoglycemia (low blood sugar), which can cause symptoms such as sweating, shakiness, confusion, and loss of consciousness. Therefore, the nurse should check the client’s glucose level and treat hypoglycemia if needed.

Choice A is wrong because HDL (high-density lipoprotein) is a type of cholesterol that is not affected by metformin or metoprolol.

Choice B is wrong because thyroid function levels are not affected by metformin or metoprolol.

Choice C is wrong because uric acid level is not affected by metformin or metoprolol.

Uric acid is a waste product that can cause gout if it accumulates in the joints. Normal ranges for blood glucose are 70 to 130 mg/dL before meals and less than 180 mg/dL two hours after meals.

Normal ranges for HDL are 40 to 60 mg/dL for men and 50 to 60 mg/dL for women.

Normal ranges for thyroid function levels vary depending on the specific test, but generally they are between 0.4 and 4.0 mIU/L for TSH (thyroid-stimulating hormone), 4.5 to 11.2 mcg/dL for T4 (thyroxine), and 80 to 180 ng/dL for T3 (triiodothyronine).

Normal ranges for uric acid are 3.4 to 7.0 mg/dL for men and 2.4 to 6.0 mg/dL for women.

A. You should anticipate taking medication to treat your disease for at least the next 3 years. B. You will need to undergo tuberculin skin tests every 6 months while taking medication for your disease. C. You should report monthly to have your blood drawn to monitor kidney function while taking medication. D. You will need to take two or more medications to treat your disease.

Correct Answer is D

Explanation

This is because TB is caused by a bacterium that can develop resistance to single-drug therapy, so a combination of drugs is used to prevent or treat drug-resistant strains. Some of the common drugs used for TB are isoniazid, rifampin, ethambutol, and pyrazinamide.

Choice A is wrong because the duration of treatment for active TB is usually 6 to 9 months, not 3 years.

Choice B is wrong because tuberculin skin tests are not reliable indicators of disease activity or response to treatment, as they can remain positive for years after successful therapy.

Choice C is wrong because blood tests to monitor kidney function are not routinely required for TB treatment unless the client has a preexisting renal impairment or is taking drugs that are nephrotoxic.

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A nurse is mixing regular insulin and NPH insulin in the same syringe prior to administering it to a client who has diabetes mellitus.
Which of the following actions should the nurse take first?