A nurse is preparing to administer 12 units of regular insulin and 8 units of NPH insulin to a patient. What is the correct method to prepare this mixture?
Use two separate syringes for each type of insulin to avoid errors.
Mix both insulins together in the vial before drawing up the dose.
Withdraw 8 units of NPH insulin first, then 12 units of regular insulin into the same syringe.
Withdraw 12 units of regular insulin first, then 8 units of NPH insulin into the same syringe.
The Correct Answer is D
A. Use two separate syringes for each type of insulin to avoid errors: While using separate syringes is safe, premixed insulin injections are commonly prepared in one syringe to reduce the number of injections, provided proper technique is followed.
B. Mix both insulins together in the vial before drawing up the dose: Mixing insulins directly in the vial can alter their pharmacokinetics and is unsafe. Each insulin should be drawn carefully to maintain its intended action.
C. Withdraw 8 units of NPH insulin first, then 12 units of regular insulin into the same syringe: Drawing NPH first can contaminate the short-acting regular insulin with intermediate-acting insulin, affecting onset and duration and potentially leading to unpredictable blood glucose control.
D. Withdraw 12 units of regular insulin first, then 8 units of NPH insulin into the same syringe: Regular insulin (short-acting) should always be drawn first, followed by NPH insulin (intermediate-acting). This prevents contamination and maintains the correct pharmacokinetic profiles of both insulins.
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Related Questions
Correct Answer is C
Explanation
A. 18 gauge, 1 1/2 inch: An 18-gauge needle is very large and long, typically used for rapid fluid administration or blood transfusions. Using this size for an intradermal injection would cause significant tissue trauma and pain.
B. 21 gauge, 1 inch: A 21-gauge, 1-inch needle is commonly used for intramuscular injections. It is too thick and too long for placement within the dermal layer, increasing the risk of incorrect administration.
C. 26–27 gauge, 1/2 inch: Intradermal injections require a very fine, short needle to deposit medication just beneath the epidermis. A 26–27 gauge needle with a 1/2-inch length allows precise placement and minimizes tissue damage.
D. 23–25 gauge, 5/8 inch: This needle size is more appropriate for subcutaneous injections. It is longer and thicker than needed for intradermal administration and may penetrate too deeply into subcutaneous tissue.
Correct Answer is D
Explanation
A. 5 mL: Writing 5 mL instead of 0.5 mL would result in a tenfold overdose, which is extremely dangerous, especially for pediatric patients.
B. 5mL: Omitting the space between the number and unit does not prevent the overdose risk; the value itself is still incorrect for the prescribed dose.
C. 50 mL: This is a hundredfold higher than the prescribed dose and would cause severe toxicity if administered.
D. 0.5 mL: Writing the dose as 0.5 mL clearly specifies the intended volume and minimizes the risk of misinterpretation or medication errors, particularly when dealing with small pediatric doses.
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