A nurse is preparing to mix short-acting and intermediate-acting insulin in one syringe to administer to a client who has type 1 diabetes mellitus. Identify the sequence the nurse should follow. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)

Draw up a volume of air equal to the volume of insulin from the intermediate-acting insulin vial.

Inject the volume of air equal to the amount of insulin to withdraw from the intermediate-acting insulin vial.

Inject the volume of air equal to the insulin dose from the short- acting insulin vial.

Withdraw the prescribed amount of insulin from the short-acting insulin vial.

Withdraw the prescribed amount of insulin from the intermediate-acting insulin vial.

Answer and Explanation

The Correct Answer is A,C,D,B,E

A. Draw up a volume of air equal to the volume of insulin from the intermediate-acting insulin vial. Air is first drawn into the syringe for the intermediate-acting insulin to prevent creating a vacuum when withdrawing it later.

C. Inject the volume of air equal to the insulin dose from the short-acting insulin vial. Injecting air into the short-acting vial prevents vacuum formation and makes withdrawal easier.

D. Withdraw the prescribed amount of insulin from the short-acting insulin vial. The short-acting insulin is withdrawn first to avoid contaminating it with intermediate-acting insulin.

B. Inject the volume of air equal to the amount of insulin to withdraw from the intermediate-acting insulin vial. Air is injected into the intermediate-acting vial before withdrawal to facilitate drawing up the insulin.

E. Withdraw the prescribed amount of insulin from the intermediate-acting insulin vial. Finally, the intermediate-acting insulin is withdrawn, completing the mixture in the syringe.

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Correct Answer is A,C,D,B,E

Explanation

C. Inject the volume of air equal to the insulin dose from the short-acting insulin vial. Injecting air into the short-acting vial prevents vacuum formation and makes withdrawal easier.

D. Withdraw the prescribed amount of insulin from the short-acting insulin vial. The short-acting insulin is withdrawn first to avoid contaminating it with intermediate-acting insulin.

E. Withdraw the prescribed amount of insulin from the intermediate-acting insulin vial. Finally, the intermediate-acting insulin is withdrawn, completing the mixture in the syringe.

A. A client who needs assistance when ambulating B. A client who consistently has difficulty using utensils while eating C. A client who has expressive aphasia D. A client who consistently coughs after drinking liquids

Correct Answer is D

Explanation

A. A client who needs assistance when ambulating: Difficulty ambulating increases fall risk and requires physical therapy, but it is not immediately life-threatening. This client needs support but does not take priority over airway or aspiration concerns.

B. A client who consistently has difficulty using utensils while eating: This reflects impaired motor coordination and may require occupational therapy. While important for independence, it does not present an urgent safety or health threat.

C. A client who has expressive aphasia: Expressive aphasia affects communication but does not compromise airway or physical safety directly. Speech therapy is beneficial, but it is not the most urgent referral.

D. A client who consistently coughs after drinking liquids: Coughing after drinking indicates possible aspiration due to impaired swallowing reflex. Aspiration can lead to pneumonia and respiratory compromise, making this client the highest priority for immediate referral to a speech-language pathologist for swallowing evaluation.

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Body System	Findings
Gastrointestinal	Client reports abdominal pain as a 9 on a pain scale of 0 to 10. Abdomen is distended and firm. Bowels sounds are distant and hypoactive.
Integumentary	Skin is warm and dry. Perianal skin is excoriated, and small ulceration is noted.
Fluid balance	Tenting of skin for 4 seconds is noted. Capillary refill is 2 seconds. Temperature 38.7° C (101.7° F) Mucous membranes are dry. Respiratory rate 20/min

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Naxlex Comprehensive Predictor Exams

Correct Answer is A,C,D,B,E

Explanation

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Correct Answer is D

Explanation

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