A nurse is reinforcing teaching about insulin administration to a school age child who has diabetes mellitus. Which of the following instructions should the nurse include?
"You should give four to six injections in one area before switching sites."
"You should aspirate for blood before injecting the insulin."
"You should inject the needle at a 30-degree angle."
"You should combine your glargine and regular insulin in the same syringe."
The Correct Answer is A
A. This statement reflects proper site rotation within a specific anatomical area. Rotating injections within the same general area (e.g., abdomen, thigh, upper arm) after 4–6 injections helps prevent lipohypertrophy while maintaining consistent absorption rates. Proper rotation within a single area is safer than frequently changing anatomical sites.
B. Aspiration is not recommended for subcutaneous insulin injections because the risk of injecting into a blood vessel is extremely low and aspiration can increase pain or tissue trauma.
C. Subcutaneous insulin should generally be injected at a 90-degree angle for most children and adults. A 30-degree angle is only used in very thin individuals to avoid intramuscular injection. Using a 30-degree angle routinely may reduce absorption consistency.
D. Glargine (long-acting insulin) should never be mixed with other insulins in the same syringe because it alters its pharmacokinetics. Mixing can lead to unpredictable absorption and blood glucose fluctuations. Only certain short-acting and intermediate-acting insulins can be safely mixed if prescribed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Antifungal ointments, such as clotrimazole or miconazole, are used to treat fungal infections like tinea capitis or ringworm. Pediculosis capitis is caused by head lice (an ectoparasite), not a fungus, so antifungal ointments are ineffective. Using them can delay appropriate treatment and does not eradicate lice or nits.
B. Hydrogen peroxide is sometimes used for minor wound cleaning or hair bleaching, but it has no proven effect on lice or nits. Its application to the scalp can cause skin irritation, dryness, and discomfort without treating the underlying infestation, making it an inappropriate intervention.
C. Head lice are species-specific parasites that infest humans and cannot survive on pets. Treating animals is unnecessary and does not prevent reinfestation. Resources and efforts should instead focus on treating the affected child, close human contacts, and contaminated personal items.
D. Lice and nits can survive on bedding, clothing, hats, and towels. Washing these items in hot water and drying them on high heat for at least 20 minutes effectively kills lice and prevents reinfestation. Items that cannot be washed can be sealed in an airtight plastic bag for 14 days. This environmental control is an essential component of comprehensive pediculosis management.
Correct Answer is A
Explanation
A. This statement indicates a need for further teaching. Isotretinoin is highly teratogenic and can cause severe birth defects. It is never safe during pregnancy, and strict pregnancy prevention measures must be followed.
B. This statement is accurate. To prevent pregnancy, clients must use two reliable forms of contraception starting one month prior to therapy, throughout treatment, and for one month after discontinuation, as recommended by the iPLEDGE program.
C. This statement is accurate. Isotretinoin can cause hyperlipidemia, so monitoring lipid levels periodically during therapy is essential to detect and manage potential complications.
D. This statement is accurate. Avoiding pregnancy is mandatory due to the high teratogenic risk associated with Isotretinoin. Clients must follow strict pregnancy prevention protocols.
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