A nurse is teaching a client how to draw up regular insulin and NPH insulin in the same syringe. Which of the following instructions should the nurse include?
Inject air into the regular insulin first.
Shake the NPH insulin until it is well mixed.
Draw up the NPH insulin into the syringe first.
Discard regular insulin that appears cloudy.
The Correct Answer is D
Choice A reason: This is incorrect. When mixing regular (clear) and NPH (cloudy) insulin, air should be injected into the NPH vial first, then into the regular insulin vial. This prevents contamination of the regular insulin with NPH insulin.
Choice B reason: This is incorrect because the nurse should not shake the NPH insulin vial, but rather roll it gently between the palms to mix it. Shaking can cause bubbles and affect the accuracy of the dose.
Choice C reason: This is incorrect because the nurse should draw up the regular insulin into the syringe first, then the NPH insulin. This prevents mixing of the NPH insulin with the regular insulin in the vial.
Choice D reason: This is correct. Regular insulin should always be clear. If it appears cloudy, it may be contaminated or expired and should be discarded.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Dextromethorphan is a cough suppressant that does not affect blood glucose levels. It is safe to use for clients with diabetes.
Choice B reason: Prednisone is a corticosteroid that can cause glucose intolerance by increasing glucose production and decreasing insulin sensitivity. It can worsen hyperglycemia and increase the risk of diabetic complications.
Choice C reason: Atorvastatin is a statin that lowers cholesterol levels and reduces the risk of cardiovascular disease. It does not cause glucose intolerance and may have a beneficial effect on glycemic control.
Choice D reason: Cimetidine is a histamine-2 receptor antagonist that reduces stomach acid production and treats ulcers and gastroesophageal reflux disease. It does not cause glucose intolerance and has no significant interaction with diabetes medications.

Correct Answer is B
Explanation
Choice A reason: Hyperkalemia is not the correct answer. Hyperkalemia is a high level of potassium in the blood. Corticosteroids do not cause hyperkalemia, but rather hypokalemia. Hyperkalemia may be caused by other factors such as renal failure, acidosis, or potassium-sparing diuretics.
Choice B reason: Hypokalemia is the correct answer. Hypokalemia is a low level of potassium in the blood. Corticosteroids can cause hypokalemia by increasing the excretion of potassium and sodium in the urine. Hypokalemia can cause muscle weakness, cramps, arrhythmias, and digoxin toxicity.

Choice C reason: Hypermagnesemia is not the correct answer. Hypermagnesemia is a high level of magnesium in the blood. Corticosteroids do not affect magnesium levels. Hypermagnesemia may be caused by other factors such as renal failure, excessive antacid use, or magnesium-containing laxatives.
Choice D reason: Hypomagnesemia is not the correct answer. Hypomagnesemia is a low level of magnesium in the blood. Corticosteroids do not affect magnesium levels. Hypomagnesemia may be caused by other factors such as malnutrition, alcoholism, or diuretic use.
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