A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if their blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?
Discard the NPH solution if it appears cloudy.
NPH is an intermediate-acting insulin.
Freeze unopened insulin vials.
Shake the insulin vigorously before loading the syringe.
The Correct Answer is B
Choice A reason: This is incorrect because NPH insulin is normally cloudy and should be gently mixed before use. However, the nurse should discard the solution if it has clumps, flakes, or crystals.
Choice B reason: This is correct because NPH insulin is an intermediate-acting insulin that has a slower onset and longer duration than short-acting or rapid-acting insulins. The nurse should explain to the client that NPH insulin provides basal coverage and may need to be combined with other types of insulin to control blood glucose levels.
Choice C reason: This is incorrect because freezing insulin can damage its potency and effectiveness. The nurse should instruct the client to store unopened insulin vials in the refrigerator and opened vials at room temperature.
Choice D reason: This is incorrect because shaking insulin can cause air bubbles and frothing, which can affect the accuracy of the dose. The nurse should instruct the client to roll the insulin vial between the palms of the hands to mix it gently.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Tachycardia is a possible adverse effect of theophylline, as it is a methylxanthine that stimulates the central nervous system and the cardiac muscle. The nurse should instruct the client to monitor their pulse rate and report any palpitations, chest pain, or irregular heartbeat.

Choice B reason: Drowsiness is not a likely adverse effect of theophylline, as it is a stimulant that increases alertness and energy. The nurse should caution the client to avoid taking the medication close to bedtime, as it may cause insomnia.
Choice C reason: Constipation is not a common adverse effect of theophylline, as it does not affect the gastrointestinal motility or secretion. The nurse should advise the client to maintain a balanced diet, adequate fluid intake, and regular exercise to prevent constipation.
Choice D reason: Oliguria is not a typical adverse effect of theophylline, as it does not impair the renal function or cause fluid retention. The nurse should encourage the client to drink enough fluids to prevent dehydration and maintain a normal urine output.
Correct Answer is C
Explanation
Choice A reason: This is incorrect because lispro insulin is a rapid-acting insulin that does not need to be administered with another type of insulin. However, the patient may need a long-acting or intermediate-acting insulin to provide basal coverage throughout the day.
Choice B reason: This is incorrect because lispro insulin has a peak action of 30 to 90 min after the injection, which means that the patient is at the highest risk of hypoglycemia during this time. The nurse should assess for hypoglycemia more frequently than 4 hr after the injection.
Choice C reason: This is correct because lispro insulin has a fast onset of action of 15 to 30 min after the injection, which means that the patient should eat a meal within 15 min of the injection to prevent hypoglycemia.
Choice D reason: This is incorrect because polyuria is a sign of hyperglycemia, not hypoglycemia. The nurse should monitor for polyuria before the insulin injection, as it may indicate that the patient's blood glucose level is high.
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