A nurse is teaching a client who is newly diagnosed with type 2 diabetes mellitus about insulin therapy. Which of the following insulin combinations should the nurse instruct the client to mix?

Insulin aspart and NPH insulin

Insulin degludec and NPH insulin.

Insulin glargine and insulin detemir

Insulin lispro and regular insulin

Answer and Explanation

The Correct Answer is A

A. Insulin aspart and NPH insulin: Insulin aspart is a rapid-acting insulin, and NPH is an intermediate-acting insulin. These can be mixed in the same syringe to provide both immediate and prolonged glucose control, with aspart covering postprandial spikes and NPH maintaining basal levels.

B. Insulin degludec and NPH insulin: Insulin degludec is an ultra-long-acting insulin and should not be mixed with any other insulin, as mixing can alter its absorption and effectiveness.

C. Insulin glargine and insulin detemir: Both glargine and detemir are long-acting insulins and should not be mixed with any other insulin, as this can interfere with their mechanism of providing a steady release.

D. Insulin lispro and regular insulin: Insulin lispro is a rapid-acting insulin, and regular insulin is short-acting. These insulins should not be mixed because they have different onset and peak times, which can lead to unpredictable glucose control.

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Correct Answer is B

Explanation

A. Increase in urinary output: Mannitol is an osmotic diuretic that promotes diuresis to reduce intracranial pressure (ICP). Increased urinary output is an expected effect and indicates the medication is working as intended.

B. Crackles on auscultation: Mannitol can lead to fluid overload, especially in clients with compromised renal or cardiac function. Crackles in the lungs suggest pulmonary edema, a serious adverse effect that should be reported immediately to prevent respiratory distress.

C. Intracranial pressure reading of 12 mm Hg: Normal ICP ranges from 5 to 15 mm Hg. A reading of 12 mm Hg is within the expected range and does not indicate an adverse effect of mannitol.

D. Glasgow coma scale rating of 15: A score of 15 indicates full consciousness and normal neurological function. This finding does not suggest an adverse reaction to mannitol.

A. "Place an aspirin in your ostomy pouch to control odor." B. "Your ostomy should start functioning in five days." C. "Empty your ostomy pouch when it becomes a third to halfway full." D. "Notify your provider if your stoma becomes dark red:"

Correct Answer is C

Explanation

A. "Place an aspirin in your ostomy pouch to control odor.": Aspirin should never be placed in an ostomy pouch, as it can damage the pouch material and irritate the stoma. Deodorizers or dietary adjustments are safer alternatives for odor control.

B. "Your ostomy should start functioning in five days.": An ostomy typically begins functioning within 2 to 4 days postoperatively, depending on bowel motility. Waiting five days without output could indicate an obstruction or ileus, requiring medical evaluation.

C. "Empty your ostomy pouch when it becomes a third to halfway full.": Keeping the pouch from becoming too full prevents leaks, discomfort, and excessive pressure on the stoma. This practice helps maintain skin integrity and ostomy function.

D. "Notify your provider if your stoma becomes dark red.": A dark red stoma is normal and indicates good blood supply. However, a stoma that turns pale, dusky, or black requires immediate medical attention, as it suggests compromised circulation and possible necrosis.

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A nurse is teaching a client who is newly diagnosed with type 2 diabetes mellitus about insulin therapy. Which of the following insulin combinations should the nurse instruct the client to mix?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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