Based on the capillary glucose measurement, a client is to receive 10 units of regular insulin. The client's medication drawer contains one vial of a 70/30 mixture of regular Insulin and Isophane insulin How should the nurse prepare the prescribed dose?

Pull up 30 units from the 70/30 vial, but only administer one third.

Withdraw ten units regular insulin from the 70/30 vial.

Withhold the dose until insulin regular is available on the unit.

Obtain a new vial of regular insulin and withdraw ten units.

Answer and Explanation

The Correct Answer is C

A) Pull up 30 units from the 70/30 vial, but only administer one third: The 70/30 insulin vial contains a mixture of 70% isophane (NPH) insulin and 30% regular insulin. If 30 units of this mixture are drawn, the actual amount of regular insulin would be 30% of 30 units, which equals 9 units. This does not equate to the 10 units of regular insulin required, making this option inaccurate for precise dosing.
B) Withdraw ten units regular insulin from the 70/30 vial: The 70/30 vial provides a fixed ratio of regular to NPH insulin. Extracting 10 units from this vial would not yield exactly 10 units of regular insulin; instead, it would include both types in the specified ratio, leading to an incorrect dosage of regular insulin.
C) Withhold the dose until insulin regular is available on the unit: Since the 70/30 vial contains a mixture and not solely regular insulin, it is necessary to withhold the dose until a vial of regular insulin is available. This ensures that the precise amount of regular insulin needed is administered, avoiding the imprecision and potential errors that could arise from using a mixed insulin vial.
D) Obtain a new vial of regular insulin and withdraw ten units: While obtaining a new vial of regular insulin is the correct approach for ensuring accurate dosing, the option of withdrawing ten units directly from a vial of regular insulin is not feasible if the current medication available is a mixture. This option assumes that the correct type of insulin is already available for use.

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Correct Answer is A

Explanation

A. Phosphate: Calcium acetate is used primarily to manage hyperphosphatemia in patients with chronic kidney disease (CKD). It works by binding to dietary phosphate in the gut, preventing its absorption, which helps lower phosphate levels in the blood. A decrease in phosphate levels indicates that the calcium acetate is effectively controlling phosphate levels.
B. pH: While maintaining normal pH levels is important in CKD, calcium acetate does not directly affect blood pH. The primary role of calcium acetate is to manage phosphate levels rather than pH balance.
C. Calcium: Calcium acetate is a phosphate binder and does not primarily target calcium levels. It can influence calcium levels indirectly, but a decrease in calcium is not the direct measure of the medication's effectiveness. Instead, monitoring phosphate levels is more indicative of the medication’s effectiveness.
D. Potassium: Calcium acetate does not have a direct effect on potassium levels. It is specifically used to manage phosphate levels in CKD patients. Changes in potassium levels would not indicate the effectiveness of calcium acetate.

A. Chronotropic effect. B. Diuresis C. Vasodilation. D. Sympatholytic action.

Correct Answer is C

Explanation

A) Chronotropic effect: This term refers to changes in heart rate. Angiotensin II receptor antagonists like valsartan primarily affect blood pressure and vascular tone, rather than directly altering heart rate.
B) Diuresis: Diuresis involves increased urine production. Although some antihypertensives can have a diuretic effect, valsartan primarily works through mechanisms other than increasing urine output.
C) Vasodilation: Angiotensin II receptor antagonists such as valsartan work by blocking the action of angiotensin II, which leads to vasodilation. This reduction in vascular resistance helps to lower blood pressure and is the primary therapeutic effect of valsartan.
D) Sympatholytic action: This refers to the suppression of sympathetic nervous system activity. Valsartan does not primarily act through sympathetic nervous system modulation but rather through direct vasodilation by blocking angiotensin II receptors.

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Based on the capillary glucose measurement, a client is to receive 10 units of regular insulin. The client's medication drawer contains one vial of a 70/30 mixture of regular Insulin and Isophane insulin How should the nurse prepare the prescribed dose?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?

Correct Answer is A

Explanation

The nurse is administering the angiotensin II receptor antagonist valsartan. Which physiological response causes its therapeutic effect?

Correct Answer is C

Explanation

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