During a return demonstration, a nursing student prepares to mix NPH and Regular insulin. Which sequence of steps indicates correct technique?

Inject air into NPH, inject air into Regular, draw Regular, draw NPH

Inject air into Regular, draw Regular, inject air into NPH, draw NPH

Inject air into Regular, inject air into NPH, draw NPH, draw Regular

Inject air into NPH, draw NPH, draw Regular

Answer and Explanation

The Correct Answer is A

Rationale:
A. When mixing NPH (intermediate-acting) and Regular (short-acting) insulin, air must first be injected into the NPH vial, then into the Regular vial, before drawing up the insulin. Drawing up the Regular insulin first ensures the short-acting insulin remains uncontaminated by NPH, which could alter its onset and peak. After the Regular insulin is drawn, the NPH dose is drawn, maintaining proper concentrations and ensuring safe, accurate administration.

B. Injecting air into Regular first and drawing Regular before NPH can result in contamination of the short-acting insulin with intermediate-acting insulin. This could affect the insulin’s onset, peak, and duration. Using the wrong sequence increases the risk of improper glucose control.

C. Drawing NPH before Regular increases the risk of contaminating the Regular insulin. Contamination can alter the pharmacokinetics of the short-acting insulin, making blood glucose management unpredictable. This sequence does not follow safe mixing guidelines.

D. Not injecting air into both vials before drawing the insulin can create a vacuum, making it difficult to withdraw the correct doses. This increases the chance of dosing errors and reduces the accuracy of the insulin administered.

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Correct Answer is ["A","B","D","E"]

Explanation

Rationale:

A. Insulin glargine is a long-acting basal insulin that is not compatible with other insulins in the same syringe due to its pH and formulation. Mixing it can alter its action, making blood glucose control unpredictable and unsafe.

B. Glargine provides a steady, peakless insulin level, which mimics basal insulin secretion and reduces the risk of hypoglycemia that can occur with peak insulin activity. This characteristic distinguishes it from short- or intermediate-acting insulins.

C. Glargine is long-acting and not meal-dependent, unlike rapid- or short-acting insulin. Timing it with meals is unnecessary and may lead to inadequate coverage or hypoglycemia if meals are delayed.

D. Consistent timing maintains stable basal insulin levels and helps achieve predictable 24-hour glycemic control. Deviating from the schedule may result in hyperglycemia or hypoglycemia.

E. Glargine is designed to provide a continuous, long-acting basal insulin effect for up to 24 hours, supporting overall glycemic stability and reducing the need for multiple daily injections for basal coverage.

A. "Exercise and losing weight can help me control my blood sugar." B. "Insulin is never used for type 2 diabetes." C. "Checking my blood sugar will help me see how well I'm managing. D. "Oral medications may be prescribed to help lower my blood sugar." E. "Healthy food choices and portion control are part of managing diabetes."

Correct Answer is ["A","C","D","E"]

Explanation

Rationale:

A. Lifestyle modifications such as regular physical activity and weight management improve insulin sensitivity and can significantly help control blood glucose levels in type 2 diabetes. This statement reflects accurate understanding of non-pharmacologic management.

B. While many patients with type 2 diabetes initially manage the condition with lifestyle changes and oral medications, insulin may be required if blood glucose is persistently elevated or during times of illness, surgery, or pregnancy. This statement demonstrates a misunderstanding of disease management.

C. Regular blood glucose monitoring allows the patient and healthcare team to assess the effectiveness of diet, exercise, and medications and make timely adjustments. This demonstrates accurate understanding of self-management.

D. Many patients with type 2 diabetes require oral hypoglycemic agents (e.g., metformin, sulfonylureas, SGLT2 inhibitors) to achieve glycemic control. Recognizing the potential need for medications reflects correct knowledge.

E. Nutrition is a cornerstone of diabetes management. Balanced meals, carbohydrate counting, and portion control help prevent blood glucose spikes and support overall health. This statement demonstrates understanding of dietary management strategies.

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During a return demonstration, a nursing student prepares to mix NPH and Regular insulin. Which sequence of steps indicates correct technique?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","B","D","E"]

Explanation

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Correct Answer is ["A","C","D","E"]

Explanation

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