Place the following steps for mixing NPH and Regular insulin in the correct order:
Add air into the Regular insulin vail
Remove the required dosage from the NPH insulin vial
Remove the required dosage from the Regular insulin vial
Add air into the NPH insulin vial
The Correct Answer is D,A,C,B
A. Add air into the Regular insulin vial: After preparing the NPH vial, air is injected into the Regular (short-acting) insulin vial. This step also equalizes pressure and facilitates accurate withdrawal of the medication. It is critical to inject air before drawing insulin to avoid creating negative pressure that can lead to dosing errors.
B. Remove the required dosage from the NPH insulin vial: Finally, the nurse withdraws the prescribed dose of NPH insulin. After Regular insulin has been drawn, NPH can be safely added to the syringe, completing the mixture while ensuring the proper sequence of short-acting before intermediate-acting insulin for accurate blood glucose control.
C. Remove the required dosage from the Regular insulin vial: The nurse withdraws the prescribed dose of Regular insulin first because it is short-acting. Drawing Regular insulin before NPH prevents contamination of the short-acting insulin with the intermediate-acting type, maintaining proper pharmacokinetics and efficacy.
D. Add air into the NPH insulin vial: The first step in mixing insulin is to inject air into the NPH (intermediate-acting) insulin vial without drawing any solution. Injecting air equalizes pressure inside the vial, making it easier to withdraw the correct dose later and preventing a vacuum from forming.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Suspected deep tissue injury: Suspected deep tissue injuries present as a purple or maroon localized area of intact skin or a blood-filled blister, indicating underlying tissue damage. These injuries are often more severe than stage 1 and involve deeper layers than the epidermis, unlike the intact red skin seen.
B. Stage 2 pressure injury: Stage 2 pressure injuries involve partial-thickness loss of skin with exposed dermis, appearing as a shallow open ulcer or blister. The presence of an open wound differentiates it from the intact skin observed in this patient, making stage 2 inconsistent.
C. Stage 1 pressure injury: Stage 1 pressure injuries are characterized by localized, nonblanchable erythema of intact skin, usually over a bony prominence. The redness indicates early tissue damage while the epidermis remains intact, representing the earliest detectable stage of pressure injury development.
D. Unstageable pressure injury: Unstageable pressure injuries involve full-thickness tissue loss in which the base of the wound is covered by slough or eschar, obscuring the depth of tissue damage. Since the skin in this patient is intact and visible, this classification is inaccurate.
Correct Answer is C
Explanation
A. Assure the patient that the reaction was probably a side effect and not an allergy: An itchy rash and wheezing after penicillin are classic signs of an allergic reaction, potentially IgE-mediated. Dismissing these symptoms as a minor side effect is unsafe, as repeat exposure could trigger anaphylaxis, including life-threatening bronchospasm, hypotension, or cardiovascular collapse.
B. Call the pharmacist: While pharmacists can provide guidance on alternative medications or interactions, immediate withholding of the suspected allergen and notifying the prescriber takes priority. Pharmacist consultation is supportive but does not replace urgent clinical decision-making regarding patient safety.
C. Withhold the medication and contact the prescriber: Withholding the penicillin prevents further exposure to a known allergen, and contacting the prescriber allows for safe substitution with an alternative antibiotic. This action aligns with best practices for allergy management and patient safety protocols in medication administration.
D. Administer the antibiotic and observe carefully for a reaction: Administering a medication despite a reported allergic reaction places the patient at high risk for immediate hypersensitivity reactions. Observation alone is insufficient to mitigate the potential for severe outcomes such as anaphylaxis, and this approach violates safe medication administration standards.
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