The client asks the nurse about storing insulin. Which response by the nurse is correct?

Vials of insulin should be refrigerated.

Insulin will last longer if kept in the freezer.

Opened vials of insulin must be discarded.

Insulin pens never have to be refrigerated.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Insulin is a protein-based hormone that is sensitive to heat and light. Exposure to high temperatures or direct sunlight can cause insulin to break down and become less effective.

Refrigeration helps to maintain the stability and potency of insulin. It is generally recommended to store unopened insulin vials in the refrigerator at a temperature between 36°F and 46°F (2°C and 8°C).

This temperature range helps to slow down the degradation process and ensure that the insulin remains effective until its expiration date.

Choice B rationale:

Insulin should never be frozen. Freezing can cause the insulin to crystallize and become unusable. Once insulin has been frozen, it cannot be thawed and used again.

Choice C rationale:

Opened vials of insulin do not need to be discarded immediately. They can be stored in the refrigerator for up to 28 days, depending on the type of insulin.

However, it is important to note the date that the vial was opened and to discard it after the recommended storage period.

Choice D rationale:

Insulin pens should be stored according to the manufacturer’s instructions. Some insulin pens can be stored at room temperature for a certain period of time, while others must be refrigerated.

It is important to read the instructions that come with the insulin pen to ensure that it is stored properly.

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Correct Answer is C

Explanation

Choice A rationale:

Hypertension is not a primary contraindication for mannitol use. While it's important to monitor blood pressure during mannitol administration, it's not the most concerning factor in this scenario.

Mannitol can even be used cautiously in hypertensive patients with conditions like intracranial hypertension or acute renal failure, where its benefits may outweigh the potential risks of exacerbating hypertension.

Choice B rationale:

Mannitol is actually indicated for the treatment of increased intracranial pressure (ICP). It works by drawing fluid from the brain tissues into the bloodstream, thereby reducing pressure within the skull.

Therefore, a patient with ICP would not be a concern for mannitol administration; rather, they would be a potential candidate for its use.

Choice D rationale:

While fluid volume overload can be a concern with mannitol use, it's typically managed with careful monitoring and fluid restriction.

The more significant concern in this scenario is congestive heart failure (CHF).

Choice C rationale:

Mannitol is contraindicated in patients with congestive heart failure (CHF). Here's why:

Increased Circulating Volume: Mannitol is an osmotic diuretic, meaning it draws fluid from the tissues into the bloodstream, increasing circulating blood volume. This can overload the already compromised heart in CHF patients, leading to worsening heart failure and pulmonary edema.

Elevated Blood Pressure: Mannitol can also cause a transient increase in blood pressure due to its osmotic effects. This can further strain the heart and worsen CHF symptoms.

Renal Impairment: CHF patients often have impaired renal function, which can reduce their ability to excrete mannitol effectively. This can lead to fluid retention and electrolyte imbalances, further complicating CHF management.

In summary, administering mannitol to a patient with CHF could potentially lead to:

Exacerbation of heart failure symptoms Pulmonary edema

Worsening renal function Electrolyte imbalances Increased risk of mortality

Therefore, it's crucial to avoid mannitol use in patients with CHF and to closely monitor fluid status and electrolytes in those who must receive it for other indications.

A. To provide moisture. B. To prevent chemical conjunctivitis. C. To prevent infection. D. To treat infection.

Correct Answer is C

Explanation

Choice A rationale:

Erythromycin ointment does not have moisturizing properties. Its primary purpose is to prevent bacterial infection, not to provide moisture to the eyes.

While some ointments may have a slight moisturizing effect, this is not the main reason for using erythromycin ointment in newborns.

If moisture is the primary concern, other products specifically designed to lubricate the eyes would be more appropriate.

Choice B rationale:

Chemical conjunctivitis is typically caused by exposure to irritants such as chlorine in swimming pools or strong chemicals. Erythromycin ointment is not effective in preventing chemical conjunctivitis.

In fact, it could potentially worsen the irritation if used in cases of chemical conjunctivitis.

If chemical conjunctivitis is suspected, flushing the eyes with water or saline solution and seeking medical attention would be the appropriate course of action.

Choice D rationale:

Erythromycin ointment is an antibiotic, but it is not typically used to treat active infections in newborns.

If a newborn has a suspected eye infection, a healthcare provider would likely prescribe a different antibiotic eye drop or ointment that is more effective in treating the specific infection.

However, erythromycin ointment can be used as a prophylactic measure to prevent eye infections, which is why it is commonly administered to newborns shortly after birth.

Choice C rationale:

Erythromycin ointment is primarily used to prevent eye infections in newborns.

It is effective against a variety of bacteria that can cause conjunctivitis, including Neisseria gonorrhoeae (the bacteria that causes gonorrhea) and Chlamydia trachomatis (the bacteria that causes chlamydia).

These bacteria can be passed from the mother to the baby during childbirth, and if left untreated, they can cause serious eye infections that can lead to vision loss.

By applying erythromycin ointment to the newborn's eyes shortly after birth, the risk of these infections can be significantly reduced.

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The client asks the nurse about storing insulin. Which response by the nurse is correct?

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Naxlex Comprehensive Predictor Exams

Which patient would be a concern for the nurse when administering mannitol (Osmitrol)?

Correct Answer is C

Explanation

The nurse is instilling erythromycin ointment to the lower lid of the newborn’s eyes. Why is this medication being given to the newborn?

Correct Answer is C

Explanation

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