The nurse is teaching a patient about home administration of insulin.
The patient will receive regular insulin and NPH insulin at 0700 every day. What is important to teach the patient?
Draw up the regular insulin last.
Draw up the insulins after mixing them in a vial.
Draw up the medications in separate syringes.
Draw up the NPH insulin last.
The Correct Answer is A
Choice A rationale
When a patient is administering both regular insulin and NPH insulin, it’s important to draw up the regular insulin first. This is because regular insulin is clear and NPH insulin is cloudy. If the NPH (cloudy) insulin were drawn up into the syringe first, it could contaminate the regular (clear) insulin when drawing it up second. This could affect the action of the regular insulin, which is meant to be fast-acting.
Choice B rationale
Mixing insulins in a vial before drawing them up is not recommended. This could lead to inaccurate dosing and potential contamination of one or both vials. It’s safer and more accurate to draw up each type of insulin separately into the syringe.
Choice C rationale
While it’s possible to administer insulin using separate syringes, it’s usually not necessary and can be more cumbersome for the patient. As long as the patient is careful to avoid contaminating the insulins and to draw them up in the correct order (regular before NPH), they can be administered together in the same syringe.
Choice D rationale
Drawing up the NPH insulin last is not correct. As mentioned earlier, the regular insulin should be drawn up first to avoid contaminating it with the NPH insulin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
A persistent cough is not directly related to the administration of famotidine. Famotidine is a histamine-2 blocker that works by decreasing the amount of acid the stomach produces. It is used to treat and prevent ulcers in the stomach and intestines and to treat conditions in which the stomach produces too much acid. A persistent cough could be a symptom of many other conditions, but it is not a direct indicator of the effectiveness or ineffectiveness of famotidine.
Choice B rationale
The absence of a sour taste in the mouth, often associated with acid reflux, could suggest that famotidine is working as it should. However, the absence of a sour taste does not definitively indicate that the medication has had its intended effect, as the patient may not have experienced this symptom even before taking the medication.
Choice C rationale
Famotidine is used to decrease the amount of acid in the stomach. A normal stomach pH is typically around 1.5 to 3.5, which is highly acidic. If a patient’s stomach pH is measured at 5, which is less acidic than normal, it could suggest that the famotidine has not had its intended effect of reducing stomach acid.
Choice D rationale
While headaches are listed as a common side effect of famotidine, the presence of headaches does not necessarily suggest that the medication has not had its intended effect. Headaches could be caused by a variety of factors and are not a direct indicator of the level of stomach acid or the effectiveness of famotidine.
Correct Answer is A
Explanation
Choice A rationale
Amoxicillin is a type of penicillin, and if a client has had a rash or any other allergic reaction to penicillin in the past, it’s possible they could have a similar reaction to amoxicillin. Therefore, the nurse should discuss with the provider the possibility of using a different antibiotic. This is important because allergic reactions to antibiotics can be severe and even life-threatening.
Choice B rationale
Administering the amoxicillin and keeping epinephrine on hand is not the best course of action. While epinephrine can be used to treat severe allergic reactions, it’s better to avoid the risk of an allergic reaction in the first place if possible.
Choice C rationale
Requesting the provider to prescribe an antihistamine would not address the potential for a serious allergic reaction to the amoxicillin. Antihistamines can help with mild allergic reactions, but they may not be sufficient for a severe reaction.
Choice D rationale
Asking for an order for a beta-lactamase resistant drug might not be necessary. Beta-lactamase resistant drugs are used to treat infections caused by bacteria that produce beta-lactamase, an enzyme that can break down and resist penicillins. However, the client’s allergy to penicillin does not necessarily mean that a beta-lactamase resistant drug is required.
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