Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is mixing a short-acting insulin and an intermediate-acting insulin in the same syringe for a client who has diabetes mellitus.
Which of the following actions should the nurse take first?
A. Draw the intermediate-acting insulin into the syringe.
When mixing insulins, you should draw the short-acting insulin into the syringe first. This is done after injecting air into both vials (first into intermediate-acting, then into short-acting). Drawing intermediate-acting insulin first can contaminate the short-acting insulin vial with the longer-acting solution, which could alter the effectiveness of future doses.
B. Draw the short-acting insulin into the syringe.
Although this step is required when mixing insulins, it is not the first step. The nurse should first inject air into both vials to maintain vial pressure.
C. Inject air into the intermediate-acting insulin vial.
The nurse should inject air into the intermediate-acting insulin vial first because it helps prevent contamination and maintains the correct pressure within the vial. Intermediate-acting insulin, typically NPH (Neutral Protamine Hagedorn), is cloudy, and air injection into the vial allows for easy withdrawal later on without disrupting the order of mixing.
D. Inject air into the short-acting insulin vial.
Injecting air into the short-acting insulin vial is necessary but should be done after injecting air into the intermediate-acting vial. By injecting air into both vials first, the nurse prevents a vacuum effect, which can make it difficult to draw up the insulin. After injecting air, the nurse can draw the short-acting insulin into the syringe before moving to the intermediate-acting insulin. This order minimizes the risk of contamination.
This question is an excerpt from Nurse Dive's nursing test bank - ATI RN Fundamentals 2019 with NGN Proctored Exam. Take the full exam now
Full Explanation
A. When mixing insulins, you should draw the short-acting insulin into the syringe first. This is done after injecting air into both vials (first into intermediate-acting, then into short-acting). Drawing intermediate-acting insulin first can contaminate the short-acting insulin vial with the longer-acting solution, which could alter the effectiveness of future doses.
B. Although this step is required when mixing insulins, it is not the first step. The nurse should first inject air into both vials to maintain vial pressure.
C. The nurse should inject air into the intermediate-acting insulin vial first because it helps prevent contamination and maintains the correct pressure within the vial. Intermediate-acting insulin, typically NPH (Neutral Protamine Hagedorn), is cloudy, and air injection into the vial allows for easy withdrawal later on without disrupting the order of mixing.
D. Injecting air into the short-acting insulin vial is necessary but should be done after injecting air into the intermediate-acting vial. By injecting air into both vials first, the nurse prevents a vacuum effect, which can make it difficult to draw up the insulin. After injecting air, the nurse can draw the short-acting insulin into the syringe before moving to the intermediate-acting insulin. This order minimizes the risk of contamination.
Similar Questions
A nurse is caring for a client who had a stroke and requires assistance with morning ADLs.
Which of the following interprofessional team members should the nurse consult?
A. Physical therapist.
Choice A is wrong because a physical therapist focuses on improving mobility and physical function.
B. Occupational therapist.
A nurse should consult an occupational therapist when caring for a client who had a stroke and requires assistance with morning ADLs. Occupational therapists specialize in helping individuals regain their ability to perform activities of daily living (ADLs) and can provide valuable assistance in this situation.
C. Speech-language pathologist.
Choice C is wrong because a speech-language pathologist focuses on improving communication and swallowing abilities.
D. Registered dietician.
Choice D is wrong because a registered dietician focuses on nutrition and dietary needs.
Full Explanation
A nurse should consult an occupational therapist when caring for a client who had a stroke and requires assistance with morning ADLs.
Occupational therapists specialize in helping individuals regain their ability to perform activities of daily living (ADLs) and can provide valuable assistance in this situation.
Choice A is wrong because a physical therapist focuses on improving mobility and physical function.
Choice C is wrong because a speech-language pathologist focuses on improving communication and swallowing abilities.
Choice D is wrong because a registered dietician focuses on nutrition and dietary needs.
A nurse is preparing to administer gentamicin 2 mg/kg IV to a client who weighs 220 Ib.
How many mg should the nurse administer? (Round the answer to the nearest whole number.
Use a leading zero if it applies. Do not use a trailing zero.).
A. 200 mg.
To calculate the dose of gentamicin to administer to a client who weighs 220 Ib, first convert the client’s weight from pounds to kilograms. 220 Ib is equivalent to 100 kg (220 Ib /.2 Ib/kg = 100 kg). Then, multiply the client’s weight in kilograms by the dose of gentamicin per kilogram: 100 kg * 2 mg/kg = 200 mg. Therefore, the nurse should administer 200 mg of gentamicin.
B. 180 mg.
Choice B is wrong because 180 mg is not the correct dose.
C. 400 mg.
Choice C is wrong because 400 mg is not the correct dose.
D. 440 mg.
Choice D is wrong because 440 mg is not the correct dose.
Full Explanation
To calculate the dose of gentamicin to administer to a client who weighs 220 Ib, first convert the client’s weight from pounds to kilograms.
220 Ib is equivalent to 100 kg (220 Ib /.2 Ib/kg = 100 kg).
Then, multiply the client’s weight in kilograms by the dose of gentamicin per kilogram: 100 kg * 2 mg/kg = 200 mg.
Therefore, the nurse should administer 200 mg of gentamicin.
Choice B is wrong because 180 mg is not the correct dose.
Choice C is wrong because 400 mg is not the correct dose.
Choice D is wrong because 440 mg is not the correct dose.
A nurse is caring for a client following a bilateral mastectomy. The client is often tearful and avoids looking at her dressings. Which of the following actions should the nurse take first?
A. Refer the client to a breast cancer support group.
Choice A is not the first action the nurse should take because referring the client to a breast cancer support group may be helpful, but it is not addressing the immediate concern of the client’s emotional state.
B. Identify the impact of the mastectomy on the client's body image.
The nurse should first identify the impact of the mastectomy on the client’s body image. This is because the client’s behavior of avoiding looking at her dressings and being tearful suggests that she may be struggling with changes to her body image after the surgery. By identifying and addressing this issue, the nurse can provide appropriate emotional support and interventions to help the client cope with these changes.
C. Encourage the client to assist with her dressing changes.
Choice C is not the first action because encouraging the client to assist with her dressing changes may be premature if she is still struggling emotionally with her body image.
D. Provide the client with a mirror to look at her mastectomy incisions.
Choice D is not the first action because providing the client with a mirror to look at her mastectomy incisions may be overwhelming for her if she is not yet ready to confront her changed appearance.
Full Explanation
The nurse should first identify the impact of the mastectomy on the client’s body image.
This is because the client’s behavior of avoiding looking at her dressings and being tearful suggests that she may be struggling with changes to her body image after the surgery.
By identifying and addressing this issue, the nurse can provide appropriate emotional support and interventions to help the client cope with these changes.
Choice A is not the first action the nurse should take because referring the client to a breast cancer support group may be helpful, but it is not addressing the immediate concern of the client’s emotional state.
Choice C is not the first action because encouraging the client to assist with her dressing changes may be premature if she is still struggling emotionally with her body image.
Choice D is not the first action because providing the client with a mirror to look at her mastectomy incisions may be overwhelming for her if she is not yet ready to confront her changed appearance.