Module 8: Med Admin Insulin/Subcutaneous (Week of 10/9)

Question 1

How can the nurse best ensure the patient’s safety when preparing insulin for administration?

Answer 1

Obtain the patient’s current blood glucose level.

Question 2

How would the nurse prepare insulin to ensure its efficacy?

Answer 2

Roll the vial of insulin suspension between the palms prior to drawing up the medication.

Question 3

When will a patient’s blood glucose levels be most affected by a short-acting insulin injection, such as Humulin-R?

Answer 3

In 2 to 3 hours

Question 4

Which of the following statements is accurate regarding insulin administration?

A. Vials of insulin may be stored in the freezer to extend their shelf life.
B. If the rapid-acting insulin ordered is unavailable, it is safe to substitute an alternative rapid-acting insulin.
C. Vials of insulin must be inspected before each use for changes in appearance.
D. All insulin must be shaken before use to redistribute particles within the suspension.

Answer 4

C. Vials of insulin must be inspected before each use for changes in appearance.

Question 5

To prevent hypoglycemia and enhance efficacy, it is appropriate to give rapid-acting insulin how many minutes before the next meal?

Answer 5

5 to 15 minutes

Question 6

The nurse is preparing to mix short- and intermediate-acting insulins to administer to a patient. Which action best preserves the insulin’s effectiveness?

A. Determining the patient’s blood glucose level
B. Refraining from injecting the intermediate-acting insulin into the short-acting vial
C. Applying clean gloves when administering the medication
D. Having another registered nurse verify the dose of both types of insulins

Answer 6

B. Refraining from injecting the intermediate-acting insulin into the short-acting vial

Question 7

2. The patient is to receive both Lantus® (insulin glargine) and regular insulin. To ensure the proper action of the insulins, what would the nurse do when preparing these two types of insulin for administration?

A. Mix the insulins in one syringe for a single injection.
B. Prepare the insulins in two syringes for separate injections.
C. Roll each vial between the palms to disperse the medication within the suspension.
D. Have another registered nurse verify the dose of the insulins.

Answer 7

B. Prepare the insulins in two syringes for separate injections.

Question 8

3. When preparing an injection that contains both short- and intermediate-acting insulins, what is the first step the nurse would take to ensure the effectiveness of the injection?

A. Insert air into the intermediate-acting insulin.
B. Warm the vials to room temperature.
C. Shake the vials to disperse the medication within the suspension.
D. Withdraw the prescribed amount of short-acting insulin after the intermediate-acting insulin.

Answer 8

A. Insert air into the intermediate-acting insulin.

Question 9

4. When preparing an injection of mixed insulin that includes 12 units of NPH and 5 units of regular insulin, how does the nurse initially confirm the proper dosage in the syringe?

A. By noting when 5 units of clear insulin is visible in the syringe
B. By noting when 12 units of cloudy insulin is visible in the syringe
C. By having another registered nurse verify the presence of 17 units of insulin
D. By verifying that the prescription confirms the medication administration record (MAR)

Answer 9

A. By noting when 5 units of clear insulin is visible in the syringe

Question 10

Which action would the nurse take when mixing intermediate- and long-acting insulins together in one syringe?
A. Draw the intermediate-acting insulin into the syringe first.
B. Draw the long-acting insulin into the syringe first.
C. Prepare two injections.
D. Draw either the intermediate- or the long-acting insulin into the syringe first.

Answer 10

C. Prepare two injections.
because you never mix long-acting insulin with any other insulins.

Question 11

Which action would the nurse take to diminish tissue irritation when administering a subcutaneous injection to a patient of average size?

A. Massage the site after administration.
B. Make sure the volume of the medication is less than 2 mL.
C. Administer the injection at a 45- to 90-degree angle.
D. Wear clean gloves while administering the injection.

Answer 11

B. Make sure the volume of the medication is less than 2 mL.

Question 12

Which needle would be most appropriate for the nurse to use when giving a subcutaneous injection to a patient of average height and weight?

A. 20-gauge, ½-inch
B. 22-gauge, 1-inch
C. 25-gauge, ⅜-inch
D. 27-gauge, 1-inch

Answer 12

C. 25-gauge, ⅜-inch

Question 13

3. What can the nurse do to minimize the discomfort of a subcutaneous injection?

A. Inject the medication rapidly.
B. Massage the injection site.
C. Cover the injection site with gauze pad after withdrawing the needle.
D. Inject the medication without pinching the skin.

Answer 13

C. Cover the injection site with gauze pad after withdrawing the needle.

Question 14

4. When preparing to administer heparin or insulin subcutaneously, which site is preferred?

A. Abdomen
B. Scapula
C. Deltoid muscle
D. Back of the upper arm

Answer 14

A. Abdomen

Question 15

5. What can the nurse do to ensure proper site selection for subcutaneous insulin injection?

A. Insert the needle at a 30-degree angle.
B. Select a different anatomical region for each injection.
C. Ask the patient to relax before inserting the needle.
D. Systematically rotate sites within the same anatomical location or area.

Answer 15

D. Systematically rotate sites within the same anatomical location or area.

Question 16

The nurse has selected a finger as the puncture site to measure the blood glucose level of a female patient with type 2 diabetes mellitus and peripheral vascular disease (PVD). Although all of the actions listed below are appropriate, which one would be of particular benefit to this patient given her medical history?

A. Reviewing her current medications
B. Inspecting the selected finger for bruising
C. Following standard precautions
D. Keeping the finger in a dependent position during the puncture

Answer 16

D. Keeping the finger in a dependent position during the puncture

Question 17

2. For which patient can the nurse delegate to nursing assistive personnel (NAP) the task of routine blood glucose monitoring?

A. Patient with non–insulin-dependent diabetes for whom steroid therapy has been ordered
B. Patient with type 2 diabetes who required insulin coverage at the last testing
C. Patient with type 1 diabetes who has had nausea and vomiting for 24 hours
D. Patient with type 2 diabetes who has had a closed reduction of a fracture of the right wrist

Answer 17

D. Patient with type 2 diabetes who has had a closed reduction of a fracture of the right wrist

Question 18

For which situation would the procedure of glucose testing be interrupted?

A. The reagent strip code matches the code on the vial.
B. An unused lancet is not available.
C. The glucose meter beeps.
D. A drop of blood forms on the patient’s skin after it is punctured.

Answer 18

B. An unused lancet is not available.

Question 19

4. A patient with type 2 diabetes mellitus tells the nurse that he has been testing his own blood glucose level six times per day for the past 3 years. What is the most appropriate action for the nurse to take?

A. Observe the patient’s testing technique for accuracy.
B. Advise the patient that he is not permitted to perform his own blood glucose testing.
C. Check with the patient’s health care provider concerning the patient’s self-testing.
D. Explain to the patient that a nurse must complete blood glucose testing.

Answer 19

A. Observe the patient’s testing technique for accuracy.

Question 20

5. Which action would the nurse carry out first when performing a blood glucose test on a patient with type 1 diabetes mellitus?

A. Apply clean gloves to minimize the risk for contamination.
B. Assess the patient’s skin for possible puncture sites.
C. Ask the patient to wash his or her hands and forearms with warm, soapy water.
D. Determine the patient’s preferred puncture site.

Answer 20

B. Assess the patient’s skin for possible puncture sites.