Page 1467 - Saunders Comprehensive Review For NCLEX-RN

medication.”

4. “I should take this medication first thing in the morning on an
empty stomach.”
5. “I can pick a time to take this medication that best fits my

lifestyle as long as I take it at the same time each day.”
528. A client with diabetes mellitus visits a health care clinic. The client’s diabetes
mellitus previously had been well controlled with glyburide daily, but
recently the fasting blood glucose level has been 180 to 200 mg/dL (10 to
11.1 mmol/L). Which medication, if added to the client’s regimen, may have
contributed to the hyperglycemia?
1. Atenolol
2. Prednisone
3. Phenelzine
4. Allopurinol

Answers

512. Answer: 1

Rationale: When preparing a mixture of short-acting insulin, such as regular
insulin, with another insulin preparation, the short-acting insulin is drawn into the
syringe first. This sequence will avoid contaminating the vial of short-acting insulin
with insulin of another type. Options 2, 3, and 4 identify correct actions for
preparing NPH and short-acting insulin.
Test-Taking Strategy: Note the strategic words, need for further teaching. These
words indicate a negative event query and ask you to select an option that is an
incorrect action. Remember RN—draw up the Regular (short-acting) insulin before
the NPH insulin.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Pharmacology: Endocrine Medications: Insulin
Health Problem: Adult Health: Endocrine: Diabetes mellitus
Priority Concepts: Client Education; Glucose Regulation
Reference: Lilley et al. (2017), pp. 504, 517.

513. Answer: 2

Rationale: Insulin in unopened vials should be stored under refrigeration until
needed. Vials should not be frozen. When stored unopened under refrigeration,
insulin can be used up to the expiration date on the vial. Options 1, 3, and 4 are
incorrect.
Test-Taking Strategy: Note the subject, how to store unopened vials of insulin.
Options 3 and 4 are comparable or alike regarding where to store the insulin and
should be eliminated. Remembering that insulin should not be frozen will assist in

1467