Remember the mnemonic: RN.

A diabetic patient receives 10 units of Regular insulin and 20 units

of NPH insulin each day after breakfast. After following normal
preparation steps for administering insulin, what should the nurse
do next?
Draw up NPH insulin first, because it is clear.
Administer each type of insulin separately for accuracy.
Draw either insulin first as long as 30 units are given.
Draw up Regular insulin first, because it is clear.
Regular (short-acting) insulin is clear. NPH (intermediate-acting) insulin is cloudy. Giving one injection is more
efficient and comfortable for the patient. Remember the mnemonic: RN (Regular to NPH). The correct
procedure for administering short- and long-acting insulins together is as follows: 1. Verify orders for insulin
types and doses. 2. Wash hands and put on gloves. 3. Roll NPH (cloudy) insulin between palms to mix
contents of the vial. Do NOT shake! 4. Clean tops of vials with alcohol prep for 5–10 seconds. 5. Inject 20
units of air into NPH vial and remove syringe. 6. Inject 10 units of air into Regular (clear) vial and withdraw 10
units. Remove syringe. 7. Insert syringe into NPH (cloudy) vial and withdraw 20 units. 8. Administer
immediately. (Within 5–10 minutes, combined insulins may be affected.)
Postoperative orders for a client include meperidine hydrochloride
50 mg IM q 4 hrs PRN. The drug is supplied in ampules of 100
mg/mL. How much will the nurse administer in each dose?
5.0 mL
0.1 mL
0.5 mL
1.0 mL
To calculate the correct dose, divide the desired dose by the amount on hand and then multiply by the
volume. (D/H × V) For this question, 50 mg ÷ 100 mg × 1 mL = 0.5 mL.

Candida albicans is a yeast-like pathogen.

A female client comes to the OB/GYN clinic with a complaint of
repeated vaginal infections. An assessment shows that she has
candidiasis caused by Candida albicans. What does the nurse
anticipate as the treatment for this client?
A prescription for a broad-spectrum antibiotic
A prescription for a penicillin suppository
An over-the-counter (OTC) vaginal douche product
A nonprescription antifungal medication
Candida albicans is treated with an antifungal medication, which can be purchased without a prescription.
The antifungals miconazole and clotrimazole are available as creams, vaginal tablets, or vaginal suppositories.
Douching is both irritating to the vagina and ineffective. Antibiotics are not used to treat yeast infections; in
fact, they are often the cause of vaginitis.
Early antibiotic administration improves outcome.
Lyme disease should be treated promptly. When a patient presents
to the Emergency Department with symptoms related to Lyme
disease, which of the following should be prescribed?
Famotidine
Simvastatin
Enalapril
Doxycycline
Doxycycline and amoxicillin are the usual prescriptions for Lyme Disease. Enalapril (Vasotec) is prescribed for
hypertension and congestive heart failure. Famotidine (Pepcid) is used for gastrointestinal disorders.
Simvastatin (Zocor) reduces cholesterol.
The longer between doses, the more need for less interference.
Which type of insulin can never be mixed with another?
Regular
Long-acting
Intermediate
Rapid-acting
Insulins are prescribed and administered for varying purposes. Some insulins, such as Rapid, Regular and
Intermediate, are often given together. However, long-acting insulins, such as insulin glargine (Lantus) cannot
be mixed or given simultaneously with another insulin, because the results would be unpredictable. Slow-
acting insulin that works over 24 hours is carefully calculated; any other insulins would interfere with its
actions.