# A client with type 1 diabetes uses insulin lispro before meals and NPH insulin in the morning. The client is preparing to eat lunch and asks the nurse to review injection technique and storage. Which actions should the nurse recommend? Select all that apply. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=558415&lang=en > language: en > subject: Adverse Effects/Contraindications/Interactions > category: PPT ## Question A client with type 1 diabetes uses insulin lispro before meals and NPH insulin in the morning. The client is preparing to eat lunch and asks the nurse to review injection technique and storage. Which actions should the nurse recommend? Select all that apply. 1 Rotate injection sites within the same anatomic region and avoid injecting into lipohypertrophic areas. 2 Administer insulin lispro when the meal tray is ordered so its onset will coincide with the anticipated delivery time. 3 When mixing lispro and NPH in the same syringe, draw up lispro first and inject immediately. 4 During travel, place unopened insulin directly against a frozen gel pack inside an insulated bag. 5 Check the manufacturer's storage guidelines and discard insulin that has been exposed to extreme temperatures. 6 Massage the injection site after lispro administration when the premeal glucose is high to speed absorption. ## Explanation The nurse should recommend rotating injections within one anatomic region while avoiding lipohypertrophic tissue (Choice 1), drawing up lispro before NPH when the products are compatible and administering the mixture promptly (Choice 3), and following product-specific storage limits while discarding insulin exposed to extreme temperatures (Choice 5). Lispro should not be given merely when a tray is ordered because an uncertain meal delay can cause hypoglycemia (Choice 2). Insulin must be protected from direct contact with frozen gel packs during travel (Choice 4). The injection site should not be massaged to speed absorption (Choice 6). ## In-depth explanation Correct Answer Choices 1, 3, 5 Clinical Reasoning The nurse should recommend rotating injections within one anatomic region while avoiding lipohypertrophic tissue (Choice 1), drawing up lispro before NPH when the products are compatible and administering the mixture promptly (Choice 3), and following product-specific storage limits while discarding insulin exposed to extreme temperatures (Choice 5). Lispro should not be given merely when a tray is ordered because an uncertain meal delay can cause hypoglycemia (Choice 2). Insulin must be protected from direct contact with frozen gel packs during travel (Choice 4). The injection site should not be massaged to speed absorption (Choice 6). Option Review - Correct — Rotating sites within the same region and avoiding lipohypertrophic areas maintains consistent insulin absorption and prevents tissue damage. - Incorrect — Lispro should be given only when the meal is immediately available, generally within 15 minutes before eating or immediately after; tray delivery can be delayed after an order is placed. - Correct — When mixing lispro and NPH, lispro is drawn first to prevent contamination of the rapid-acting insulin with NPH, and the mixture is injected promptly to maintain stability. - Incorrect — Insulin may be carried in an insulated container, but direct contact with a frozen gel pack can freeze and damage it. A barrier should prevent freezing, and any frozen insulin must be discarded. - Correct — Checking storage guidelines and discarding insulin exposed to extreme temperatures ensures medication potency and patient safety. - Incorrect — Massaging an insulin injection site can make absorption less predictable and should not be used to accelerate the effect of lispro. Sources 12026 NCLEX-RN Test Plan 2DailyMed: Insulin lispro ## Clinical scenario A client with type 1 diabetes is preparing to eat lunch in a hospital room. The client uses insulin lispro before meals and NPH insulin in the morning. The nurse is reviewing the client's injection technique and storage practices. ## Related questions - [A client is admitted to the emergency department after ingesting an unknown amount of acet…](https://mymerci.kr/pages/nclex_q.php?qn_id=362720&lang=en) - [A client with chronic heart failure is prescribed metoprolol 25 mg orally twice daily. Bef…](https://mymerci.kr/pages/nclex_q.php?qn_id=362756&lang=en) - [A 28-year-old client with type 1 diabetes receives regular insulin 6 units and NPH insulin…](https://mymerci.kr/pages/nclex_q.php?qn_id=362792&lang=en) - [A client receives IV vancomycin 1 g every 12 hours for MRSA bacteremia. Before the next do…](https://mymerci.kr/pages/nclex_q.php?qn_id=362833&lang=en) - [A client with bipolar disorder has been taking lithium carbonate 600 mg orally three times…](https://mymerci.kr/pages/nclex_q.php?qn_id=362894&lang=en) - [A nurse is monitoring a client receiving a continuous IV heparin infusion for pulmonary em…](https://mymerci.kr/pages/nclex_q.php?qn_id=363988&lang=en) - [A nurse is preparing to initiate a weight-based continuous IV unfractionated heparin infus…](https://mymerci.kr/pages/nclex_q.php?qn_id=364107&lang=en) - [A nurse is providing discharge teaching to a 65-year-old client newly prescribed warfarin …](https://mymerci.kr/pages/nclex_q.php?qn_id=364872&lang=en) ## Read in another language - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=558415&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=558415&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=558415&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=558415&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=558415&lang=vi) --- More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en) _For study reference only. Always follow current clinical guidelines and your institution’s protocols._