NCLEX-PN® ExaminationPharmacological TherapiesEasy
A licensed practical nurse (LPN) is preparing to administer 10 units of NPH insulin subcutaneously to a client with type 2 diabetes. The client's blood glucose level is 250 mg/dL. Which action should the LPN take immediately before administering the insulin?
- ARoll the insulin vial gently between the palms of the hands.
- BAdminister the insulin into the deltoid muscle.
- CMassage the injection site after administration.
- DShake the insulin vial vigorously to mix.
Show answer & explanationAnswer & explanation
Correct answer: A. Roll the insulin vial gently between the palms of the hands.
NPH insulin is a suspension and needs to be gently mixed before administration to ensure a uniform dose. Rolling the vial between the palms warms it slightly and disperses the particles evenly without creating air bubbles or denaturing the protein.
Why the other options are wrong
- B. Insulin is typically administered subcutaneously, not intramuscularly, to ensure proper absorption and avoid rapid, unpredictable effects.
- C. Massaging the injection site can increase absorption and is generally not recommended for insulin as it can lead to unpredictable glucose levels.
- D. Shaking the insulin vigorously can cause foaming and denature the insulin protein, reducing its effectiveness.
Insulin Administration: NPH
NPH insulin is an intermediate-acting insulin suspension that requires gentle mixing before administration to ensure accurate dosing.
- NPH is a cloudy suspension.
- Must be gently rolled, not shaken.
- Administered subcutaneously.
Memory trick: NPH: Never Pounce, Handle Gently