Endocrine Question #45


The nurse instructs a client on self-administration of Humulin N and Humulin R insulins through client Teach-Back and demonstration. The nurse knows the client understands the instruction through demonstration of which action?


  1. The client withdrew 20 Units Humulin N (NPH) first then Humulin R next
    • Rationale:
  2. The client withdrew 10 Units Humulin R (Regular) first, followed by 20 Units Humulin N
    • Rationale:
  3. The client withdrew 20 Units Humulin N in one syringe and 10 Units Humulin R in a second syringe
    • Rationale:
  4. The client withdrew 30 Units Lente and stated Lente is to never be mixed.
    • Rationale:



When mixing cloudy (NPH or Humulin N) and clear (Regular or Humulin R), the clear must be withdrawn from the insulin bottle FIRST and cloudy next. Air is withdrawn and placed into the cloudy first, then air into the clear. After the air is placed into the clear, withdraw the clear unit dosage followed by the cloudy. Some use the mnemonic of Cloudy to Clear (AIR Draw)…then Clear to Cloudy (MED DRAW). Another is RN when drawing up insulin: Draw up R, then Draw up N. Do not draw up N (cloudy into the syringe first. Two syringes are not necessary. While Lantus is not routinely mixed with another insulin, the question indicates Humulin N and Humulin R will be used.

Learning Outcomes

Test Taking Tip

Video Rationale