A client receives 20 units of isophane insulin suspension (NPH) insulin at 0730. The nurse teaches the client that signs of hypoglycemia are most likely to occur at what time?

0900

1400

2100

1100

Answer and Explanation

The Correct Answer is D

A.   This time falls shortly after the onset of NPH insulin. While hypoglycemia could start to occur around this time, it is less likely to be at its peak.
B.   This time is past the peak range of NPH insulin. The likelihood of hypoglycemia is lower as the insulin effect would be tapering off.
C.   This time is well past the usual duration of NPH insulin. By this point, the risk of hypoglycemia would be significantly decreased.
D.   This time falls within the peak action of NPH insulin (approximately 4-12 hours post-administration). This is when hypoglycemia is most likely to occur due to the greatest effect of the insulin.

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Correct Answer is A

Explanation

A. Clients with PAD often experience claudication (pain in the legs due to inadequate blood flow) during exercise. They should be encouraged to walk to the point of pain, then rest until the pain subsides, and then continue walking. This approach can improve circulation over time.
B. While it’s crucial to monitor leg ulcers, exercise can still be beneficial unless advised otherwise by a healthcare provider. Walking can promote circulation, which is important for healing. However, if a leg ulcer is present, the client should consult their healthcare provider about appropriate activity levels.
C. While elevating the feet can help reduce swelling, it's generally more beneficial for clients with PAD to keep their legs in a dependent position after walking. This position encourages blood flow to the legs, which can help alleviate symptoms and improve circulation.
D. Exercise that encourages movement and maintains blood flow to the legs is important for those with PAD. While certain positions may exacerbate symptoms, exercises like walking should be encouraged. Keeping the feet in a dependent position can help with blood flow post-exercise.

A. Serum fasting glucose 101 mg/dL B. platelets 160,000 uL C. Serum creatinine 2.5 mg/dL D. Hemoglobin 13.6 g/dL

Correct Answer is C

Explanation

A. A serum fasting glucose level of 101 mg/dL indicates a mild elevation but is not significantly high enough to contraindicate the use of TMP-SMX. It does not directly relate to the medication’s safety.
B. A platelet count of 160,000 µL is within normal limits (normal range is typically 150,000-450,000 µL). This result does not indicate any contraindication for using TMP-SMX.

C. A serum creatinine level of 2.5 mg/dL indicates impaired kidney function (normal range is typically 0.6-1.2 mg/dL). TMP-SMX can be contraindicated in patients with significant renal impairment due to the potential for drug accumulation and toxicity, particularly affecting renal function.
D. A hemoglobin level of 13.6 g/dL is within normal limits (normal range is approximately 13.5-17.5 g/dL for males and 12.0-15.5 g/dL for females). This result does not indicate a contraindication for using TMP- SMX.

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A client receives 20 units of isophane insulin suspension (NPH) insulin at 0730. The nurse teaches the client that signs of hypoglycemia are most likely to occur at what time?

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