A nurse is caring for a client who receives insulin lispro each morning at 0730. The nurse should anticipate the client's insulin to peak around which of the following times?

1100

0830

1730

1400

Answer and Explanation

The Correct Answer is B

A. 1100: This time corresponds approximately to the peak of short-acting insulin (regular insulin), which typically peaks 2–4 hours after administration. Insulin lispro is rapid-acting and peaks much earlier, so 1100 is too late for peak action.

B. 0830: Insulin lispro is a rapid-acting insulin that begins to work within 15 minutes, peaks in about 30–90 minutes, and has a duration of 3–5 hours. Administered at 0730, its peak effect would occur around 0830–0900, aligning with postprandial glucose control.

C. 1730: This time is too late to reflect the peak of insulin lispro administered in the morning. By this time, the rapid-acting insulin would have largely worn off, and the client’s blood glucose would be influenced by basal insulin or other meals.

D. 1400: This corresponds more closely to the peak of intermediate-acting insulin (NPH) administered in the morning, not rapid-acting insulin. Insulin lispro’s short peak period makes 1400 too delayed for its expected maximal effect.

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Correct Answer is A

Explanation

A. Call EMS if a seizure lasts 5 min or more: Prolonged seizures lasting 5 minutes or longer can progress to status epilepticus, a medical emergency that requires immediate intervention to prevent hypoxia, brain injury, or other complications. Parents should be instructed to activate emergency services promptly if seizures exceed this duration or if multiple seizures occur without full recovery.

B. Restrain the child at the onset of the seizure: Physical restraint during a seizure can cause injury to both the child and caregiver. Safe seizure management includes protecting the child from nearby hazards while allowing the seizure to run its course, rather than attempting to forcibly stop movements.

C. Offer the child a bubble bath every evening: Bubble baths are not specifically related to seizure safety or management. While baths can be part of routine hygiene, parents should avoid leaving the child unattended in water due to the risk of drowning during a seizure episode.

D. Place the child in a prone position during the seizure: Placing a child in the prone position increases the risk of airway obstruction and aspiration. Standard seizure safety includes positioning the child on their side (lateral recumbent) to maintain airway patency and facilitate drainage of secretions.

A. Administer bupropion 1 hr before meals. B. Allow the client access to food throughout the day. C. Weigh the client once weekly. D. Observe the client for 1 hr after meals.

Correct Answer is D

Explanation

A. Administer bupropion 1 hr before meals: Bupropion is contraindicated in clients with bulimia nervosa due to an increased risk of seizures. Antidepressants such as SSRIs, like fluoxetine, are preferred for managing bulimia and comorbid depression.

B. Allow the client access to food throughout the day: Unrestricted access to food can trigger binge-eating episodes in clients with bulimia nervosa. Structured meal planning with scheduled eating times is more effective in reducing binge-purge behaviors.

C. Weigh the client once weekly: Weekly weighing is insufficient for monitoring rapid weight fluctuations associated with bulimia. Daily or more frequent monitoring, combined with close observation, is recommended to identify sudden changes and ensure safety.

D. Observe the client for 1 hr after meals: Post-meal observation helps prevent purging behaviors, such as self-induced vomiting or misuse of laxatives. This intervention directly addresses the core pathology of bulimia nervosa and supports safety and behavioral modification strategies.

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A nurse is caring for a client who receives insulin lispro each morning at 0730. The nurse should anticipate the client's insulin to peak around which of the following times?

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