A nurse is caring for a patient who has diabetes and plans to administer his regular insulin subcutaneously before he eats breakfast at 0800. After checking the client's morning glucose level, which of the following actions should the nurse take?
Give the insulin after the patient has completed 3/4 of their breakfast
Give the insulin 30 min after breakfast with the patient's other routine medicines.
Give the insulin at 0730.
Give the insulin at 0700.
The Correct Answer is C
A. Incorrect. Regular insulin should be given before a meal to allow time for onset; giving it after eating delays its effect, increasing hyperglycemia risk.
B. Incorrect. Administering regular insulin after breakfast is inappropriate as it may not align with meal-related glucose spikes.
C. Correct. Regular insulin has an onset of 30 minutes. Administering it at 0730 ensures optimal timing for glucose control when breakfast is eaten at 0800.
D. Incorrect. Giving insulin too early (at 0700) increases the risk of hypoglycemia before food intake.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Obtain the patient's blood glucose level between 2a.m-4a.m – Correct Answer. The Somogyi effect occurs when nighttime hypoglycemia triggers a rebound hyperglycemia in the morning. Checking the blood glucose level during the early morning hours helps confirm this phenomenon.
B. Check the patient for a change in level of consciousness between 2a.m-4a.m – Incorrect. While severe hypoglycemia can affect consciousness, the best way to confirm the Somogyi effect is through blood glucose monitoring.
C. Withhold the nighttime snack and check the glucose at 6:00 a.m. – Incorrect. A nighttime snack can help prevent the hypoglycemia that leads to the Somogyi effect.
D. Administer an increased dose of NPH insulin in the evening. – Incorrect. Increasing insulin could worsen nighttime hypoglycemia, making the Somogyi effect worse.
Correct Answer is A
Explanation
A. Reflect on how she's feeling, and encourage her to express other fears that she has about his injury – Acknowledging emotions and encouraging open expression helps the mother process her grief and begin adjusting to the reality of the injury.
B. Explain that you aren't sure, but you will ask the physician to talk to her right away – Deferring to the physician misses an opportunity for emotional support.
C. Advise her that it isn’t in his best interest for her to be so upset, and explain the importance of moral support – This dismisses her emotions rather than addressing them.
D. Reassure her that given time and motivation he will return to normal function – Providing false reassurance is inappropriate, as a C5 spinal cord injury results in permanent loss of function.
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