If both Insulin glargine (Lantus) and insulin lispro (Humalog) are due simultaneously, the nurse can mix the two insulins in the same syringe and administer them as one injection.

Choice A rationale

Lispro (Humalog) is a rapid-acting insulin used for mealtime glucose control. It has an onset of 15 minutes and peaks within 30 minutes to 1 hour, making it unsuitable for basal dosing.

Choice B rationale

Aspart (NovoLog), another rapid-acting insulin, is similar to lispro in its onset and peak times. It is also used for mealtime glucose control, not basal glucose regulation.

Choice C rationale

Regular insulin (Humulin R) is a short-acting insulin with an onset of 30 minutes to 1 hour and a peak of 2 to 4 hours. It cannot provide the steady basal glucose control required for 24-hour coverage.

Choice D rationale

Glargine (Lantus) is a long-acting insulin that provides consistent basal glucose control with no pronounced peak. It is designed for once-daily dosing to maintain stable glucose levels over 24 hours, meeting the requirements for basal dosing. .

Choice A rationale

Chewing gum can increase salivary production, and while saliva may neutralize some stomach acid, the act of chewing can stimulate swallowing and possibly exacerbate symptoms by introducing excess air into the stomach. For GERD patients, avoiding gum may help reduce bloating and gas discomfort.

Choice B rationale

Elevating the head of the bed reduces the likelihood of acid reflux during sleep by using gravity to prevent stomach contents from flowing backward into the esophagus. This strategy aligns with GERD management guidelines and reduces nighttime symptoms.

Choice C rationale

Taking antacids between meals and at bedtime helps neutralize stomach acid temporarily, providing short-term relief of GERD symptoms. While effective, long-term use without addressing dietary and lifestyle factors is not ideal for managing GERD.

Choice D rationale

Eating small meals is beneficial for GERD, as it prevents overdistension of the stomach, but having a bedtime snack contradicts GERD management principles. Late-night eating may increase the risk of acid reflux when lying down, thus requiring more teaching.