Mr. D receives a daily injection of 70/30 NPH/regular insulin premix at 7:00 AM. The nurse expects that a hypoglycemic reaction is most likely to occur between:

09:00 AM and 11:00 AM

08:00 AM and 10:00 AM

07:00 AM and 09:00 AM

12:00 PM and 3:00 PM

Answer and Explanation

The Correct Answer is A

The peak time of 70/30 NPH/regular insulin premix is usually 2 to 12 hours after injection, with an average peak time of 4 to 6 hours. This means that the highest risk of hypoglycemia is typically 4 to 6 hours after the injection, which would fall between 11:00 AM and 1:00 PM. However, it's important to note that hypoglycemic reactions can occur at any time, so the client should be monitored closely throughout the day for any signs or symptoms of low blood sugar.

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Correct Answer is D

Explanation

The patient has been diagnosed with type 2 diabetes and reports following a reduced-calorie diet but has not lost any weight. This suggests that the patient may not be following the diet as prescribed or may have other factors aﬀecting their blood glucose levels. Additionally, the patient did not bring their glucose monitoring record, which is an important tool for assessing blood glucose control over time.

In this situation, obtaining a fasting blood glucose level or an oral glucose tolerance test may provide a snapshot of the patient's blood glucose level at the time of the test, but these tests do not provide information about blood glucose control over the past few months. A urine dipstick for glucose is a less reliable method for assessing blood glucose control and is not recommended for routine monitoring.

Therefore, obtaining a glycosylated hemoglobin (HbA1c) level is the most appropriate test in this situation. HbA1c reﬂects the average blood glucose level over the past 2-3 months and is recommended for routine monitoring of blood glucose control in patients with diabetes. This test can provide valuable information about the eﬀectiveness of the patient's diet and any other interventions aimed at controlling their blood glucose levels.

A. I should weigh myself daily and report any sudden weight loss or gain." B. I need to limit my ﬂuid intake to no more than 1 quart of liquids a day," C. I will eat foods high in potassium because the diuretics cause potassium loss.” D. I need to shop for foods that are low in sodium and avoid adding salt to foods.

Correct Answer is C

Explanation

The correct answer is c. I will eat foods high in potassium because the diuretics cause potassium loss.

Rationale for Choice A:

Statement:"I should weigh myself daily and report any sudden weight loss or gain."
Rationale:This statement is correct.It's crucial for patients with SIADH to monitor their weight daily as even slight fluctuations can signal fluid imbalances.Sudden weight gain can indicate fluid retention,while sudden weight loss might suggest dehydration.Both scenarios warrant medical attention.

Rationale for Choice B:

Statement:"I need to limit my fluid intake to no more than 1 quart of liquids a day."
Rationale:This statement is also correct.Fluid restriction is a cornerstone of SIADH management.By limiting fluid intake,patients can help prevent the buildup of excess fluid in the body,which can lead to complications such as hyponatremia (low sodium levels in the blood) and edema.

Rationale for Choice C:

Statement:"I will eat foods high in potassium because the diuretics cause potassium loss."
Rationale:This statement is incorrect.While some diuretics used in the treatment of SIADH can indeed cause potassium loss,this is not a universal side effect.Furthermore,increasing potassium intake without medical supervision can be dangerous,potentially leading to hyperkalemia (high potassium levels in the blood).It's essential for patients to consult with their healthcare providers for individualized guidance on potassium intake.

Rationale for Choice D:

Statement:"I need to shop for foods that are low in sodium and avoid adding salt to foods."
Rationale:This statement is correct.A low-sodium diet is often recommended for patients with SIADH to help manage fluid balance and prevent hyponatremia.Restricting sodium intake can reduce fluid retention and help maintain appropriate sodium levels in the blood.

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Mr. D receives a daily injection of 70/30 NPH/regular insulin premix at 7:00 AM. The nurse expects that a hypoglycemic reaction is most likely to occur between:

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Naxlex Comprehensive Predictor Exams

During a clinic visit 3 months following a diagnosis of type 2 diabetes, the patient reports following a reduced-calorie diet. The patient has not lost any weight and did not bring the glucose-monitoring record. The nurse will plan to obtain a(n)

Correct Answer is D

Explanation

When teaching a patient with chronic SIADH about long-term management of the disorder, the nurse determines that additional instruction is needed when the patient says:

Correct Answer is C

Explanation

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