The client diagnosed with Type I diabetes calls the clinic with a blood glucose level of 285 mg/dL and symptoms of a sore throat, cough, and fever. The clinic triage nurse advises the client to:

limit intake to non-caloric containing liquids until the glucose is within normal limits.

monitor blood glucose levels every 4 hours and go to the clinic if it continues to rise.

decrease intake of carbohydrates until blood glucose level is less than 200 mg/dL

hold the morning prescribed dose of insulin.

Answer and Explanation

The Correct Answer is B

A.   While staying hydrated is essential, especially during illness, limiting intake to non-caloric liquids could lead to inadequate caloric intake and worsen the client’s condition. Instead, the client should maintain a balanced intake of fluids and carbohydrates as tolerated.
B.   This is a reasonable approach. Monitoring blood glucose levels regularly allows the client to assess how their body is responding to the illness and any adjustments in insulin. If the levels continue to rise, it is important for the client to seek medical attention to prevent complications like diabetic ketoacidosis (DKA).
C.   While it is important to manage carbohydrate intake, completely decreasing carbohydrate intake can lead to inadequate caloric consumption, which is especially risky during an illness. The body needs energy, and people with diabetes must balance carbohydrate intake with insulin administration to avoid complications.
D.   Holding insulin can lead to dangerously high blood glucose levels. Clients with Type 1 diabetes require insulin regardless of illness, and it’s crucial to adjust the insulin regimen based on current blood glucose levels and carbohydrate intake.

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Correct Answer is D

Explanation

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.

A. the heparin provides anticoagulation until the warfarin becomes effective. B. this combination facilitates the dissolving of the clot. C. smaller doses of both drugs can be used with this method of administration. D. this combination provides immediate maximum protection against clot formation.

Correct Answer is A

Explanation

A. Heparin acts quickly to provide immediate anticoagulation, while warfarin takes several days to reach therapeutic levels. Heparin ensures that the client is adequately anticoagulated during the initial phase while waiting for warfarin to take effect.
B. Neither heparin nor warfarin directly dissolves clots. They are both anticoagulants that prevent further clot formation and allow the body's natural processes (fibrinolysis) to break down the existing clot over time. The combination does not specifically facilitate the dissolution of clots.
C. This statement is misleading. The use of both medications is not primarily about reducing the doses. Instead, each medication has its own dosing based on the patient’s needs, and the combination is used for timing and efficacy rather than dose reduction.
D. While heparin does provide immediate anticoagulation, saying it provides "maximum protection" could be misleading. It does ensure effective anticoagulation in the short term, but the maximum effectis related to individual response and therapeutic levels, which vary. Additionally, once warfarin reaches therapeutic levels, it becomes the primary agent for long-term anticoagulation.

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The client diagnosed with Type I diabetes calls the clinic with a blood glucose level of 285 mg/dL and symptoms of a sore throat, cough, and fever. The clinic triage nurse advises the client to:

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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