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The client with type 1 diabetes mellitus is prescribed to take NPH (Humulin N) insulin at 5 PM each day. The client should be instructed that the greatest risk of hypoglycemia will occur about what time?

A.

1AM while sleeping

B.

PM shortly after lunch

C.

6 PM shortly after dinner

D.

11:00 AM, shortly before lunch

Answer and Explanation

The Correct Answer is A

1 AM while sleeping: NPH insulin, like Humulin N, typically reaches its peak effectiveness  about 4-12 hours after administration. Since the client takes it at 5 PM, the time of greatest risk  for hypoglycemia is around 1 AM when the insulin's effects are at their peak. This is a critical  period for monitoring blood glucose levels.

B. 8 PM shortly after dinner: By 8 PM, the NPH insulin's effectiveness is not at its peak. It's been  about 3 hours since administration, and the insulin is still working to lower blood glucose levels.  This time frame is not associated with the highest risk of hypoglycemia. 

C. 6 PM shortly after dinner: At 6 PM, it's been only about an hour since the client took the NPH  insulin. The insulin is just beginning to take effect, and the risk of hypoglycemia is not as high as  it would be later in the night. 

D. 11:00 AM, shortly before lunch: By 11:00 AM, the effects of the NPH insulin from the  previous evening have largely worn off. This time frame is not associated with a high risk of  hypoglycemia related to the evening dose of NPH insulin.


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Related Questions

Correct Answer is ["A","C","D","E"]

Explanation

A: Hepatomegaly is a common manifestation of acromegaly, as excess growth hormone can cause organ enlargement.

B: Moon face is associated with Cushing's syndrome, not acromegaly. In acromegaly, facial changes are characterized by bony enlargement and coarsening of features, not the rounded face seen in Cushing's syndrome.

C: Coarse facial features are a classic sign of acromegaly due to the overgrowth of facial bones and soft tissue, leading to prominent brows, a larger nose, and a protruding jaw.

D: Enlarged distal extremities, such as hands and feet, are typical in acromegaly because of excessive growth hormone, which affects the growth plates in the bones and causes an increase in size and thickness.

E: This can occur due to optic nerve involvement, which is associated with pituitary tumors that can cause acromegaly. Vision changes, including loss of color discrimination, may be noted as a result of pressure on the optic chiasm.

Correct Answer is A

Explanation

A. Have an eye examination once per year - Regular eye examinations are crucial for detecting and managing retinopathy, a complication of diabetes that affects the eyes.

B. Examine your feet carefully every day - Daily foot examinations are essential to detect any early signs of foot problems, which is particularly important in preventing complications like nephropathy.

C. Wear compression stockings - Compression stockings are not directly related to preventing retinopathy and nephropathy in diabetes. They are more commonly used to improve blood flow in the legs.

D. "Maintain stable blood glucose levels" - While maintaining stable blood glucose levels is important for overall diabetes management, it is not specific to preventing retinopathy and nephropathy. It is a general principle for managing diabetes.

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