The nurse has administered NPH insulin at 1700.
At what time would the nurse anticipate the peak action of this insulin?
Between 2100 and 0500
There is no peak action with neutral protamine hagedorn insulin
Between 1800 and 2100
At 1930
The Correct Answer is A
Choice A rationale:
NPH insulin is an intermediate-acting insulin that typically peaks 6-12 hours after administration.
Given that the insulin was administered at 1700 (5:00 PM), the peak action would be expected to occur between 2100 (9:00 PM) and 0500 (5:00 AM).
This time frame aligns with the known pharmacokinetics of NPH insulin.
It's crucial for nurses to be aware of the peak action times of different insulin types to effectively manage blood glucose levels and adjust insulin doses accordingly.
Choice B rationale:
Incorrect. NPH insulin does have a peak action, as explained above.
It's important to understand that even intermediate-acting insulins have a period of peak activity when they exert their strongest glucose-lowering effect.
Choice C rationale:
Incorrect. This time frame is too early to represent the peak action of NPH insulin. The peak action typically occurs later, between 6-12 hours after administration.
Choice D rationale:
Incorrect. This time point is too specific to accurately represent the peak action of NPH insulin.
The peak action can vary within the 6-12 hour window, depending on individual factors and injection site.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
Rationale for Choice A: Nitroglycerin IV gtt, titrate for SBP > 180mmHg
Mechanism of action: Nitroglycerin is a potent vasodilator that acts primarily on veins, but also has some arterial vasodilatory effects. It relaxes vascular smooth muscle by stimulating the production of nitric oxide, which causes vasodilation. This decrease in preload (venous return to the heart) and afterload (resistance against which the heart pumps) leads to a reduction in blood pressure.
Indications: Nitroglycerin is a preferred agent for hypertensive emergencies associated with acute heart failure, acute coronary syndromes, and aortic dissection. It is also effective in hypertensive emergencies with elevated intracranial pressure.
Dosage and administration: Nitroglycerin is typically administered as an intravenous infusion, starting at a low dose and titrating up based on blood pressure response. The goal is to titrate the medication to maintain systolic blood pressure below 180 mmHg.
Contraindications: Nitroglycerin is contraindicated in patients with a known hypersensitivity to nitrates, severe hypotension (systolic blood pressure < 90 mmHg), or those who have recently used phosphodiesterase-5 inhibitors (such as sildenafil).
Monitoring: During nitroglycerin infusion, it's essential to monitor blood pressure closely, as well as heart rate, for any signs of hypotension or tachycardia.
Rationale for Choice B: Labetalol (Normodyne) 10mg IVP q 10 minutes prn for SBP >170 mmHg
Mechanism of action: Labetalol is a mixed alpha- and beta-adrenergic blocker. It blocks the effects of norepinephrine and epinephrine, leading to vasodilation and a decrease in heart rate.
Indications: Labetalol is a versatile agent that can be used in various hypertensive emergencies, including those associated with acute aortic dissection, acute coronary syndromes, and pre-eclampsia/eclampsia. It's also useful in patients with a history of asthma or chronic obstructive pulmonary disease (COPD), as it has less bronchoconstrictive effects than beta-blockers like propranolol.
Dosage and administration: Labetalol can be administered as an intravenous bolus or infusion. In this scenario, it's prescribed as a 10mg intravenous push every 10 minutes as needed for systolic blood pressure greater than 170 mmHg.
Contraindications: Labetalol is contraindicated in patients with severe bradycardia, heart block, cardiogenic shock, or decompensated heart failure.
Monitoring: During labetalol administration, it's important to monitor blood pressure, heart rate, and electrocardiogram (ECG) for any signs of bradycardia, heart block, or other arrythmias.
Rationale for Choice D: Nitroprusside (Nitropress) IV gtt titrate to keep SBP < 160 mmHg
Mechanism of action: Nitroprusside is a potent vasodilator that acts directly on both arterioles and veins. It relaxes vascular smooth muscle by releasing nitric oxide, leading to a rapid and profound decrease in blood pressure.
Indications: Nitroprusside is often reserved for hypertensive emergencies that are refractory to other agents or those that require rapid blood pressure control, such as hypertensive encephalopathy or acute aortic dissection.
Dosage and administration: Nitroprusside is administered as an intravenous infusion and titrated to the desired blood pressure response. The goal is to keep systolic blood pressure below 160 mmHg.
Contraindications: Nitroprusside is contraindicated in patients with severe renal impairment or those with increased intracranial pressure.
Monitoring: Nitroprusside therapy requires close monitoring of blood pressure, as well as monitoring for thiocyanate toxicity (a metabolite of nitroprusside) in patients with prolonged infusion or renal impairment.
Correct Answer is A
Explanation
Choice A rationale:
Oxytocin is a hormone that stimulates uterine contractions. It is not a tocolytic, which is a medication that inhibits uterine contractions. In fact, oxytocin is often used to induce labor or to augment labor that is progressing slowly.
It acts on the myofibrils in the uterine muscle, causing them to contract more forcefully and frequently. This leads to cervical dilation and effacement, and ultimately to the birth of the baby.
Oxytocin is typically administered as an intravenous (IV) infusion. The dosage is carefully titrated to achieve the desired effect on the uterus.
It is important to note that oxytocin can have serious side effects, including uterine hyperstimulation, fetal distress, and postpartum hemorrhage. Therefore, it should only be used under the close supervision of a healthcare provider.
Choice B rationale:
Magnesium sulfate is a tocolytic that is often used to prevent preterm labor. It works by relaxing the smooth muscle of the uterus.
It is typically administered as an IV infusion. The dosage is carefully monitored to ensure that the magnesium level in the blood does not become too high.
Side effects of magnesium sulfate can include flushing, nausea, vomiting, and headache. In rare cases, it can also cause serious complications such as respiratory depression and cardiac arrest.
Choice C rationale:
Nifedipine is a calcium channel blocker that is sometimes used as a tocolytic. It works by relaxing the smooth muscle of the uterus and blood vessels.
It is typically administered as an oral tablet. Side effects of nifedipine can include headache, dizziness, flushing, and low blood pressure.
Choice D rationale:
Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that is sometimes used as a tocolytic. It works by inhibiting the production of prostaglandins, which are substances that promote uterine contractions.
It is typically administered as an oral tablet or suppository. Side effects of indomethacin can include nausea, vomiting, heartburn, and diarrhea.
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