The nurse is teaching a client with type 1 diabetes mellitus (DM) about the onset, peak, and duration of a new prescription for glargine insulin. If the insulin is administered at 0800, when is the client most likely to experience hypoglycemia?

Midmorning.

No peak occurs.

Midafternoon.

Shortly after midnight.

Answer and Explanation

The Correct Answer is B

Choice A reason: Midmorning is not a likely time for experiencing hypoglycemia after administering glargine insulin at 0800, because glargine insulin has a slow onset of action (about 1 hour) and does not have a pronounced peak effect. Glargine insulin is a long-acting insulin that provides a steady level of insulin throughout the day and night.

Choice B reason: No peak occurs is the correct answer for when hypoglycemia is most likely to occur after administering glargine insulin at 0800, because glargine insulin does not have a pronounced peak effect that could cause a sudden drop in blood glucose levels. Glargine insulin is a long-acting insulin that provides a steady level of insulin throughout the day and night.

Choice C reason: Midafternoon is not a likely time for experiencing hypoglycemia after administering glargine insulin at 0800, because glargine insulin has a long duration of action (about 24 hours) and does not have a pronounced peak effect. Glargine insulin is a long-acting insulin that provides a steady level of insulin throughout the day and night.

Choice D reason: Shortly after midnight is not a likely time for experiencing hypoglycemia after administering glargine insulin at 0800, because glargine insulin has a long duration of action (about 24 hours) and does not have a pronounced peak effect. Glargine insulin is a long-acting insulin that provides a steady level of insulin throughout the day and night.

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Correct Answer is ["B","C","D"]

Explanation

Choice A reason:

Seizures are not a common side effect of morphine, and they are unlikely to contribute to this client's fall risk. Seizures can occur in rare cases of morphine overdose, hypersensitivity, or withdrawal, but they are not expected in a client who is receiving a continuous and monitored dose of morphine. Therefore, choice A is incorrect.

Choice B reason:

Nausea is a common side effect of morphine, and it can contribute to this client's fall risk. Nausea can cause the client to feel dizzy, weak, or unsteady, and it can also impair the client's appetite and hydration status. Nausea can also trigger vomiting, which can increase the risk of aspiration or dehydration. Therefore, choice B is correct.

Choice C reason:

Orthostatic hypotension is a common side effect of morphine, and it can contribute to this client's fall risk. Orthostatic hypotension is a sudden drop in blood pressure that occurs when the client changes position from lying to sitting or standing. Orthostatic hypotension can cause the client to feel faint, dizzy, or lightheaded, and it can also increase the risk of syncope (loss of consciousness) or cardiac arrhythmias. Therefore, choice C is correct.

Choice D reason:

Sedation is a common side effect of morphine, and it can contribute to this client's fall risk. Sedation can cause the client to feel sleepy, drowsy, or confused, and it can also impair the client's alertness and coordination. Sedation can also reduce the client's ability to respond to stimuli or alarms, and it can increase the risk of respiratory depression or coma. Therefore, choice D is correct.

Choice E reason:

Euphoria is a common side effect of morphine, and it can contribute to this client's fall risk. Euphoria is a feeling of intense happiness or well-being that is induced by the activation of opioid receptors in the brain. Euphoria can cause the client to feel overconfident, impulsive, or reckless, and it can also impair the client's judgment and perception of reality. Euphoria can also increase the risk of psychological dependence or addiction. Therefore, choice E is correct.

Choice F reason:

Itching is a common side effect of morphine, and it can contribute to this client's fall risk. Itching is caused by the release of histamine from mast cells in response to the stimulation of opioid receptors in the skin. Itching can cause the client to scratch excessively, which can damage the skin and increase the risk of infection. Itching can also distract the client from other sensations or warnings, and it can reduce the client's comfort and quality of life. Therefore, choice F is correct.

Choice G reason:

Urinary retention is a common side effect of morphine, and it can contribute to this client's fall risk. Urinary retention is the inability to empty the bladder completely or voluntarily due to the inhibition of bladder contraction by opioid receptors in the urinary tract. Urinary retention can cause the client to feel pain, discomfort, or urgency in the lower abdomen, and it can also increase the risk of urinary tract infection or kidney damage. Urinary retention can also prompt the client to attempt to get out of bed without assistance or supervision, which can increase the risk of falling. Therefore, choice G is correct.

A. Promotes stomach emptying and prevents gastric reflux. B. Buffers hydrochloric acid and prevents gastric erosion. C. Prevents indigestion associated with ingestion of spicy foods. D. Binds with phosphorus in foods and prevents absorption.

Correct Answer is D

Explanation

Choice A reason: Promoting stomach emptying and preventing gastric reflux is not a relevant action of sevelamer, which is a phosphate binder that lowers serum phosphate levels in patients with CKD. Gastric reflux may be caused by other factors, such as hiatal hernia, obesity, or spicy foods.

Choice B reason: Buffering hydrochloric acid and preventing gastric erosion is not a pertinent action of sevelamer, which does not affect gastric acidity or mucosal integrity. Gastric erosion may be caused by other factors, such as NSAIDs, alcohol, or Helicobacter pylori infection.

Choice C reason: Preventing indigestion associated with ingestion of spicy foods is not a significant action of sevelamer, which does not affect digestion or food tolerance. Indigestion may be caused by other factors, such as overeating, stress, or gallstones.

Choice D reason: Binding with phosphorus in foods and preventing absorption is the correct action of sevelamer, which should be taken with meals to reduce the amount of phosphorus that enters the bloodstream from the diet. High serum phosphate levels can cause bone loss, calcification of soft tissues, and secondary hyperparathyroidism in patients with CKD.

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The nurse is teaching a client with type 1 diabetes mellitus (DM) about the onset, peak, and duration of a new prescription for glargine insulin. If the insulin is administered at 0800, when is the client most likely to experience hypoglycemia?

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Naxlex Comprehensive Predictor Exams

Patient Data Exhibits The charge nurse places a fall precautions sign on the client's door. What side effects of morphine could contribute to this client's fall risk? Select all that apply.

Correct Answer is ["B","C","D"]

Explanation

The nurse is administering sevelamer during lunch to a client with chronic kidney disease (CKD). The client asks the nurse to bring the medication later. The nurse should describe which action of sevelamer as an explanation for taking it with meals?

Correct Answer is D

Explanation

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