The patient's meal has been delivered, and the nurse checks the patient's pre-meal blood sugar.
The result is 50 mg/dL. The patient is clammy, diaphoretic, and non-arousable.
The next step the nurse should take is:
Administer 1 mg Glucagon IM.
Administer 25 g of dextrose IVP.
Hold the insulin and encourage the patient to eat their meal.
Administer 7 units of Humalog insulin.
The Correct Answer is B
Choice A rationale
Administering 1 mg of glucagon intramuscularly stimulates glycogenolysis in the liver, increasing blood glucose levels. However, it is slower in onset compared to IV dextrose, which is critical in a non-arousable patient with a dangerously low blood glucose level of 50 mg/dL. Time efficiency is vital in this emergency.
Choice B rationale
Administering 25 g of dextrose IV pushes glucose directly into the bloodstream, providing an immediate increase in blood glucose. This is the most appropriate action for a non-arousable, hypoglycemic patient. Normal blood glucose ranges between 70-100 mg/dL fasting, making this an emergency requiring prompt correction.
Choice C rationale
Encouraging the patient to eat may be effective in mild hypoglycemia, but not for a critically low level like 50 mg/dL in a non-arousable patient. This delay can result in prolonged neuroglycopenic effects, worsening the patient’s condition.
Choice D rationale
Administering 7 units of Humalog insulin would worsen the hypoglycemia by facilitating glucose uptake into cells, which is contraindicated in this situation. Instead, glucose administration is required to correct the hypoglycemia immediately.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Assisting the patient to the bathroom is within the scope of practice for a Nursing Aide (NA) and does not require advanced training, making it an appropriate task to delegate while ensuring patient needs are met.
Choice B rationale
Teaching weight-bearing precautions involves patient education, which is the responsibility of the Registered Nurse (RN) due to the need for professional judgment and instruction clarity.
Choice C rationale
Pain level assessment requires critical thinking and professional judgment, which are within the RN’s scope of practice. This cannot be delegated to an NA.
Choice D rationale
Instruction on incentive spirometer use requires understanding of therapeutic goals, patient capability, and respiratory assessment, tasks specific to the RN and beyond the scope of an NA.
Correct Answer is A
Explanation
Choice A rationale
Insulin glargine (Lantus) is a long-acting insulin used for basal glycemic control in diabetic patients. It has a slow onset and a steady release over approximately 24 hours, mimicking natural insulin secretion to stabilize blood glucose levels and prevent fluctuations.
Choice B rationale
Rapid-acting insulins, such as insulin lispro or aspart, have fast onsets and short durations to manage postprandial glucose spikes. Insulin glargine does not have these properties, as it is used for long-term basal control rather than immediate blood sugar regulation.
Choice C rationale
Intermediate-acting insulins like NPH have a shorter duration and peak effect compared to long-acting insulins. Insulin glargine provides a consistent effect over 24 hours, distinguishing it from intermediate-acting options.
Choice D rationale
Short-acting insulins are designed for pre-meal blood sugar control with a quick onset and limited duration. Insulin glargine does not fit this description due to its long-acting properties.
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