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 C
Explanation
Choice A rationale
Applying a warm pack is inappropriate for controlling active bleeding, as it can exacerbate blood flow to the site, worsening the hemorrhage rather than controlling it effectively.
Choice B rationale
Using a tourniquet above the bleeding site is a last-resort method typically reserved for life-threatening bleeding. It may cause complications such as nerve damage or ischemia, so other measures are prioritized first.
Choice C rationale
Direct pressure or sterile pressure dressing with elevation minimizes blood loss effectively by compressing the damaged vessels, promoting clot formation, and utilizing gravity to reduce the pressure at the wound site. It is the recommended first-line method.
Choice D rationale
Placing an ice pack on the bleeding site may reduce localized blood flow by inducing vasoconstriction but is less effective than direct pressure for stopping active hemorrhage. It is secondary to other control measures.
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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