With what client should the nurse question the administration of human insulin?
A client who has been diagnosed with gestational diabetes.
A client with type 2 diabetes, controlled with oral antidiabetic agents, who has a systemic infection.
A client whose type 2 diabetes is controlled by diet and exercise.
A client who has been living with type 1 diabetes for 20 years.
The Correct Answer is C
The nurse should question the administration of human insulin to this client because they do not need exogenous insulin to maintain normal blood glucose levels. Human insulin is indicated for clients who have type 1 diabetes or type 2 diabetes that cannot be controlled by oral antidiabetic agents, diet, or exercise.
Choice A is wrong because a client who has been diagnosed with gestational diabetes may need human insulin to control their blood glucose levels during pregnancy, as oral antidiabetic agents are contraindicated.
Choice B is wrong because a client with type 2 diabetes, controlled with oral antidiabetic agents, who has a systemic infection may need human insulin to manage their blood glucose levels during periods of stress, as infection can increase blood glucose levels and impair the action of oral antidiabetic agents.
Choice D is wrong because a client who has been living with type 1 diabetes for 20 years needs human insulin to replace the endogenous insulin that their pancreas cannot produce.
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Correct Answer is D
Explanation
Glargine is a long-acting insulin that can provide a steady level of insulin for up to 24 hours. This would be suitable for a client who does not want to administer insulin on the plane, as they can take it once a day at the same time.
Choice A. Glulisine is wrong because glulisine is a rapid-acting insulin that starts working within 15 minutes and lasts for 3 to 4 hours.
This would require frequent injections and monitoring of blood glucose levels.
Choice B. Lispro is wrong because lispro is also a rapid-acting insulin that starts working within 15 minutes and lasts for 3 to 4 hours.
This would also require frequent injections and monitoring of blood glucose levels.
Choice C. Aspart is wrong because aspart is another rapid-acting insulin that starts working within 15 minutes and lasts for 3 to 4 hours.
This would also require frequent injections and monitoring of blood glucose levels.
Normal ranges for blood glucose levels are 70 to 130 mg/dL before meals and less than 180 mg/dL two hours after meals.
Correct Answer is B
Explanation
This is because teriparatide affects calcium and phosphorus metabolism in a pattern consistent with the known actions of endogenous PTH (eg, increases serum calcium and decreases serum phosphorus)12.
Choice A is wrong because teriparatide does not decrease serum calcium, but increases it.
Choice C is wrong because teriparatide does not increase serum phosphorus, but decreases it.
Choice D is wrong because teriparatide does not decrease serum calcium, but increases it.
Normal ranges for serum calcium are 8.5 to 10.2 mg/dL and for serum phosphorus are 2.5 to 4.5 mg/dL.
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