The nurse is preparing to administer a regular insulin IV bo...

The nurse is preparing to administer a regular insulin IV bolus to a client. The primary health care provider (PHCP) has prescribed an initial bolus dose of 0.1 unit/kg. The client weighs 242 lbs. How much regular insulin should the nurse administer to the client as an IV bolus?

Correct Answer: 11

Rationale: Convert 242 lbs to kg: 242 ÷ 2.2 = 110 kg. Calculate dose: 110 kg × 0.1 unit/kg = 11 units. Thus, 11 units of regular insulin should be administered.

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The nurse should............ because...........

A. obtain an order to change the intravenous fluids (IV)
B. pause the regular insulin infusion
C. continue the regular insulin infusion
D. the client's glucose level warrants a change in IV fluids.
E. the glucose level is dropping too fast.
F. the glucose level is dropping at a therapeutic level.

Correct Answer: A, D

Rationale: In DKA, as glucose drops, IV fluids may need adjustment (e.g., to dextrose-containing fluids) to prevent hypoglycemia while continuing insulin to resolve acidosis.

The nurse is teaching a client with diabetes mellitus (type two) newly prescribed rapid-acting insulin. Which of the following information should the nurse include?

A. Once you open your vial of insulin, discard it 25 days after opening it.
B. Inject yourself with this insulin 20-30 minutes before meals.
C. You can inject yourself with this insulin while you are actively eating.
D. This insulin is administered right before you go to bed to minimize overnight blood sugar spikes.

Correct Answer: C

Rationale: Rapid-acting insulin, like lispro, can be injected just before or during meals to match carbohydrate intake. Vials are typically good for 28 days, not 25, and bedtime dosing is for long-acting insulin.

The nurse is caring for a client who has adrenal insufficiency (Addison's disease). Which of the following interventions would be a priority?

A. Administer prescribed hydrocortisone
B. Offer salty snacks and water
C. Assess skin integrity
D. Encourage frequent rest periods

Correct Answer: A

Rationale: Adrenal insufficiency causes cortisol deficiency, leading to hypotension and weakness. Administering hydrocortisone is critical to replace cortisol and stabilize the client. Salty snacks, skin checks, and rest are supportive but not the priority.

The nurse is caring for a client with diabetic ketoacidosis (DKA) who is receiving an infusion of regular insulin. Which of the following clinical data should be reported to the primary healthcare provider (PHCP) immediately?

A. Glucose 297 mg/dL, 16.52 mmol/L (70-110 mg/dL, 4.0-11.0 mmol/L)
B. Potassium 3.2 mEq/L, 3.2 mmol/L (3.5-5 mEq/L, 3.5-5.1 mmol/L)
C. BUN 24 mg/dL, 8.568 mmol/L (10-20 mg/dL, 2.5 to 6.4 mmol/L)
D. Hemoglobin A1C 8.9% ( < 7%, 4.8%-6.0%)

Correct Answer: B

Rationale: In DKA, insulin shifts potassium into cells, risking hypokalemia. A level of 3.2 mEq/L is critical and needs immediate reporting to prevent arrhythmias. Glucose, BUN, and HbA1C are monitored but less urgent.

The nurse is assessing a client with diabetic ketoacidosis (DKA). Which of the following would be an expected finding?

A. Thready pulse
B. Jugular venous distention (JVD)
C. Coarse tremors
D. Tachycardia
E. Orthostatic hypotension

Correct Answer: A, D, E

Rationale: DKA causes dehydration, leading to thready pulse, tachycardia, and orthostatic hypotension. JVD suggests fluid overload, and coarse tremors are not typical.