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The nurse is reviewing instructions for a patient with type 2 diabetes who also takes insulin injections as part of the therapy. The nurse asks the patient 'What should you do if your fasting blood glucose is 44 mg/dL?' Which response by the patient reflects a correct understanding of insulin therapy?
- A. I will call my doctor right away.
- B. I will give myself the regular insulin.
- C. I will take an oral form of glucose.
- D. I will rest until the symptoms pass.
Correct Answer: C
Rationale: A fasting blood glucose of 44 mg/dL indicates hypoglycemia, requiring immediate oral glucose intake (e.g., glucose tablets) to raise blood sugar. Insulin would worsen it, and delaying or calling the doctor is not optimal.
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The insulin order reads 'Give 15 units insulin glargine, SUBQ, every evening after dinner.' Choose the proper syringe for this injection.
- A. interderm_1.PNG
- B. interderm_2.PNG
- C. interderm_3.PNG
- D. interderm_4.PNG
Correct Answer: B
Rationale: Insulin glargine requires an insulin syringe marked in units for accurate dosing. Other syringes (not specified in options) are not suitable for insulin administration.
A patient in the emergency department was showing signs of hypoglycemia and had a fingerstick glucose level of 38 mg/dL. The patient has just become unconscious. The nurse will anticipate which action to be next?
- A. Having the patient eat glucose tablets
- B. Having the patient consume fruit juice, a nondiet soft drink, or crackers
- C. Administering intravenous glucose (50% dextrose)
- D. Calling the lab to order a fasting blood glucose level
Correct Answer: C
Rationale: Unconscious patients with hypoglycemia require IV glucose (e.g., 50% dextrose) to rapidly restore blood sugar, as oral intake is not possible. Lab tests are not immediate priorities.
When teaching a patient who is starting metformin, which instruction by the nurse is correct?
- A. Take metformin if your blood glucose level is above 100 mg/dL.
- B. Take this 60 minutes after breakfast.
- C. Take the medication on an empty stomach 1 hour before meals.
- D. Take the medication with food to reduce gastrointestinal (GI) effects.
Correct Answer: D
Rationale: Metformin should be taken with food to minimize GI side effects like nausea and diarrhea. Timing with specific glucose levels or empty stomach is incorrect.
A patient with a history of chronic obstructive pulmonary disease (COPD) and type 2 diabetes has been treated for pneumonia for the past week. The patient has been receiving intravenous corticosteroids as well as antibiotics as part of his therapy. At this time, the pneumonia has resolved, but when monitoring the blood glucose levels, the nurse notices that the level is still elevated. What is the best explanation for this elevation?
- A. The antibiotics may cause an increase in glucose levels.
- B. The corticosteroids may cause an increase in glucose levels.
- C. The patient's type 2 diabetes has converted to type 1.
- D. The hypoxia caused by the COPD causes an increased need for insulin.
Correct Answer: B
Rationale: Corticosteroids increase blood glucose by inducing insulin resistance and stimulating gluconeogenesis. Antibiotics, COPD hypoxia, or type 1 conversion are not the primary causes.
The nurse is preparing to administer insulin intravenously. Which statement about the administration of intravenous insulin is true?
- A. Insulin is never given intravenously.
- B. Only regular insulin can be administered intravenously.
- C. Insulin aspart or insulin lispro can be administered intravenously, but there must be a 50% dose reduction.
- D. Any form of insulin can be administered intravenously at the same dose as that is ordered for subcutaneous administration.
Correct Answer: B
Rationale: Only regular insulin is approved for IV administration, typically in emergencies like diabetic ketoacidosis, due to its predictable pharmacokinetics.