Nokea
The nurse is teaching a group of patients about management of diabetes. Which statement about basal dosing is correct?
- A. Basal dosing delivers a constant dose of insulin.
- B. With basal dosing, you can eat what you want and then give yourself a dose of insulin.
- C. Glargine insulin is given as a bolus with meals.
- D. Basal-bolus dosing is the traditional method of managing blood glucose levels.
Correct Answer: A
Rationale: Basal dosing, such as with glargine, provides a steady insulin level to maintain baseline glucose control. Glargine is not a bolus insulin, and basal-bolus is a modern approach.
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Which action is most appropriate regarding the nurse's administration of a rapid-acting insulin to a hospitalized patient?
- A. Give it within 15 minutes of mealtime.
- B. Give it after the meal has been completed.
- C. Administer it once daily at the time of the midday meal.
- D. Administer it with a snack before bedtime.
Correct Answer: A
Rationale: Rapid-acting insulin, like lispro, should be given within 15 minutes of a meal to match the postprandial glucose spike, mimicking natural insulin response.
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.
The nurse knows to administer acarbose, an alpha-glucosidase inhibitor, at which time?
- A. 30 minutes before breakfast
- B. With the first bite of each main meal
- C. 30 minutes after breakfast
- D. Once daily at bedtime
Correct Answer: B
Rationale: Acarbose is taken with the first bite of each main meal to inhibit carbohydrate digestion, reducing postprandial glucose spikes.
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.
A 55-year-old woman with type 2 diabetes has recently been placed on glipizide. She asks the nurse when the best time would be to take this medication. What is the nurse's best response?
- A. Take this medication in the morning, 30 minutes before breakfast.
- B. Take this medication in the evening with a snack.
- C. This medication needs to be taken after the midday meal.
- D. It does not matter what time of day you take this medication.
Correct Answer: A
Rationale: Glipizide, a sulfonylurea, is taken 30 minutes before breakfast to align insulin secretion with postprandial glucose rise, mimicking normal physiology.