A 55-year-old patient with type 2 diabetes is admitted to the hospital and is on NPH insulin. The patient experiences symptoms of hypoglycemia. At what time after administration of NPH insulin should the nurse be most vigilant for signs of hypoglycemia due to the peak action of the insulin?

18-24 hours after administration

4-12 hours after administration

12-18 hours after administration

1-2 hours after administration

Answer and Explanation

The Correct Answer is B

Choice A Reason:

NPH insulin is an intermediate-acting insulin that typically has a duration of action of about 12 to 16 hours. The peak action, however, occurs much earlier, making 18-24 hours after administration an incorrect choice for the peak time of hypoglycemia risk.

Choice B Reason:

NPH insulin generally peaks 4 to 12 hours after administration This is the period when the insulin is most effective at lowering blood glucose levels, and therefore, the time when the patient is at the highest risk for hypoglycemia. Monitoring for signs of hypoglycemia during this window is crucial to ensure patient safety.

Choice C Reason:

While NPH insulin can have effects lasting up to 16 hours, the peak action occurs earlier, between 4 to 12 hours. Therefore, 12-18 hours after administration is not the correct time frame for the peak action of NPH insulin.

Choice D Reason:

NPH insulin starts to act within 1 to 2 hours after administration, but this is not the peak time. The peak action, when the risk of hypoglycemia is highest, occurs later, between 4 to 12 hours after administration.

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Correct Answer is A

Explanation

Choice A Reason:

Monitoring platelet counts and assessing for signs of bleeding is crucial for managing thrombocytopenia. Thrombocytopenia is characterized by a low platelet count, which increases the risk of bleeding. Regular monitoring helps in detecting any significant drops in platelet levels, allowing for timely interventions to prevent severe bleeding. Assessing for signs of bleeding, such as petechiae, bruising, or nosebleeds, is essential to manage the condition effectively and prevent complications.

Choice B Reason:

Administering aspirin to manage pain and prevent clot formation is not appropriate for patients with thrombocytopenia. Aspirin is an antiplatelet agent that inhibits platelet function, which can exacerbate bleeding tendencies in patients with low platelet counts. Using aspirin in this context could increase the risk of bleeding and is therefore contraindicated.

Choice C Reason:

Administering a diuretic to reduce fluid retention and swelling is not relevant for managing thrombocytopenia. Diuretics are used to manage conditions like hypertension and edema but do not address the underlying issue of low platelet counts. In fact, diuretics can lead to electrolyte imbalances, which may complicate the patient’s condition further.

Choice D Reason:

Encouraging the patient to increase physical activity to improve circulation is not a priority intervention for thrombocytopenia. While physical activity is generally beneficial for overall health, it can increase the risk of trauma and bleeding in patients with low platelet counts. It is important to avoid activities that could lead to injury and bleeding in these patients.

A. “If I forget to take my eye drops, I should wait until the next time they are due.” B. “Every two years I will need to have my vision checked by an eye doctor.” C. “I should call the clinic before taking any over-the-counter medications.” D. “When my vision improves, I will be able to stop taking the eye drops.”

Correct Answer is C

Explanation

Choice A Reason:

The statement “If I forget to take my eye drops, I should wait until the next time they are due” is incorrect. For chronic open-angle glaucoma, it is important to take eye drops as prescribed to maintain consistent intraocular pressure control. If a dose is missed, the patient should take it as soon as they remember, unless it is almost time for the next dose. Skipping doses can lead to fluctuations in eye pressure, which can worsen the condition.

Choice B Reason:

The statement “Every two years I will need to have my vision checked by an eye doctor” is not accurate. Patients with chronic open-angle glaucoma typically need more frequent monitoring, often every 3 to 6 months, depending on the severity of the condition and the stability of their intraocular pressure. Regular check-ups are crucial for adjusting treatment and preventing vision loss.

Choice C Reason:

The statement “I should call the clinic before taking any over-the-counter medications” indicates an understanding of the teaching. Some over-the-counter medications can affect intraocular pressure or interact with glaucoma medications. Consulting with a healthcare provider before taking new medications helps ensure that they do not interfere with glaucoma management.

Choice D Reason:

The statement “When my vision improves, I will be able to stop taking the eye drops” is incorrect. Glaucoma is a chronic condition that requires ongoing treatment to manage intraocular pressure and prevent further damage to the optic nerve. Stopping medication can lead to a rapid increase in eye pressure and potential vision loss.

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A 55-year-old patient with type 2 diabetes is admitted to the hospital and is on NPH insulin. The patient experiences symptoms of hypoglycemia. At what time after administration of NPH insulin should the nurse be most vigilant for signs of hypoglycemia due to the peak action of the insulin?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 55-year-old male patient is admitted to the hospital with a diagnosis of thrombocytopenia. Upon assessment, you note petechiae on his lower extremities, and he reports fatigue and occasional nosebleeds. Which of the following interventions should be prioritized for this patient?

Correct Answer is A

Explanation

A nurse is reinforcing teaching with a client who has been newly diagnosed with chronic open-angle glaucoma. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is C

Explanation

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