A client has been prescribed insulin based on carbohydrate counting adjustments. The carbohydrate ratio is 1:10, the premeal target blood sugar is 110, and the high blood sugar correction factor is 50. The client’s premeal blood sugar was 225 and they consumed the following for dinner: 6 ounces baked chicken breast (0 g), 1 cup brown rice (45 g), 1 cup steamed broccoli (12 g), 2 TBS margarine (0 g). How many units of insulin will the nurse administer for the carbohydrates that were consumed?
4.5 units
5.7 units
6.2 units
7.1 units
The Correct Answer is B
Choice A rationale
This choice suggests that the nurse would administer 4.5 units of insulin for the carbohydrates consumed. However, this is not accurate. The carbohydrate ratio is 1:10, meaning 1 unit of insulin is needed for every 10 grams of carbohydrates. The client consumed 57 grams of carbohydrates (45g from rice + 12g from broccoli). Therefore, the calculation would be 57g ÷ 10 = 5.7 units of insulin. This choice underestimates the amount of insulin needed, which could lead to hyperglycemia, or high blood sugar.
Choice B rationale
This choice is correct. The client’s carbohydrate ratio is 1:10, meaning 1 unit of insulin is needed for every 10 grams of carbohydrates. The client consumed 57 grams of carbohydrates (45g from rice + 12g from broccoli). Therefore, the calculation would be 57g ÷ 10 = 5.7 units of insulin. This amount of insulin would help to properly metabolize the carbohydrates consumed and maintain the client’s blood sugar within the target range.
Choice C rationale
This choice suggests that the nurse would administer 6.2 units of insulin for the carbohydrates consumed. However, this is not accurate. The carbohydrate ratio is 1:10, meaning 1 unit of insulin is needed for every 10 grams of carbohydrates. The client consumed 57 grams of carbohydrates (45g from rice + 12g from broccoli). Therefore, the calculation would be 57g ÷ 10 = 5.7 units of insulin. This choice overestimates the amount of insulin needed, which could lead to hypoglycemia, or low blood sugar.
Choice D rationale
This choice suggests that the nurse would administer 7.1 units of insulin for the carbohydrates consumed. However, this is not accurate. The carbohydrate ratio is 1:10, meaning 1 unit of insulin is needed for every 10 grams of carbohydrates. The client consumed 57 grams of carbohydrates (45g from rice + 12g from broccoli). Therefore, the calculation would be 57g ÷ 10 = 5.7 units of insulin. This choice significantly overestimates the amount of insulin needed, which could lead to hypoglycemia, or low blood sugar.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
While notifying the healthcare provider is an important step when an IV has infiltrated, it is not the immediate priority action.
Choice B rationale
Adding promethazine to the allergy list would not be appropriate unless the patient had an allergic reaction to the medication.
Choice C rationale
Continuing to monitor the site would not be the immediate priority action. The nurse should first stop the IV infusion to prevent further damage.
Choice D rationale
The nurse’s priority action should be to stop the IV infusion. This prevents further infiltration and potential tissue damage. After stopping the infusion, the nurse can then take further steps such as notifying the healthcare provider and assessing the patient’s condition.
Correct Answer is C
Explanation
Choice A rationale
A persistent cough is not directly related to the administration of famotidine. Famotidine is a histamine-2 blocker that works by decreasing the amount of acid the stomach produces. It is used to treat and prevent ulcers in the stomach and intestines and to treat conditions in which the stomach produces too much acid. A persistent cough could be a symptom of many other conditions, but it is not a direct indicator of the effectiveness or ineffectiveness of famotidine.
Choice B rationale
The absence of a sour taste in the mouth, often associated with acid reflux, could suggest that famotidine is working as it should. However, the absence of a sour taste does not definitively indicate that the medication has had its intended effect, as the patient may not have experienced this symptom even before taking the medication.
Choice C rationale
Famotidine is used to decrease the amount of acid in the stomach. A normal stomach pH is typically around 1.5 to 3.5, which is highly acidic. If a patient’s stomach pH is measured at 5, which is less acidic than normal, it could suggest that the famotidine has not had its intended effect of reducing stomach acid.
Choice D rationale
While headaches are listed as a common side effect of famotidine, the presence of headaches does not necessarily suggest that the medication has not had its intended effect. Headaches could be caused by a variety of factors and are not a direct indicator of the level of stomach acid or the effectiveness of famotidine.
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