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

Answer and Explanation

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.

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Correct Answer is C

Explanation

Step 1 is: The client’s finger stick blood glucose is 128, which is within the normal range, so no additional insulin is needed for blood sugar correction. The client has 4 units of insulin lispro scheduled with meals. Therefore, the nurse will administer the scheduled 4 units of insulin.

A. Draw up the regular insulin last. B. Draw up the insulins after mixing them in a vial. C. Draw up the medications in separate syringes. D. Draw up the NPH insulin last.

Correct Answer is A

Explanation

Choice A rationale
When a patient is administering both regular insulin and NPH insulin, it’s important to draw up the regular insulin first. This is because regular insulin is clear and NPH insulin is cloudy. If the NPH (cloudy) insulin were drawn up into the syringe first, it could contaminate the regular (clear) insulin when drawing it up second. This could affect the action of the regular insulin, which is meant to be fast-acting.
Choice B rationale
Mixing insulins in a vial before drawing them up is not recommended. This could lead to inaccurate dosing and potential contamination of one or both vials. It’s safer and more accurate to draw up each type of insulin separately into the syringe.
Choice C rationale
While it’s possible to administer insulin using separate syringes, it’s usually not necessary and can be more cumbersome for the patient. As long as the patient is careful to avoid contaminating the insulins and to draw them up in the correct order (regular before NPH), they can be administered together in the same syringe.
Choice D rationale
Drawing up the NPH insulin last is not correct. As mentioned earlier, the regular insulin should be drawn up first to avoid contaminating it with the NPH insulin.

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Naxlex Comprehensive Predictor Exams

The nurse is to administer insulin to a diabetic client. The finger stick blood glucose is 128. The client has 4 units of insulin lispro scheduled with meals in addition to the following adjustments scale. How many units of insulin will the nurse administer?

Correct Answer is C

Explanation

The nurse is teaching a patient about home administration of insulin. The patient will receive regular insulin and NPH insulin at 0700 every day. What is important to teach the patient?

Correct Answer is A

Explanation

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