A nurse is preparing to administer lispro insulin to a client who has type 1 diabetes mellitus. Which of the following actions should the nurse take?

Administer with short-acting insulin.

Assess for hypoglycemia 4 hr after the insulin injection.

Inject the insulin 15 min before a meal.

Monitor for polyuria.

Answer and Explanation

The Correct Answer is C

Choice A reason: This is incorrect because lispro insulin is a rapid-acting insulin that does not need to be administered with another type of insulin. However, the patient may need a long-acting or intermediate-acting insulin to provide basal coverage throughout the day.

Choice B reason: This is incorrect because lispro insulin has a peak action of 30 to 90 min after the injection, which means that the patient is at the highest risk of hypoglycemia during this time. The nurse should assess for hypoglycemia more frequently than 4 hr after the injection.

Choice C reason: This is correct because lispro insulin has a fast onset of action of 15 to 30 min after the injection, which means that the patient should eat a meal within 15 min of the injection to prevent hypoglycemia.

Choice D reason: This is incorrect because polyuria is a sign of hyperglycemia, not hypoglycemia. The nurse should monitor for polyuria before the insulin injection, as it may indicate that the patient's blood glucose level is high.

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Correct Answer is A

Explanation

The correct answer is a. Alcohol.

Choice A: Alcohol

Reason: Alcohol can significantly affect blood glucose levels in patients taking glimepiride. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) can occur depending on the amount and frequency of alcohol consumption. Alcohol can enhance the blood sugar-lowering effect of glimepiride, leading to a dangerous drop in blood sugar levels, known as hypoglycemia. Symptoms of hypoglycemia include dizziness, confusion, weakness, and in severe cases, loss of consciousness. Therefore, it is advised to avoid alcohol while taking glimepiride.

Choice B: Milk

Reason: There are no known interactions between glimepiride and milk. Milk does not affect the absorption or efficacy of glimepiride. Therefore, it is generally safe to consume milk while taking this medication.

Choice C: Grapefruit juice

Reason: Grapefruit juice might theoretically increase the levels of drugs metabolized by CYP2C9, including glimepiride, due to its potential to inhibit CYP2C9 enzymes. However, this interaction has not been reported in humans and is considered unlikely to have a significant clinical impact. Therefore, grapefruit juice is not a major concern for patients taking glimepiride.

Choice D: Coffee

Reason: Coffee and other caffeinated beverages may increase blood sugar levels, which can counteract the effects of glimepiride. However, this interaction is not as significant as the interaction with alcohol. It is generally advised to monitor blood sugar levels and consume coffee in moderation while taking glimepiride.

A. Immediate onset B. Absence of rebound congestion C. Shorter duration D. More potent effect

Correct Answer is B

Explanation

Choice A reason: This is incorrect because orally administered decongestants do not have an immediate onset. They take longer to act than nasal sprays because they have to be absorbed through the gastrointestinal tract. Nasal sprays act directly on the nasal mucosa and have a faster onset.

Choice B reason: This is correct because orally administered decongestants do not cause rebound congestion. Rebound congestion is a condition in which the nasal passages become more swollen and congested after the effect of the nasal spray wears off. This can lead to overuse and dependence on the nasal spray. Orally administered decongestants do not have this effect because they act systemically and not locally.

Choice C reason: This is incorrect because orally administered decongestants do not have a shorter duration. They have a longer duration than nasal sprays because they are metabolized more slowly by the liver. Nasal sprays have a shorter duration because they are eliminated more quickly by the nasal mucosa.

Choice D reason: This is incorrect because orally administered decongestants are not more potent than nasal sprays. They have a similar potency, but they have a different mechanism of action. Orally administered decongestants act on the alpha-adrenergic receptors in the blood vessels, causing vasoconstriction and reducing congestion. Nasal sprays act on the beta-adrenergic receptors in the bronchial smooth muscle, causing bronchodilation and improving airflow.

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A nurse is preparing to administer lispro insulin to a client who has type 1 diabetes mellitus. Which of the following actions should the nurse take?

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