A nurse is providing discharge teaching for a patient with insulin glargine (Lantus). Which instructions are correct? SELECT ALL THAT APPLY

"Do not mix this insulin with others in the same syringe."

"This insulin has no pronounced peak."

"It should be taken immediately before meals."

"Take this insulin at the same time each day."

"It provides 24-hour blood sugar control."

Answer and Explanation

Correct Answer : A,B,D,E

Rationale:

A. Insulin glargine is a long-acting basal insulin that is not compatible with other insulins in the same syringe due to its pH and formulation. Mixing it can alter its action, making blood glucose control unpredictable and unsafe.

B. Glargine provides a steady, peakless insulin level, which mimics basal insulin secretion and reduces the risk of hypoglycemia that can occur with peak insulin activity. This characteristic distinguishes it from short- or intermediate-acting insulins.

C. Glargine is long-acting and not meal-dependent, unlike rapid- or short-acting insulin. Timing it with meals is unnecessary and may lead to inadequate coverage or hypoglycemia if meals are delayed.

D. Consistent timing maintains stable basal insulin levels and helps achieve predictable 24-hour glycemic control. Deviating from the schedule may result in hyperglycemia or hypoglycemia.

E. Glargine is designed to provide a continuous, long-acting basal insulin effect for up to 24 hours, supporting overall glycemic stability and reducing the need for multiple daily injections for basal coverage.

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Correct Answer is C

Explanation

Rationale:

A. Insulin is a protein-based hormone. Freezing causes crystal formation and denaturation of protein structure, which destroys the insulin's ability to lower blood glucose. Using frozen insulin can lead to hyperglycemia due to ineffective doses. Therefore, freezing is contraindicated.

B. Freezing insulin, whether opened or unopened, renders it inactive. Proper storage is essential to maintain potency; storing in a freezer is a common error that can result in ineffective therapy and poor glycemic control.

C. Refrigeration (2–8°C / 36–46°F) preserves insulin stability and potency until the expiration date. Most insulin formulations remain effective for the full shelf life when stored this way. Keeping unopened insulin in the fridge also reduces the risk of accidental temperature fluctuations that can degrade the medication.

D. Once insulin is opened, most vials or pens can be kept at room temperature (up to 30°C / 86°F) for a limited period (usually 28 days for many types, longer for some formulations) without loss of efficacy. Room temperature storage: Reduces injection discomfort (cold insulin can cause burning), maintains potency if within manufacturer-specified duration and must still avoid extremes of heat or freezing

A. Increase fluid intake B. Use stool softeners or bulk-forming agents C. Limit physical activity D. Encourage high-fiber foods E. Schedule regular bowel times

Correct Answer is ["A","B","D","E"]

Explanation

Rationale:

A. Adequate hydration is crucial for softening stool and promoting bowel motility, especially in MS patients who may have neurogenic bowel or decreased mobility. Insufficient fluid intake can lead to hard, dry stools, worsening constipation and increasing the risk of complications like hemorrhoids or fecal impaction.

B. Medications such as docusate (stool softener) or psyllium (bulk-forming fiber) can help prevent straining and make bowel movements easier. In MS, nerve damage may reduce peristalsis and bowel coordination, so these agents support regularity and prevent complications associated with chronic constipation.

C. Physical activity stimulates the gastrointestinal tract and bowel motility. In MS patients, immobility already contributes to constipation due to slower colonic transit. Limiting activity would aggravate constipation. Gentle exercise, such as walking or stretching, should be encouraged to improve bowel function.

D. Fiber increases stool bulk and water retention, which helps stimulate peristalsis and improve regularity. Foods like whole grains, fruits, and vegetables are recommended. Low-fiber diets, common in some MS patients due to chewing/swallowing difficulties or diet restrictions, can worsen constipation.

E. Establishing a consistent routine, often after meals to take advantage of the gastrocolic reflex, encourages predictable bowel movements. This is especially important in MS clients with neurogenic bowel, who may have decreased sensory awareness of the need to defecate. Ignoring this can lead to infrequent, difficult, or incomplete bowel movements.

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A nurse is providing discharge teaching for a patient with insulin glargine (Lantus). Which instructions are correct? SELECT ALL THAT APPLY

Nursing Test Bank

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Correct Answer is C

Explanation

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Correct Answer is ["A","B","D","E"]

Explanation

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A nurse is providing discharge teaching for a patient with insulin glargine (Lantus). Which instructions are correct? SELECT ALL THAT APPLY