A patient diagnosed with diabetes is being discharge to home with regular insulin and insulin glargine (Lantus). During discharge teaching the patient asks what is the difference between the 2 types of insulin. What is your best response?
"Insulin glargine will only be given if her blood sugars are higher than 200 mg/dL."
"Insulin glargine is the same as regular insulin, and she will require several injections during the day."
"Insulin glargine helps to manage elevated blood sugars after she eats, and she will require injections three times a day."
"Insulin glargine will help control her blood sugar for 24 hours and will need to be given one time per day."
The Correct Answer is D
A. "Insulin glargine will only be given if her blood sugars are higher than 200 mg/dL.": Glargine is a long-acting insulin administered on a fixed schedule, not based on immediate blood glucose readings. Using it only for high readings would prevent stable baseline glucose control and increase the risk of hyperglycemia.
B. "Insulin glargine is the same as regular insulin, and she will require several injections during the day.": Glargine differs from regular insulin because it has a slow, steady release over 24 hours and is usually given once daily. Confusing it with regular insulin could lead to dosing errors and inadequate glucose management.
C. "Insulin glargine helps to manage elevated blood sugars after she eats, and she will require injections three times a day.": Postprandial glucose is primarily managed by rapid-acting or short-acting insulin, not glargine. Glargine provides basal coverage rather than mealtime glucose control, so multiple daily injections for meals are unnecessary.
D. "Insulin glargine will help control her blood sugar for 24 hours and will need to be given one time per day.": Glargine is a long-acting insulin that maintains steady basal insulin levels for approximately 24 hours. It is administered once daily to stabilize fasting and baseline blood glucose, complementing rapid-acting insulin for mealtime coverage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Triptans: Triptans are selective serotonin receptor agonists that constrict cranial blood vessels and reduce inflammation, directly relieving acute migraine symptoms. They are first-line therapy for moderate to severe migraine attacks and provide rapid symptom relief, including headache and associated nausea or sensitivity to light.
B. Antidepressants: Antidepressants, such as amitriptyline, are primarily used for migraine prevention rather than acute treatment. They modulate neurotransmitters to reduce migraine frequency over time but do not provide immediate relief during an active attack.
C. Antibiotics: Antibiotics have no role in treating migraines because migraine pathophysiology is neurologic and vascular, not infectious. Using antibiotics would not alleviate pain or associated migraine symptoms and could contribute to unnecessary side effects.
D. Beta-blockers: Beta-blockers, such as propranolol, are used for migraine prophylaxis to prevent future attacks, not for acute symptom relief. They work by reducing sympathetic nervous system activity but do not provide immediate relief once a migraine has started.
Correct Answer is C
Explanation
A. Albuterol: The patient has already used a short-acting beta-2 agonist, so repeating albuterol may provide some relief but is unlikely to be sufficient for an acute exacerbation with persistent tachypnea and hypoxia. Additional interventions targeting severe airway inflammation may be required.
B. Theophylline: Theophylline is a bronchodilator used for long-term asthma management, not for immediate relief in acute severe exacerbations. Its slow onset and narrow therapeutic range make it inappropriate for emergency treatment in this scenario.
C. Epinephrine: Epinephrine is indicated in severe acute asthma or anaphylactic reactions when rapid bronchodilation is needed. It works on alpha and beta receptors to reduce airway edema, relax bronchial smooth muscle, and improve oxygenation. In the ER, epinephrine provides fast-acting relief for life-threatening airway obstruction.
D. Dexamethasone: Dexamethasone is a corticosteroid that reduces airway inflammation but has a delayed onset of action. While important for sustained management, it does not provide immediate relief for acute shortness of breath or hypoxia and is typically given alongside fast-acting agents.
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