A patient with diabetes is starting on insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?
Lispro (Humalog)
NPH (Humulin N)
Detemir (Levemir)
Glargine (Lantus)
The Correct Answer is A
Choice A reason: Lispro (Humalog) is a type of insulin that is used for mealtime coverage. It is a rapid-acting insulin that starts to work within 15 minutes, peaks in about an hour, and lasts for 2 to 4 hours. It mimics the natural insulin response to food intake, and helps to lower the blood glucose level after meals. The nurse will discuss using lispro for mealtime coverage, and instruct the patient to inject it within 15 minutes before or after eating.
Choice B reason: NPH (Humulin N) is a type of insulin that is not used for mealtime coverage. It is an intermediate-acting insulin that starts to work within 2 to 4 hours, peaks in 4 to 12 hours, and lasts for 12 to 18 hours. It provides a steady background of insulin throughout the day, and helps to control the blood glucose level between meals and overnight. The nurse will discuss using NPH for basal coverage, and instruct the patient to inject it once or twice a day, usually in the morning and/or evening.
Choice C reason: Detemir (Levemir) is a type of insulin that is not used for mealtime coverage. It is a long-acting insulin that starts to work within 1 to 2 hours, has no peak, and lasts for up to 24 hours. It provides a constant level of insulin throughout the day, and helps to maintain the blood glucose level at a stable range. The nurse will discuss using detemir for basal coverage, and instruct the patient to inject it once or twice a day, depending on the individual needs.
Choice D reason: Glargine (Lantus) is a type of insulin that is not used for mealtime coverage. It is a long-acting insulin that starts to work within 1 to 2 hours, has no peak, and lasts for up to 24 hours. It provides a constant level of insulin throughout the day, and helps to maintain the blood glucose level at a stable range. The nurse will discuss using glargine for basal coverage, and instruct the patient to inject it once a day, usually at the same time every day.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: 1:00 PM is not the correct time to monitor the patient for signs of hypoglycemia related to the insulin's peak action. Humalog is a rapid acting insulin that starts to work within 15 minutes, peaks in about an hour, and lasts for 2 to 4 hours. Therefore, the peak action of Humalog given at 8:00 AM would be around 9:00 AM, not 1:00 PM.
Choice B reason: 8:00 PM is also not the correct time to monitor the patient for signs of hypoglycemia related to the insulin's peak action. As explained in choice A, Humalog peaks in about an hour and lasts for 2 to 4 hours. Therefore, the effect of Humalog given at 8:00 AM would wear off by 12:00 PM, not 8:00 PM.
Choice C reason: There is no peak action for this insulin is an incorrect statement. Humalog does have a peak action, as described in choice A. The peak action of an insulin is the time when the insulin is most effective in lowering the blood glucose level. The peak action of an insulin can vary depending on the type, dose, and individual response of the patient.
Choice D reason: 9:00 AM is the correct time to monitor the patient for signs of hypoglycemia related to the insulin's peak action. Hypoglycemia is a condition of low blood glucose level, which can cause symptoms such as sweating, shaking, hunger, headache, dizziness, confusion, and loss of consciousness. Hypoglycemia can occur when the insulin dose is too high, the food intake is too low, or the physical activity is too high. The nurse should monitor the patient for signs of hypoglycemia around the peak action of the insulin, as this is when the blood glucose level is most likely to drop. The nurse should also teach the patient how to prevent, recognize, and treat hypoglycemia.
Correct Answer is A
Explanation
Choice A reason: Purplish streaks on the abdomen are also known as striae. They are caused by the thinning and weakening of the skin due to excess cortisol, a hormone that is elevated in Cushing syndrome. Striae are a common sign of Cushing syndrome, along with weight gain, moon face, and buffalo hump.
Choice B reason: Chronically low blood pressure is not associated with Cushing syndrome. Cushing syndrome can cause high blood pressure, due to the effects of cortisol on the cardiovascular system. Low blood pressure can be a sign of adrenal insufficiency, which is the opposite of Cushing syndrome.
Choice C reason: Bronzed appearance of the skin is not related to Cushing syndrome. Bronzed skin can be a sign of Addison's disease, which is a condition of low cortisol and low aldosterone. Addison's disease can cause hyperpigmentation of the skin, especially in the areas exposed to sun, such as the face, neck, and hands.
Choice D reason: Decreased axillary and pubic hair is also not related to Cushing syndrome. Cushing syndrome can cause increased hair growth, especially on the face, chest, and back. This is due to the androgenic effects of cortisol. Decreased hair growth can be a sign of hypothyroidism, which is a condition of low thyroid hormone.
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