Insulin glargine (Lantus) U-100 is prescribed for a hospitalized patient who has diabetes. When will the nurse expect to administer this drug?

In the morning and at 4:00 PM

Approximately 15 to 30 minutes before each meal

After meals and at bedtime

Once daily at bedtime

Answer and Explanation

The Correct Answer is D

A. Administering insulin twice daily (morning and afternoon) is typical for intermediate-acting insulins (e.g., NPH), not for insulin glargine. Glargine is designed for once-daily dosing due to its long, steady action.

B. Giving insulin 15–30 minutes before meals is appropriate for short-acting insulin (e.g., regular insulin), which is intended to control postprandial glucose spikes. Insulin glargine is not meal-related and should not be timed with meals.

C. Administering insulin after meals and at bedtime is more consistent with rapid-acting insulin regimens or correctional insulin. Insulin glargine is basal insulin, not used for immediate glucose control after eating.

D. Insulin glargine (Lantus) is a long-acting basal insulin with no pronounced peak and a duration of about 24 hours. It is typically administered once daily at the same time each day, commonly at bedtime, to provide consistent background insulin coverage.

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Correct Answer is ["A","C"]

Explanation

A. Vasoconstrictors (such as epinephrine) cause local vasoconstriction, which reduces blood flow at the injection site. This slows the rate at which the anesthetic is absorbed into the systemic circulation. As a result, plasma drug levels remain lower, decreasing the likelihood of systemic toxicity (e.g., CNS effects like seizures or cardiovascular effects such as arrhythmias). This is particularly important with potent local anesthetics like lidocaine or bupivacaine, where high systemic levels can be dangerous.

B. Vasoconstrictors do not prevent bradycardia. Instead, they stimulate adrenergic receptors, which can lead to increased heart rate (tachycardia) and elevated blood pressureif absorbed systemically. Therefore, they are used cautiously in clients with cardiovascular disease. Preventing bradycardia is not a therapeutic goal of adding vasoconstrictors.

C. By decreasing local blood flow, vasoconstrictors delay the removal of the anesthetic from the injection site, allowing it to remain in contact with nerve fibers longer. This prolongs the duration of anesthesia, which is beneficial during longer procedures and reduces the need for repeated dosing.

D. Vasoconstrictors actually decrease (not enhance) absorptioninto systemic circulation. This is the key mechanism behind both reduced toxicity and prolonged action. Enhanced absorption would increase systemic drug levels, which is the opposite of the intended effect.

E. Because vasoconstrictors slow drug absorption and keep the anesthetic localized, they prolong rather than shortenthe duration of action. Shortening duration would require faster systemic uptake, which vasoconstrictors specifically prevent.

A. Decreased glucose levels B. Decreased white blood cell count C. increased red blood cell count D. Increased platelet count

Correct Answer is B

Explanation

A. Antithyroid drugs, such as methimazoleand propylthiouracil (PTU), do not directly affect blood glucose levels. While thyroid hormones themselves influence metabolism, the primary effect of antithyroid medications is on thyroid hormone synthesis, not on glucose regulation.

B. One of the most serious adverse effectsof antithyroid drugs is agranulocytosis, which manifests as a significant reduction in white blood cells (particularly neutrophils). This greatly increases the risk of infection, sometimes with minimal warning signs. Patients may present with fever, sore throat, or other early infection symptoms, which should prompt immediate discontinuation of the drug and medical evaluation. Routine monitoring of WBC counts, especially early in therapy, helps detect this rare but life-threatening complication.

C. Antithyroid medications do not increase red blood cell count. Erythropoiesis is unrelated to the mechanism of these drugs. Any changes in RBCs would likely be due to unrelated conditions, not the antithyroid therapy.

D. Platelet counts are not typically affectedby antithyroid drugs. Thrombocytopenia is rare and not a standard laboratory concern for patients taking these medications.

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Insulin glargine (Lantus) U-100 is prescribed for a hospitalized patient who has diabetes. When will the nurse expect to administer this drug?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Vasoconstrictors are combined with local anesthetics for which reasons? (Select all that apply, one, several or none)

Correct Answer is ["A","C"]

Explanation

When reviewing the laboratory values of a patient who is taking antithyroid drugs, the nurse will monitor for which adverse effect?

Correct Answer is B

Explanation

The most dangerous toxicity of methimazole.

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Inhalation anesthetics fall into what two categories? (Select all that apply, one, some or all)

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