Mr. D receives a daily injection of 70/30 NPH/regular insulin premix at 7:00 AM. The nurse expects that a hypoglycemic reaction is most likely to occur between:

09:00 AM and 11:00 AM

08:00 AM and 10:00 AM

07:00 AM and 09:00 AM

12:00 PM and 3:00 PM

Answer and Explanation

The Correct Answer is A

The peak time of 70/30 NPH/regular insulin premix is usually 2 to 12 hours after injection, with an average peak time of 4 to 6 hours. This means that the highest risk of hypoglycemia is typically 4 to 6 hours after the injection, which would fall between 11:00 AM and 1:00 PM. However, it's important to note that hypoglycemic reactions can occur at any time, so the client should be monitored closely throughout the day for any signs or symptoms of low blood sugar.

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Correct Answer is B

Explanation

Sudden discontinuation of prednisone can result in adrenal insufficiency and can lead to life-threatening complications. The nurse should also instruct the patient to report any symptoms of an infection, such as fever, to the doctor promptly, as prednisone can mask signs of an infection.

Monitoring for mood alterations and daily weight measurement are also important aspects of care, but they are not as crucial as the need to gradually taper oﬀ the medication.

A. Electrocardiographic (ECG) changes and dysrhythmias related to hypokalemia. B. The presence of hypovolemic shock related to osmotic diuresis. C. Cardiovascular collapse resulting from the eﬀects of hyperglycemia. D. Fluid overload resulting from aggressive ﬂuid replacement.

Correct Answer is A

Explanation

Electrocardiographic (ECG) changes and dysrhythmias related to hypokalemia are the main reasons for initiating cardiac monitoring in patients with diabetic ketoacidosis. In diabetic ketoacidosis, insulin deficiency causes the body to break down fat for energy, leading to the production of ketones and resulting in metabolic acidosis. In addition, glucose and potassium are lost in the urine due to osmotic diuresis. Hypokalemia can cause ECG changes and dysrhythmias, which can be life-threatening.

Hypokalemia is a common complication of DKA and can lead to ECG changes such as ST-segment depression, T-wave inversion, and U waves².

Hypovolemic shock related to osmotic diuresis is an important consideration in the management of diabetic ketoacidosis, but it is not the primary reason for initiating cardiac monitoring.

Cardiovascular collapse resulting from the eﬀects of hyperglycemia is not a common complication of diabetic ketoacidosis, and it is not the primary reason for initiating cardiac monitoring.

Fluid overload resulting from aggressive ﬂuid replacement is a potential complication of diabetic ketoacidosis, but it is not the primary reason for initiating cardiac monitoring.

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Mr. D receives a daily injection of 70/30 NPH/regular insulin premix at 7:00 AM. The nurse expects that a hypoglycemic reaction is most likely to occur between:

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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