The client with type 1 diabetes mellitus is prescribed to take NPH (Humulin N) insulin at 5 PM each day. The client should be instructed that the greatest risk of hypoglycemia will occur about what time?
1AM while sleeping
PM shortly after lunch
6 PM shortly after dinner
11:00 AM, shortly before lunch
The Correct Answer is A
1 AM while sleeping: NPH insulin, like Humulin N, typically reaches its peak effectiveness about 4-12 hours after administration. Since the client takes it at 5 PM, the time of greatest risk for hypoglycemia is around 1 AM when the insulin's effects are at their peak. This is a critical period for monitoring blood glucose levels.
B. 8 PM shortly after dinner: By 8 PM, the NPH insulin's effectiveness is not at its peak. It's been about 3 hours since administration, and the insulin is still working to lower blood glucose levels. This time frame is not associated with the highest risk of hypoglycemia.
C. 6 PM shortly after dinner: At 6 PM, it's been only about an hour since the client took the NPH insulin. The insulin is just beginning to take effect, and the risk of hypoglycemia is not as high as it would be later in the night.
D. 11:00 AM, shortly before lunch: By 11:00 AM, the effects of the NPH insulin from the previous evening have largely worn off. This time frame is not associated with a high risk of hypoglycemia related to the evening dose of NPH insulin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. 6.3% - This HbA1c level indicates good blood glucose control. It suggests that the client has been effectively managing their blood sugar levels over the past few months.
B. 7.86 - This is an atypical way of presenting HbA1c values. Typically, it is expressed as a percentage, so this value needs to be converted to be compared accurately.
C. 10% - This HbA1c level is elevated and indicates poor blood glucose control. It suggests that the client's blood sugar levels have been consistently high over the past few months.
D. 8.56% - This HbA1c level is elevated and indicates poor blood glucose control. It suggests that the client's blood sugar levels have been consistently high over the past few months.
Correct Answer is A
Explanation
A. Correct. Chvostek's sign is a clinical sign of hypocalcemia. It is elicited by tapping on the facial nerve, just anterior to the ear, and observing for facial twitching or spasm.
B. Incorrect. Kernig's sign is a test for assessing meningitis and involves flexing the hip and knee at 90-degree angles and then extending the knee. This test is not relevant to the client's reported symptoms.
C. Incorrect. Brudzinski's sign is another test for assessing meningitis. It involves flexing the neck forward and observing for involuntary flexion of the hips and knees. This test is not relevant to the client's reported symptoms.
D. Incorrect. Babinski's sign is used to assess upper motor neuron lesions. It involves stimulating the sole of the foot, and in a positive response, the big toe extends upward. This test is not relevant to the client's reported symptoms.
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