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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?

A.

1AM while sleeping

B.

PM shortly after lunch

C.

6 PM shortly after dinner

D.

11:00 AM, shortly before lunch

Answer and Explanation

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.


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Related Questions

Correct Answer is B

Explanation

A. Semi-Fowler's with neck extended: Keeping the neck extended can put strain on the surgical incision site, increasing the risk of complications. It's important to avoid excessive neck movement.

B. Semi-Fowler's with neck in a neutral position: This position is optimal for clients post-thyroidectomy. It helps reduce swelling and pressure on the surgical site while maintaining the neck in a neutral and supported position.

C. High Fowler's with neck extended: A high Fowler's position with the neck extended may increase the risk of strain on the surgical incision and should be avoided.

D. High Fowler's with the neck in a neutral position: While a high Fowler's position can be comfortable for the client, it's important to ensure that the neck is in a neutral position to minimize strain on the surgical incision.

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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