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 ["4"]
Explanation
One gram is equal to 1000 milligrams, one milliliter is equal to 0.2 teaspoons, and one teaspoon is equal to 5 milliliters. Using these conversion factors, the nurse can perform the following steps:
- Multiply the prescribed amount of cough syrup by 1000 to get the equivalent in milligrams: 0.4 g x 1000 = 400 mg
- Divide the equivalent in milligrams by the dosage strength of the syrup to get the equivalent in milliliters: 400 mg / 100 mg/5 mL = 20 mL
- Multiply the equivalent in milliliters by 0.2 to get the equivalent in teaspoons: 20 mL x 0.2 = 4 teaspoons
Therefore, the nurse will instruct the client to take 4 teaspoons of cough syrup every 4 hours.
Correct Answer is D
Explanation
- Choice A Rationale: Placing the head of the bed in the flat position is not recommended as it can increase the risk of airway obstruction and reduce venous drainage from the head, which is especially critical after thyroid surgery.
- Choice B Rationale: While deep breathing is important postoperatively, it is not specific to thyroidectomy care and should be done more frequently than every 4 hours to ensure adequate ventilation and prevent atelectasis.
- Choice C Rationale: Hyperextending the client's neck can be harmful post-thyroidectomy as it may put stress on the surgical site, potentially leading to dehiscence or damage to the area.
- Choice D Rationale: Checking the client's voice every 2 hours is essential after a thyroidectomy because vocal cord paralysis can be an indicator of recurrent laryngeal nerve damage, which is a potential complication of the surgery. Monitoring the voice allows for early detection and intervention.
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