The nurse administered regular insulin subcutaneously to a client with diabetes mellitus type 1 at 0700. At what time will the client be most at risk for hypoglycemia?
Between 0730 and 0830
Between 1500 and 1700
Between 1200 and 1400
Between 0900 and 1100
The Correct Answer is D
A. Between 0730 and 0830: Regular insulin has an onset of about 30 minutes, but it does not reach peak plasma concentration this early. Blood glucose may begin to fall slightly, but the risk for clinically significant hypoglycemia is still low during this initial absorption phase.
B. Between 1500 and 1700: Regular insulin’s duration extends up to 6–8 hours, but its pharmacodynamic activity is weakest during the late phase. By mid-afternoon, serum insulin levels have declined substantially, making hypoglycemia unlikely unless additional factors such as excessive exercise or skipped meals are involved.
C. Between 1200 and 1400: By this time, regular insulin is nearing the end of its effective window, with plasma levels falling as it is metabolized. While mild hypoglycemia is still possible in sensitive clients, this period does not correlate with the drug’s peak activity and is not the highest-risk interval.
D. Between 0900 and 1100: Regular insulin peaks about 2–4 hours after administration, producing its maximum glucose-lowering effect during this period. Insulin-driven cellular uptake of glucose is highest, increasing the likelihood of symptomatic hypoglycemia, especially without adequate carbohydrate intake.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Ensure the client eats their lunch before 1100: Lunch typically occurs later in the day, so timing it before 1100 does not align with NPH insulin’s peak, which occurs approximately 4–6 hours after administration. This action would not effectively prevent hypoglycemia during the peak period.
B. Teach the client to avoid caloric intake at 1200: Avoiding food intake near the insulin peak increases the risk of hypoglycemia. Clients need adequate carbohydrate intake when insulin levels are highest to maintain blood glucose within a safe range.
C. Provide the client with an afternoon snack at 1500: NPH insulin administered at 0900 peaks around mid- to late-afternoon. Providing a snack during this time helps prevent hypoglycemia by supplying glucose to match the insulin’s maximum action, maintaining safe blood glucose levels.
D. Make sure the client eats their breakfast at 0900: While eating at the time of insulin administration is important, the risk of hypoglycemia is greatest at the peak later in the day. Breakfast alone does not prevent hypoglycemia during the afternoon peak of NPH insulin.
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
Explanation
• Biguanide: Metformin belongs to the biguanide class of oral hypoglycemic agents. It lowers blood glucose by decreasing hepatic glucose production, improving insulin sensitivity, and enhancing peripheral glucose uptake.
• Type 2 diabetes mellitus: Metformin is indicated for clients with type 2 diabetes mellitus. It helps control fasting and postprandial blood glucose levels, reduces hemoglobin A1c, and is often first-line therapy in overweight or insulin-resistant patients.
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