The nurse administers 10 units of insulin lispro to a client at 0630 and anticipates that the client must have breakfast by:
0650
0700
0640
0710
The Correct Answer is B
This timing allows for 30 minutes after administration. Since insulin lispro starts working in about 15 minutes, having breakfast at this time ensures that the client’s blood sugar is managed effectively without risking hypoglycemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. While taking vital signs can provide useful information about the client's overall condition, it does not directly address the immediate concern of potential hypoglycemia. The priority is to assess blood glucose levels, as this will guide further actions.
B. Glucagon is used for severe hypoglycemia when the client is unable to consume glucose orally. However, before administering glucagon, it is essential to confirm hypoglycemia by checking the blood glucose level. This ensures that glucagon is only used when absolutely necessary.
C. Checking the blood glucose level will quickly determine whether the client is experiencing hypoglycemia. If the blood glucose is low, appropriate treatment (such as administering glucose or a fast-acting carbohydrate) can be initiated. If it’s within normal limits, other potential causes for the symptoms can be explored.
D. While it may be necessary to notify the physician depending on the outcome of the blood glucose reading or if the client’s condition worsens, it is not the first action. Immediate assessment of blood glucose is essential to determine the appropriate course of action.
Correct Answer is D
Explanation
A. While an elastic bandage can provide some compression to control bleeding, its primary purpose post-amputation is not to prevent bleeding but to support the healing process. It does help cover the incision, but this is not its main function in the context of shaping the stump.
B. Phantom limb pain is a common phenomenon after amputation, where the patient feels sensations in the amputated limb. Wrapping the stump may provide some psychological comfort, but the elastic bandage does not directly decrease phantom limb pain.
C. While adequate compression can help with circulation, the primary function of wrapping the stump is not to prevent blood clots. Preventing blood clots is more relevant to immobilization and other measures, particularly in the early postoperative period.
D. The elastic bandage helps to compress the soft tissue of the stump, promoting a well-shaped residual limb. This shaping is important for fitting prosthetics later and helps minimize edema (swelling) in the area post-surgery.
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