The nurse administers neutral protamine Hagedorn (NPH) insulin to a client at 0900. What action should the nurse plan to take to prevent hypoglycemia when the medication peaks?
Ensure the client eats their lunch before 1100
Teach the client to avoid caloric intake at 1200
Provide the client with an afternoon snack at 1500
Make sure the client eats their breakfast at 0900
The Correct Answer is C
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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Levothyroxine 125 mcg once daily: Levothyroxine does not have significant interactions with fentanyl. Co-administration does not increase the risk of respiratory depression or sedation and is generally safe in pain management contexts.
B. Ibuprofen 400 mg PO every 6 hours PRN: NSAIDs like ibuprofen can be safely used alongside fentanyl for additional analgesia. There is no significant pharmacologic interaction that would increase the risk of severe adverse effects such as respiratory depression.
C. Lorazepam 1 mg PO every 8 hours PRN: Both fentanyl and lorazepam are central nervous system (CNS) depressants. Concurrent use can lead to additive effects, significantly increasing the risk of respiratory depression, profound sedation, hypotension, and even death, making this combination particularly concerning.
D. Penicillin 500 mg IV every 8 hours: Penicillin does not interact with fentanyl in a way that would enhance CNS depression or cause serious adverse effects. Co-administration is generally considered safe.
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
Explanation
- Hepatotoxicity: Acetaminophen overdose or chronic high-dose use can lead to liver injury and potentially acute liver failure. Hepatotoxicity is a major concern, particularly in clients with preexisting liver disease or chronic alcohol use.
- Stevens-Johnson syndrome: Although rare, acetaminophen can trigger severe skin reactions such as Stevens-Johnson syndrome or toxic epidermal necrolysis. These life-threatening reactions require immediate discontinuation of the drug and medical intervention.
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