The nurse has administered NPH insulin at 1700.
At what time would the nurse anticipate the peak action of this insulin?
Between 2100 and 0500
There is no peak action with neutral protamine hagedorn insulin
Between 1800 and 2100
At 1930
The Correct Answer is A
Choice A rationale:
NPH insulin is an intermediate-acting insulin that typically peaks 6-12 hours after administration.
Given that the insulin was administered at 1700 (5:00 PM), the peak action would be expected to occur between 2100 (9:00 PM) and 0500 (5:00 AM).
This time frame aligns with the known pharmacokinetics of NPH insulin.
It's crucial for nurses to be aware of the peak action times of different insulin types to effectively manage blood glucose levels and adjust insulin doses accordingly.
Choice B rationale:
Incorrect. NPH insulin does have a peak action, as explained above.
It's important to understand that even intermediate-acting insulins have a period of peak activity when they exert their strongest glucose-lowering effect.
Choice C rationale:
Incorrect. This time frame is too early to represent the peak action of NPH insulin. The peak action typically occurs later, between 6-12 hours after administration.
Choice D rationale:
Incorrect. This time point is too specific to accurately represent the peak action of NPH insulin.
The peak action can vary within the 6-12 hour window, depending on individual factors and injection site.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Requesting an order for morphine sulfate IV 2 mg over 1-5 minutes would not be appropriate at this time for several reasons: The patient has already received a dose of 4 mg 15 minutes ago, and it has not been effective in relieving the chest pain.
The patient is showing signs of increased respiratory effort, which could be a sign of respiratory depression. Administering an additional dose of morphine could worsen the respiratory depression.
The patient's heart rate is 82 beats per minute, which is within the normal range.
The patient's blood pressure is 135/88 mm Hg, which is also within the normal range.
Choice C rationale:
Administering naloxone (Narcan) to counteract respiratory depression would not be appropriate at this time because the patient is not showing signs of severe respiratory depression. Naloxone is a medication that is used to reverse the effects of opioid overdose. It is typically only used in situations where the patient is experiencing life-threatening respiratory depression.
Choice D rationale:
Administering morphine sulfate IV 4 mg over 1-5 minutes would not be appropriate for the reasons listed above. It could worsen the patient's respiratory depression and potentially lead to other complications.
Choice B is the best answer because it is the most conservative and safest option. By withholding the next dose of morphine and informing the provider about the patient's symptoms, the nurse can ensure that the patient receives the appropriate care and that any potential complications are avoided.
Correct Answer is C
Explanation
Choice A rationale:
Insulin resistance is a condition in which the body's cells become less responsive to insulin, requiring more insulin to maintain normal blood glucose levels.
It's primarily caused by factors such as obesity, physical inactivity, and genetic predisposition. Rotating injection sites does not directly address these underlying causes of insulin resistance.
It can help ensure consistent insulin absorption, but it's not the primary mechanism for preventing insulin resistance.
Choice B rationale:
Allergic reactions to insulin are rare but can occur.
They typically manifest as localized symptoms at the injection site, such as redness, swelling, itching, or pain.
In severe cases, systemic reactions like hives, difficulty breathing, or anaphylaxis can occur.
Rotating injection sites might reduce the risk of localized allergic reactions by preventing repeated exposure to insulin in the same area of skin.
However, it does not prevent systemic allergic reactions, which are immune-mediated and not dependent on the injection site.
Choice C rationale:
Lipodystrophy is a condition characterized by abnormal changes in fat distribution under the skin. It can occur as a complication of repeated insulin injections at the same site.
There are two main types of lipodystrophy:
Lipohypertrophy: This involves the accumulation of excess fatty tissue at injection sites, creating visible lumps or bumps. Lipoatrophy: This involves the loss of fatty tissue at injection sites, leading to depressions or indentations in the skin.
Both lipohypertrophy and lipoatrophy can interfere with insulin absorption, leading to unpredictable blood glucose control.
Rotating injection sites helps to prevent lipodystrophy by distributing insulin injections over a wider area of skin, reducing the likelihood of repeated trauma to the same tissue.

Choice D rationale:
Insulin shock, also known as hypoglycemia, is a condition that occurs when blood glucose levels drop too low.
It can be caused by several factors, including excessive insulin dosing, missed meals, or increased physical activity. Rotating injection sites does not directly affect the risk of insulin shock.
It's essential for individuals using insulin to monitor their blood glucose levels regularly, adjust insulin doses as needed, and follow a balanced diet and exercise plan to prevent hypoglycemia.
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