The nurse is caring for a client who receives an intermediate-acting insulin, Humulin N (Novolin N, Neutral Protamine Hagedorn insulin, isophane, NPH), 25 units daily at 7 a.m. When is hypoglycemia most likely to occur?

2 pm

5 am

10 am

10 pm

Answer and Explanation

The Correct Answer is A

A. NPH insulin typically has an onset of 1–2 hours, peaks around 4–12 hours after administration, and lasts about 18–24 hours. Given the 7 a.m. administration, the peak effect—and thus the highest risk for hypoglycemia—would occur roughly between 11 a.m. and 7 p.m., making 2 p.m. the most likely time for hypoglycemia.
B. 5 a.m. is before the insulin peak and unlikely to cause hypoglycemia.
C. 10 a.m. is closer to the onset but may be before peak action.
D. 10 p.m. is typically after the insulin effect has declined.

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Correct Answer is D

Explanation

A. While Coca-Cola contains sugar and could raise blood glucose, it should not be given without first confirming hypoglycemia through a blood glucose reading.
B. Glucagon is typically reserved for severe hypoglycemia when the client is unconscious or unable to swallow. This client is conscious and able to communicate symptoms.
C. Administering glucose tablets is appropriate after confirming hypoglycemia, not before.
D. The client’s symptoms—anxiety, nervousness, and sweating—are classic signs of hypoglycemia. The nurse’s priority is to obtain a glucose reading via finger stick to assess the client’s current glucose level before initiating treatment.

A. Institute urine glucose monitoring. B. Administer an oral hypoglycemic. C. Administer supplemental doses of regular insulin according to the sliding scale. D. Decrease the rate of intravenous infusion.

Correct Answer is C

Explanation

A. Urine glucose monitoring is less accurate and not the priority in managing elevated blood glucose.
B. Oral hypoglycemics are not effective or recommended for type 1 diabetes because they do not replace insulin.
C. Elevated blood glucose in a client with type 1 diabetes post-surgery is typically managed by administering regular insulin doses as per sliding scale to maintain glycemic control.
D. Decreasing IV fluids is not indicated unless they contain glucose and are contributing to hyperglycemia; this decision depends on the fluid type and physician orders.

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The nurse is caring for a client who receives an intermediate-acting insulin, Humulin N (Novolin N, Neutral Protamine Hagedorn insulin, isophane, NPH), 25 units daily at 7 a.m. When is hypoglycemia most likely to occur?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While hospitalized and recovering from an episode of diabetic ketoacidosis, the client calls the nurse and reports feeling anxious, nervous, and sweaty. What is the nurse's priority action based on the client's report?

Correct Answer is D

Explanation

Four hours after surgery, the blood glucose level of a client who has type 1 diabetes is elevated. Which of the following actions would the nurse expect?

Correct Answer is C

Explanation

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