The nurse is caring for a female client with type 2 diabetes mellitus who exhibits confusion, light-headedness, and aberrant behavior. The client is still conscious. The nurse should first administer:

15 to 20 g of a fast-acting carbohydrate such as orange juice.

I.V. bolus of dextrose 50%.

I.M. or subcutaneous glucagon.

10 U of fast-acting insulin

Answer and Explanation

The Correct Answer is C

A. 15 to 20 g of a fast-acting carbohydrate such as orange juice:
This is a standard and initial treatment for hypoglycemia. Fast-acting carbohydrates, like orange juice or glucose tablets, can quickly raise blood sugar levels. However, in the scenario described, the client is still conscious, and glucagon may be a more appropriate choice.

B. I.V. bolus of dextrose 50%:
Intravenous (IV) dextrose is a more aggressive intervention and is typically reserved for severe cases of hypoglycemia or for unconscious patients. It is not the first-line treatment for conscious patients.

C. I.M. or subcutaneous glucagon:
Glucagon is a hormone that raises blood sugar levels by promoting the conversion of stored glycogen in the liver to glucose. It is administered either intramuscularly (I.M.) or subcutaneously. In a conscious patient with hypoglycemia who cannot take oral carbohydrates, glucagon can be an effective and rapid way to raise blood sugar levels.

D. 10 U of fast-acting insulin:
Administering more insulin in a situation of hypoglycemia would worsen the condition. The goal in hypoglycemia is to raise blood sugar, and giving more insulin would have the opposite effect.

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Correct Answer is D

Explanation

A. It is rapidly absorbed, has a fast onset of action:
Explanation: This statement is incorrect. Glargine (Lantus) actually has a slow onset of action and a prolonged duration of action. It is formulated to provide a steady level of insulin in the body over an extended period.

B. Administer the total daily dosage in two doses:
Explanation: This is not the recommended administration for glargine. It is typically administered once daily to provide basal insulin coverage over a 24-hour period.

C. Draw up the drug first, then add regular insulin:
Explanation: Mixing glargine with other insulins is not recommended. Glargine should be administered separately to maintain its extended duration of action. It should not be mixed with other insulins in the same syringe.

D. Do not mix with other insulins:
Explanation: This is the correct statement. Glargine should not be mixed with other insulins. It should be administered alone to maintain its "peakless" basal coverage. Mixing it with other insulins could alter its pharmacokinetics and compromise its effectiveness.

A. "The test needs to be repeated following a 12-hour fast." B. "It tells us about your sugar control for the last 3 months." C. "It looks like you aren't following the prescribed diabetic diet." D. "Your insulin regimen needs to be altered significantly."

Correct Answer is B

Explanation

A. "The test needs to be repeated following a 12-hour fast."
This statement is not accurate. The hemoglobin A1c test does not require fasting. It reflects the average blood glucose levels over the past two to three months and is not affected by short-term changes in diet or fasting.

B. "It tells us about your sugar control for the last 3 months."
This statement is accurate. The hemoglobin A1c test provides information about the average blood glucose levels over the past two to three months. It's a valuable tool for assessing long-term glycemic control.

C. "It looks like you aren't following the prescribed diabetic diet."
The hemoglobin A1c test reflects overall glycemic control over several months and is not solely influenced by recent dietary habits. While diet plays a role in diabetes management, this statement oversimplifies the interpretation of the A1c result.

D. "Your insulin regimen needs to be altered significantly."
While a high A1c may indicate a need for adjustments in the treatment plan, the decision to alter the insulin regimen should be based on a comprehensive assessment of the patient's overall diabetes management, including lifestyle, diet, and other factors. It may not solely be determined by the A1c result.

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The nurse is caring for a female client with type 2 diabetes mellitus who exhibits confusion, light-headedness, and aberrant behavior. The client is still conscious. The nurse should first administer:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following should be included in the teaching plan for a patient receiving glargine (Lantus), "peakless" basal insulin?

Correct Answer is D

Explanation

A male client with type 1 diabetes mellitus with a hemoglobin A1c test result of 12.7%. In discussing the result with the client, the nurse would be most accurate in stating:

Correct Answer is B

Explanation

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