The nurse is teaching a client with type 1 diabetes mellitus about the onset, peak, and duration of a new prescription for glargine insulin. If the insulin is self administered at 0800, when is the client most likely to experience hypoglycemia?

Midmorning

Shortly after midnight

No peak occurs.

Midafternoon.

Answer and Explanation

The Correct Answer is C

A. Midmorning: Short-acting and some intermediate-acting insulins peak during midmorning, but glargine insulin is long-acting and designed to provide a steady level of insulin without a pronounced peak, making midmorning hypoglycemia unlikely.

B. Shortly after midnight: Although nighttime hypoglycemia can occur with other types of insulin, glargine releases slowly over 24 hours, maintaining a relatively flat serum insulin concentration and reducing the risk of nocturnal hypoglycemia.

C. No peak occurs: Glargine insulin is formulated to have no pronounced peak, instead providing a continuous, steady release over approximately 24 hours. This flat profile minimizes the risk of sudden hypoglycemic episodes associated with peak insulin levels.

D. Midafternoon: Hypoglycemia during midafternoon is more characteristic of short-acting or intermediate-acting insulins, not glargine. Since glargine has a steady release, it does not typically cause time-specific hypoglycemia like shorter-acting insulins do.

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Correct Answer is A

Explanation

A. Report the finding to the healthcare provider: Yellow discoloration of the skin, or jaundice, suggests possible liver dysfunction, which can occur with acetaminophen toxicity, especially if taken chronically or in high doses. Promptly reporting this finding is crucial so that further evaluation and intervention can be initiated to prevent worsening liver injury.

B. Check the client's capillary glucose level: Although liver dysfunction can eventually affect glucose metabolism, checking a capillary glucose level does not directly address the urgent concern of jaundice and potential hepatotoxicity related to acetaminophen use.

C. Advise the client to reduce the medication dose: Simply advising dose reduction without proper evaluation could delay diagnosis and treatment of potentially serious liver damage. A healthcare provider needs to assess the situation before any medication changes are made.

D. Use a pulse oximeter to assess oxygen saturation: Oxygen saturation monitoring is essential for respiratory or cardiac concerns but does not directly relate to jaundice or liver function. Therefore, it would not be the appropriate first action in this situation.

A. Absence of xerostomia. B. Denies stress incontinence. C. Urinary output equals intake. D. No terminal urinary dribbling.

Correct Answer is C

Explanation

A. Absence of xerostomia: Bethanechol, a cholinergic agonist, can stimulate salivary secretions and reduce dry mouth (xerostomia), but its primary therapeutic use in urinary retention focuses on improving bladder emptying rather than treating oral dryness. Thus, this is not the best indicator of its effectiveness for urinary issues.

B. Denies stress incontinence: Stress incontinence is unrelated to the mechanism of bethanechol, which promotes bladder contraction to facilitate complete emptying. Denying stress incontinence does not necessarily confirm that urinary retention has been resolved.

C. Urinary output equals intake: Bethanechol stimulates the detrusor muscle of the bladder, enhancing its contraction and promoting urination. When urinary output matches intake, it indicates that the bladder is emptying properly, reflecting the medication’s intended therapeutic effect in managing urinary retention.

D. No terminal urinary dribbling: Absence of dribbling may suggest better bladder control, but it does not directly confirm the resolution of urinary retention. Complete and regular bladder emptying, indicated by output equaling intake, is a more accurate measure of effective treatment.

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The nurse is teaching a client with type 1 diabetes mellitus about the onset, peak, and duration of a new prescription for glargine insulin. If the insulin is self administered at 0800, when is the client most likely to experience hypoglycemia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While assessing a client who takes acetaminophen for chronic pain, the nurse observes that the client's skin looks yellow in color. Which action should the nurse take in response to this finding?

Correct Answer is A

Explanation

Which assessment finding indicates to the nurse that the prescription bethanechol is effective for a client diagnosed with urinary retention?

Correct Answer is C

Explanation

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