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 B

Explanation

A. Trouble sleeping: Sleep disturbances are not a major concern before administering pyridostigmine. Although insomnia can occur with many medications, it is not directly impacted by pyridostigmine, nor does it influence the decision to give the drug safely.

B. Recent oral intake: Pyridostigmine should be given on a consistent schedule relative to meals to optimize absorption and minimize gastrointestinal side effects. Additionally, coordinating dosing with food can help maximize muscle strength for chewing and swallowing, critical concerns in myasthenia gravis.

C. Unexplained weight loss: While significant weight loss could suggest disease progression or nutritional problems, it is not immediately relevant to the safe administration of pyridostigmine. Monitoring weight is important long-term but does not alter short-term dosing considerations.

D. Difficulty with urination: Pyridostigmine can affect smooth muscle function, including the bladder, but urinary issues are not the primary focus prior to administration. Ensuring safe medication absorption and effectiveness related to food intake is more critical immediately before dosing.

A. Use a stool softener as needed. B. Discontinue when spasms cease. C. Avoid the ingestion of alcohol. D. Take medication with meals.

Correct Answer is B

Explanation

A. Use a stool softener as needed: Baclofen can cause constipation as a side effect due to its muscle-relaxant properties. Using a stool softener as needed is an appropriate and safe strategy to manage this potential issue without needing additional instruction.

B. Discontinue when spasms cease: Baclofen should not be abruptly discontinued because sudden withdrawal can lead to serious complications such as seizures, hallucinations, or rebound spasticity. Clients must be taught to taper the medication gradually under healthcare provider supervision.

C. Avoid the ingestion of alcohol: Alcohol can potentiate the central nervous system depressant effects of baclofen, increasing the risk of sedation, dizziness, and respiratory depression. Clients should be advised to avoid alcohol while on this medication.

D. Take medication with meals: Taking baclofen with meals helps reduce gastrointestinal upset, such as nausea, which can occur with muscle relaxants. This practice is appropriate and does not require additional instruction.

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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

A client with myasthenia gravis receives a new prescription for pyridostigmine. Which information should the nurse obtain to prior to administering the medication?

Correct Answer is B

Explanation

A client with muscle spasticity receives a prescription for baclofen. Which information provided by the client requires additional instruction by the nurse?

Correct Answer is B

Explanation

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