The nurse is teaching a group of patients about management of diabetes. Which statement about basal dosing is correct?
Basal dosing delivers a constant dose of insulin.
With basal dosing, you can eat what you want and then give yourself a dose of insulin.
Glargine insulin is given as a bolus with meals.
Basal-bolus dosing is the traditional method of managing blood glucose levels.
The Correct Answer is A
Choice A rationale: Basal dosing involves a continuous, low-level release of insulin throughout the day and night to mimic the pancreas's natural basal insulin secretion. This helps to maintain stable blood glucose levels between meals and overnight, preventing hyperglycemia. Long-acting insulins like glargine or detemir are used for this purpose.
Choice B rationale: This statement describes bolus or prandial insulin dosing, not basal dosing. Bolus insulin is administered before meals to manage the anticipated rise in blood glucose from food intake. Basal insulin provides a constant background level and does not correlate with specific meals.
Choice C rationale: Glargine is a long-acting basal insulin. It is designed to be given once or twice a day to provide a steady, continuous insulin level. Bolus insulin, such as lispro or aspart, is given with meals to cover the carbohydrate intake. Glargine should never be used as a bolus with meals due to its delayed onset and peakless profile.
Choice D rationale: Basal-bolus dosing is the modern, intensive method of managing blood glucose, not the traditional one. The traditional approach often involved fixed-dose insulin regimens. Basal-bolus therapy, which combines long-acting basal insulin with short-acting bolus insulin, is a more flexible and effective approach that more closely mimics normal pancreatic function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale: Tetany is a neuromuscular hyperexcitability disorder caused by hypocalcemia, which can be a complication of a thyroidectomy due to accidental removal or damage to the parathyroid glands. Symptoms include tingling sensations, muscle spasms, and carpopedal spasms. While a possible post-surgical complication, the client’s signs of high temperature, tachycardia, and restlessness point to a different, more severe condition.
Choice B rationale: Hypoglycemia is a state of low blood glucose, typically below 70 mg/dL. Symptoms include sweating, shakiness, confusion, and hunger. The client’s signs of a high temperature, tachycardia, and extreme restlessness are not classic symptoms of hypoglycemia. Furthermore, hypoglycemia is not typically a complication of a thyroidectomy unless the client has a pre-existing diabetic condition.
Choice C rationale: A thyroid crisis, or thyroid storm, is a life-threatening complication of hyperthyroidism that can be precipitated by surgery, particularly a thyroidectomy, in an inadequately prepared client. It is characterized by a massive release of thyroid hormones, leading to a hypermetabolic state with symptoms including extremely high fever, severe tachycardia, altered mental status, and cardiovascular collapse. The client's symptoms are classic signs of this condition.
Choice D rationale: Diabetic ketoacidosis (DKA) is a severe complication of uncontrolled diabetes mellitus characterized by hyperglycemia, metabolic acidosis, and ketone body production. Symptoms include fruity breath, abdominal pain, and Kussmaul respirations. A thyroidectomy is not a direct cause of DKA. The client’s signs and symptoms, particularly the very high temperature, are not typical of DKA.
Correct Answer is A
Explanation
Choice A rationale: Hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is characterized by extremely high blood glucose levels (often over 600 mg/dL), severe dehydration, and altered mental status. The presence of negative ketones differentiates it from diabetic ketoacidosis. The body's remaining insulin production is enough to prevent ketosis but not enough to control severe hyperglycemia.
Choice B rationale: Diabetic ketoacidosis (DKA) is a severe complication characterized by hyperglycemia, dehydration, and the presence of ketones in the blood and urine. The client's lab results in this scenario specifically state "negative ketones," which rules out DKA as the primary diagnosis. Fruity breath would also be present in DKA.
Choice C rationale: Diabetic neuropathy is a long-term complication of diabetes that affects the nerves, leading to symptoms like numbness, tingling, or pain. It is a chronic condition and does not manifest with the acute metabolic crisis of extremely high blood glucose (1000 mg/dL), dehydration, and malaise described in the scenario.
Choice D rationale: Diabetic nephropathy is a chronic complication affecting the kidneys, characterized by progressive kidney damage and eventual kidney failure. While elevated BUN can be a sign, the acute presentation with extremely high glucose and dehydration is more indicative of a life-threatening metabolic emergency like HHNS rather than chronic organ damage.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.