The patient was taking metformin before this hospitalization.
To facilitate better glucose control, the patient has been switched to insulin therapy while hospitalized.

The patient asks the nurse why it is so important to time meals with the insulin injection and to give him an example of a long-acting insulin.

The nurse will tell the patient that an example of a long-acting insulin is:

Choice A rationale

Valerian is a sedative herb used to treat insomnia and anxiety. It promotes sleep and has a calming effect on the central nervous system. Therefore, insomnia is the opposite of its intended therapeutic effect and would not be considered an adverse effect.

Choice B rationale

Valerian is not typically associated with causing jaundice or yellow skin. Yellow skin is a symptom of liver dysfunction, which is more commonly associated with certain other herbal supplements. While rare, liver injury is possible with valerian.

Choice C rationale

Valerian may affect blood clotting and can increase the risk of bleeding. This can manifest as bruising or an increased propensity for bleeding. Patients taking anticoagulants or antiplatelet drugs should be cautioned about this potential interaction.

Choice D rationale

Valerian is used as a sleep aid and sedative. It does not typically increase appetite. Increased appetite is more often associated with certain psychotropic medications or medical conditions, and it is not a known adverse effect of valerian.

Choice A rationale

Metoprolol is a beta-blocker used for long-term management of angina by reducing myocardial oxygen demand. It is not suitable for immediate relief of an acute anginal attack because its onset of action is slower than that required for rapid symptom resolution.

Choice B rationale

Nitroglycerin is a potent vasodilator that is the preferred medication for immediate relief of acute angina. It works by relaxing vascular smooth muscle, primarily in the veins, leading to a reduction in preload and myocardial oxygen demand, and also dilating coronary arteries.

Choice C rationale

Amlodipine is a long-acting calcium channel blocker used for the prevention of angina. It is not used for acute attacks because its primary effect is on chronic vasodilation and reduction of afterload, and it does not have a rapid onset of action suitable for immediate relief.

Choice D rationale

Aspirin is an antiplatelet agent used to prevent myocardial infarction in patients with coronary artery disease. While it is often administered during a suspected heart attack to reduce clot formation, it does not provide immediate symptomatic relief of anginal pain.