The patient's meal has been delivered, the nurse checks the patient's pre-meal blood sugar, and the result is 243 mg/dL. The patient is awake, alert, hungry, and able to swallow.
The next step the nurse should take is:

Choice A rationale

Biologic response modifiers are primarily used for autoimmune diseases like rheumatoid arthritis due to their ability to target specific components of the immune system. They are not standard for osteoarthritis, as OA is a degenerative joint disease without a significant autoimmune component. These treatments do not address the inflammation or pain related to OA effectively.

Choice B rationale

Opiates are used for severe, short-term pain management but carry risks such as addiction and tolerance. They do not address the underlying inflammation in osteoarthritis. Long-term use is generally avoided for OA as safer options like NSAIDs are more effective for managing chronic symptoms without these risks.

Choice C rationale

Disease-Modifying Antirheumatic Drugs (DMARDs) are more effective for autoimmune conditions like rheumatoid arthritis, not osteoarthritis. OA lacks the autoimmune pathology targeted by DMARDs, making them unsuitable for managing OA symptoms like pain or stiffness.

Choice D rationale

NSAIDs are the first-line therapy for OA as they effectively reduce both inflammation and pain associated with the condition. By inhibiting cyclooxygenase enzymes, NSAIDs decrease prostaglandin production, leading to improved joint function and symptom control, making them the most common choice for OA symptom management.

Choice A rationale

Mixing insulin glargine and lispro in the same syringe is contraindicated due to their incompatible chemical formulations. Glargine’s acidic pH alters lispro’s effectiveness when mixed, impairing glycemic control. Separate administration preserves their individual pharmacokinetics and therapeutic actions.

Choice B rationale

Separate injections ensure each insulin maintains its unique action profile. Glargine provides basal control, while lispro manages rapid postprandial spikes. Their chemical incompatibility mandates separate administration, optimizing glycemic management and reducing potential adverse effects from mixed formulations.