NUR 243 ACTUAL EXAM 3 | WITH COMPLETE QUESTIONS AND ANSWERS |
2025/206 LATEST UPDATED | 100 % RATED AND VERIFIED SOLUTIONS | GET
AN A+
A patient who has type 2 diabetes has a glycated hemoglobin A1c (HbA1c) of 10%. The nurse should make which
change to the nursing care plan?
Refer the patient to a diabetes educator because the result reflects poor glycemic control.
Glycemic control is adequate; no changes are needed.
Hypoglycemia is a risk; teach the patient the symptoms.
Instruct the patient to limit activity and weekly exercise. - (answers)Refer the patient to a diabetes educator because the
result reflects poor glycemic control.
A patient who has type 2 diabetes is taking nateglinide [Starlix]. Which response should a nurse expect the patient to
have if the medication is achieving the desired therapeutic effect?
Inhibition of carbohydrate digestion
Promotion of insulin secretion
Decreased insulin resistance
Inhibition of ketone formation - (answers)Promotion of insulin secretion
,Nateglinide is a meglitinide medication that acts to increase pancreatic insulin release. It is used as an adjunct to calorie
restriction and exercise to maintain glycemic control in patients with type 2 diabetes. It does not act to reduce insulin
resistance or inhibit carbohydrate digestion. It should not be used to manage diabetic ketone formation, because its
glucose-lowering effects are too slow to be of benefit.
Which instruction should the nurse provide when teaching a patient to mix regular insulin and NPH insulin in the same
syringe?
"Draw up the clear regular insulin first, followed by the cloudy NPH insulin."
"It is not necessary to rotate the NPH insulin vial when it is mixed with regular insulin."
"The order of drawing up insulin does not matter as long as the insulin is refrigerated."
"Rotate subcutaneous injection sites each day among the arm, thigh, and abdomen." - (answers)"Draw up the clear
regular insulin first, followed by the cloudy NPH insulin."
To ensure a consistent response, only NPH insulin is appropriate for mixing with a short-acting insulin. Unopened vials
of insulin should be refrigerated; current vials can be kept at room temperature for up to 1 month. Drawing up the regular
insulin into the syringe first prevents accidental mixture of NPH insulin into the vial of regular insulin, which could alter
the pharmacokinetics of subsequent doses taken out of the regular insulin vial. NPH insulin is a cloudy solution, and it
should always be rotated gently to disperse the particles evenly before loading the syringe. Subcutaneous injections
should be made using one region of the body (eg, the abdomen or thigh) and rotated within that region for 1 month.
,A patient is scheduled to start taking insulin glargine [Lantus]. On the care plan, a nurse should include which of these
outcomes related to the therapeutic effects of the medication?
Blood glucose control for 24 hours
Mealtime coverage of blood glucose
Less frequent blood glucose monitoring
Peak effect achieved in 2 to 4 hours - (answers)Blood glucose control for 24 hours
Insulin glargine is administered as a once-daily subcutaneous injection for patients with type 1 diabetes. It is used for
basal insulin coverage, not mealtime coverage. It has a prolonged duration, up to 24 hours, with no peaks. Blood glucose
monitoring is still an essential component to achieve tight glycemic control.
A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700. Which action should the nurse
take?
Take the patient's blood pressure.
Give the patient's PRN dose of insulin.
Check the patient's capillary blood sugar.
Advise the patient to lie down with the legs elevated. - (answers)Check the patient's capillary blood sugar.
, The patient is showing symptoms of hypoglycemia at 5:00 PM. NPH has a peak action of 8 to 10 hours after
administration. Based on the duration of action of NPH insulin, the patient's hypoglycemic symptoms are from the 8:00
AM injection of NPH insulin. An injection of NPH insulin at 2:00 AM, 1:00 PM, or 3:00 PM would not cause
hypoglycemic symptoms based on the average duration of action of NPH insulin.
A teaching plan for a patient who is taking lispro [Humalog] should include which instruction by the nurse?
"Inject this insulin with your first bite of food, because it is very fast acting."
"The duration of action for this insulin is about 8 to 10 hours, so you'll need a snack."
"This insulin needs to be mixed with regular insulin to enhance the effects."
"To achieve tight glycemic control, this is the only type of insulin you'll need." - (answers)"Inject this insulin with your
first bite of food, because it is very fast acting."
Lispro is a rapid-acting insulin and has an onset of action of 15 to 30 minutes with a peak action of about 2 hours, not 8
to 10 hours. Because of its rapid onset, it is administered immediately before a meal or with meals to control the blood
glucose rise after meals. Lispro insulin must be combined with an intermediate- or a long-acting insulin, not regular
insulin (which also is a short-duration insulin), for glucose control between meals and at night. To achieve tight glycemic
control, patients must combine different types of insulin based on their duration of action
A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin normally work in my body?" The nurse
explains that normal insulin has which action in the body?
2025/206 LATEST UPDATED | 100 % RATED AND VERIFIED SOLUTIONS | GET
AN A+
A patient who has type 2 diabetes has a glycated hemoglobin A1c (HbA1c) of 10%. The nurse should make which
change to the nursing care plan?
Refer the patient to a diabetes educator because the result reflects poor glycemic control.
Glycemic control is adequate; no changes are needed.
Hypoglycemia is a risk; teach the patient the symptoms.
Instruct the patient to limit activity and weekly exercise. - (answers)Refer the patient to a diabetes educator because the
result reflects poor glycemic control.
A patient who has type 2 diabetes is taking nateglinide [Starlix]. Which response should a nurse expect the patient to
have if the medication is achieving the desired therapeutic effect?
Inhibition of carbohydrate digestion
Promotion of insulin secretion
Decreased insulin resistance
Inhibition of ketone formation - (answers)Promotion of insulin secretion
,Nateglinide is a meglitinide medication that acts to increase pancreatic insulin release. It is used as an adjunct to calorie
restriction and exercise to maintain glycemic control in patients with type 2 diabetes. It does not act to reduce insulin
resistance or inhibit carbohydrate digestion. It should not be used to manage diabetic ketone formation, because its
glucose-lowering effects are too slow to be of benefit.
Which instruction should the nurse provide when teaching a patient to mix regular insulin and NPH insulin in the same
syringe?
"Draw up the clear regular insulin first, followed by the cloudy NPH insulin."
"It is not necessary to rotate the NPH insulin vial when it is mixed with regular insulin."
"The order of drawing up insulin does not matter as long as the insulin is refrigerated."
"Rotate subcutaneous injection sites each day among the arm, thigh, and abdomen." - (answers)"Draw up the clear
regular insulin first, followed by the cloudy NPH insulin."
To ensure a consistent response, only NPH insulin is appropriate for mixing with a short-acting insulin. Unopened vials
of insulin should be refrigerated; current vials can be kept at room temperature for up to 1 month. Drawing up the regular
insulin into the syringe first prevents accidental mixture of NPH insulin into the vial of regular insulin, which could alter
the pharmacokinetics of subsequent doses taken out of the regular insulin vial. NPH insulin is a cloudy solution, and it
should always be rotated gently to disperse the particles evenly before loading the syringe. Subcutaneous injections
should be made using one region of the body (eg, the abdomen or thigh) and rotated within that region for 1 month.
,A patient is scheduled to start taking insulin glargine [Lantus]. On the care plan, a nurse should include which of these
outcomes related to the therapeutic effects of the medication?
Blood glucose control for 24 hours
Mealtime coverage of blood glucose
Less frequent blood glucose monitoring
Peak effect achieved in 2 to 4 hours - (answers)Blood glucose control for 24 hours
Insulin glargine is administered as a once-daily subcutaneous injection for patients with type 1 diabetes. It is used for
basal insulin coverage, not mealtime coverage. It has a prolonged duration, up to 24 hours, with no peaks. Blood glucose
monitoring is still an essential component to achieve tight glycemic control.
A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700. Which action should the nurse
take?
Take the patient's blood pressure.
Give the patient's PRN dose of insulin.
Check the patient's capillary blood sugar.
Advise the patient to lie down with the legs elevated. - (answers)Check the patient's capillary blood sugar.
, The patient is showing symptoms of hypoglycemia at 5:00 PM. NPH has a peak action of 8 to 10 hours after
administration. Based on the duration of action of NPH insulin, the patient's hypoglycemic symptoms are from the 8:00
AM injection of NPH insulin. An injection of NPH insulin at 2:00 AM, 1:00 PM, or 3:00 PM would not cause
hypoglycemic symptoms based on the average duration of action of NPH insulin.
A teaching plan for a patient who is taking lispro [Humalog] should include which instruction by the nurse?
"Inject this insulin with your first bite of food, because it is very fast acting."
"The duration of action for this insulin is about 8 to 10 hours, so you'll need a snack."
"This insulin needs to be mixed with regular insulin to enhance the effects."
"To achieve tight glycemic control, this is the only type of insulin you'll need." - (answers)"Inject this insulin with your
first bite of food, because it is very fast acting."
Lispro is a rapid-acting insulin and has an onset of action of 15 to 30 minutes with a peak action of about 2 hours, not 8
to 10 hours. Because of its rapid onset, it is administered immediately before a meal or with meals to control the blood
glucose rise after meals. Lispro insulin must be combined with an intermediate- or a long-acting insulin, not regular
insulin (which also is a short-duration insulin), for glucose control between meals and at night. To achieve tight glycemic
control, patients must combine different types of insulin based on their duration of action
A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin normally work in my body?" The nurse
explains that normal insulin has which action in the body?
