a 32 year old patient with diabetes is starting on intensive insulin therapy which type of insulin will the nurse discuss using for mealtime coverage

ATI RN

ATI Leadership

1. A 32-year-old patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?

A. Lispro (Humalog)
B. Glargine (Lantus)
C. Detemir (Levemir)
D. NPH (Humulin N)

Correct answer: A

Rationale: For mealtime coverage in intensive insulin therapy, rapid-acting insulins like Lispro (Humalog) are used. Lispro has a quick onset of action, making it suitable for covering the rise in blood sugar levels after meals. Glargine (Lantus), Detemir (Levemir), and NPH (Humulin N) are all long-acting insulins and are not appropriate for mealtime coverage as they do not act quickly enough to manage postprandial glucose spikes.

2. What is the main focus of a clinical governance framework?

A. Financial performance
B. Regulatory compliance
C. Patient care quality
D. Staff satisfaction

Correct answer: C

Rationale: The main focus of a clinical governance framework is patient care quality. This framework is designed to ensure that patient care is safe, effective, and patient-centered. Choice A, financial performance, is not the main focus of a clinical governance framework, although financial aspects may be considered. Choice B, regulatory compliance, is important but not the primary focus of a clinical governance framework. Choice D, staff satisfaction, is also important but is not the main focus of a clinical governance framework, which primarily centers around patient care quality.

3. An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to

A. give a bolus of 50% dextrose.
B. insert a large-bore IV catheter.
C. initiate oxygen via nasal cannula.
D. administer glargine (Lantus) insulin.

Correct answer: B

Rationale: In a patient with hyperosmolar hyperglycemic syndrome (HHS), severe dehydration and electrolyte imbalances are common. To address these issues, the priority intervention is to insert a large-bore IV catheter for fluid resuscitation and electrolyte replacement. Giving a bolus of 50% dextrose would worsen the hyperglycemia. Initiating oxygen via nasal cannula may be beneficial for respiratory support but is not the priority in this scenario. Administering glargine (Lantus) insulin is not the initial treatment for HHS as it does not address the underlying severe dehydration and electrolyte imbalances.

4. Which of the following is an example of an ethical dilemma in nursing?

A. Choosing between two equally undesirable alternatives
B. Reporting a colleague's unethical behavior
C. Balancing patient confidentiality with the need to disclose information
D. Deciding whether to comply with a patient's request that conflicts with professional ethics

Correct answer: D

Rationale: The correct answer is D. An ethical dilemma in nursing involves deciding whether to comply with a patient's request that conflicts with professional ethics, balancing competing values and principles. Choices A, B, and C do not directly represent ethical dilemmas in nursing. Choice A describes a general ethical dilemma, choice B involves professional conduct rather than a dilemma, and choice C refers to a confidentiality issue rather than conflicting ethical principles.

5. Which statement to a patient newly diagnosed with type 2 diabetes is correct?

A. Complications of type 2 diabetes are less serious than those of type 1 diabetes.
B. Insulin is not used to control blood glucose in patients with type 2 diabetes.
C. Changes in diet and exercise may control blood glucose levels in type 2 diabetes.
D. Type 2 diabetes is usually diagnosed when the patient is admitted with a hyperglycemic coma.

Correct answer: C

Rationale: Choice C is the correct statement to convey to a patient newly diagnosed with type 2 diabetes. Lifestyle modifications, such as changes in diet and exercise, are essential components of managing type 2 diabetes. These changes can help control blood glucose levels and improve overall health. Options A, B, and D are incorrect statements. While complications of type 2 diabetes can be serious, they are different from those of type 1 diabetes. Some patients with type 2 diabetes may require insulin therapy, but it is not true that insulin is not used at all. Type 2 diabetes is not typically diagnosed during a hyperglycemic coma, as it is usually identified through routine screenings or symptoms unrelated to a coma.