Free LPN Diabetes Care: Glucose and Insulin Questions and Answers — Questions and Answers
Question 1: An LPN is preparing to administer a mixture of regular insulin and NPH insulin. What is the correct procedure for drawing up the insulins?
- Draw up the NPH insulin, then the regular insulin in the same syringe.
- Draw up the regular insulin, then the NPH insulin in the same syringe. (Correct answer)
- Use two separate syringes for the injections.
- Draw up the NPH insulin, clear the air bubbles, then add the regular insulin.
Correct answer: Draw up the regular insulin, then the NPH insulin in the same syringe.
When mixing insulins, the clear (short-acting, like Regular) insulin should be drawn up before the cloudy (intermediate-acting, like NPH) insulin. This prevents contaminating the short-acting insulin vial with the intermediate-acting insulin. The mnemonic 'clear before cloudy' is helpful.
Question 2: A client with type 1 diabetes reports feeling shaky, dizzy, and diaphoretic. The LPN checks the client's blood glucose, which is 58 mg/dL. The client is conscious and able to swallow. What is the LPN's priority action?
- Administer the client's scheduled dose of long-acting insulin.
- Provide the client with 4 oz of orange juice. (Correct answer)
- Give the client a protein bar and a glass of milk.
- Notify the registered nurse (RN) immediately without taking action.
Correct answer: Provide the client with 4 oz of orange juice.
The client is experiencing hypoglycemia. The priority for a conscious client is to provide a fast-acting carbohydrate to raise blood glucose levels quickly. The 'rule of 15' suggests giving 15 grams of a simple carbohydrate, such as 4 oz (120 mL) of juice or regular soda, and rechecking blood glucose in 15 minutes.
Question 3: When reinforcing teaching about insulin injection site rotation, what is the best instruction for the LPN to provide?
- Use the same injection spot for every dose.
- Alternate between the right and left arm for each injection.
- Rotate sites within one area before moving to a new area. (Correct answer)
- Only use the abdomen for insulin injections.
Correct answer: Rotate sites within one area before moving to a new area.
To ensure consistent insulin absorption and prevent lipodystrophy (changes in subcutaneous fat), clients should rotate injection sites within one anatomical area (e.g., the abdomen) for about a week before moving to a new area (e.g., the thigh). Using the same exact spot repeatedly can cause tissue damage.
Question 4: A client is prescribed rapid-acting insulin (lispro) on a sliding scale to be administered before meals. The LPN should administer the insulin at what time?
- 30 to 60 minutes before the meal
- At the same time each day, regardless of meals
- Immediately after finishing the meal
- No more than 15 minutes before the meal begins (Correct answer)
Correct answer: No more than 15 minutes before the meal begins
Rapid-acting insulins, like lispro, aspart, and glulisine, have a very fast onset of action (10-15 minutes). They should be administered shortly before meals (within 15 minutes) to coincide with the rise in blood glucose from food intake.
Question 5: An LPN is obtaining a capillary blood glucose sample from a client's fingertip. Which technique is correct?
- Puncture the center of the fingertip pad.
- Milk the finger vigorously before the puncture.
- Puncture the side of the fingertip. (Correct answer)
- Use the first drop of blood for the reading.
Correct answer: Puncture the side of the fingertip.
The sides of the fingertips have fewer nerve endings and are more vascular than the center pad, making the puncture less painful and yielding a better blood sample. The first drop of blood should be wiped away as it may be contaminated with tissue fluid.
Question 6: Which statement accurately describes the action of long-acting insulin, such as insulin glargine?
- It has a rapid onset and a peak action in 1-2 hours.
- It must be administered 30 minutes before each meal.
- It provides a steady level of insulin with no significant peak. (Correct answer)
- It is cloudy in appearance and must be gently rolled before use.
Correct answer: It provides a steady level of insulin with no significant peak.
Long-acting insulins (glargine, detemir) are designed to provide a steady, continuous level of insulin over a 24-hour period. They do not have a pronounced peak, which reduces the risk of hypoglycemia between meals and overnight. This mimics the basal insulin secretion of a healthy pancreas.
Question 7: A client with diabetes mellitus is being discharged. The LPN reinforces teaching about the signs of hyperglycemia. Which symptom should the client be taught to report?
- Shakiness and sweating
- Cool, clammy skin
- Increased thirst and frequent urination (Correct answer)
- Sudden confusion and headache
Correct answer: Increased thirst and frequent urination
The classic symptoms of hyperglycemia are the '3 Ps': Polydipsia (excessive thirst), Polyuria (excessive urination), and Polyphagia (excessive hunger). These occur as the body tries to get rid of excess glucose through the urine, leading to dehydration and thirst.
Free LPN Diabetes Care: Glucose and Insulin Questions and Answers
An LPN is preparing to administer a mixture of regular insulin and NPH insulin.
What is the correct procedure for drawing up the insulins?