LPN Diabetes Care: Glucose and Insulin 2 — Questions and Answers
Question 1: A patient with type 2 diabetes has a fasting blood glucose of 58 mg/dL and reports feeling shaky and sweating. What is the LPN's priority action?
- Give 15 g of fast-acting carbohydrate and recheck glucose in 15 minutes (Correct answer)
- Administer scheduled insulin dose immediately
- Call the physician before giving anything by mouth
- Offer a full meal and recheck glucose in one hour
Correct answer: Give 15 g of fast-acting carbohydrate and recheck glucose in 15 minutes
The 15-15 rule—15 g rapid carbohydrate, recheck in 15 minutes—is the standard first-line treatment for mild-to-moderate hypoglycemia in a conscious patient.
Question 2: Insulin glargine (Lantus) is prescribed for a diabetic patient. Which statement about this insulin is correct?
- It has a peak action at 4–6 hours after injection
- It should never be mixed with other insulins in the same syringe (Correct answer)
- It is the preferred insulin for treating acute hypoglycemia
- It must be administered 30 minutes before meals
Correct answer: It should never be mixed with other insulins in the same syringe
Glargine is a peakless, long-acting basal insulin whose acidic pH makes it incompatible for mixing with other insulins.
Question 3: Which injection site allows the fastest absorption of subcutaneous insulin?
- Abdomen (Correct answer)
- Outer thigh
- Upper arm
- Buttocks
Correct answer: Abdomen
The abdomen provides the fastest and most consistent insulin absorption due to its rich subcutaneous blood supply.
Question 4: A nurse is teaching a patient how to store an opened vial of regular insulin. Which instruction is correct?
- Keep it at room temperature for up to 28–30 days (Correct answer)
- Refrigerate immediately after every use
- Discard after 7 days once opened
- Freeze to extend shelf life beyond the expiration date
Correct answer: Keep it at room temperature for up to 28–30 days
An opened vial of most insulins can safely remain at room temperature (below 77°F) for up to 28–30 days; freezing destroys insulin.
Question 5: A patient on NPH insulin asks why their glucose tends to drop around 2–4 AM. What is the best explanation?
- NPH peaks 6–12 hours after injection, coinciding with nighttime if given at dinner (Correct answer)
- Nighttime exercise increases insulin sensitivity
- Liver glycogen is depleted during sleep
- Basal metabolic rate drops to zero during deep sleep
Correct answer: NPH peaks 6–12 hours after injection, coinciding with nighttime if given at dinner
NPH peaks at 6–12 hours; an evening dose peaks in the early morning hours, which can cause nocturnal hypoglycemia.
Question 6: Which of the following is a sign of hyperglycemia that an LPN should report to the supervising nurse or physician?
- Polyuria, polydipsia, and blurred vision (Correct answer)
- Diaphoresis, tremors, and pallor
- Bradycardia and hypotension
- Pinpoint pupils and bradypnea
Correct answer: Polyuria, polydipsia, and blurred vision
Classic hyperglycemia symptoms are the three polys—polyuria, polydipsia, polyphagia—plus fatigue and blurred vision; the other options suggest hypoglycemia or unrelated conditions.
Question 7: When drawing up a combined dose of regular and NPH insulin, in which order should the nurse proceed?
- Inject air into NPH vial, then regular; draw regular first, then NPH (Correct answer)
- Draw NPH first, then add regular to the same syringe
- Mix them in a separate cup before drawing into the syringe
- Inject air into regular vial, then NPH; draw NPH first, then regular
Correct answer: Inject air into NPH vial, then regular; draw regular first, then NPH
The mnemonic 'clear before cloudy' means draw clear (regular) insulin first to prevent contaminating it with NPH.
LPN Diabetes Care: Glucose and Insulin 2
A patient with type 2 diabetes has a fasting blood glucose of 58 mg/dL and reports feeling shaky and sweating.
What is the LPN's priority action?