Insulin Administration

Chapter 15

1. Which term describes insulin that is derived from outside the human body?
2. Endogenous
3. Progenic
4. Exogenous
5. Antigenic
6. The nurse is caring for a patient with diabetes when the laboratory calls with a blood glucose value of 329 mg/dL for the client. Which term describes this finding?
7. Hypoglycemia
8. Hyperglycemia
9. Preprandial
10. Postprandial
11. From what source is human insulin produced?
12. Porcine (pork) sources
13. Bovine (beef) sources
14. Human serum
15. Recombinant DNA technology
16. Which is an example of a rapid-acting insulin?
17. Insulin lispro (Humalog)
18. Insulin glargine (Lantus)
19. NPH insulin (Humulin N)
20. Regular insulin (Novolin R)
21. A nurse suspects that her unconscious patient is experiencing hypoglycemia. The patient has a saline lock in place. Per protocol, what should the nurse do first?
22. Notify the healthcare provider.
23. Subcutaneously inject rapid-acting insulin.
24. Administer 4 ounces of fruit juice.
25. Administer 25 mL of 50% dextrose over 1 to 3 minutes.
26. A nurse is preparing a patient’s injection of 43 units NPH insulin. Which of the following syringes is the most appropriate to use for this injection?
27. 1-mL TB syringe
28. 50-unit insulin syringe
29. 3-mL syringe
30. 30-unit insulin syringe
31. A provider orders this sliding scale insulin protocol for a patient:

Administer insulin aspart (Humalog), subcut, before each meal,

based on the following blood glucose (BG) levels:

BG level less than 110 mg/dL 0 units

BG level between 111 and 150 mg/dL 2 units

BG level between 151 and 170 mg/dL 4 units

BG level between 171 and 199 mg/dL 6 units

BG level over 200 mg/dL Call provider.

The patient’s blood glucose just before breakfast is 132 mg/dL. How many units of insulin aspart (Humalog) will the nurse administer?

1. 0 units
2. 2 units
3. 4 units
4. 6 units
5. What type of syringe should the nurse choose to administer U-100 insulin?
6. U-100 insulin syringe
7. U-500 insulin syringe
8. 1 mL TB syringe
9. 3-mL syringe
10. When mixing NPH insulin with regular insulin, which of the following should the nurse draw up in the syringe first?
11. Regular insulin
12. NPH insulin
13. NPH and regular insulin should not be mixed together.
14. The order does not matter.
15. How often should the catheter site for an insulin pump be changed?
16. Daily
17. Every 3 days
18. Weekly
19. Monthly
20. What is the duration of action of long-acting insulins such as insulin glargine (Lantus) and insulin detemir (Levemir)?
21. 6 hours
22. 12 hours
23. 24 hours
24. 36 hours
25. The nurse is caring for a patient with diabetes mellitus who has pressed the nurse call complains of feeling weak, dizzy, and sweaty. Upon checking a finger stick glucose, the nurse notes the reading is 56 mg/dL. What should the nurse do first?
26. Administer glucagon 1 mg intramuscularly.
27. Administer the client’s usual dose of glargine insulin (Lantus).
28. Administer 25 mL of 50% dextrose solution intravenously over 1 to 3 minutes.
29. Administer 4 ounces of fruit juice to the patient.
30. The nurse has just administered glucagon 1 mg intramuscularly to a patient with a finger stick glucose of 32 mg/dL. The patient is unconscious and does not have IV access. What should the nurse do next?
31. Notify the healthcare provider.
32. Turn the patient to the lateral position.
33. Elevate the head of the patient’s bed to 90 degrees.
34. Recheck the patient’s finger stick glucose.
35. Place the steps of mixing NPH and regular insulin in the correct order.
36. Inject air into the regular insulin vial.
37. Clean the rubber stoppers of both vials with separate alcohol wipes.
38. Withdraw the ordered amount of insulin from the NPH vial.
39. Inject air into the NPH insulin vial.
40. Withdraw the ordered amount of insulin from the regular insulin vial.
41. The nurse is admitting a client with type 1 diabetes mellitus to the medical-surgical unit. From the list of healthcare provider orders below, which ones should the nurse question? Select all that apply.
42. Fill the insulin pump with glargine (Lantus) insulin.
43. Place the client on a sliding scale for bolus insulin from the pump.
44. Administer Glucophage (metformin) 500 mg before breakfast and supper.
45. Check a finger stick glucose before meals and at bedtime.
46. Change the insulin pump tubing site every 3 days.
47. The nurse is preparing to administer Lantus insulin 36 units. Mark the syringe below at the correct dosage.

1. The nurse has mixed NPH insulin 28 units plus regular insulin 7 units in a syringe as ordered. Which syringe pictured contains the ordered amount?
2. Syringe 1

1. Syringe 2

1. Syringe 3

1. Syringe 4

1. How many units of insulin does the syringe below contain?

1. 22 units
2. 24 units
3. 21 units
4. 19 units
5. The nurse has received an order to mix regular insulin 9 units with NPH insulin 15 units. Mark the syringe pictured with the final amount of insulin that the nurse will correctly administer.

1. How many units of insulin does the syringe below contain?

1. .72 unit
2. 71 units
3. 72 units
4. 0.72 mL