NCLEX PN Exam Practice Test Practice Question

Scenario/Extract:

Medication administration record
Allergies: No known allergies
Sliding-Scale Blood Glucose Levels Regular Insulin Dose
<150 mg/dL (<8.3 mmol/L) 0 units
150-199 mg/dL (8.3-11.0 mmol/L) 3 units
200-249 mg/dL (11.1-13.8 mmol/L) 6 units
250-299 mg/dL (13.9-16.6 mmol/L) 9 units
300-349 mg/dL (16.7-19.4 mmol/L) 12 units
>350 mg/dL (>19.4 mmol/L) 15 units and notify the health care provider

A client with type 1 diabetes has a prescription for 20 units of NPH insulin daily at 7:30 AM and regular insulin before meals, based on a sliding scale. At 7:00 AM, the client's blood glucose level is 220 mg/dL (12.2 mmol/L), and the client's breakfast tray has arrived. What action should the nurse take?

Correct Answer: D

Rationale: Regular insulin is drawn up first to prevent NPH contamination, and both can be mixed in one syringe for a blood glucose of 220 mg/dL, assuming a sliding scale of 6 units. Administering after the meal or using separate injections is incorrect.

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