LPN Diabetes Care: Glucose and Insulin 5

Question 1

A patient on insulin therapy reports eating extra food to prevent hypoglycemia. What is the most important education point the nurse should address?

Accepted Answer

Extra food raises blood glucose and weight without preventing hypoglycemia caused by excess insulin

Answer

Snacking before exercise is always appropriate and should be encouraged freely

Answer

Carbohydrate counting is not necessary for patients on basal insulin alone

Answer

The patient should simply reduce the insulin dose without provider guidance

Question 2

A nurse is assessing insulin injection sites on a patient who always injects in the same spot. What complication should the nurse look for?

Accepted Answer

Lipohypertrophy—a lumpy, fatty buildup that impairs insulin absorption

Answer

Lipoatrophy only occurs with older animal-derived insulins, so it is not a concern

Answer

Bruising alone is the only expected complication of repeated injections

Answer

Scar tissue at the injection site increases insulin absorption

Question 3

Which statement correctly describes the relationship between exercise and blood glucose in a patient with type 1 diabetes?

Accepted Answer

Exercise generally lowers blood glucose but can cause hyperglycemia if the patient is insulin-deficient at the time of exercise

Answer

Exercise always lowers blood glucose, so insulin doses should be doubled on active days

Answer

Exercise has no significant effect on blood glucose in type 1 diabetes

Answer

Only aerobic exercise affects blood glucose; resistance training does not

Question 4

A newly diagnosed diabetic patient asks why the provider ordered both insulin glargine at bedtime and insulin aspart with meals. What is the best explanation?

Accepted Answer

Glargine covers background insulin needs 24 hours a day, while aspart controls the glucose spike that occurs after eating

Answer

Glargine is given at bedtime because it only works during sleep

Answer

Aspart is a long-acting insulin that keeps glucose stable between meals

Answer

The two insulins are interchangeable; this regimen doubles the safety margin

Question 5

Which of the following patients is at highest risk for hyperosmolar hyperglycemic state (HHS)?

Accepted Answer

An elderly patient with type 2 diabetes who develops pneumonia and reduced oral intake

Answer

A 16-year-old with type 1 diabetes who skips a meal

Answer

A type 2 diabetic patient on metformin with a fasting glucose of 140 mg/dL

Answer

A pregnant patient with gestational diabetes on diet control alone

Question 6

A patient's blood glucose before lunch is 245 mg/dL. The sliding scale orders 4 units of regular insulin for glucose 201–250 mg/dL. The patient also has a scheduled mealtime dose of 8 units of regular insulin. What total dose should the LPN prepare?

Accepted Answer

12 units (8 scheduled + 4 correction)

Answer

4 units (correction dose only; skip scheduled dose when glucose is high)

Answer

8 units (scheduled dose only; never add correction at mealtime)

Answer

16 units (double the scheduled dose when glucose exceeds 200)

Question 7

A patient with diabetes and chronic kidney disease (CKD) stage 4 is at increased risk for which insulin-related problem?

Accepted Answer

Prolonged hypoglycemia because the kidneys normally degrade insulin and this capacity is reduced

Answer

Insulin resistance requiring higher doses due to uremic toxins

Answer

Rapid insulin clearance leading to frequent hyperglycemia

Answer

No change in insulin pharmacokinetics with CKD