A patient is prescribed long-acting insulin (glargine) for basal control of blood glucose. Which statement by the nurse is correct when educating the patient?
"This insulin peaks in 2-4 hours."
"You will need to take this insulin with your meals."
"This insulin provides a steady level of insulin over 24 hours."
"You will need to administer this insulin three times a day."
The Correct Answer is C
A. This insulin does not peak like short-acting insulin; glargine provides a consistent release of insulin without a peak effect.
B. Long-acting insulin is not meant to be taken with meals, as it provides basal control and is typically taken once daily, not with each meal.
C. This statement is correct; glargine provides a steady level of insulin over 24 hours, helping to maintain consistent blood glucose levels throughout the day and night.
D. Long-acting insulin is usually administered once daily, so stating that it must be given three times a day is incorrect.
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Correct Answer is D
Explanation
A. Giving the drug with food may delay absorption but does not affect the extent of the first-pass effect.
B. Administering the drug in small, frequent doses may help maintain therapeutic levels but will not significantly alter the first-pass effect.
C. Limiting protein intake could reduce drug binding to proteins, but this is not a standard approach for managing first-pass metabolism.
D. Administering the drug intravenously bypasses the gastrointestinal tract and liver, avoiding the first-pass effect, thereby increasing the amount of free drug available to body cells.
Correct Answer is ["A","B","C","D"]
Explanation
A. Spontaneous bleeding after taking an anticoagulant is a secondary action that occurs due to the anticoagulant's effect on blood clotting, which is an undesired effect when it leads to excessive bleeding.
B. Dizziness after starting an antihypertensive is a common secondary action related to the lowering of blood pressure, which can lead to hypotension and resultant dizziness.
C. Drowsiness after taking an antihistamine is a well-known secondary action, especially with first-generation antihistamines, which can cause sedation as a side effect.
D. Diarrhea after taking an antibiotic is a secondary action that can occur due to disruption of the normal gut flora, leading to gastrointestinal upset. All these examples illustrate secondary effects of medications.