Description
Math for Clinical Practice 2nd Edition Macklin Chernecky Infortuna Test Bank
ISBN-13: 978-0323064996
ISBN-10: 032306499X
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Macklin: Math for Clinical Practice, 2nd Edition
Chapter 17: Insulin
Test Bank
PROBLEM
- Determine the total number of units of insulin to be drawn up and which insulin syringe (30, 50, 100 units) is the best to use.
4 units regular insulin, 11 units NPH insulin
____________________ Syringe = ______________ units of total insulin
ANS:
Syringe = 30 units 4 + 11 = 15
REF: Test 1
- Determine the total number of units of insulin to be drawn up and which insulin syringe (30, 50, 100 units) is the best to use.
3 units regular insulin, 8 units NPH insulin
____________________ Syringe = ______________ units of total insulin
ANS:
Syringe = 30 units 3 + 8 = 11
REF: Test 1
- Determine the total number of units of insulin to be drawn up and which insulin syringe (30, 50, 100 units) is the best to use.
14 units regular insulin, 20 units NPH insulin
____________________ Syringe = ______________ units of total insulin
ANS:
Syringe = 50 units 14 + 20 = 34
REF: Test 1
- Determine the total number of units of insulin to be drawn up and which insulin syringe (30, 50, 100 units) is the best to use.
10 units regular insulin, 34 units NPH insulin
____________________ Syringe = ______________ units of total insulin
ANS:
Syringe = 50 units 10 + 34 = 44
REF: Test 1
- Determine the total number of units of insulin to be drawn up and which insulin syringe (30, 50, 100 units) is the best to use.
20 units regular insulin, 36 units NPH insulin
____________________ Syringe = ______________ units of total insulin
ANS:
Syringe = 100 units 20 + 36 = 56
REF: Test 1
- Determine the total number of units of insulin to be drawn up and which insulin syringe (30, 50, 100 units) is the best to use.
17 units regular insulin, 40 units NPH insulin
____________________ Syringe = ______________ units of total insulin
ANS:
Syringe = 100 units 17 + 40 = 57
REF: Test 1
- Determine the total number of units of insulin to be drawn up and which insulin syringe (30, 50, 100 units) is the best to use.
4 units regular insulin, 20 units NPH insulin
____________________ Syringe = ______________ units of total insulin
ANS:
Syringe = 30 units 4 + 20 = 24
REF: Test 1
- Determine the total number of units of insulin to be drawn up and which insulin syringe (30, 50, 100 units) is the best to use.
17 units regular insulin, 24 units NPH insulin
____________________ Syringe = ______________ units of total insulin
ANS:
Syringe = 50 units 17 + 24 = 41
REF: Test 1
- Determine the total number of units of insulin to be drawn up and which insulin syringe (30, 50, 100 units) is the best to use.
21 units regular insulin, 34 units NPH insulin
____________________ Syringe = ______________ units of total insulin
ANS:
Syringe = 100 units 21 + 34 = 55
REF: Test 1
- Determine the total number of units of insulin to be drawn up and which insulin syringe (30, 50, 100 units) is the best to use.
12 units regular insulin, 33 units NPH insulin
____________________ Syringe = ______________ units of total insulin
ANS:
Syringe = 50 units 12 + 33 = 45
REF: Test 1
- Answer the question and mark and label syringe volume with NPH and regular insulins.
The patient is to receive 5 units regular insulin for a blood glucose of 250 mg/dL. Where would you draw the arrow to represent the correct level?
ANS:
REF: Clinical Scenario 1
- Answer the question and mark and label syringe volume with NPH and regular insulins.
The patient is to receive 15 units regular insulin and 33 units NPH insulin because his blood sugar value from the laboratory has returned as 546 mg/dL. Which insulin would be drawn first? Draw two arrows next to the syringe: one arrow to indicate where the first insulin would be drawn to and a second arrow for the total insulin dose.
Indicate which insulin should be drawn up first.
ANS:
Regular insulin
REF: Clinical Scenario 1
- Answer the question and mark and label syringe volume with NPH and regular insulins.
Clinically, you often mix insulins, always drawing up regular insulin first into a syringe. On the following figure, draw an arrow that corresponds to the dose of regular insulin if you have a total insulin dose of 65 units with 38 units of NPH insulin.
ANS:
65 – 38 = 27 units regular insulin
REF: Clinical Scenario 1
- Answer the question and mark and label syringe volume with NPH and regular insulins.
Your patient has a finger-stick of 370 mg/dL and normally receives a dose of 35 units NPH insulin now. What would be the total dose of the prescribed now dose of 9 units regular insulin and 35 units NPH insulin?
ANS:
REF: Clinical Scenario 1
- Clinically, you always first draw up the regular insulin into a syringe and then add the second type of insulin. You need to know the additive total volume of the insulin syringe when mixing insulins. If you have a total dose of 65 units and you know 23 units are regular insulin, what is the dose of the other insulin?
ANS:
65 units – 23 = 42 units
REF: Clinical Scenario 1
- What size insulin syringe would be ideal to give the dose of 4 units of regular insulin?
- 100 unit
- 50 unit
- 30 unit
ANS:
C
REF: Clinical Scenario 1
- Answer the question and mark and label syringe volume with NPH and regular insulins.
Your diabetic patient normally receives 30 units NPH insulin subcutaneous every morning. Your patient is also on hyperalimentation and needs to be covered sliding scale regular insulin. The patient’s blood sugar is 467 mg/dL. The patient is to receive 12 units regular insulin and 30 units NPH insulin. Draw two arrows next to the syringe: one arrow to indicate where the first insulin would be drawn and a second arrow for the total insulin dose. Additionally, indicate which insulin should be drawn up first.
ANS:
REF: Clinical Scenario 1
- In good clinical practice, a nurse tries to reduce the number of actual injections to the patient to increase comfort and prevent infection. What size syringe is needed to administer 20 units regular insulin and 46 units NPH insulin?
ANS:
100 unit syringe
REF: Clinical Scenario 1
- Answer the question and mark and label syringe volume with NPH and regular insulins.
Your diabetic patient normally receives 50 units NPH insulin subcutaneous every morning. Your patient is also on total parenteral nutrition (TPN) and needs to be covered sliding scale regular insulin. The patient’s blood sugar is 820 mg/dL. The patient is to receive 24 units regular insulin and 50 units NPH insulin. Which insulin would be drawn first? Draw two arrows next to the syringe: one arrow to indicate where the first insulin would be drawn to and a second arrow for the total insulin dose. Additionally, indicate which insulin should be drawn up first.
ANS:
Regular insulin
REF: Clinical Scenario 1
- Answer the question and mark and label syringe volume with NPH and regular insulins.
Your diabetic patient normally receives 16 units NPH insulin subcutaneous every morning. Your patient is also noncompliant and you have discovered three candy bar wrappers in his trash can. The patient’s blood sugar finger stick is 254 mg/dL. After you have notified the advanced practice nurse, the patient is to receive 5 units regular insulin and 16 units NPH insulin now. Which insulin would be drawn first? Draw two arrows next to the syringe: one arrow to indicate where the first insulin would be drawn to and a second arrow for the total insulin dose. Additionally, indicate which insulin should be drawn up first.
ANS:
Regular insulin
REF: Clinical Scenario 1
- Determine the number of units of regular insulin, based on glucose level. If the blood glucose is above 150 mg/dL, administer 1 unit regular insulin for every 30 mg/dL increase. Round your answer.
Blood glucose = 174 mg/dL
ANS:
174 – 150 = 24
No insulin
REF: Test 2
- Determine the number of units of regular insulin, based on glucose level. If the blood glucose is above 150 mg/dL, administer 1 unit regular insulin for every 30 mg/dL increase. Round your answer.
Blood glucose = 256 mg/dL
ANS:
256 – 150 = 106; 106 ÷ 30 = 3.5
4 units regular insulin
REF: Test 2
- Determine the number of units of regular insulin, based on glucose level. If the blood glucose is above 150 mg/dL, administer 1 unit regular insulin for every 30 mg/dL increase. Round your answer.
Blood glucose = 198 mg/dL
ANS:
198 – 150 = 48; 48 ÷ 30 = 1.6
2 units regular insulin
REF: Test 2
- Determine the number of units of regular insulin, based on glucose level. If the blood glucose is above 150 mg/dL, administer 1 unit regular insulin for every 30 mg/dL increase. Round your answer.
Blood glucose = 322 mg/dL
ANS:
322 – 150 = 172; 172 ÷ 30 = 5.7
6 units regular insulin
REF: Test 2
- Determine the number of units of insulin based on grams of carbohydrates consumed. Administer 1 unit regular insulin for every 8 g carbohydrates consumed.
Carbohydrates consumed = 15 g + 7 g + 42 g + 25 g
ANS:
89 g ÷ 8 = 11.1
11 units regular insulin
REF: Test 2
- Determine the number of units of insulin based on grams of carbohydrates consumed. Administer 1 unit regular insulin for every 8 g carbohydrates consumed.
Carbohydrates consumed = 23 g + 25 g + 12 g + 8 g
ANS:
68 g ÷ 8 = 8.5
9 units regular insulin
REF: Test 2
- Determine the number of units of insulin based on grams of carbohydrates consumed. Administer 1 unit regular insulin for every 8 g carbohydrates consumed.
Carbohydrates consumed = 48 g + 15 g + 22 g + 0 g
ANS:
85 g ÷ 8 = 10.6
11 units regular insulin
REF: Test 2
- Determine the number of units of insulin based on grams of carbohydrates consumed. Administer 1 unit regular insulin for every 8 g carbohydrates consumed.
Carbohydrates consumed = 27 g + 30 g + 45 g + 26 g
ANS:
128 g ÷ 8 = 16 units regular insulin
REF: Test 2
- Determine total units insulin, based on glucose level and carbohydrates consumed. Administer 1 unit regular insulin for every 30 mg/dL increase in glucose above 150 mg/dL and 0.8 unit regular insulin for every 15 g carbohydrates consumed.
Blood glucose = 274 mg/dL
Carbohydrates consumed = 48 g + 36 g + 15 g + 22 g + 12 g
ANS:
| 274 – 150 = 124 | 124 ÷ 30 = 4.1 | 4 units | |
| Carbohydrates = 133 g ÷ 15 = 8.8 | 9 ´ 0.8 = 7.2 | 7 units | |
| 4 + 7 = 11 units regular insulin | |||
REF: Test 2
- Determine total units insulin, based on glucose level and carbohydrates consumed. Administer 1 unit regular insulin for every 30 mg/dL increase in glucose above 150 mg/dL and 0.8 unit regular insulin for every 15 g carbohydrates consumed.
Blood glucose = 186 mg/dL
Carbohydrates consumed = 28 g + 32 g + 0 g + 12 g
ANS:
| 186 – 150 = 36 ÷ 30 = 1.2 = 1 unit | |
| Carbohydrates = 72 g ÷ 15 = 4.8 | 5 ´ 0.8 = 4 units |
| 1 + 4 = 5 units regular insulin |
REF: Test 2
- Answer this question using the following information and mark the syringes.
The patient is to receive insulin as follows:
Administer 0.8 units insulin for every 15 g carbohydrates consumed. For a blood glucose greater than 150 mg/dL, administer 1 unit insulin for every 30 mg/dL increase in the blood glucose above 150 mg/dL.
For lunch, the patient had a blood glucose of 142 mg/dL and has eaten the following:
| Item | Carbohydrate Content |
| 1 apple | 15 g |
| 8 oz milk | 12 g |
| 3 oz ground beef patty | 40 g |
| 1 hamburger bun | 23 g |
| 4 oz French fries | 25 g |
How much insulin should you administer?
ANS:
The patient does not need any insulin for his blood glucose level of 142 mg/dL.
Carbohydrate intake 115 g
115 ÷ 15 = 7.7 carbohydrate units
7.7 ´ 0.8 = 6 units insulin
0 unit + 6 units = 6 units regular insulin
REF: Clinical Scenario 2
- Answer this question using the following information and mark the syringes.
The patient is to receive insulin as follows:
Administer 0.8 units insulin for every 15 g carbohydrates consumed. For a blood glucose greater than 150 mg/dL, administer 1 unit insulin for every 30 mg/dL increase in the blood glucose above 150 mg/dL.
For lunch, the patient had a blood glucose of 142 mg/dL and has eaten the following:
| Item | Carbohydrate Content |
| 1 apple | 15 g |
| 8 oz milk | 12 g |
| 3 oz ground beef patty | 40 g |
| 1 hamburger bun | 23 g |
| 4 oz French fries | 25 g |
For dinner, your patient has a blood glucose of 182 mg/dL and has eaten 128 g carbohydrates. How much insulin should you administer?
ANS:
182 mg/dL – 150 mg/dL= 32
32 ÷ 30 = 1 blood glucose unit
1 ´ 1 = 1 unit regular insulin
Carbohydrate intake 128 g
128 ÷ 15 = 8.5 round to 9 carbohydrate units
9 ´ 0.8 unit = 7.2 round to 7 units insulin
1 unit + 7 = 8 units insulin
REF: Clinical Scenario 2
- Answer this question using the following information and mark the syringes.
The patient is to receive insulin as follows:
Administer 0.8 units insulin for every 15 g carbohydrates consumed. For a blood glucose greater than 150 mg/dL, administer 1 unit insulin for every 30 mg/dL increase in the blood glucose above 150 mg/dL.
For lunch, the patient had a blood glucose of 142 mg/dL and has eaten the following:
| Item | Carbohydrate Content |
| 1 apple | 15 g |
| 8 oz milk | 12 g |
| 3 oz ground beef patty | 40 g |
| 1 hamburger bun | 23 g |
| 4 oz French fries | 25 g |
At bedtime, your patient’s blood glucose is 126 mg/dL. How much insulin should you administer?
ANS:
The patient’s blood glucose level of 126 mg/dL is below the target level of 150 mg/dL.
The patient is not eating at this time. The patient does not require any insulin at this time.
REF: Clinical Scenario 2
- Answer this question using the following information and mark the syringes.
The patient is to receive insulin as follows:
Administer 0.8 units insulin for every 15 g carbohydrates consumed. For a blood glucose greater than 150 mg/dL, administer 1 unit insulin for every 30 mg/dL increase in the blood glucose above 150 mg/dL.
For lunch, the patient had a blood glucose of 142 mg/dL and has eaten the following:
| Item | Carbohydrate Content |
| 1 apple | 15 g |
| 8 oz milk | 12 g |
| 3 oz ground beef patty | 40 g |
| 1 hamburger bun | 23 g |
| 4 oz French fries | 25 g |
At breakfast, the patient’s blood glucose is 121 mg/dL. The patient is going to eat 126 g carbohydrates. How much insulin should you administer?
ANS:
The patient is not over the target blood glucose range and does not need any additional insulin for the blood glucose.
Carbohydrate intake 126 g
126 ÷ 15 = 8.4, round to 8 carbohydrate units
8 ´ 0.8 unit = 6.4 units round to 6
6 units + 0 units = 6 units of insulin
REF: Clinical Scenario 2
- Answer this question using the following information and mark the syringes.
The patient is to receive insulin as follows:
Administer 0.8 units insulin for every 15 g carbohydrates consumed. For a blood glucose greater than 150 mg/dL, administer 1 unit insulin for every 30 mg/dL increase in the blood glucose above 150 mg/dL.
For lunch, the patient had a blood glucose of 142 mg/dL and has eaten the following:
| Item | Carbohydrate Content |
| 1 apple | 15 g |
| 8 oz milk | 12 g |
| 3 oz ground beef patty | 40 g |
| 1 hamburger bun | 23 g |
| 4 oz French fries | 25 g |
At lunch, the patient’s blood glucose is 248 mg/dL. The patient is going to eat 75 g carbohydrates. How much insulin should you administer?
ANS:
248 mg/dL – 150 mg/dL= 98
98 ÷ 30 = 3.2 round to 3 blood glucose units
3 ´ 1 unit = 3 units insulin
Carbohydrate intake 75 g
75 ÷ 15 = 5 carbohydrate units
5 ´ 0.8 unit = 4 units insulin
3 units + 4 units = 7 units of insulin
REF: Clinical Scenario 2
- Answer this question using the following information and mark the syringes.
The patient is to receive insulin as follows:
Administer 1 unit insulin for every 8 g carbohydrates consumed. For a blood glucose greater than 130 mg/dL, administer 1 unit insulin for every 30 mg/dL increase in the blood glucose above 130 mg/dL.
At breakfast, your patient has a blood glucose of 141 mg/dL and has eaten the following:
| Item | Carbohydrate Content |
| 1 apple | 15 g |
| 8 oz milk | 12 g |
| 1 bowl cereal | 48 g |
| 1 piece toast | 12 g |
| 3 strips bacon | 0 g |
How much insulin should you administer?
ANS:
141 mg/dL – 130 mg/dL =11
11 ÷ 30 = 0.36 blood glucose unit (round to 0 units)
The patient does not need any insulin for the blood glucose level.
Carbohydrate intake = 87 g
87 ÷ 8 = 10.8 (Round to 11 carbohydrate units)
11 ´ 1 unit of insulin = 11 units of insulin
11 units + 0 units = 11 units of insulin
REF: Clinical Scenario 2
- Answer this question using the following information and mark the syringes.
The patient is to receive insulin as follows:
Administer 1 unit insulin for every 8 g carbohydrates consumed. For a blood glucose greater than 130 mg/dL, administer 1 unit insulin for every 30 mg/dL increase in the blood glucose above 130 mg/dL.
At breakfast, your patient has a blood glucose of 98 mg/dL and has eaten the following:
| Item | Carbohydrate Content |
| 1 granola bar | 26 g |
| 8 oz of milk | 12 g |
| 1 cheese sandwich | 27 g |
| 2 oz potato chips | 30 g |
| Grapes | 20 g |
How much insulin should you administer?
ANS:
The patient is not over the target blood glucose range of 130 and does not need any
additional insulin for blood glucose correction.
Carbohydrate intake = 115 g
115 ÷ 8 = 14.3 (Round to 14 carbohydrate units)
14 ´ 1 unit of insulin = 14 units of insulin
14 units + 0 units = 14 units of insulin
REF: Clinical Scenario 2
- Answer this question using the following information and mark the syringes.
The patient is to receive insulin as follows:
Administer 1 unit insulin for every 8 g carbohydrates consumed. For a blood glucose greater than 130 mg/dL, administer 1 unit insulin for every 30 mg/dL increase in the blood glucose above 130 mg/dL.
At lunch, the patient’s blood glucose is 154 mg/dL. The patient is going to eat 168 g carbohydrates. How much insulin should you administer?
ANS:
154 mg/dL – 130 mg/dL = 24
24 ÷ 30 = 0.8 (Round to 1 blood glucose unit)
1 ´ 1 unit insulin = 1 unit
Carbohydrate intake = 168 g
168 ÷ 8 = 21 carbohydrate units
21 ´ 1 unit of insulin = 21 units of insulin
21 units + 1 unit = 22 units of insulin
REF: Clinical Scenario 2
- Answer this question using the following information and mark the syringes.
The patient is to receive insulin as follows:
Administer 1 unit insulin for every 8 g carbohydrates consumed. For a blood glucose greater than 130 mg/dL, administer 1 unit insulin for every 30 mg/dL increase in the blood glucose above 130 mg/dL.
The patient is going to eat French fries (48 g carbohydrates) and a hamburger on a bun (23 g carbohydrates) and is to take 1 unit insulin for every 8 g of carbohydrates consumed. How much insulin should the patient take to cover the French fries and hamburger?
ANS:
Carbohydrate intake = 48 g + 23 g = 71 g
71 ÷ 8 = 8.8 (Round to 9)
9 ´ 1 units = 9 units of insulin
REF: Clinical Scenario 2
- Answer this question using the following information and mark the syringes.
The patient is to receive insulin as follows:
Administer 1 unit insulin for every 8 g carbohydrates consumed. For a blood glucose greater than 130 mg/dL, administer 1 unit insulin for every 30 mg/dL increase in the blood glucose above 130 mg/dL.
The patient’s blood glucose is 236 mg/dL. The patient is to take 1 unit insulin for every 25 mg/dL increase in blood glucose over 120 mg/dL. How much insulin should the patient take?
ANS:
236 mg/dL – 120 mg/dL = 116
116 ÷ 25 = 4.6 units (Round to 5 blood glucose units)
1 ´ 5 units = 5 units of insulin
REF: Clinical Scenario 2
