Page 1469 - Saunders Comprehensive Review For NCLEX-RN

statement as the answer. Recalling the adverse effects and drug interactions
associated with this medication will assist you in eliminating options 2 and 4. Next,
recalling the mechanism of action of this medication will help you determine that
this medication is suited for clients who skip meals, thereby leading you to the
correct option.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Pharmacology: Endocrine Medications: Oral Hypoglycemic
Health Problem: Adult Health: Endocrine: Diabetes mellitus
Priority Concepts: Client Education; Glucose Regulation
Reference: Lewis et al. (2017), pp. 1130-1131.

516. Answer: 1

Rationale: Exenatide is an incretin mimetic used for type 2 diabetes mellitus only.
It is not recommended for clients taking insulin. Hence the nurse should withhold
the medication and question the PHCP regarding this prescription. Although
options 2 and 3 are correct statements about the medication, in this situation the
medication should not be administered. The medication is packaged in prefilled
pens ready for injection without the need for drawing it up into another syringe.
Test-Taking Strategy: Note the strategic words, most appropriate. Focus on the
name of the medication, recalling that it is used for the treatment of type 2 diabetes
mellitus. Eliminate option 4 because the medication is packaged in prefilled pens
ready for injection. From the remaining options, focus on the data in the question.
Although options 2 and 3 are appropriate when administering this medication, this
client should not receive this medication.
Level of Cognitive Ability: Analyzing
Client Needs: Safe and Effective Care Environment
Integrated Process: Nursing Process—Planning
Content Area: Pharmacology: Endocrine Medications: Oral Hypoglycemic
Health Problem: Adult Health: Endocrine: Diabetes mellitus
Priority Concepts: Clinical Judgment; Glucose Regulation
Reference: Ignatavicius, Workman, Rebar (2018), p. 1292.

517. Answer: 1, 3

Rationale: Humulin NPH is an intermediate-acting insulin. The onset of action is
60 to 120 minutes, it peaks in 6 to 14 hours, and its duration of action is 16 to 24
hours. Regular insulin is a short-acting insulin. Depending on the type, the onset of
action is 30 to 60 minutes, it peaks in 1 to 5 hours, and its duration is 6 to 10 hours.
Hypoglycemic reactions most likely occur during peak time. Insulin should be at
room temperature when administered. Clients may need their insulin dosages
increased during times of illness. Insulin vials should never be shaken vigorously.
Regular insulin is always drawn up before NPH.
Test-Taking Strategy: Focus on the subject, client instructions regarding insulin.
Eliminate option 4 because of the word vigorously. Use knowledge regarding the

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