Page 1470 - Saunders Comprehensive Review For NCLEX-RN

characteristics of insulin; procedures for administration; and the onset, peak, and
duration of action for insulin and insulin administration to select from the remaining
options. Remember that NPH insulin peaks in 6 to 14 hours and regular insulin
peaks in 1 to 5 hours.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Pharmacology: Endocrine Medications: Insulin
Health Problem: Adult Health: Endocrine: Diabetes mellitus
Priority Concepts: Client Education; Glucose Regulation
Reference: Hodgson, Kizior (2018), p. 596.

518. Answer: 1, 2, 3, 4

Rationale: Repaglinide, a rapid-acting oral hypoglycemic agent that stimulates
pancreatic insulin secretion, should be taken before meals (approximately 30
minutes before meals) and should be withheld if the client does not eat.
Hypoglycemia is a side effect of repaglinide and the client should always be
prepared by carrying a simple sugar at all times. Metformin is an oral hypoglycemic
given in combination with repaglinide and works by decreasing hepatic glucose
production. A common side effect of metformin is diarrhea. Muscle pain may occur
as an adverse effect from metformin, but it might signify a more serious condition
that warrants primary health care provider notification, not the use of
acetaminophen.
Test-Taking Strategy: Focus on the subject, oral medications to treat diabetes
mellitus. Thinking about the pathophysiology of diabetes mellitus and recalling the
actions and effects of these medications are needed to answer correctly.
Level of Cognitive Ability: Analyzing
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: Hodgson, Kizior (2018), pp. 732, 1017-1018.

519. Answer: 1

Rationale: Aspirin and other over-the-counter medications should not be taken
unless the client consults with the PHCP. The client needs to take the medication at
the same time every day and should be instructed not to stop the medication. A
slight weight gain as a result of an improved appetite is expected; however, after the
dosage is stabilized, a weight gain of 5 pounds (2.25 kg) or more weekly should be
reported to the PHCP. Caffeine-containing foods and fluids need to be avoided
because they may contribute to steroid-ulcer development.
Test-Taking Strategy: Note the strategic words, further teaching is necessary. These
words indicate a negative event query and ask you to select an option that is an
incorrect statement. Remember that a client taking prednisone should not take other

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