Difficulty: Medium
Average Score: 87%
Full-length
The home health care nurse is caring for a 30-year-old woman with type I diabetes mellitus. The client has been maintained on a regimen of NPH and regular insulin and a 1,800-calorie diabetic diet with normal blood sugar levels. Morning self-monitoring blood sugar (SMBG) readings the past two days were 205 mg/dL and 233 mg/dL. The nurse expects the physician to
Correct answer
B
Rationale
Elevated morning blood sugar levels (205 and 233 mg/dL) suggest the dawn phenomenon, where early morning hyperglycemia occurs due to hormonal changes. Adjusting the evening NPH insulin dose (e.g., adding 3 units at 10 PM) helps control this. Reducing the diet (A) is unnecessary, regular insulin (C) peaks too early, and eliminating the snack (D) may worsen control.