Insulin Scenario #1

10 Questions | Total Attempts: 145

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Insulin Quizzes & Trivia

Strengthen your insulin skills with this insulin quiz. Scores don't count for anything besides trying to improve comfort and skills with insulin management.


Questions and Answers
  • 1. 
    KK is a patient in your hospital.  You receive an order for Lantus 39 units Q24h for him.  What do you need to assess?
    • A. 

      What is KK's renal function?

    • B. 

      What is KK's HgbA1c?

    • C. 

      What is KK's weight?

    • D. 

      Was KK on hypoglycemics at home prior to admission?

    • E. 

      Are there any medications that are causing KK's BG to be so high?

    • F. 

      Is KK receiving nutrition?

    • G. 

      What hyperglycemia treatment is KK currently receiving?

    • H. 

      Does KK has a history of diabetes?

  • 2. 
    You find out that KK is a 64 yo male who has type 2 diabetes, and he is currently on an insulin infusion in the ICU.  He was on glyburide-metformin and sitagliptin at home.  His A1c is 7.9.  He is 6'2" and weighs 155kg.  His SCr is 1.  His insulin infusion was just decreased to 6 units/hr, but had been @ 12 units/hr for the previous 6 hours.  He is getting tube feeds, Glucerna 1.5 @ 60mL/hr.  There are no medications that are likely to be contributing to KK's hyperglycemia.  What should you do?  (May be more than one answer.)
    • A. 

      Add correctional insulin.

    • B. 

      Lantus 39 units Q24h is not enough for a patient who is on an insulin infusion @ 6-12 units/hr, so you should page the MD and offer to have pharmacy dose this patient's insulin.

    • C. 

      Verify the order.

    • D. 

      Lantus 39 units Q24h is not enough for a patient who is on an insulin infusion @ 6-12 units/hr, so you should page the MD and recommend a higher dose.

  • 3. 
    The MD tells you to have pharmacy to dose this patient's insulin.  Calculate KK's daily insulin requirement based on his insulin infusion rate.  (May be more than one answer.)
    • A. 

      144 units

    • B. 

      252 units

    • C. 

      264 units

  • 4. 
    You decide to use the average rate over the past 6 hours to calculate KK's daily insulin requirement, we get 264 units/day.  What total daily dose of insulin is/are reasonable in order to transition KK to sub-Q insulin?  (May be more than one answer.)
    • A. 

      58 units

    • B. 

      78 units

    • C. 

      158 units

    • D. 

      185 units

    • E. 

      211 units

    • F. 

      264 units

  • 5. 
    You decide to be conservative, and calculate the total daily sub-Q insulin dose at 60% of the daily insulin infusion requirement, which is 158 units.  What dose of Lantus do you want to start for basal coverage?  (May be more than one answer.)
    • A. 

      Lantus 10 units Q24h

    • B. 

      Lantus 20 units Q24h

    • C. 

      Lantus 40 units Q12h

    • D. 

      Lantus 79 units Q24h

    • E. 

      Lantus 158 units Q24h

  • 6. 
    When should the insulin infusion be discontinued?  (May be more than one answer.)
    • A. 

      1 hour before the first dose of Lantus is administered

    • B. 

      As soon as the first dose of Lantus is administered

    • C. 

      1 hour after the first dose of Lantus is administered

    • D. 

      2 hours after the first dose of Lantus is administered

  • 7. 
    What dose of prandial lispro do you want to start?  (May be more than one answer.)
    • A. 

      Lispro 5 units TIDAC

    • B. 

      Lispro 5 units Q6h

    • C. 

      Lispro 12 units TIDAC

    • D. 

      Lispro 13 units Q4h

    • E. 

      Lispro 20 units Q6h

  • 8. 
    What other orders should you enter?  (May be more than one answer.)
    • A. 

      Correctional insulin

    • B. 

      Fingersticks to correlate with prandial insulin

    • C. 

      Time insulin infusion to end 2 hours after first dose of Lantus is scheduled

    • D. 

      D/C Q1h fingersticks from insulin infusion

  • 9. 
    You decided to start KK on Lantus 40 units Q12h, lispro 13 units Q4h, and lispro 1-5 units prn BG >150mg/dL.  The next day you assess the results.  KK's BG range is 151-229mg/dL.  What adjustments do you want to make?
    • A. 

      Increase prandial lispro to 20 units Q4h

    • B. 

      No adjustments since 1 day is not enough time to assess response to insulin regimen

    • C. 

      Increase prandial lispro to 16 units Q4h

    • D. 

      Increase correctional insulin to 2-8 units prn BG >150mg/dL

    • E. 

      Increase Lantus to 50 units Q12h

    • F. 

      Increase Lantus to 80 units Q12h

  • 10. 
    What is causing KK's hyperglycemia?  (May be more than one answer.)
    • A. 

      His uncontrolled diabetes

    • B. 

      Stress from acute illness

    • C. 

      Morbid obesity

    • D. 

      His propofol infusion

    • E. 

      Phos replacements on the critical care electrolyte replacement protocol