Practice Test | Level 3 | Insulin Therapy | 2026

Insulin

Mr. Pasteur is started on the following insulin regimen: 22uNPH/10uReg before breakfast, 5u Reg before dinner and 10uNPH before bedtime. His BMI is 33. His before morning blood glucose levels are consistently above 140 mg/dL. What change in insulin therapy could help improve his a.m. glucose levels?

Decrease before dinner regular insulin

Increase am NPH insulin

Change bedtime NPH to before dinner instead of before bedtime

Increase bedtime NPH

AT is a 43-year-old newly started on insulin. Choose the survival topic that is essential for AT to know before discharge from the hospital with a prescription for insulin pens.

managing insulin doses when traveling across time zones

how to adjust insulin dose before exercise

signs of hypoglycemia

proper storage of insulin pens

signs of hypoglycemia

For a person with type 1 diabetes who is using intensive diabetes therapy, meals and snacks can be scheduled according to:

Usual eating habits

Insulin action times

The calorie content

Meal spacing

usual eating habits

Which medications can cause hypoglycemia and weight gain?

Actos and Avandia

Insulin and sulfonylureas

Steroids

Atypical antipsychotics

Insulin and sulfonylureas

What is a critical teaching point for bolus insulins?

Monitor for allergic reaction at injection site

Eat within 15 - 30 minutes of injection

Inject at a 90 degree angle

Gently shake insulin before injection

Eat within 15 - 30 minutes of injection

Mrs. S is having trouble sleeping and complains of waking up with frequent nightmares. She is on an insulin pump. What is your best response?

Instruct her to avoid alcohol after with dinner

Encourage her to try yoga or meditation before sleep.

Gently ask her if she would like to share her fears.

Evaluate basal insulin rate

Evaluate basal insulin rate

What blood glucose best reflects the effectiveness of basal insulin?

post meal

pre lunch

post dinner

A.M. fasting

A.M. fasting

Basal insulin therapy is best described as which of the following:

Long acting insulin administration to control post prandial blood glucose levels

Intermediate acting insulin that must be given twice daily.

Administration of a premixed insulin solution to control pre and post prandial blood glucose levels.

Long acting insulin administration to control between meals and am blood glucose levels.

Long acting insulin administration to control between meals and am blood glucose levels.

MR is 68 with type 2 diabetes and tells you that their provider increased their NPH insulin to three times a day and told them to adjust the NPH insulin dose based on their pre-meal blood sugar levels. What is the best response?

Are you sure that your provider ordered NPH insulin three times a day?

NPH is an intermediate acting basal insulin that is usually injected once or twice daily.

Please make another appointment and bring in all the medications and insulin you are taking.

Thanks for letting me know. Let me double check the orders.

Thanks for letting me know. Let me double check the orders.

BT is heading to the south of France for a 25th wedding anniversary vacation! They usually take 32 units glargine at 10 PM each night along with 5-7 units bolus insulin with meals. There is a nine hour time difference between the United States and France. They ask you how to adjust their basal insulin. What is the best response?

Split the glargine into 16 units and take it twice a day to maintain blood glucose stability.

Try to get an insulin pump before heading on vacation to improve insulin delivery flexibility.

Continue taking the glargine every 24 hours regardless of time zone differences.

Take the bolus insulin with each meal and hold the glargine for 9 hours.

Continue taking the glargine every 24 hours regardless of time zone differences.