The nurse is preparing to administer a prescribed subcutaneous insulin lispro dose. The meal tray is unexpectedly delayed. Which action should the nurse take?
1Administer lispro now and ask the client to wait quietly for the meal
2Hold lispro until the meal is available and coordinate administration with eating✓ Correct answer
3Substitute the same dose of insulin glargine and administer it at the scheduled time
4Dilute lispro in IV fluid and infuse it slowly until the meal tray arrives
Explanation
Insulin lispro acts rapidly and should be coordinated closely with food. If the meal is not available, hold the dose and resolve the delay to reduce hypoglycemia risk rather than administering early or substituting another insulin.
Quick answer Hold insulin lispro until the meal is available, then coordinate the dose with eating. Giving rapid-acting insulin without dependable carbohydrate intake can produce preventable hypoglycemia.
Why this is correct Lispro begins lowering glucose quickly. Its benefit and safety depend on matching insulin action with absorbed carbohydrate, so an unexpected meal delay changes the immediate administration conditions even though the prescription itself has not changed.
Easy analogy or mental picture Rapid-acting insulin is like sending a shuttle to meet an arriving train. If the train is delayed, sending the shuttle early leaves it with nothing to meet; the analogy does not replace glucose checks or individualized correction instructions.
Memory hook Rapid insulin needs ready food: no tray, no routine premeal dose yet.
NCLEX decision rule Before giving rapid-acting mealtime insulin, verify that the client can eat and that food is available. If intake is delayed or uncertain, hold and clarify timing while monitoring glucose according to the care plan.
Why the other choices are wrong Giving lispro before food increases hypoglycemia risk. Glargine is not an interchangeable substitute for a mealtime dose, and adding subcutaneous lispro to IV fluid changes the prescribed route and administration method.
References
[1]
NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing
[2]
FDA: Humalog Insulin Lispro Prescribing InformationU.S. Food and Drug Administration