# A nurse is reviewing several insulin orders. For each cue, drag it to the insulin product that best matches the clinical situation. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=568364&lang=en > language: en > subject: Medication Administration > category: PPT ## Question A nurse is reviewing several insulin orders. For each cue, drag it to the insulin product that best matches the clinical situation. **1.** Administer 15 minutes before a meal to cover postprandial glucose rise Select a category NPH insulin Insulin lispro Insulin glargine **2.** Use for correction of hyperglycemia at bedtime when no food is planned Select a category NPH insulin Insulin lispro Insulin glargine **3.** Give once daily at the same time each evening as basal coverage Select a category NPH insulin Insulin lispro Insulin glargine **4.** Do not mix with other insulins in the same syringe Select a category NPH insulin Insulin lispro Insulin glargine **5.** Clear, colorless solution that does not require resuspension Select a category NPH insulin Insulin lispro Insulin glargine **6.** Cloudy suspension that requires gentle rolling before administration Select a category NPH insulin Insulin lispro Insulin glargine **7.** Administer twice daily to provide basal coverage with peaks Select a category NPH insulin Insulin lispro Insulin glargine ## Explanation The cues describe clinical scenarios that require matching insulin products to their onset, peak, duration, appearance, and administration requirements. Lispro is a rapid-acting insulin used to cover mealtime glucose excursions. Regular insulin is a short-acting insulin that can be given intravenously in acute settings. NPH is an intermediate-acting insulin that is cloudy and requires gentle mixing before administration. Glargine is a long-acting basal insulin that is clear and should not be mixed with other insulins. ## In-depth explanation Quick answer The correct matches are based on the pharmacological profiles and clinical administration requirements of each insulin product. Why this is correct Each cue describes a clinical situation that aligns with the characteristics of a specific insulin product. For example, a clear basal insulin given once daily without mixing matches glargine, while a cloudy insulin requiring resuspension matches NPH. Clinical picture Insulin products differ in onset, peak, duration, appearance, and compatibility. Rapid-acting insulins like lispro are used for prandial coverage. Short-acting regular insulin can be given intravenously. Intermediate-acting NPH is a cloudy suspension. Long-acting glargine is clear and cannot be mixed with other insulins. Memory hook Remember the mnemonic: 'Clear before cloudy' for drawing up insulins, and 'Glargine is clear and alone' for administration. NPH is the only cloudy insulin among the common products. NCLEX decision rule Match insulin products to their clinical use: rapid-acting for meals, short-acting for IV use, intermediate-acting for twice-daily basal coverage with mixing, and long-acting for once-daily basal without mixing. Why the alternatives are wrong Incorrect matches would result from confusing onset times (e.g., using lispro for basal coverage), mixing incompatible insulins (e.g., glargine with regular), or failing to recognize that NPH requires resuspension. Sources 1NCSBN 2026 NCLEX-RN Test Plan 2WHO: types and modes of action of insulin 3DailyMed: insulin glargine prescribing information ## Clinical scenario Insulin safety check The nurse verifies the current prescription, glucose result, nutrition plan, and facility protocol before administration. ## Key concepts - **Rapid-acting insulin** — Insulin with onset of 10-30 minutes, peak of 30-90 minutes, and duration of 3-5 hours, used to cover mealtime glucose excursions. - **Short-acting insulin** — Insulin with onset of 30-60 minutes, peak of 2-4 hours, and duration of 5-8 hours, can be given intravenously under protocol. - **Intermediate-acting insulin** — Insulin with onset of 1-2 hours, peak of 4-12 hours, and duration of 18-24 hours, appears cloudy and requires gentle mixing. ## Related questions - [Before giving a scheduled dose of digoxin, the nurse obtains an apical pulse of 54/min in …](https://mymerci.kr/pages/nclex_q.php?qn_id=374883&lang=en) - [An older adult taking digoxin reports nausea, poor appetite, and yellow-green halos. 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