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A
Check the patient's name only
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B
Verify insulin type, dose, and timing with a second licensed nurse per facility policy — insulin is a high-alert medication; double-check the type (Regular, NPH, Glargine, etc.), dose in units, and timing (before meal, at bedtime) to prevent dosing errors
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C
Check the meal tray is at the bedside
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D
Verify blood glucose only after administration
Why this is the answer
INSULIN DOUBLE-CHECK is a safety standard in most facilities because insulin errors are common and dangerous. What to verify: TYPE — insulin types look similar but have vastly different durations and onset times; NPH and Regular insulin are often confused; Lantus (glargine) is a 24-hour insulin that looks like regular but gives fatal hypoglycemia if given when Regular was intended; DOSE — insulin is measured in UNITS, not mL; conversion errors happen; TIMING — Regular insulin 30-60 minutes before meals; lispro/aspart immediately before meals; Lantus once daily at bedtime; BLOOD GLUCOSE — check before administering and hold if below the parameter (typically hold if glucose below 70 mg/dL); TWO-NURSE VERIFICATION — per facility policy, most high-alert insulin doses require two licensed nurses to independently verify before administration.
Source: NCLEX-PN, Insulin Safety Double-Check