NABP NAPLEX Exam - Topic 1 Question 113 Discussion

Actual exam question for NABP's NAPLEX exam

Question #: 113
Topic #: 1

JM is a 32-year-old women who comes to your diabetic clinic with complain of several episodes of hypoglycemi

a. She is on Insulin NPH/regular 70/30, 22 units twice a day with breakfast and dinner. 8 units with lunch.

After discussing with physician you decide to decrease the total daily insulin by 10% and change to insulin glargine once a day and Insulin Lispro three time a day at ratio of 50:50 -- 50 % of long and 50 % of short acting insulin.

What is her new insulin regimen? Round down to the nearest 1 unit.

A16 units of insulin glargine once daily, Insulin Lispro 4 units 3 times a day with meals

B15 units of insulin glargine once daily, Insulin Lispro 5 units 3 times a day with meals

C23 units of insulin glargine once daily, Insulin Lispro 7 units 3 times a day with meals

D30 units of insulin glargine once daily, Insulin Lispro 6 units 3 times a day with meals

E18 units of insulin glargine once daily, Insulin Lispro 6 units 3 times a day with meals

Show Suggested Answer

Suggested Answer: C

22 2 + 7 = 51 units of total insulin per day. Decrease by 10% 51 units 0.9 = 45.9 units per day round up to 46 units. 46 units 0.50 = 23 units, administer 23 units of insulin glargine once daily. 46 units 0.50 = 23 units total Insulin Lispro. Round down, divided by three times a day, 7 units 3 times a day with meals.

by Haydee at Nov 23, 2025, 12:48 AM

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Serina

1 month ago

E is a bit off. I’d stick with A or B for safety.

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Gayla

1 month ago

I’m leaning towards B too. 15 units is a good reduction.

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Linwood

2 months ago

D is definitely too much insulin. A or B makes more sense.

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Venita

2 months ago

C seems too high for glargine. I’d go with A.

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Socorro

2 months ago

I feel like B is the best choice. 15 units sounds right.

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Hannah

2 months ago

I’m surprised they’re switching to glargine; it’s a big change!

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Deandrea

2 months ago

Definitely not D, that’s way too high!

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Art

2 months ago

B) 15 units of insulin glargine once daily, Insulin Lispro 5 units 3 times a day with meals. Sounds like a good compromise between the long and short-acting insulin.

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Louann

3 months ago

D) 30 units of insulin glargine once daily, Insulin Lispro 6 units 3 times a day with meals. Wait, is that too much insulin? I'm so confused.

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Roslyn

3 months ago

This question is making my head spin. I'll just go with C) and hope for the best.

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Donette

3 months ago

E) 18 units of insulin glargine once daily, Insulin Lispro 6 units 3 times a day with meals. Yep, that's the one.

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Quinn

4 months ago

A) 16 units of insulin glargine once daily, Insulin Lispro 4 units 3 times a day with meals. Looks good, but I'd round up to the nearest unit just to be safe.

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Lavera

4 months ago

B) 15 units of insulin glargine once daily, Insulin Lispro 5 units 3 times a day with meals. Seems like the right answer to me.

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Leonida

4 months ago

I feel like option B makes sense since it seems to balance the long and short-acting insulin, but I'm not entirely confident about the numbers.

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France

4 months ago

I practiced a similar question where we had to switch from NPH to glargine, but I can't recall the exact ratios we used for Lispro.

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Cory

4 months ago

I think the total daily insulin was 62 units before the change, so 10% would be about 6 units, right?

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German

4 months ago

I remember we talked about reducing the total daily insulin by 10%, but I'm not sure how to calculate that exactly.

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Lai

5 months ago

Okay, I think I've got a good strategy. I'll break this down into smaller steps, calculate the new total daily insulin, and then divide it up accordingly. Gotta stay focused and double-check my work.

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Kimberlie

5 months ago

Whoa, this is a lot of information to process. I better read through it carefully and make sure I understand all the details before I start calculating. Don't want to make any silly mistakes.

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Louvenia

5 months ago

Alright, I've got this. I just need to do the math step-by-step and make sure I'm rounding down to the nearest unit. I feel confident I can get the right answer.

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Christa

5 months ago

I think the answer is A. It seems reasonable.

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Blair

5 months ago

Wait, how did we get to 16 units for glargine? Seems off.

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Muriel

5 months ago

JM's total daily insulin was 66 units before the reduction.

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Tula

6 months ago

I think option A looks right based on the calculations!

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Flo

6 months ago

This question is a real insulin-ator. I'm going with E) just to see if I can get lucky.

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Lenna

6 months ago

Okay, let's see. I need to figure out the total daily insulin and then split it into the long-acting and short-acting components. This will take some thinking, but I think I can work it out.

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