A client admitted to the emergency department with deep rapid respirations, fruity breath odor, and blood glucose of 520 mg/dL. Which insulin administration method is most appropriate?

Rationale: A. Glargine is a long-acting, basal insulin with a peakless effect. It is not suitable for acute hyperglycemic emergencies, such as diabetic ketoacidosis (DKA), because it does not act quickly enough to reduce dangerously high blood glucose levels. B. Lispro is a rapid-acting insulin, but intramuscular injection is not standard; it is administered subcutaneously. IM absorption can be unpredictable and may not provide reliable glucose lowering in emergencies. C. NPH is an intermediate-acting insulin with delayed onset (1–2 hours) and a peak at 4–12 hours. It cannot rapidly lower blood glucose in an acute hyperglycemic crisis, making it inappropriate for emergency management. D. Regular insulin given IV acts immediately and can be titrated continuously to rapidly reduce blood glucose in emergencies like DKA. IV administration allows close monitoring of glucose and potassium levels and is considered the standard of care for acute hyperglycemic crises in hospitalized patients.