Pharmacology Quiz: Insulin Dosing And Hypoglycemia
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Insulin Dosing And HypoglycemiaQuestion 1 of 20

A patient with type 1 diabetes uses an insulin pump with insulin aspart. At 12:00 PM, his blood glucose was 220 mg/dL, and he administered a correction bolus. At 1:30 PM, his blood glucose is 190 mg/dL. Believing the first dose was insufficient, he administers another full correction bolus. Which of the following is the most likely outcome at approximately 3:00 PM?

Persistent hyperglycemia due to insulin resistance.
Euglycemia due to appropriately timed dose stacking.
Significant hypoglycemia due to overlapping insulin action.
Ketoacidosis due to insufficient overall insulin.
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Pharmacology Quiz

Pharmacology Quiz: Insulin Dosing And Hypoglycemia

Practice Insulin Dosing And Hypoglycemia in Pharmacology with focused quiz questions that help you check what you know, review explanations, and build confidence with test-style prompts.

What this quiz covers

This quiz focuses on Insulin Dosing And Hypoglycemia, giving you a quick way to practice the rules, question types, and explanations that matter most for Pharmacology.

How to use this quiz

Try each quiz question before looking at the correct answer. Use the explanations to review missed ideas, then come back to similar questions until the pattern feels familiar.

All questions

Question 1

A patient with type 1 diabetes uses an insulin pump with insulin aspart. At 12:00 PM, his blood glucose was 220 mg/dL, and he administered a correction bolus. At 1:30 PM, his blood glucose is 190 mg/dL. Believing the first dose was insufficient, he administers another full correction bolus. Which of the following is the most likely outcome at approximately 3:00 PM?

  1. Persistent hyperglycemia due to insulin resistance.
  2. Euglycemia due to appropriately timed dose stacking.
  3. Significant hypoglycemia due to overlapping insulin action. (correct answer)
  4. Ketoacidosis due to insufficient overall insulin.
Explanation: This scenario describes "insulin stacking." Insulin aspart has a duration of action of 3-5 hours. The first correction dose is still actively lowering blood glucose when the second dose is administered. The effects of both doses will overlap and peak, leading to an excessive amount of active insulin and a high risk of severe hypoglycemia.

Question 2

A 45-year-old man with type 2 diabetes on insulin therapy feels shaky and anxious. His blood glucose is 62 mg/dL. He is conscious and able to swallow. According to the "Rule of 15," which of the following is the most appropriate initial treatment?

  1. A full-size chocolate bar containing 30 grams of carbohydrates.
  2. One tablespoon of peanut butter on a slice of whole wheat bread.
  3. 4 ounces (120 mL) of regular fruit juice. (correct answer)
  4. 8 ounces (240 mL) of whole milk.
Explanation: The "Rule of 15" for mild to moderate hypoglycemia involves consuming 15 grams of a fast-acting carbohydrate. Fruit juice is an excellent choice as it is a simple carbohydrate that is rapidly absorbed. A chocolate bar (A), peanut butter (B), and whole milk (D) all contain fat and/or protein, which delay gastric emptying and slow glucose absorption, making them less effective for rapid correction of hypoglycemia.

Question 3

A 72-year-old patient with type 2 diabetes and stage 4 chronic kidney disease (eGFR 25 mL/min/1.73m²) has been experiencing recurrent episodes of hypoglycemia. His insulin regimen has not changed recently. Which physiological change best explains his increased risk of hypoglycemia related to his insulin therapy?

  1. Increased insulin sensitivity in peripheral tissues.
  2. Decreased hepatic gluconeogenesis.
  3. Reduced renal clearance of insulin. (correct answer)
  4. Impaired counter-regulatory hormone response.
Explanation: The kidneys are responsible for clearing a significant portion (30-80%) of exogenous insulin from circulation. In chronic kidney disease, this clearance is reduced, leading to a prolonged insulin half-life and accumulation. This effect increases the risk of hypoglycemia, often necessitating a reduction in insulin dosage. While other factors may contribute, reduced clearance is the primary pharmacokinetic reason for increased hypoglycemia risk from exogenous insulin in renal failure.

Question 4

A patient with type 1 diabetes on insulin glargine 20 units at bedtime and insulin lispro 6 units with each meal is scheduled for surgery and is ordered to be NPO (nothing by mouth) after midnight. Which is the most appropriate insulin order for the morning of the surgery?

  1. Hold both insulin glargine and insulin lispro.
  2. Administer the usual dose of 20 units of insulin glargine; hold insulin lispro.
  3. Administer a reduced dose (e.g., 10 units) of insulin glargine; hold insulin lispro. (correct answer)
  4. Administer the usual dose of insulin lispro; hold insulin glargine.
Explanation: For a patient with type 1 diabetes who is NPO, prandial (mealtime) insulin like lispro must be held to prevent hypoglycemia. However, basal insulin (glargine) is essential to suppress ketogenesis and prevent diabetic ketoacidosis (DKA). Standard practice is to continue basal insulin but at a reduced dose (typically 50-75% of the usual dose) to lower the risk of hypoglycemia in the absence of nutritional intake.

Question 5

A 30-year-old male with type 1 diabetes presents with severe hypoglycemia after consuming several alcoholic beverages on an empty stomach. He had taken his usual dose of pre-meal insulin lispro, anticipating a meal he never ate. What is the primary mechanism by which alcohol consumption exacerbated his hypoglycemia?

  1. Alcohol directly stimulates pancreatic beta-cells to release more insulin.
  2. Alcohol metabolism in the liver inhibits gluconeogenesis. (correct answer)
  3. Alcohol increases the absorption rate of subcutaneous insulin.
  4. Alcohol competitively inhibits the renal clearance of insulin.
Explanation: The metabolism of ethanol by alcohol dehydrogenase increases the NADH/NAD+ ratio in hepatocytes. This altered redox state inhibits key steps in gluconeogenesis (the body's process for producing glucose), such as the conversion of lactate to pyruvate. By impairing this crucial defense mechanism against falling blood sugar, alcohol potentiates the hypoglycemic effect of insulin, especially in a fasting state.

Question 6

A 55-year-old patient with a 30-year history of type 1 diabetes reports that his wife has found him confused and disoriented on several occasions with a low fingerstick glucose, but he felt no preceding symptoms like shakiness or palpitations. This clinical picture is most consistent with which of the following complications?

  1. Insulin resistance
  2. Diabetic autonomic neuropathy (correct answer)
  3. Diabetic somatic neuropathy
  4. Gastroparesis
Explanation: This patient is describing hypoglycemia unawareness. The early warning signs of hypoglycemia (palpitations, tremor, anxiety) are adrenergic symptoms mediated by the autonomic nervous system. In long-standing diabetes, autonomic neuropathy can develop, blunting this response. Consequently, the patient does not recognize hypoglycemia until neuroglycopenic symptoms (confusion, seizure, coma) occur at a much lower blood glucose level.

Question 7

A patient with type 2 diabetes on NPH and regular insulin experiences hypoglycemia (58 mg/dL) at 4:00 PM, one hour before his scheduled dinner. He consumes 4 ounces of orange juice. Fifteen minutes later, his blood glucose is 95 mg/dL. What is the most appropriate next step for this patient?

  1. Eat his scheduled dinner as planned, ensuring it contains a complex carbohydrate. (correct answer)
  2. Re-check blood glucose every hour until his dinner at 5:00 PM.
  3. Administer a small dose of regular insulin to prevent rebound hyperglycemia.
  4. Consume another 15 grams of simple carbohydrates immediately to be safe.
Explanation: When managing hypoglycemia, you need to understand the "15-15 rule" and recognize when treatment has been successful. This question tests your knowledge of hypoglycemia management and the appropriate follow-up care. The patient's blood glucose rose from 58 mg/dL to 95 mg/dL after consuming orange juice, indicating successful treatment of the hypoglycemic episode. Since his glucose is now in the normal range (70-140 mg/dL) and it's close to his scheduled mealtime, the most appropriate action is to proceed with his planned dinner, ensuring it contains complex carbohydrates to provide sustained glucose release and prevent another hypoglycemic episode. Choice A is correct because the hypoglycemia has been adequately corrected, and a balanced meal with complex carbohydrates will help maintain stable blood glucose levels. Choice B is unnecessarily cautious - with glucose normalized and dinner imminent, frequent monitoring isn't needed. Choice C is dangerous because administering insulin when glucose has just recovered from hypoglycemia could trigger another hypoglycemic episode; there's no indication of impending hyperglycemia that would require insulin. Choice D could cause rebound hyperglycemia since the patient's glucose is already normal at 95 mg/dL - additional simple carbohydrates aren't needed and could overshoot the target range. Key strategy: Remember the 15-15 rule (15g carbs, wait 15 minutes, recheck), but once hypoglycemia resolves and mealtime approaches, focus on maintaining stability with appropriate nutrition rather than continued aggressive treatment. Always avoid insulin administration immediately after treating hypoglycemia.

Question 8

A 60-year-old patient with newly diagnosed, poorly controlled type 2 diabetes (initial A1c 12.5%) is started on an intensive insulin regimen. Over two weeks, his average blood glucose drops from ~350 mg/dL to ~130 mg/dL. He calls the clinic complaining of shakiness, sweating, and anxiety when his fingerstick glucose is 110 mg/dL. What is the best explanation for his symptoms?

  1. The rapid decrease in blood glucose has triggered a counter-regulatory response. (correct answer)
  2. His glucose meter is providing inaccurate, falsely low readings.
  3. He is experiencing an allergic reaction to the insulin formulation.
  4. He has developed hypoglycemia unawareness due to autonomic dysfunction.
Explanation: When you encounter questions about diabetes management and glucose control, focus on how the body adapts to chronic hyperglycemia and responds to rapid normalization. This patient is experiencing pseudohypoglycemia—symptoms of hypoglycemia at normal glucose levels. After prolonged exposure to very high blood glucose (averaging ~350 mg/dL), his body has reset its glucose "thermostat." The brain and counter-regulatory systems have adapted to function at these elevated levels. When glucose drops rapidly to normal ranges (~110 mg/dL), the body interprets this as dangerously low and triggers the sympathetic nervous system response: shakiness, sweating, and anxiety. This is why answer A is correct—the counter-regulatory response is activated despite normal glucose levels. Answer B is incorrect because his glucose meter reading of 110 mg/dL aligns with his improved average of ~130 mg/dL, suggesting accurate readings. Answer C is wrong because allergic reactions to insulin typically present with local injection site reactions or systemic allergic symptoms, not hypoglycemic-like symptoms that correlate with specific glucose levels. Answer D represents a different phenomenon—hypoglycemia unawareness occurs after repeated true hypoglycemic episodes that blunt the warning symptoms, but this patient is having enhanced symptoms at normal glucose levels. Study tip: Remember that in poorly controlled diabetes, rapid glucose normalization often causes pseudohypoglycemia. The key clue is symptoms of hypoglycemia when glucose levels are actually normal or near-normal. This concept frequently appears on pharmacology exams testing diabetes management principles.

Question 9

A paramedic is treating an adult patient with severe hypoglycemia (25 mg/dL) through a small, fragile peripheral IV in the hand. The protocol allows for administration of either 50 mL of 50% dextrose (D50W) or 100 mL of 25% dextrose (D25W) to deliver 25 grams of glucose. Which of the following provides the strongest rationale for choosing D25W in this specific situation?

  1. D25W has a more rapid onset of action than D50W.
  2. D50W is associated with a much higher risk of rebound hyperglycemia.
  3. Administration of D50W requires a central venous catheter, which is not available.
  4. D25W is less hyperosmolar, reducing the risk of phlebitis and extravasation injury. (correct answer)
Explanation: When treating hypoglycemia with IV dextrose, you need to consider both the glucose dose and the osmolarity of the solution, especially when working with fragile vascular access. Both D50W and D25W can deliver the same 25 grams of glucose, but their different concentrations create very different osmotic effects. D25W is the better choice here because it's significantly less hyperosmolar than D50W. The 50% dextrose solution is extremely concentrated and creates high osmotic pressure that can damage vessel walls, leading to phlebitis (vein inflammation) and potentially severe tissue necrosis if extravasation occurs. With a small, fragile hand IV, this risk is particularly concerning since hand veins are delicate and extravasation in this area can cause significant functional impairment. Looking at the incorrect options: (A) is wrong because both solutions have similar onset times once administered—the glucose enters circulation at comparable rates. (B) is incorrect because rebound hyperglycemia risk depends on the total glucose dose, not the concentration, and both deliver identical amounts. (C) is false because D50W can be given through peripheral IVs, though it's not ideal for fragile access. The key principle is that while both solutions deliver equivalent therapeutic effect, the lower osmolarity of D25W makes it much safer for compromised vascular access. Remember: in pharmacology, the same drug dose can have different risk profiles based on concentration and osmolarity. Always consider vascular access quality when choosing between concentrated versus diluted formulations of the same medication.

Question 10

A patient using an insulin pump for type 1 diabetes reports an episode of severe overnight hypoglycemia. Upon review of his pump history, it is noted that he administered a 10-unit bolus at 10:00 PM. The patient states he was tired and intended to set his overnight infusion rate, not give a bolus. This error represents a fundamental confusion between which two pump features?

  1. The correction factor and the insulin-to-carb ratio.
  2. A temporary basal rate and an extended bolus.
  3. The active insulin time and the bolus wizard calculator.
  4. A manual bolus and the basal rate program. (correct answer)
Explanation: When you encounter insulin pump questions, focus on understanding the core pump functions: boluses deliver immediate insulin doses, while basal rates provide continuous background insulin throughout the day. In this scenario, the patient accidentally gave himself a 10-unit bolus instead of adjusting his overnight basal rate. A bolus delivers all 10 units immediately, causing rapid blood glucose reduction and overnight hypoglycemia. In contrast, a basal rate would have delivered that same amount gradually over many hours, maintaining steady glucose control. This confusion between immediate versus continuous insulin delivery explains the severe hypoglycemic episode. Answer D correctly identifies this fundamental mix-up between a manual bolus (immediate insulin delivery) and basal rate programming (continuous background insulin). Answer A is wrong because correction factors (insulin units needed to lower glucose by a set amount) and insulin-to-carb ratios (units needed per gram of carbohydrate) are calculation tools, not delivery methods. Answer B incorrectly suggests confusion between two advanced features: temporary basal rates (short-term basal adjustments) and extended boluses (boluses delivered over time), neither of which matches this scenario. Answer C is incorrect because active insulin time (how long insulin remains active) and bolus calculators are computational features, not the delivery mechanism confusion described. For pump questions, always distinguish between the two fundamental delivery modes: boluses for immediate needs (meals, corrections) and basal rates for continuous background coverage. Most pump errors involve confusing these basic functions rather than advanced features.

Question 11

A 45-year-old man with type 2 diabetes on insulin therapy feels shaky and anxious. His blood glucose is 62 mg/dL. He is conscious and able to swallow. According to the "Rule of 15," which of the following is the most appropriate initial treatment?

  1. A full-size chocolate bar containing 30 grams of carbohydrates.
  2. One tablespoon of peanut butter on a slice of whole wheat bread.
  3. 4 ounces (120 mL) of regular fruit juice. (correct answer)
  4. 8 ounces (240 mL) of whole milk.
Explanation: The "Rule of 15" for mild to moderate hypoglycemia involves consuming 15 grams of a fast-acting carbohydrate. Fruit juice is an excellent choice as it is a simple carbohydrate that is rapidly absorbed. A chocolate bar (A), peanut butter (B), and whole milk (D) all contain fat and/or protein, which delay gastric emptying and slow glucose absorption, making them less effective for rapid correction of hypoglycemia.

Question 12

An emergency department nurse is triaging a patient with a known history of diabetes who presents with altered mental status. Which of the following clinical signs would most strongly suggest hypoglycemia as the etiology rather than diabetic ketoacidosis (DKA)?

  1. Kussmaul respirations and a fruity odor on the breath.
  2. Severe dehydration with poor skin turgor and dry mucous membranes.
  3. Gradual onset of symptoms over several days.
  4. Diaphoresis, pallor, and a normal respiratory pattern. (correct answer)
Explanation: When encountering a diabetic patient with altered mental status, you need to quickly differentiate between hypoglycemia and diabetic ketoacidosis (DKA), as they require opposite treatments and have different urgency levels. Hypoglycemia triggers a massive sympathetic nervous system response as the body attempts to raise blood glucose. This creates the classic triad: diaphoresis (sweating), pallor, and tachycardia, while respiratory patterns remain normal since there's no metabolic acidosis to compensate for. The onset is typically rapid, and patients may appear tremulous or confused but won't have the distinctive breath odor or breathing pattern of DKA. Let's examine why the other options point toward DKA instead: Option A describes Kussmaul respirations (deep, rapid breathing) and fruity breath odor, which are hallmarks of DKA. The breathing compensates for metabolic acidosis, while ketones create the characteristic smell. Option B reflects the severe dehydration common in DKA due to osmotic diuresis from hyperglycemia. Option C describes DKA's typical presentation—symptoms develop gradually over hours to days as glucose and ketones accumulate, unlike hypoglycemia's rapid onset. The key distinction is that hypoglycemia is a sympathetic emergency with sweating and pallor but normal breathing, while DKA is a metabolic emergency with dehydration, acidosis, and compensatory hyperventilation. Remember: "Wet and pale" suggests low glucose; "dry and deep breathing" suggests DKA. This differentiation is crucial because giving insulin to a hypoglycemic patient could be fatal.

Question 13

A teenager with type 1 diabetes on a basal-bolus regimen (glargine and aspart) takes his usual pre-lunch insulin aspart dose. Immediately after lunch, he engages in an unplanned, strenuous 90-minute basketball game. He is at highest risk for developing hypoglycemia at which time point?

  1. During the first 15 minutes of exercise.
  2. Approximately 1-2 hours after starting exercise. (correct answer)
  3. 8-12 hours after the exercise has ended.
  4. The following morning before breakfast.
Explanation: The risk of hypoglycemia is greatest when the peak effect of insulin coincides with the glucose-lowering effect of exercise. Insulin aspart peaks approximately 1-2 hours after injection. Exercise increases glucose uptake by muscles. Therefore, the period 1-2 hours after the meal and injection, during the strenuous activity, represents the time of maximal glucose lowering from both insulin and exercise, posing the highest acute risk.

Question 14

An 80-kg patient in the ICU develops severe hypoglycemia (blood glucose 30 mg/dL) and is obtunded. The standard protocol is to administer 25 grams of dextrose intravenously. The hospital stocks 50% dextrose in water (D50W) in 50 mL vials. How many milliliters of D50W should be administered?

  1. 25 mL
  2. 50 mL (correct answer)
  3. 75 mL
  4. 100 mL
Explanation: D50W means there are 50 grams of dextrose in 100 mL of solution. This gives a concentration of 0.5 grams/mL. To administer the required 25 grams of dextrose, the volume needed is calculated as: Volume = Total Dose / Concentration = 25 g / (0.5 g/mL) = 50 mL. Therefore, a full 50 mL vial should be administered.

Question 15

A patient with diabetic ketoacidosis has been stabilized on a continuous intravenous insulin infusion. The physician plans to transition the patient to subcutaneous insulin glargine. To ensure a smooth transition and prevent rebound hyperglycemia, when should the IV insulin infusion be discontinued?

  1. Immediately after the first subcutaneous glargine dose is administered.
  2. 30 minutes before the first subcutaneous glargine dose is administered.
  3. 1 to 2 hours after the first subcutaneous glargine dose is administered. (correct answer)
  4. 6 hours after the first subcutaneous glargine dose is administered.
Explanation: IV regular insulin has a very short half-life (minutes). Long-acting insulins like glargine have a delayed onset of action, typically 1-2 hours. To prevent a gap in insulin coverage that would lead to rebound hyperglycemia, the IV insulin infusion must be continued for 1-2 hours after the first subcutaneous dose of long-acting insulin is given, allowing it to begin working before the infusion is stopped.

Question 16

A 68-year-old male with type 1 diabetes, hypertension, and a history of myocardial infarction is brought to the emergency department with confusion and irritability. His medications include insulin glargine, insulin lispro, and propranolol. His point-of-care blood glucose is 42 mg/dL. Which of the following signs or symptoms would most likely be present despite his use of propranolol?

  1. Tachycardia
  2. Tremors
  3. Diaphoresis (correct answer)
  4. Palpitations
Explanation: Non-selective beta-blockers like propranolol mask the adrenergic symptoms of hypoglycemia (tachycardia, tremors, palpitations) by blocking beta-adrenergic receptors. However, diaphoresis (sweating) is mediated by post-ganglionic sympathetic neurons that release acetylcholine, acting on muscarinic receptors. Therefore, sweating is not masked by beta-blockade and remains a key warning sign of hypoglycemia in these patients.

Question 17

A patient with type 1 diabetes who is also a competitive marathon runner experiences severe hypoglycemia after a long training run. Her coach administers an appropriate dose of intramuscular glucagon, but her blood glucose level fails to rise significantly after 15 minutes. What is the most likely reason for the treatment failure?

  1. The patient's hepatic glycogen stores were depleted by the exercise. (correct answer)
  2. Intramuscular administration provides poor bioavailability for glucagon.
  3. The patient has developed antibodies to the glucagon preparation.
  4. The patient has undiagnosed severe hepatic insufficiency.
Explanation: When you encounter questions about glucagon treatment failure, focus on glucagon's mechanism of action: it stimulates hepatic glycogenolysis (breakdown of stored glycogen into glucose) and gluconeogenesis (creation of new glucose from other substrates). In this marathon runner with type 1 diabetes, the most likely cause of glucagon treatment failure is depleted hepatic glycogen stores from prolonged exercise (A). During extended aerobic activity like marathon training, the liver progressively breaks down its glycogen reserves to maintain blood glucose levels. When glycogen stores are exhausted, glucagon has no substrate to work with—it's like trying to withdraw money from an empty bank account. The hormone is functioning normally, but there's simply no stored glycogen left to convert to glucose. Option B is incorrect because intramuscular glucagon has excellent bioavailability and is the standard emergency route when intravenous access isn't available. The absorption is reliable and typically produces effects within 10-15 minutes. Option C represents an extremely rare occurrence. While glucagon antibodies can theoretically develop, this would typically happen after repeated exposures over time, not in a routine emergency situation. Option D is unlikely in an otherwise healthy competitive athlete. Severe hepatic insufficiency would present with other clinical signs and would probably prevent someone from training at marathon level. Study tip: Remember that glucagon's effectiveness depends entirely on available glycogen stores. In scenarios involving prolonged exercise, fasting, or chronic illness, consider glycogen depletion as the primary cause of glucagon treatment failure rather than drug-related factors.

Question 18

A 68-year-old male with type 1 diabetes, hypertension, and a history of myocardial infarction is brought to the emergency department with confusion and irritability. His medications include insulin glargine, insulin lispro, and propranolol. His point-of-care blood glucose is 42 mg/dL. Which of the following signs or symptoms would most likely be present despite his use of propranolol?

  1. Tachycardia
  2. Tremors
  3. Diaphoresis (correct answer)
  4. Palpitations
Explanation: Non-selective beta-blockers like propranolol mask the adrenergic symptoms of hypoglycemia (tachycardia, tremors, palpitations) by blocking beta-adrenergic receptors. However, diaphoresis (sweating) is mediated by post-ganglionic sympathetic neurons that release acetylcholine, acting on muscarinic receptors. Therefore, sweating is not masked by beta-blockade and remains a key warning sign of hypoglycemia in these patients.

Question 19

A 19-year-old patient with type 1 diabetes reports frequent morning headaches, night sweats, and fasting blood glucose readings of 200-250 mg/dL. In response, he independently increased his evening insulin glargine dose, but the morning hyperglycemia worsened. Which intervention is most appropriate to confirm the suspected underlying cause?

  1. Increase the evening insulin glargine dose further to overcome insulin resistance.
  2. Check blood glucose at 3:00 AM to assess for nocturnal hypoglycemia. (correct answer)
  3. Switch the evening insulin glargine to a morning administration time.
  4. Add a bedtime snack containing only simple carbohydrates.
Explanation: The patient's symptoms (night sweats, headaches) and paradoxical worsening of morning hyperglycemia after increasing evening insulin suggest the Somogyi effect. This is rebound hyperglycemia caused by a counter-regulatory hormone surge in response to nocturnal hypoglycemia. The definitive diagnostic step is to check a blood glucose level between 2:00 and 3:00 AM to document the hypoglycemic event.

Question 20

An 80-kg patient in the ICU develops severe hypoglycemia (blood glucose 30 mg/dL) and is obtunded. The standard protocol is to administer 25 grams of dextrose intravenously. The hospital stocks 50% dextrose in water (D50W) in 50 mL vials. How many milliliters of D50W should be administered?

  1. 25 mL
  2. 50 mL (correct answer)
  3. 75 mL
  4. 100 mL
Explanation: D50W means there are 50 grams of dextrose in 100 mL of solution. This gives a concentration of 0.5 grams/mL. To administer the required 25 grams of dextrose, the volume needed is calculated as: Volume = Total Dose / Concentration = 25 g / (0.5 g/mL) = 50 mL. Therefore, a full 50 mL vial should be administered.