Diabetes Pharm Exam

Insulin onset 30 min given SubQ

Regular

Insulin Peak 2.5-5 hours

Regular given SQ

What angle should be used on an average sized pt. when giving a subcutaneous injection with an insulin pen? 15 degrees 30 degrees 45 degrees 90 degrees

90 degrees

Mr. Johnson will received his short acting insulin at 12:00 what time will it take effect 12:20 PM 1:30 PM 12:00 PM 2:00 PM

12:20 PM

A bedtime snack is provided as the intermediate insulin is effective for what duration. 6-8 hours 10-14 hours 16-20 hours 24-28 hours

16-20 hours

Guidelines for Oral Antidiabetic Therapy for Type II Diabetes-fasting blood glucose level

200 mg/dl or less

What is the normal blood glucose level in a non-diabetic? 70-100 40-80 60-110 75-95

70-100

What is the onset of action time for Humulin R insulin if administered subcutaneously? 5-15 minutes 30-60 minutes 1-2 hours 2-3 hours

30-60 minutes

Mr. Johnson was given his insulin Humalog at 12:00 pm what time will the peak start 12:30 PM 6:00 PM 1:30 PM 8:00 PM

8:00 PM

Ms. Betty is due her NPH insulin at 4:00 PM she should get her dinner tray at 4:00 PM 2:30 PM 4:20 PM 5:15 PM

4:20 PM

Type 1 diabetics may receive ______ of their morning dose of insulin preoperatively 10-20% 25-40% 50-60% 75-90%

50-60%

The patient tells the nurse that he has been treating his stomach pain with a lot of calcium carbonate. It is most important for the nurse to assess the patient for A.Burnett's syndrome. B.hypernatremia. C.metabolic alkalosis. D.acid rebound.

A. Burnett's syndrome

Ondansetron has been ordered for the patient undergoing cancer chemotherapy to control the severe nausea and vomiting. What side effects should the nurse observe for? A.Headache, dizziness, and fatigue B.Anorexia and hair loss C.Abdominal cramping and irritability D.Psychosis and middle ear disturbances

A. Headache, dizziness, and fatigue

A patient who complains of gastric distress from aspirin will most likely benefit from the administration of which medication? • A.Misoprostol B.Lansoprazole C.Magaldrate D.Magnesium trisilicate

A. Misoprostol

An older adult patient reports taking aluminum hydroxide on a daily basis to relieve symptoms of gastroesophageal reflux disease (GERD). The nurse needs to evaluate for which condition? A.Constipation B.Diarrhea C.Flatulence D.Abdominal pain

A. Constipation is a common side effect with aluminum hyroxide

Which medications are most likely to be included in a common triple drug therapy program for peptic ulcer disease from H. pylori? A.Metronidazole, omeprazole and clarithromycin B.Amoxicillin, Tetracycline and metronidazole C.Bismuth subsalicylate, tetracycline and amoxicillin D.Ciprofloxacin and sucralfate

A. This is a combination of 2 antibiotics and a PPI. B is incorrect because they are all antibiotics, c would not be indicated unless the meds in A. did not work, and they would still need a PPI to make it a quad therapy combination. D is only two medications and sucralfate is not indicated for H-Pylori.

A patient who has constipation is prescribed a bisacodyl suppository. Which explanation will the nurse use to explain the action of bisacodyl? A. Acts on smooth intestinal muscle to gently increase peristalsis B. Absorbs water into the intestines to increase bulk and peristalsis C. Lowers surface tension and increases water accumulation in the intestines D. Pulls salts into the colon and increases water in the feces to increase bulk

A. Acts on smooth intestinal muscle to gently increase peristalsis

Of the following groups of medications, which can be used as antiemetics? Select all that apply. A. Anticholinergics B. Antihistamines C. Cannabinoids D. Opioids E. Phenothiazines

A. Anticholinergics B. Antihistamines C. Cannabinoids D. Opioids E. Phenothiazines

The nurse is administering difenoxin with atropine to a patient. Which should be included in the patient teaching regarding this medication? Select all that apply. A. Caution the patient to avoid laxative abuse B. Record the frequency of bowel movement C. Caution the patient against taking sedatives concurrently D. Encourage the patient to increase fluids E. instruct the patient to avoid this drug if he or she has narrow-angle glaucoma F. Teach the patient that the drug acts by drawing water into the intestine

A. Caution the patient to avoid laxative abuse B. Record the frequency of bowel movement C. Caution the patient against taking sedatives concurrently D. Encourage the patient to increase fluids E. instruct the patient to avoid this drug if he or she has narrow-angle glaucoma F. Teach the patient that the drug acts by drawing water into the intestine

Which area(s) in the brain cause(s) vomiting when stimulated? Select all that apply. A. Chemoreceptor trigger zone B. Nausea center C. Medulla D. Vertigo center E. Vomiting center

A. Chemoreceptor trigger zone B. Nausea center C. Medulla D. Vertigo center E. Vomiting center

A patient received regular insulin at 7:30 am. At 9:30 am the patient feels slightly hungry and has a dull headache. The nurse should A. test the patient's blood glucose level. B. ensure that the patient has a meal. C. provide the patient with 4 ounces of orange juice. D. administer the next dose of insulin.

A. test the patient's blood glucose level.

The nurse is teaching a group of nursing students about the use of antipsychotic drugs for antiemetic purposes. The nurse will explain that, when given as antiemetics, these drugs are given: a. in smaller doses. b. less frequently. c. with anticholinergics. d. with antihistamines.

ANS: A Antipsychotic medications are used in smaller doses when administered for antiemetic purposes.

Which statement by a patient taking glipizide indicates that more teaching is indicated? • A."I will use a new needle every time I take the medication." B."I will take the medication once a day in the morning." C."I will eat my breakfast very soon after taking my Glucotrol." D."This medication stimulates my pancreatic cells to make insulin."

ANS: A Glipizide (Glucotrol) is an oral antidiabetic agent. It is well absorbed from the GI tract and is highly protein-bound. Parenteral administration of this medication is not indicated. All other options are correct.

A patient with type 1 diabetes mellitus is ordered insulin therapy once daily to be administered at bedtime. What is the type of insulin the patient is most likely receiving? A. Insulin glargine B. Lente insulin C. Lispro insulin D. Regular insulin

ANS: A Insulin glargine (Lantus) is long-acting insulin with an onset of 1 hour. It is evenly distributed over a 24-hour duration of action; thus, it is administered once a day, usually at bedtime. Intermediate-acting insulins include neutral-protamine-Hagedorn (NPH), Lente, and Humulin N. Rapid-acting insulins include insulin lispro. Regular insulin is short acting.

A patient received regular insulin at 7:30 am. At 9:30 am the patient feels slightly hungry and has a dull headache. The nurse should • A.test the patient's blood glucose level. B.ensure that the patient has a meal. C.provide the patient with 4 ounces of orange juice. D.administer the next dose of insulin.

ANS: A The peak time for regular insulin is 2 to 4 hours. It is most important for the nurse to check the patient's blood glucose level to prevent a possible hypoglycemic reaction (insulin shock).

A child has been prescribed activated charcoal. What is the likely reason this is being ordered? a. Ingestion of a toxic substance b. Severe vomiting c. Nausea d. Motion sickness

ANS: A Activated charcoal is given to prevent the absorption of ingested toxic substances. Activated charcoal does not have a role in the treatment of nausea, vomiting or motion sickness.

A child is brought to the emergency department after ingestion of a toxic substance. The child is alert and conscious and is reported to have ingested kerosene 20 minutes prior. The nurse will anticipate administering a. activated charcoal. b. an anticholinergic antiemetic. c. gastric lavage. d. syrup of ipecac.

ANS: A Activated charcoal is used when patients have ingested a caustic substance or a petroleum distillate in a patient who is alert and awake. Gastric lavage is no longer used as therapy. Syrup of ipecac is not recommended.

An appropriate goal when teaching a patient who has diarrhea is that the patient: a. will have less frequent, more formed stools. b. will not have a stool for 1 to 2 days. c. will receive adequate intravenous fluids. d. will receive appropriate antibiotic therapy.

ANS: A An appropriate goal is that patients will have formed, less frequent stools, not an absence of stools. Receiving adequate intravenous fluids or antibiotic therapy are interventions, not goals.

A patient who takes propantheline bromine (Pro-Banthine) and omeprazole (Prilosec) for an ulcer will begin taking an antacid. The nurse will give which instruction to the patient regarding how to take the antacid? a. Take the antacid 2 hours after taking the propantheline. b. Take the antacid along with a meal. c. Take the antacid with milk. d. Take the antacid with the propantheline bromine.

ANS: A Antacids can slow the absorption of anticholinergics and should be taken 2 hours after anticholinergic administration. Antacids should be given 1 to 3 hours after a meal and should not be given with dairy products.

A patient who is taking diphenoxylate with atropine (Lomotil) to treat diarrhea asks the nurse why it contains atropine. The nurse will explain that atropine is added, in part, to: a. decrease abdominal cramping. b. increase intestinal motility. c. minimize nausea and vomiting. d. provide analgesia.

ANS: A Atropine is added to decrease abdominal cramping and slow intestinal motility through its anticholinergic effects. It does not affect nausea and vomiting or pain.

A patient who is receiving chemotherapy will be given dronabinol (Marinol) to prevent nausea and vomiting. The nurse will tell the patient that this drug will be given at which time? a. Before and after the chemotherapy b. During chemotherapy c. Immediately prior to chemotherapy d. 24 hours prior to chemotherapy

ANS: A Cannabinoids are indicated for use prior to and after chemotherapy. Dronabinol is given 1-3 hours prior to chemotherapy and then every 2-4 hours after.

The nurse is caring for a patient who has Zollinger-Ellison syndrome. Which medication order would the nurse question for this patient? a. Cimetidine (Tagamet) b. Pantoprazole (Protonix) c. Rabeprazole (Aciphex) d. Ranitidine (Zantac)

ANS: A Cimetidine is not effective for treating Zollinger-Ellison syndrome. The other medications may be used to treat Zollinger-Ellison syndrome.

A patient who has type 1 diabetes mellitus asks the nurse about using a combination insulin product such as Humalog 70/30. The nurse will tell the patient that use of this product: a. depends on individual insulin needs. b. is useful for patients with severe insulin resistance. c. means less rotation of injection sites. d. requires refrigeration at all times

ANS: A Combination products are convenient because the patient does not have to mix insulin, but the products depend on individual needs, since the doses are fixed. They are generally not used for patients with severe insulin resistance that require large insulin doses. Patients must continue to rotate injection sites. They do not require refrigeration after first use.

The nurse is teaching a patient who is about to take a long car trip about using dimenhydrinate (Dramamine) to prevent motion sickness. What information is important to include when teaching this patient? a. "Do not drive while taking this medication." b. "Dry mouth is a sign of toxicity with this medication." c. "Take the medication 1 to 2 hours prior to beginning the trip." d. "Take 100 mg up to 6 times daily for best effect."

ANS: A Drowsiness is a common side effect of dimenhydrinate, so patients should be cautioned against driving while taking this drug. Dry mouth is a common side effect and not a sign of toxicity. The drug should be taken 30 minutes prior to travel. The maximum recommended dose is 400 mg per day.

A patient who has type 2 diabetes mellitus asks the nurse why the provider has changed the oral antidiabetic agent from tolbutamide (Orinase) to glipizide (Glucotrol). The nurse will explain that glipizide a. has a longer duration of action. b. has fewer gastrointestinal side effects. c. may be taken on an as-needed basis. d. does not cause hypoglycemia.

ANS: A Glipizide is a second-generation sulfonylurea. It has a longer duration of action than the first-generation sulfonylurea tolbutamide. It has many gastrointestinal side effects. It is taken once daily, not as needed. All sulfonylureas can contribute to hypoglycemia.

The nurse is instructing a patient who will take psyllium (Metamucil) to treat constipation. What information will the nurse include when teaching this patient? a. The importance of consuming adequate amounts of water b. The need to monitor for systemic side effects c. The onset of action of 30 to 60 minutes after administration d. The need to use the dry form of Metamucil to prevent cramping

ANS: A Insufficient fluid intake can cause the drug to solidify in the gastrointestinal tract, thus counseling on ingestion of adequate amounts of water is important. Psyllium is not systemically absorbed, so it does not have systemic side effects. Onset of action for psyllium is between 10 and 24 hours. All forms of bulk forming laxatives can contribute to GI side effects such as cramping.

A patient is ordered to receive insulin lispro at mealtimes. The nurse will instruct this patient to administer the medication at which time? a. 10-15 min before eating b. 15 min after eating c. 30 min before eating d. 10 min after eating

ANS: A Lispro acts faster than regular insulin, and patients should be taught to give this medication 10-15 minutes before eating.

A patient reports having three to four stools, which are sometimes hard, per week. The patient states that this represents less bowel movements than normal for her. The nurse will perform which action? a. Recommend increased intake of fluids and dietary fiber. b. Request an order for a stimulant laxative as needed. c. Request an order for a stool softener. d. Request an order for magnesium citrate.

ANS: A This patient is having stools that are within the normal range for frequency, but she does state that she generally has more frequent bowel movements. Nonpharmacologic measures, such as increased intake of fluids and dietary fiber, should be used first to help soften stools.

A patient is taking rabeprazole (Aciphex) 20 mg per day to treat a duodenal ulcer. After 10 days of treatment, the patient reports that the pain has subsided. The nurse will counsel the patient to: a. continue the medication for up to 4-8 total weeks of treatment. b. reduce the medication dose by half. c. stop taking the medication. d. take the medication every other day.

ANS: A With treatment, ulcer pain may subside earlier, but the healing process may take 1 to 2 months. Patients should be counseled to take the drug for the length of time prescribed. Reducing the dose or taking less frequently is not recommended.

A patient who recently began having mild symptoms of gastroesophageal reflux disease (GERD) is reluctant to take medication. What non-pharmacological measures will the nurse recommend to minimize this patient's symptoms? (Select all that apply.) a. Avoiding hot, spicy foods b. Avoiding tobacco products c. Drinking a glass of red wine with dinner d. Eating a snack before bedtime e. Taking ibuprofen with food f. Using a small pillow for sleeping g. Wearing well-fitted clothing

ANS: A, B, E Hot, spicy foods aggravate gastric upset, tobacco increases gastric secretions, and ibuprofen on an empty stomach increases gastric secretions, so patients should be taught to avoid these actions. Alcohol should be avoided since it increases gastric secretions. Eating at bedtime increases reflux, as does laying relatively flat to sleep, or wearing fitted clothing.

Which time frame would be most appropriate for administering sliding-scale lispro insulin? A.Within 30 minutes of consuming breakfast B.When the breakfast tray is served and ready to eat C.Within 1 hour of obtaining blood glucose measurement D.Within 15 minutes of obtaining blood glucose measurement

ANS: B Lispro should be given 5 minutes before eating because the onset of action is 5 to 15 minutes.

The parent of a child who is receiving chemotherapy asks the nurse why metoclopramide (Reglan) is not being used to suppress vomiting. The nurse will explain that, in children, this drug is more likely to cause which adverse effect? a. Excess sedation b. Extrapyramidal symptoms c. Paralytic ileus d. Vertigo

ANS: B Metoclopramide can cause extrapyramidal symptoms, and these effects are more likely in children. Children are not more prone to sedative effects, paralytic ileus, or vertigo while taking this drug.

A patient is prescribed metformin. Which is a side effect/adverse effect common to metformin? A.Seizures B.Constipation C.Bitter or metallic taste D.Polyuria and polydipsia

ANS: C Metformin has a bitter or metallic taste. Seizures, constipation, polyuria, and polydipsia are not side effects/adverse effects of metformin.

The parent of an 18-month-old toddler calls the clinic to report that the child has vomited 5 times that day. The nurse determines that the child has had three wet diapers in the past 6 hours. What will the nurse recommend for this child? a. Administering an OTC antiemetic medication such as diphenhydramine b. Giving frequent, small amounts of Pedialyte c. Keeping the child NPO until vomiting subsides d. Taking the child to the emergency department for IV fluids

ANS: B The child is not dehydrated as evidenced by adequate wet diapers, so nonpharmacologic measures, such as oral fluids, are recommended. Antiemetics are not recommended unless dehydration occurs. Intravenous fluids are given when dehydration is present.

Which antacid is most likely to cause acid rebound? a. Aluminum hydroxide b. Calcium carbonate c. Magnesium hydroxide d. Magnesium trisilicate

ANS: B While calcium carbonate is most effective among the listed antacids in neutralizing acid, a significant amount can be systemically absorbed and can cause acid rebound. The other antacids do not have significant systemic absorption.

The nurse is caring for a patient who has unexplained, recurrent vomiting and who is unable to keep anything down. Until the cause of the vomiting is determined, the nurse will anticipate administering which medications? a. Antibiotics and antiemetics b. Intravenous fluids and electrolytes c. Nonprescription antiemetics d. Prescription antiemetics

ANS: B Antiemetics can mask the underlying cause of vomiting and should not be used until the cause is determined unless vomiting is so severe that dehydration and electrolyte imbalance occur. Nonpharmacologic measures, such as fluid and electrolyte replacement, should be used. Antibiotics are only used if an infectious cause is determined.

A female patient with a peptic ulcer asks the nurse if misoprostol would be a good option for her because it works well for her mother. Upon review of her medication list it is noted that she takes a prenatal vitamin daily. What will the nurse do? a. Recommend use of misoprostol since it works well for her mother. b. Explain to the patient that misoprostol is contraindicated during pregnancy and for women of childbearing age. c. Tell the patient to purchase misoprostol over the counter. d. Tell her that misoprostol is just another PPI and that she should just purchase a PPI that is available over the counter.

ANS: B Misoprostol is a synthetic prostaglandin analog that can be used to prevent and treat peptic ulcers, particularly in people using high doses of NSAIDs. As a prostaglandin analog, misoprostol is contraindicated during pregnancy and for women of childbearing age. Misoprostol is available by prescription only.

The nurse receives the following order for insulin: IV NPH (Humulin NPH) 10 units. The nurse will perform which action? a. Administer the dose as ordered. b. Clarify the insulin type and route. c. Give the drug subcutaneously. d. Question the insulin dose.

ANS: B NPH insulin is not indicated for intravenous administration. The nurse should clarify the order. The nurse should not administer the drug by a different route without first discussing the order with the provider.

A patient asks the nurse the best way to prevent traveler's diarrhea. The nurse will provide which recommendation to the patient? a. "Ask your provider for prophylactic antibiotics." b. "Drink bottled water and eat only well-cooked meats." c. "Eat fresh, raw fruits and vegetables." d. "Take loperamide (Imodium) every day."

ANS: B Patients traveling to areas with potential traveler's diarrhea should be counseled to drink bottled water and eat meats that are well cooked. Prophylactic antibiotics are not recommended. Patients should eat cooked, washed fruits and vegetables. Loperamide is not recommended for use as a prophylactic agent

A patient who has been instructed to use a liquid antacid medication to treat gastrointestinal upset asks the nurse about how to take this medication. What information will the nurse include when teaching this patient? a. Take a laxative if constipation occurs. b. Take 60 minutes after meals and at bedtime. c. Take with at least 8 ounces of water to improve absorption. d. Take with milk to improve effectiveness.

ANS: B Since maximum acid secretion occurs after eating and at bedtime, antacids should be taken 1 to 3 hours after eating and at bedtime. Taking antacids with meals slows gastric emptying time and causes increased gastrointestinal (GI) secretions. Patients should not self-treat constipation or diarrhea. Patients should use 2 to 4 ounces of water when taking to ensure that the drug enters the stomach; more than that will increase gastric emptying time. If possible, antacids should not be taken with milk or foods high in vitamin D.

A patient was administered regular insulin 30 minutes ago, but has not received a breakfast tray. The patient is experiencing nervousness and tremors. What is the nurse's first action? a. Administer glucagon. b. Give the patient orange juice. c. Notify the kitchen to deliver the tray. d. Perform bedside glucose testing.

ANS: B The patient is symptomatic and has hypoglycemia. The nurse should give orange juice. Glucagon is given for patients unable to ingest carbohydrates. The kitchen should be notified, and bedside glucose testing should be performed, but only after the patient is given carbohydrates.

A patient with a peptic ulcer has been diagnosed with H. pylori. The provider has ordered lansoprazole (Prevacid), clarithromycin (Biaxin), and metronidazole (Flagyl). The patient asks the nurse why two antibiotics are needed. The nurse will explain that two antibiotics a. allow for less toxic dosing. b. combat bacterial resistance. c. have synergistic effects. d. improve acid suppression.

ANS: B The use of two antibiotics when treating H. pylori peptic ulcer disease helps to combat bacterial resistance because H. pylori develops resistance rapidly. Giving two antibiotics, in this case, is not to reduce the dose or to cause synergistic effects. Antibiotics do not affect acid production.

A patient who is unconscious and has a pulse is brought to the emergency department. The patient is wearing a Medic-Alert bracelet indicating type 1 diabetes mellitus. The nurse will anticipate an order to administer: a. cardiopulmonary resuscitation (CPR). b. glucagon. c. insulin. . orange juice.

ANS: B This patient is most likely hypoglycemic. Glucagon is given if patients are unable to ingest a carbohydrate, such as orange juice. CPR is not indicated. Insulin will compound the hypoglycemia

The nurse is teaching a group of nursing students about diabetes. The nurse explains that which type of diabetes is the most common? a. Type 1 diabetes mellitus b. Type 2 diabetes mellitus c. Diabetes insipidus d. Secondary diabetes

ANS: B Type 2 diabetes mellitus is the most common type of diabetes.

A nurse gives a patient NPH insulin at 8:00 am. At 2:00 pm the nurse finds the patient extremely lethargic but conscious. The patient is diaphoretic and slightly combative. The nurse should • A.call the health care provider. B.ensure that the patient has a meal. C.provide the patient with 4 ounces of orange juice. D.administer the next dose of insulin.

ANS: C NPH is an intermediate-acting insulin that peaks in 6 to 12 hours. Because the patient is conscious, it is most important for the nurse to provide the orange juice to prevent a possible hypoglycemic reaction (insulin shock).

The patient experiences the Somogyi effect. Which statement regarding the Somogyi effect does the nurse identify as being true? A.This is a hyperglycemic condition. B.The condition usually occurs immediately after dinner. C.It is a response to excessive insulin. D.Management usually requires increase of the bedtime insulin dose.

ANS: C The Somogyi effect is a response to excessive insulin resulting in a hypoglycemic condition usually occurring in the predawn hours of 2:00 to 4:00 am. A rapid decrease in blood glucose during the nighttime hours stimulates a release of hormones (e.g., cortisol, glucagon, epinephrine) to increase blood glucose by lipolysis, gluconeogenesis, and glycogenolysis, thus creating the Somogyi effect. Management of the Somogyi effect involves monitoring blood glucose between 2:00 am and 4:00 am and reducing the bedtime insulin dosage.

When teaching the patient about the storage of insulin, which statement will the nurse include? A. Keep the insulin in the freezer. B. Warm the insulin in the microwave before administration. C. Do not place insulin in sunlight or a warm environment. D. Open insulin vials lose their strength after one year.

ANS: C Unopened insulin vials are refrigerated until needed. Once an insulin vial has been opened, it may be kept (1) at room temperature for 1 month or (2) in the refrigerator for 3 months. Insulin is less irritating to the tissues when injected at room temperature. Insulin vials should not be put in the freezer. In addition, insulin vials should not be placed in direct sunlight or in a high-temperature area. Prefilled syringes should be stored in the refrigerator and should be used within 1 to 2 weeks. Opened insulin vials lose their strength after approximately 3 months.

The nurse is teaching a patient how to administer insulin. The patient is thin with very little body fat. The nurse will suggest injecting insulin: a. by pinching up the skin and injecting straight down. b. in the abdomen only with the needle at a 90-degree angle. c. subcutaneously with the needle at a 45- to 60-degree angle. d. using the thigh and buttocks areas exclusively.

ANS: C In a thin person, with little fatty tissue, the needle is inserted at a 45- to 60-degree angle. In other patients, a 45- to 90-degree angle is acceptable. There is no recommendation for preferring one site over another

A patient reports that they are taking a rapid-acting insulin with meals, but can't remember the name. Which of the following products is a rapid-acing insulin? a. Regular insulin (Novolin R) b. Insulin glargine (Lantus) c. Insulin lispro (Humalog) d. Insulin degludec (Tresiba)

ANS: C Insulin lispro (Humalog) is a rapid-acing insulin product. Regular insulin is considered a short-acting insulin. Insulin glargine and insulin degludec are long-acting insulins.

The nurse is teaching a patient who is newly diagnosed with type 1 diabetes mellitus about insulin administration. Which statement by the patient indicates a need for further teaching? a. "I should rotate my injection sites." b. "I should give each injection a knuckle length away from a previous injection." c. "I will not be concerned about a raised knot under my skin from injecting insulin." d. "Insulin is absorbed better from subcutaneous sites on my abdomen."

ANS: C Lipohypertrophy presents as a raised lump or knot on the skin surface caused by repeated injections into the same site, and this can interfere with insulin absorption. Patients are encouraged to rotate injection sites, giving each injection at least a knuckle length away from the previous injection. Insulin absorption is most predictable when given in abdominal areas.

A patient who experiences motion sickness when flying asks the nurse the best time to take the medication prescribed to prevent motion sickness for a 0900 flight. The nurse will instruct the patient to take the medication at which time? a. As needed, at the first sign of nausea b. At 0700, before leaving for the airport c. At 0830, just prior to boarding the plane d. When seated, just prior to takeoff

ANS: C Motion sickness medication has its onset in 30 minutes. The patient should be instructed to take the medication a half hour prior to takeoff. It is not used as needed.

A patient who is diagnosed with peptic ulcer disease has been started on a regimen that includes ranitidine (Zantac) 300 mg daily at bedtime. The patient calls the clinic 2 days later to report no relief from discomfort. What action will the nurse take? a. Contact the provider to discuss changing to cimetidine (Tagamet). b. Notify the provider to discuss increasing the dose. c. Reassure the patient that it may take 1 to 2 weeks to notice an improvement in symptoms. d. Suggest that the patient split the medication into twice daily dosing.

ANS: C Patients taking histamine2 blockers can expect abdominal pain to decrease after 1 to 2 weeks of drug therapy. Cimetidine is not as potent as ranitidine and interacts with many medications through the cytochrome P450 system. Three hundred milligrams is the maximum recommended dose.

A 45-year-old patient who is overweight has had a diagnosis of type 2 diabetes for 2 years. The patient uses 20 units of long-acting insulin per day. The patient's fasting blood glucose (FBG) is 190 mg/dL. The patient asks the nurse about using an oral antidiabetic agent. The nurse understands that oral antidiabetic agents: a. cannot be used if the patient is overweight. b. cannot be used once a patient requires insulin. c. may be used in patients with type 2 diabetes in combination with insulin. d. may not be used since this patient's fasting blood glucose is too high.

ANS: C Patients with type 2 diabetes often use long-acting insulin in combination with oral agents to manage blood glucose.

A patient reports experiencing flatulence and abdominal distension to the nurse. Which over-the-counter medication will the nurse recommend? a. Alka-Seltzer b. Maalox c. Simethicone d. Tums

ANS: C Simethicone is an antigas agent. Maalox Gas contains simethicone, while regular Maalox does not. The other products do not contain simethicone.

The patient is ordered cimetidine. It is most important for the nurse to teach the patient about what dietary needs? A.Avoid use of salt substitutes. B.Eat foods rich in vitamin B12. C.Eat a high-protein diet. D.Avoid citrus foods.

B. Eat foods rich in vitamin B12.

A woman who is 2 months pregnant reports having morning sickness every day and asks if she can take any medications to treat this problem. The nurse will recommend that the patient try which intervention first? a. Discuss a possible need for intravenous fluids with her provider. b. Contacting the provider to discuss prescribing a prescription antiemetic. c. Use nonpharmacologic measures, such as eating crackers or dry toast. d. Take over-the-counter antiemetics such as diphenhydramine.

ANS: C To minimize risk to the fetus, the nurse should first recommend nonpharmacologic measures such as drinking flat soda or weak tea or eating crackers or dry toast. If this is not effective, intravenous fluids may become necessary depending on the severity of vomiting and dehydration. Pregnant women should consult with their provider before taking prescription or over-the-counter antiemetics.

A patient develops type 2 diabetes mellitus. The nurse will explain that this type of diabetes: a. is generally triggered by medications. b. is not as common as type 1 diabetes. c. is often related to heredity and obesity. d. will not require insulin therapy.

ANS: C Type 2 diabetes is often caused by obesity and hereditary factors. Secondary diabetes is triggered by medications. Type 2 diabetes is the most common type of diabetes. Patients with type 2 diabetes may eventually require treatment with insulin.

A patient has been taking famotidine (Pepcid) 20 mg bid to treat an ulcer but continues to have pain. The provider has ordered lansoprazole (Prevacid) 15 mg per day. The patient asks why the new drug is necessary, since it is more expensive. The nurse will explain that lansoprazole: a. can be used for long-term therapy. b. does not interact with other drugs. c. has fewer medication side effects. d. is more potent than famotidine.

ANS: D Famotidine is a histamine2 (H2) blocker. When patients fail therapy with these agents, proton pump inhibitors, which can inhibit gastric acid secretion up to 90% greater than the H2 blockers, are used. Lansoprazole is not for long-term treatment and has drug interactions and drug side effects, as do all other medications.

The nurse is caring for an older adult who is receiving diphenoxylate with atropine (Lomotil) to treat severe diarrhea. The nurse will monitor this patient closely for which effect? a. Bradycardia b. Fluid retention c. Urinary incontinence d. Respiratory depression

ANS: D Diphenoxylate is an opioid agonist and can cause respiratory depression. Children and older adults are more susceptible to this effect. It contains atropine, so it will increase heart rate and potentially contribute to urinary retention. It does not contribute to fluid retention.

A patient who has type 1 diabetes mellitus must take a glucocorticoid medication for osteoarthritis. When teaching this patient, the nurse will explain that there may be a need to: a. decrease the glucocorticoid dose. b. decrease the insulin dose. c. increase the glucocorticoid dose. d. increase the insulin dose.

ANS: D Glucocorticoids can cause hyperglycemia, so the insulin dose may need to be increased. Changing the glucocorticoid dose is usually not recommended. Decreasing the insulin dose will only compound the hyperglycemic effects.

The nurse will administer parenteral insulin to a patient who will receive a mixture of NPH (Humulin NPH) and regular (Humulin R). The nurse will give this medication via which route? a. Intradermal b. Intramuscular c. Intravenous d. Subcutaneous

ANS: D Insulin is given by the subcutaneous route. NPH insulin is not indicated for intravenous use.

An elderly patient reports using Maalox frequently to treat acid reflux. The nurse should notify the patient's provider to request an order for which laboratory tests? a. Liver enzymes and serum calcium b. Liver enzymes and serum magnesium c. Renal function tests and serum calcium d. Renal function tests and serum magnesium

ANS: D Maalox contains magnesium and carries a risk of hypermagnesemia, especially with decreased renal function. Older patients have an increased risk of poor renal function, so this patient should especially be evaluated for hypermagnesemia.

The parent of a junior high school child who has type 1 diabetes asks the nurse if the child can participate in sports. The nurse will tell the parent: a. that strenuous exercise is not recommended for children with diabetes. b. that the child must be monitored for hyperglycemia while exercising. c. to administer an extra dose of regular insulin prior to exercise. d. to send a snack with the child to eat just prior to exercise.

ANS: D Patients generally need less insulin with increased exercise, so the child should consume a snack to prevent hypoglycemia. Exercise is an integral part of diabetes management. Hypoglycemia is more likely to occur, and extra insulin is not indicated.

Which statement by a patient who will begin using an insulin pump indicates understanding of this device? a. "I will have an increased risk for hypoglycemia." b. "I will leave this on when bathing or swimming." c. "I will not need to count carbohydrates anymore." d. "I will still need to monitor serum glucose."

ANS: D Patients using an insulin pump will still monitor serum glucose and count carbohydrates. The advantage of the pump is that it is programmed to deliver continuous rapid-acting insulin in varying amounts at different times throughout the day. Changes in food intake can alter the risk for hypoglycemia if the pump is not adjusted accordingly. Most devices must be removed when bathing or swimming.

A patient who is overweight is being evaluated for diabetes. The patient has a blood glucose level of 160 mg/dL and a hemoglobin A1c of 5.8%. The nurse understands that this patient has which condition? a. Diabetes mellitus b. Hypoglycemia c. Normal blood levels d. Prediabetes

ANS: D Patients with a hemoglobin A1c between 5.7% and 6.4% are considered to have prediabetes. A level of 6.5% or more indicates diabetes. The patient is hyperglycemic.

A patient asks the nurse about using loperamide (Imodium) to treat infectious diarrhea. Which response will the nurse give? a. "Loperamide results in many central nervous system (CNS) side effects." b. "Loperamide has no effect on infectious diarrhea." c. "Loperamide is taken once daily." d. "Loperamide can be used to treat diarrheal symptoms but may also slow the exit of the infectious organisms from the GI tract."

ANS: D Patients with infectious diarrhea should be cautioned about using loperamide since slowing transit through the intestines may prolong the exposure to the infectious agent. Loperamide causes less CNS depression than other antidiarrheals. It is taken multiple times per day as needed.

The nurse is caring for a patient who has postoperative nausea and vomiting. The surgeon has ordered promethazine HCl (Phenergan). Which aspect of this patient's health history would be of concern? a. Asthma b. Diabetes c. GERD d. Glaucoma

ANS: D Promethazine is contraindicated in patients with glaucoma since it is an anticholinergic medication. It should be used with caution in patients with asthma. The other two conditions are not concerning with this medication.

The nurse is caring for a patient who will begin taking omeprazole (Prevacid) 20 mg per day for 4 to 8 weeks to treat gastroesophageal reflux disease esophagitis. The nurse learns that the patient takes digoxin. The nurse will contact the provider for orders to: a. decrease the dose of omeprazole. b. increase the dose of digoxin. c. increase the omeprazole to 60 mg per day. d. monitor for digoxin toxicity.

ANS: D Proton pump inhibitors can enhance the effects of digoxin, so patients should be monitored for digoxin toxicity. Changing the dose of either medication is not indicated prior to obtaining lab results that indicated elevated digoxin levels.

The patient asks the nurse about storing insulin. Which response by the nurse is correct? a. "All insulin vials must be refrigerated before and during use." b. "Insulin will last longer if kept in the freezer." c. "Opened vials of insulin must be discarded after first use." d. "Some insulin products do not require refrigeration during use."

ANS: D Some insulin products do not require refrigeration during use. Storing insulin in the freezer is not recommended. Opened vials may either be kept at room temperature or refrigerated. Drug information for each product should be reviewed for drug-specific storage information.

A patient who has been taking ranitidine (Zantac) continues to have pain associated with a peptic ulcer. A noninvasive breath test is negative. Which treatment does the nurse expect the provider to order for this patient? a. Adding an over-the-counter antacid to the patient's drug regimen b. A dual drug therapy regimen c. Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec) d. Lansoprazole (Prevacid) instead of ranitidine

ANS: D This patient does not have H. pylori ulcer disease, so dual and triple drug therapy with antibiotics is not indicated. Patients who fail treatment with a histamine2 blocker should be changed to a proton pump inhibitor (PPI) such as lansoprazole. PPIs tend to inhibit gastric acid secretion up to 90% greater than the histamine antagonists.

A patient who has symptoms of peptic ulcer disease will undergo a test that requires drinking a liquid containing 13C urea and breathing into a container. The nurse will explain to the patient that this test is performed to a. assess the level of hydrochloric acid. b. detect H. pylori antibodies. c. measure the pH of gastric secretions. d. test for the presence of H. pylori.

ANS: D When H. pylori is suspected, a noninvasive test is performed by administering 13C urea, which, in the presence of H. pylori, will release 13CO2. The test does not measure the amount of HCl acid or the pH and does not detect H. pylori antibodies.

The best place to administer insulin is Abdomen Rotation of arms thighs hips 2 inches apart

Abdomen

A client with a glucose of 258 mg/dl sliding scale insulin order at HS. The nurse should: Call the physician Encourage the intake of fluids Give the client 1/2 c. of orange juice Administer the insulin as ordered

Administer the insulin as ordered

The nurse will do what to reduce the GI symptoms associated with metformin (Glucophage)? Give on an empty stomach Hold for 48 hours after a contrast dye study Administer with food Avoid administration with insulin

Administer with food

Which is not true of antacids? Antacids should be taken 2 hrs after anticholinergic meds. Antacids should not be given with dairy products. Antacids should be given 1 to 3 hours after a meal. Antacids should be taken with anticholinergic meds.

Antacids should be taken with anticholinergic meds.

When administering the histamine2 blocker ranitidine, the nurse will A.monitor laboratory results because ranitidine decreases the effect of oral anticoagulants. B.separate ranitidine and antacid dosage by at least 1 hour if possible. C.teach the patient to avoid foods rich in vitamin B12. D.expect a reduction in the patient's pain to occur after 5 days of therapy.

B. separate ranitidine and antacid dosage by at least 1 hour if possible.

A toddler ingests a small amount of household cleaning fluid. What is the safest advice for the nurse to provide the caregiver? • A.Give the child fluids and proceed to the emergency department. B.Call the poison control center and follow directions. C.Administer syrup of ipecac and monitor for vomiting. D.Have the toddler eat bread to absorb the substance.

B. Calling poison control is imperative as they will give instructions for the correct way to handle each substance, weather it can be vomited, and when to go tot eh emergency room. Giving water will not help and may flush the toxin further down. Administering syrup of ipecac would not be the first step as we need to know if this household cleaner is caustic and can not be vomited. Activated Charcoal would be the absorbent of choice, again, if indicated by the substance. Fun fact: Often times poison control is staffed with an RN!

A patient with nausea is taking odansetron. She asks the nurse how this drug works. The nurse is aware that this medication has which action? A. Enhances histamine1 receptor sites B. Blocks serotonin receptors in the chemoreceptor trigger zone C. Blocks dopamine receptors in the chemoreceptor trigger zone D. Stimulates anticholinergic receptor sites

B. Blocks serotonin receptors in the chemoreceptor trigger zone

A patient complains of constipation and requires a laxative. In providing teaching for this patient, the nurse reviews the common causes of constipation, including which cause? A. Motion sickness B. Poor dietary habits C. Food intolerance D. Bacteria (Escherichia Coli)

B. Poor dietary habits

Which time frame would be most appropriate for administering sliding-scale lispro insulin? A. Within 30 minutes of consuming breakfast B. When the breakfast tray is served and ready to eat C. Within 1 hour of obtaining blood glucose measurement D. Within 15 minutes of obtaining blood glucose measurement

B. When the breakfast tray is served and ready to eat

A patient with peptic ulcer disease is noted to have a positive breath test for H. pylori. The nurse would anticipate treating the patient with A.antacids and narcotics. B.pepsin inhibitors and antiemetics. C.proton pump inhibitors and antibiotics. D.emetic agents and tranquilizers.

C. proton pump inhibitors and antibiotics.

A patient is ordered a phenothiazine antiemetic for treatment of nausea and vomiting associated with chemotherapy. The drug will be most effective if administered • A.as requested by the patient. B.1 hour after chemotherapy administration. C.the night before treatment, the day of treatment, and for 24 hours after treatment. D.the day of treatment.

C. the night before treatment, the day of treatment, and for 24 hours after treatment.

A patient is prescribed metformin. Which is a side effect/adverse effect common to metformin? A. Seizures B. Constipation C. Bitter or metallic taste D. Polyuria and polydipsia

C. Bitter or metallic taste

A pt. is NPO for OR, and has an AM dose of Lantus insulin ordered. The nurse should do what? Clarify order with the physician. Give the insulin as ordered. Hold the insulin Discontinue the insulin.

Clarify order with the physician.

A patient with a gastric ulcer is ordered sucralfate. This medication works to A.calm the patient to reduce acid production. B.block the H2 receptors. C.neutralize the gastric acids. D.coat the gastric lining.

D. coat the gastric lining.

A patient is using scopolamine to prevent motion sickness. About which common side effect should the nurse teach the patient? A. Diarrhea B. Vomiting C. Insomnia D. Dry mouth

D. Dry mouth

What is EPS? the ability to read minds. Estimated Passing Score Extra Pyramidal Symptoms External Pacing Set

Extra Pyramidal Symptoms

T/F: To test a Hgb A1C the patient must fast? True False

False

Antidiabetics and complementary therapies-increases insulin levels and have a direct hypoglycemic effect

Garlic, bitter melon, aloe, or gymnema

Antidiabetics and complementary therapies-Lowers blood glucose levels

Ginseng

The patient is cool, clammy and glucose is 60. What should the nurse do first? Administer insulin Give dose of Metformin (Glucophage) Give 15 grams of oral carbohydrate Wait 15 minutes and recheck glucose.

Give 15 grams of oral carbohydrate

Which drug is given for severe hypoglycemia? insulin lispro (Humalog) Glucagon exenatide (Byetta) Glycogen

Glucagon

Which oral antidiabetic agent has the greatest risk for causing hypoglycemia? Metformin (Glucophage) Glyburide (Diabeta) Exenatide (Byetta) Canagliflozin (Invokana)

Glyburide (Diabeta)

When a client is in DKA the insulin that would be administered is Human NPH insulin Human regular insulin Insulin lispro injection Insulin glargine

Human regular insulin

This Insulin Is only given IV Humalog NPH Humulin R Long Acting

Humulin R

All of the following are components of Metabolic Syndrome, EXCEPT Insulin resistance Central obesity Dyslipidemia Hypotension

Hypotension

The following insulin administration is used in the initial treatment of hyperglycemia of DKA Subcutaneous Intramuscular IV bolus only IV bolus followed by continuous infusion

IV bolus followed by continuous infusion

What lab result would indicate a diabetic patient may have kidney injury? Increased levels of albumin in the urine. Glucose tolerance test of 140 A Hemoglobin A1C level of 8.5% Increased cortisol levels

Increased levels of albumin in the urine.

All of the following are oral diabetic medication except Stimulators Absorption Delayers Sensitizers Insulin

Insulin

This type of medicine helps decrease glucose production by the liver Insulin Sensitizers Insulin Stimulators Absorption Delayers Acarbose

Insulin Sensitizers

This type of drug should not be given to patient who have sulfa allergies Metformin Insulin Stimulator Absorption Delayers Prandin

Insulin Stimulator

Why can't Lantus insulin be mixed with other insulins? It will cause an allergic reaction. It will change the pH of the solution. It will cause a hypoglycemic reaction. It will cause basal dosing.

It will change the pH of the solution.

Insulin Peak-no peak

Lantus

Insulin Peak 30-90 minutes

Lispro

Insulin onset 15-30 minutes

Lispro

The insulin that has the most rapid onset of action would be Lente Lispro Ultralente Humulin

Lispro

Insulin onset 15 minutes given IV

Regular

What is the important concept related to vomiting? Stopping the vomiting ASAP. Giving the client IV fluids. Making sure the client stays hydrated despite the vomiting. Taking the client to the ED.

Making sure the client stays hydrated despite the vomiting.

St. John's Wort

May alter metabolism of repaglinide May affect BG level when taken with tolbutamide

Ginko

May cause hypoglycemia with glipizide May enhance Metformin May increase drug level of Pioglitazone May decrease effectiveness of tolbutamide

Chromium

May decrease insulin requirements

Milk Thistle

May improve insulin sensitivity

A patient is scheduled for a xray with contrast dye which medication should be held Insulin Precose Actose Metformin

Metformin

Insulin Peak 4-12 hours

NPH

Insulin onset 1-2 hours

NPH

The following is an intermediate acting insulin Regular Glaragine Lantus NPH

NPH

Special considerations for oral hypoglycemics-contraindicated in Class III and IV heart failure

Pioglitazone

Insulin forces which of the following electrolytes out of the plasma and into the cells Calcium magnesium Phosphorus Potassium

Potassium

Special considerations for oral hypoglycemics-the ONLY antidiabetic agent approved for Type I

Pramlintide

Bloating and flatulance are side affects of Prandin Plavix Phentemine Precose

Precose

The priority nursing diagnosis for diabetes is Risk for ineffective health maintentenance Risk for low blood sugar ineffective coping Risk for hypertension

Risk for ineffective health maintentenance

Antidiabetics and complementary therapies-decrease the therapeutic effect of insulin , have a hyperglycemic effect

Rosemary or Stinging Nettle

Glarargine insuline peaks in 70 min 1 hour 2-5 hours There is no peak for this insulin

There is no peak for this insulin

Which is true of using antipsychotics (like tranquilizers) for nausea? They must be given in larger doses. They must be combined with antihistamines. They need to be given more frequently. They are given in smaller doses.

They are given in smaller doses.

Why is diet important in the treatment of diabetes? So the patient may have an implantable pump To better control blood glucose levels To prevent morbid obesity To increase insulin receptors

To better control blood glucose levels

T/F: "Typically" - Type I DM is insulin dependent while Type II DM is insulin resistant? True False

True

Which statement by a patient taking glipizide indicates that more teaching is indicated? a. "I will use a new needle every time I take the medication." b. "I will take the medication once a day in the morning." c. "I will eat my breakfast very soon after taking my Glucotrol." d. "This medication stimulates my pancreatic cells to make insulin."

a. "I will use a new needle every time I take the medication."

A patient with type 1 diabetes mellitus is ordered insulin therapy once daily to be administered at bedtime. What is the type of insulin the patient is most likely receiving? a. Insulin glargine b. Lente insulin c. Lispro insulin d. Regular insulin

a. Insulin glargine

anti diabetic drugs are designed to control signs and symptoms of diabetes mellitus. the nurse primarily expects a decrease in which? a. blood glucose b. fat metabolism c. glycogen storage d. protein mobilization

a. blood glucose

a nurse is teaching a patient how to recognize the symptoms of hypoglycemia. which symptoms should be included in the teaching? (select all that apply) a. headache b. nervousness c. bradycardia d. sweating e. thirst f. sweet breath odor

a. headache b. nervousness c. bradycardia d. sweating e. thirst f. sweet breath odor

a patient is prescribed glipizide. the nurse knows that which side effects and adverse effects may be expected? (select all that apply) a. tachypnea b. tachycardia c. increased alertness d. increased weight gain e. visual disturbances f. hunger

a. tachypnea b. tachycardia c. increased alertness d. increased weight gain e. visual disturbances f. hunger

a patient is newly diagnosed with type 1 diabetes mellitus and requires daily insulin injections. which instructions should the nurse include in the teaching of insulin administration? (select all that apply) a. teach family members how to administer glucagon by injection when the patient has a hyperglycemic reaction b. instruct the patient about the necessity for compliance with prescribed insulin therapy c. teach the patient that hypoglycemic reactions are more likely to occur at the onset of action time d. instruct the patient in the care and handling of the insulin container and syringe

a. teach family members how to administer glucagon by injection when the patient has a hyperglycemic reaction b. instruct the patient about the necessity for compliance with prescribed insulin therapy c. teach the patient that hypoglycemic reactions are more likely to occur at the onset of action time d. instruct the patient in the care and handling of the insulin container and syringe

Special considerations for oral hypoglycemics-class of antidiabetic med that causes flatulence, diarrhea and abd pain

alpha-glucosidase inhibitors

a patient is to receive insulin before breakfast, and the time of breakfast tray delivery is variable. the nurse knows that which insulin should not be administered until the breakfast tray has arrived and the patient is ready to eat? a. NPH b. Lispro c. glargine d. regular

b. Lispro

a patient is receiving a daily dose of NPH insulin at 7:30 AM. the nurse expects the peak effect of this drug to occur at what time? a. 8:15 am b. 10:30 am c. 5:00 pm d. 11:00 pm

c. 5:00 pm

When teaching the patient about the storage of insulin, which statement will the nurse include? a. Keep the insulin in the freezer. b. Warm the insulin in the microwave before administration. c. Do not place insulin in sunlight or a warm environment. d. Open insulin vials lose their strength after one year.

c. Do not place insulin in sunlight or a warm environment.

The patient experiences the Somogyi effect. Which statement regarding the Somogyi effect does the nurse identify as being true? a. This is a hyperglycemic condition. b. The condition usually occurs immediately after dinner. c. It is a response to excessive insulin. d. Management usually requires increase of the bedtime insulin dose.

c. It is a response to excessive insulin.

When metoclopramide (Reglan) is given for nausea, the nurse plans to caution the patient to avoid which substance? a. milk b. coffee c. alcohol d. carbonated beverages

c. alcohol

a patient is diagnosed with type 2 diabetes mellitus. the nurse is aware that which statement is true about this patient? a. the patient is most likely a teenager b. the patient is most likely a child younger than 10 years c. heredity and obesity are major causative factors d. viral infections contribute most to disease development

c. heredity and obesity are major causative factors

A nurse gives a patient NPH insulin at 8:00 am. At 2:00 pm the nurse finds the patient extremely lethargic but conscious. The patient is diaphoretic and slightly combative. The nurse should a. call the health care provider. b. ensure that the patient has a meal. c. provide the patient with 4 ounces of orange juice. d. administer the next dose of insulin.

c. provide the patient with 4 ounces of orange juice.

Which oral anti-diabetic drug has a black box warning of potential amputation? metformin (Glucophage) sitagliptin (Januvia) canagliflozin (Invokana) pioglitazone (Actos)

canagliflozin (Invokana)

Antidiabetics and complementary therapies-may decrease insulin requirements

chromium

Which of the following are signs of hypoglycemia? clammy, hungry, headache dry mouth, extreme thirst frequent urge to urinate, drowsiness stomach pain, bed wetting

clammy, hungry, headache

Insulin onset 2 hours given SubQ

detemir or lantus

Which type of insulin is given at night due to its long action? asapart glargine NPH novolog

glargine

Beta cells release insulin while Alpha cells release?20sec glucagon insulin receptors glucose glycogen

glucagon

Antidiabetics and complementary therapies-may potentiate hypoglycemia when used with glipizide or metformin

green tea

Which of these is not a side effect of Histamine 2 blockers? impotence hyperthermia dizziness gynecomastia

hyperthermia

Guidelines for Oral Antidiabetic Therapy for Type II Diabetes-required units of insulin per day

less than 40 units

Rosemary and stinging nettle

may cause hyperglycemia

Garlic, Ginseng, bitter melon, bilberry, aloe, Hawthorne, and gymnema

may cause hypoglycemia.

Black Cohosh

may potentiate the hypoglycemic effects of insulin and oral antidiabetic drugs

After a CT, the patient with DM II should hold which medication for 48 hours? they do not hold any medications metformin glipizide insulin

metformin

Special considerations for oral hypoglycemics-oral antidiabetic with side effects: metallic taste and lactic acidosis

metformin

Guidelines for Oral Antidiabetic Therapy for Type II Diabetes-weight

normal or overweight

Guidelines for Oral Antidiabetic Therapy for Type II Diabetes-Age of onset of Diabetes

over 40 years of age

Which of these ingested substances would be appropriate for the use of syrup of ipecac? gasoline lye bleach pills

pills

Which antidiabetic med is linked to bladder CA if used for more than 1 year? pioglitazone repaglinide luraglutide metformin

pioglitazone

Insulin Peak 15-30 minutes

regular given IV

Guidelines for Oral Antidiabetic Therapy for Type II Diabetes-required to have normal function of this system

renal and/or hepatic

Which of the following were the first oral agents to treat type 2 diabetes? DDP-4 Inhibitors sulfonylureas Biguanides Meglitinides

sulfonylureas

Special considerations for oral hypoglycemics-contraindicated in Type one diabetes

sulfonylureas or metformin

Why is it important to monitor timing of rapid insulin around meals? to increase blood glucose levels prior to meals to prevent the patient from overeating to avoid hypoglycemic reactions to inhibit the absorption of glucose at meals

to avoid hypoglycemic reactions

Which is NOT a side effect of Promethazine? moderate sedation hypotension Extrapyramidal Symptoms weight loss

weight loss

Rapid acting insulin: Oral inhalation

■ Afrezza 1/2 life: 2-3.5 hours Onset: 12-15 minutes Peak: 53 minutes Duration: 2.5 hours

Rapid acting insulin: Glulisine

■ Apidra 1/2 life: 5-6 minutes Onset: 20-30 minutes Peak: 55 minutes Duration: 1.5 hours

Rapid acting insulin: Lispro

■ Humalog (insulin lispro) 1/2 life: 1 hour Onset: 15-30 minutes Peak: 30-90 minutes Duration: 3-5 hours

Short acting insulin: Insulin Regular

■ Humulin R, Novolin R, Actrapid SUB Q: 1/2 life: 1.5 hours Onset: 30 minutes Peak: 1.5-3.5 hours Duration: 4-12 hours IV: 1/2 life: 1.5 hours Onset: 15 minutes Peak: 15-30 minutes Duration: 2-6 hours

Long acting insulin: Glargine

■ Lantus, Basaglar, and Toujeo 1/2 life: 5-6 minutes Onset: 1-1.5 hours Peak: None Duration: 24 hours

Long acting insulin: Detemir

■ Levemir, Levemir FlexTouch 1/2 life: 5-6 minutes Onset: 1-2 hours Peak: 6-8 hours Duration: 24 hours

Intermediate acting insulin: Isophane NPH

■ Novolin N Innolet, Novolin N 1/2 life: 5-6 minutes Onset: 1.5 hours Peak: 4-12 hours Duration: 14-24 hours

Rapid acting insulin: Aspart

■ Novolog 1/2 life: 1.5 hour Onset: 10-20 minutes Peak: 40-50 minutes Duration: 3-5 hours

Long acting insulin: Degludec

■ Tresiba 1/2 life: 25 hours Onset: 1 hour Peak: 12 hours Duration: 42 hours