Pharm. Chapter 38

A nurse is providing patient education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which of the following statements by the patient will alert the nurse that special instructions regarding insulin are necessary?

"I am on the middle school track team."

The nurse is discussing diabetes with a group of individuals who are at risk for the disease. Which statement by a participant indicates an understanding of the role of insulin in the disease?

"Insulin assists glucose molecules to enter the cells of muscle and fat tissues."

When preparing to administer an insulin injection, the nurse would use which sized needle?

25 gauge, ½ inch

A man is brought to the emergency department. He is nonresponsive, and his blood glucose level is 32 mg/dL. Which of the following would the nurse expect to be ordered?

Glucagon

A patient is to be administered glipizide (Glucotrol). Which of the following factors would prohibit the administration of glipizide (Glucotrol) to this patient?

Allergy to sulfonamides

A nurse is assigned to administer glargine to a patient at a health care facility. What precaution should the nurse take when administering glargine?

Avoid mixing glargine with other insulin.

A client is receiving glipizide as treatment for his type 2 diabetes. The nurse understands that this drug acts by which of the following?

Binding to potassium channels on pancreatic beta cells

When reviewing sites for insulin administration with a client, which site, if stated by the client as an appropriate site, indicates the need for additional teaching?

Buttocks

A female client visits the physician's office after routine labs are drawn. The nurse notes that her A1C is 9. How does the nurse interpret this finding?

Client's average blood glucose is above normal.

A patient has been noncompliant with his diabetic medication regimen and develops diabetic ketoacidosis. Which of the following would the nurse assess?

Deep respirations

The nurse is educating a client who will be adding an injection of pramlintide to his insulin regimen. What information is most important for the nurse to share with this client to ensure safe medication administration?

Do not give pramlintide in the same site where insulin is administered.

Insulin binds with and activates receptors on cell membranes. Once insulin-receptor binding occurs, the membranes become highly permeable to glucose. Which of the following actions does this enable?

Entry of glucose into the cells

Patients with type 2 diabetes have nonfunctioning beta pancreatic cells.

False

Which of the following would alert the nurse to suspect that a client is developing ketoacidosis?

Fruity breath odor

Which of the following would a nurse identify as an example of a sulfonylurea?

Glyburide

The nurse is interviewing a client who was diagnosed with type 2 diabetes about four months ago. The client never records glucometer readings but says that everything is just fine. What laboratory test does the nurse anticipate the health care provider will order for this client?

HbA1c

The physician has ordered a change of prescription from rapid-acting insulin to an intermediate-acting type. Which of the following adverse effects must the nurse closely monitor for in the patient?

Hypoglycemia

When describing the effects of incretins on blood glucose control to a group of students, which of the following would an instructor include?

Increases insulin release

When administering insulin, which of the following would be most appropriate?

Insert the needle at a 45-degree angle for injection.

A nurse at a health care facility is assigned to administer insulin to the patient. Which of the following interventions should the nurse perform before administering each insulin dose?

Inspect the previous injection site for inflammation.

Which of the following is an example of long acting insulin?

Insulin glargine (Lantus)

A client newly diagnosed with type 1 diabetes asks the nurse why he cannot just take a pill. The nurse would incorporate knowledge of which of the following when responding to this client?

Insulin is needed because the beta cells of the pancreas are no longer functioning.

Which of the following is an example of rapid acting insulin? (Choose one)

Insulin lispro (Humalog)

Which of the following would be appropriate to include in teaching your client with type 2 diabetes?

It is possible with weight loss and exercise to discontinue the use of antidiabetic medication.

Which of the following would be least appropriate when administering insulin by subcutaneous injection?

Massaging the site after removing the needle

After teaching a class about the various drugs used to control blood glucose, the instructor determines that the teaching was successful when the class identifies which of the following as a biguanide?

Metformin

A nurse is caring for a patient with diabetes mellitus who is receiving an oral antidiabetic drug. Which of following ongoing assessments should the nurse perform when caring for this patient?

Observe the patient for hypoglycemic episodes.

A nurse is preparing an in-service presentation for a group of staff members on diabetes. Which of the following would the nurse include as the primary delivery system for insulin?

Subcutaneous injection

A patient is in diabetic ketoacidosis. The patient blood glucose level is over 600. The physician has ordered the patient to receive an initial dose of 25 units of insulin. What type of insulin will be administered intravenously?

Regular insulin

A patient at a health care facility has been prescribed diazoxide for hypoglycemia due to hyperinsulinism. What adverse reactions to the drug should the nurse monitor for in the patient?

Tachycardia

Glycosylated hemoglobin measures average blood glucose over what time period? (Choose one)

The past 3 or 4 months

Amylin is a peptide hormone secreted with insulin by the beta cells of the pancreas and is important in the regulation of glucose control during the postprandial period. True or false?

True

Regular insulin may be administered intravenously or intramuscularly in an emergency situation.

True

The nurse monitoring a client receiving insulin glulisine (Apidra) notices the client has become confused, diaphoretic, and nauseated. The nurse checks the client's blood glucose and it is 60 mg/dL. Which of the following can a nurse give to treat a client with a hypoglycemic episode? Select all that apply:

• Hard candy • Orange or other fruit juice • Glucose tablets