Prep U Q7: Diabetes
A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse most likely administer? a. insulin lispro b. insulin glargine c. insulin detemir d. isophane insulin suspension
a
The nurse is educating a client who is beginning therapy with acarbose and tells the client to take the medication with the first bite of each main meal to help prevent what adverse effect? a. Dizziness b. Bloating and diarrhea c. Nausea and vomiting d. Chest pain
b
T/F Clients with type 2 diabetes have nonfunctioning beta pancreatic cells.
F
A client who is a newly diagnosed diabetic is prescribed glyburide. The nurse caring for this client identifies which occurrence is a classic symptom of hyperglycemia? a. Grand mal seizures b. Tachycardia c. Excessive urination d. Hemiparesis
c
The female client is scheduled to get her breakfast tray at 0700. At what time should she receive her prescribed dose of NPH insulin? a. 2100 (9 pm) b. 1400 (2pm) c. 0630 (6:30 am) d. 1100 (11 am)
c
A client is admitted to the Emergency Department in diabetic ketoacidosis (DKA) with a blood glucose level of 33 mmol/L. The provider orders an initial dose of 25 U insulin IV. Which type of insulin will be administered? a. NPH insulin b. Humulin L insulin c. Humulin N insulin d. Regular insulin
d
T/F Regular insulin may be administered intravenously or intramuscularly in an emergency situation.
T
A client newly diagnosed with type 1 diabetes asks the nurse why the client cannot just take a pill. The nurse would incorporate what knowledge when responding to this client? a. Insulin is needed because the beta cells of the pancreas are no longer functioning. b. The insulin is more effective in establishing control of blood glucose levels initially. c. More insulin is needed than that which the client can produce naturally. d. The client most likely does not exercise enough to control his glucose levels.
a
After reviewing information about different insulin preparations, a nursing student demonstrates understanding of the information when the student identifies which medication as an example of a long-acting insulin? a. insulin glargine b. insulin lispro c. insulin aspart d. isophane insulin suspension
a
Which HbA1c result would indicate that a client's diabetes is under good control? a. 7% b. 14% c. 12% d. 8%
a
Which would a nurse identify as an example of a sulfonylurea? a. Glyburide b. Metformin c. Acarbose d. Miglitol
a
A female client visits the health care provider's office after routine labs are drawn. The nurse notes that her A1C is 9. How does the nurse interpret this finding? a. Client is in good glycemic control. b. Client's average blood glucose is above normal. c. Client's blood glucose levels are not consistent. d. Client's blood glucose demonstrates longstanding hypoglycemia.
b
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? a. Assess the skin for ulcers, cuts, and sores. b. Observe the patient for hypoglycemic episodes. c. Monitor the patient for lipodystrophy. d. Document family medical history.
b
The pathophysiology class is studying diabetes. A student asks the instructor what is considered a sign of a hypoglycemic reaction. The instructor's response would be: a. dry, flaky skin. b. diaphoresis. c. flushing of the face. d. fruity breath.
b
The health care provider has ordered a change of prescription from rapid-acting insulin to an intermediate-acting type. Which adverse effect must the nurse closely monitor for in the client? a. Bradycardia b. Lipodystrophy c. Hypoglycemia d. Hypotension
c
The nurse is caring for a client taking insulin. The nurse realizes the client is experiencing symptoms of hypoglycemia when the client displays: a. increased pulse rate and fruity smelling breath. b. decreased respiratory rate and hot, dry skin. c. weakness, sweating, and decreased mentation. d. increased thirst and increased urine output.
c
When describing the effects of incretins on blood glucose control to a group of students, which would an instructor include? a. Increases glucagon release b. Increases GI emptying c. Increases insulin release d. Increases protein building
c
A 2-month-old male child is diagnosed with diabetes. His parents are having difficulty measuring 2 units of insulin in the U-100 syringe. What would the nurse expect the health care provider to order? a. U-50 (50 units/mL) insulin b. U-20 (20 units/mL) c. insulin U-30 (30 units/mL) d. insulin U-10 (10 units/mL) insulin
d
In what condition is human insulin not recommended for diabetic clients? a. Gestational diabetes b. Type 2 diabetes controlled on oral antidiabetic agents with systemic infection c. Type 1 diabetes of many years d. Type 2 diabetes controlled by diet
d
What antidiabetic agent is approved for the nurse to administer to children 10 years old and older with type 2 diabetes? a. Pioglitazone b. Repaglinide c. Luraglutide d. Metformin
d
Which is the best indicator of overall diabetic control? a. Fasting blood glucose levels b. 2-hour postprandial blood glucose levels c. Absence of acetone in the urine d. Glycosylated hemoglobin level
d
A nurse is caring for a client with elevated blood glucose levels who is to receive alpha-glucosidase inhibitor drug therapy. The nurse understands that this therapy would be contraindicated if the client had which condition? Select all that apply. a. cirrhosis b. chronic intestinal diseases c. colonic ulceration d. type I diabetes e. severe heart failure
a, b, c
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 what as a biguanide? a. Metformin b. Miglitol c. Tolbutamide d. Glipizide
a
A client who began treatment for type 2 diabetes 8 months ago is now meeting with a diabetic nurse for a scheduled follow-up. How can the nurse best assess the client's glycemic control since beginning treatment? a. Assess the most recent hemoglobin A1C levels. b. Arrange to have the client's random blood glucose measured. c. Dialogue with the client about implemented management strategies. d. Review and discuss the data contained in the client's written blood glucose log.
a
A client with diabetes is undergoing testing for glycosylated hemoglobin. The nurse instructs the client that this test measures average blood glucose over what time period? a. the past 3 or 4 months b. the past 7 to 10 days c. the past 1 or 2 months d. the past 12 to 24 hours
a
A nurse at a health care facility is assigned to administer insulin to the patient. Which intervention should the nurse perform before administering each insulin dose? a. Inspect the previous injection site for inflammation. b. Keep prefilled syringes horizontally. c. Check for symptoms of myalgia or malaise. d. Do not administer insulin kept at room temperature.
a
A nurse is preparing to administer an insulin that is clear. Which insulin would the nurse most likely administer? a. humulin R b. humulin N c. humulin U d. humulin L
a
The nurse is caring for a client taking bromocriptine (Cycloset). What is an advantage of this medication? a. Reduces risk of heart attack or stroke b. Has no adverse effects c. Is taken four times a day d. Long-term studies needed
a
The nurse is interviewing a client who was diagnosed with type 2 diabetes four months ago. The client does not records glucometer readings but reports no concerns. What laboratory test does the nurse anticipate the health care provider will order for this client? a. HbA1c b. Stat urine for glucose c. Fasting blood glucose in the AM d. Insulin level
a
The nurse is preparing patient teaching for a diabetic patient who is to begin pramlintide acetate (Symlin) therapy, which will be taken in addition to insulin. What would be the priority nursing instruction to include in the patient teaching? a. The drug is injected subcutaneously immediately before a major meal. b. The drug has a rapid onset of action. c. Inject the drug at least 2 inches away from any insulin injection site. d. Do not combine the drug with insulin in the same syringe.
a
The nurse is preparing to administer insulin lispro (Humalog) to a client at 7 AM. What is the nurse's priority intervention related to this medication? a. Make sure the client's breakfast is available in the next 5-10 minutes. b. Monitor the client for a hypoglycemic reaction at noon. c. Cleanse the administration site with soap and water before administration. d. Have the client lie quietly for 45 minutes.
a
What hormone, secreted with insulin, increases satiety and suppresses glucagon secretion? a. Amylin b. Amylase c. Aldosterone d. Anti-diuretic hormone
a
What statement would be appropriately included in the teaching concerning type 2 diabetes? a. "Regular exercise makes your body better able to use the insulin it produces." b. "Until you need to start insulin injections, you do not have to check your blood sugar." c. "Clients with type 2 diabetes always progress to insulin injections if they do not follow dietary guidelines." d. "If you drink alcohol, it may be necessary for you to increase your oral antidiabetic medication."
a
A nurse should take what steps prior to administering insulin glargine (Lantus) to a client? Select all that apply. a. Check the expiration date on the vial. b. Shake the vial vigorously. c. Check the health care provider's orders for the type and dosage of insulin. d. Remove all air bubbles from the syringe barrel. d. Mix with short-acting insulin prior to administration.
a, c, d
After teaching a group of students about the various methods for the delivery of insulin, the instructor determines that the teaching was successful when the students identify which method as most commonly used for administration? a. Subcutaneous injection b. Insulin pen c. Jet injector d. Implantable infusion pump
b
An insulin-dependent diabetic male client is having trouble with hypoglycemia late in the morning. During the health history, the nurse becomes aware of the most likely cause. What would cause the late morning hypoglycemia? a. The client likes to nap when he comes home from work before his evening meal. b. The client jogs two miles in the morning before he goes to work. c. The client likes to have an early lunch with his girlfriend. d. The client eats oatmeal early in the morning before his morning.
b
What instructions would be important to give to a 50-year-old client with type 2 diabetes who has been switched from glyburide (DiaBeta), a sulfonylurea, to repaglinide, a meglitinide? a. "It is less potent, so you will need to take a larger dose." b. "It stimulates insulin production, so you need to eat soon after taking the medication." c. "It is more potent and longer lasting, so you should take it every other day." d. "The two medications are virtually the same."
b
When learning about type 1 diabetes, what would the student nurses learn is a distinguishing characteristic of this disease? a. Blood glucose level can be controlled with diet. b. b. Exogenous insulin is required for life. c. Oral agents can control the disease process. d. It always starts in childhood.
b
A student asks the nursing instructor what insulin has the quickest therapeutic effect once administered. What would be the best response? a. PZI (Humulin U) b. NPH (Humulin N) c. Regular (Humulin R) d. Ultralente (Humulin U Ultralente)
c
A young man has been diagnosed with type 2 diabetes and has been prescribed glyburide. Which statement suggests that the nurse should perform further health education? a. "I'll keep in mind that glyburide can possibly cause me to have low blood sugar." b. "I'll make sure to check with my provider before I start taking any other medications." c. "I'll plan to take my glyburide each night before I go to bed." d. "I know that glyburide won't cure my diabetes, but it will help me have safe blood sugar levels."
c
As a diabetic educator, the nurse is teaching a newly diagnosed diabetic client about aspects of the disease process. What would the nurse tell the client about the body's control of glucose? a. The body uses what you take in b. Storage of glucose is very limited c. It is related to fat and protein metabolism d. Balancing energy conservation with energy consumption is very difficult
c
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? a. "Insulin is used to move carbohydrate particles from the gastrointestinal system to the liver." b. "Insulin is stimulated by the liver to break down proteins and provide the body with nutrients." c. "Insulin assists glucose molecules to enter the cells of muscle and fat tissues." d. "Insulin causes fat to be broken down to provide energy for the body."
c
When administering insulin, what would be most appropriate? a. Shake the vial vigorously to ensure thorough mixing before drawing up the dose. b. Firmly spread the skin of the area of the intended site of injection. c. Insert the needle at a 45-degree angle for injection. d. Massage the injection site firmly after removing the needle and syringe.
c
A nurse is working with a newly diagnosed diabetic client on understanding hypoglycemia and insulin reactions. Which action would be most important for the client to understand when planning the response to an insulin reaction? a. Inject a prescribed dose of insulin as soon as you suspect the reaction is occurring. b. Stay calm and still until the reaction subsides. c. Notify your health care provider immediately. d. Take an oral dose of some form of glucose as soon as possible.
d
The health care provider prescribes glyburide for a client who is a newly diagnosed type 2 diabetic. The nurse knows that this medication produces hypoglycemia by: a. stopping the production of insulin in the liver. b. increasing the use of insulin by the muscles. c. preventing glucose absorption from the stomach. d. increasing insulin secretion from the pancreas.
d
The nurse is caring for a postoperative client whose diabetes has been well controlled on acarbose (Precose). The client is not allowed to take anything orally following complications of abdominal surgery and is receiving high-glucose total parenteral nutrition via a central IV line. What medication can the nurse administer intravenously to control the client's blood glucose level? a. Glyburide b. Acarbose c. NPH insulin d. Regular insulin
d