Pharm201 CH 42
When learning about type 1 diabetes, what would the student nurses learn is a distinguishing characteristic of this disease?
Exogenous insulin is required for life.
Clients with type 2 diabetes have nonfunctioning beta pancreatic cells.
False
When teaching a client about insulin administration, the nurse would instruct the client to administer insulin aspart at which time?
immediately before a meal
A client is receiving metformin therapy at a health care facility. The client is also prescribed glucocorticoids. The nurse would be alert for which adverse reaction due to the interaction of these two drugs?
increased risk of lactic acidosis
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?
"I'll plan to take my glyburide each night before I go to bed."
A client, who is 42 years old and newly diagnosed with type 2 diabetes, has attended educational sessions to provide insight into the diagnosis. Which of the client's statements should prompt the nurse to provide further teaching
"I'm disappointed, but I take some solace in the fact that I won't ever have to have insulin injections."
A client, who is 42 years old and newly diagnosed with type 2 diabetes, has attended educational sessions to provide insight into the diagnosis. Which of the client's statements should prompt the nurse to provide further teaching?
"I'm disappointed, but I take some solace in the fact that I won't ever have to have insulin injections."
The nurse has just completed discharge instructions to a client who will be using a pen device to deliver his insulin dose. What statement by the client indicates a need for further instruction?
"If I forget to take my insulin pen, I will be able to use the one that my wife uses."
What distinguishing characteristic is associated with type 1 diabetes?
Exogenous insulin is required for life.
The nurse is preparing to administer a mixture of 12 units regular insulin and 45 units NPH insulin to a client with a blood sugar of 378 mg/dL. After the nurse draws the medication into the syringe, what is the nurse's next action?
Check the dosage with another nurse.
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."
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?
"It stimulates insulin production, so you need to eat soon after taking the medication."
What statement would be appropriately included in the teaching concerning type 2 diabetes?
"Regular exercise makes your body better able to use the insulin it produces."
The client is scheduled to get a breakfast tray at 07:00. At what time should the client receive a prescribed dose of insulin lispro?
06:45
Which HbA1c result would indicate that a client's diabetes is under good control?
7%
A diabetic client has been admitted to the ICU with diabetic ketoacidosis (DKA). What is the first step in the treatment of this client?
Administration of IV fluids
A nurse diabetes educator is planning an initial visit to a home care client who was recently diagnosed with diabetes mellitus. Which skills would the nurse help the client learn?
All the above
Insulin analogs are synthesized in the laboratory by altering the type or sequence of amino acids in insulin molecules. Which of the following insulin analogs is a short-acting product?
All the above
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?
Assess the most recent hemoglobin A1C levels.
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?
Excessive urination
A client has been noncompliant with the diabetic medication regimen and develops diabetic ketoacidosis. Which would the nurse assess?
Deep respirations
Insulin binds with and activates receptors on cell membranes. Once insulin-receptor binding occurs, the membranes become highly permeable to glucose. Which action does this enable?
Entry of glucose into the cells
The nurse is working with a client who uses an insulin pump for management of type 1 diabetes. The nurse should remind the client that the needle on the pump needs to be changed how often?
Every 1-3 days
A diabetic client is taking regular and NPH insulin to manage diabetes. What is the best evaluation tool to measure the overall client response to the insulin therapy?
Glycosylated hemoglobin (HbAlc) levels
Which is the best indicator of overall diabetic control?
Glycosylated hemoglobin levels
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?
HbA1c
A nurse is preparing to administer an insulin that is clear. Which insulin would the nurse most likely administer?
Humulin R
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?
Hypoglycemia
The nurse is caring for an adolescent newly diagnosed with type 1 diabetes. The client says, "I can't believe I'm going to spend the rest of my life sticking myself with needles." What future possibilities for insulin delivery can the nurse share with this client? Select all that apply.
Implantable insulin pump Insulin patch Inhaled insulin
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?
Metformin
A client is receiving acarbose. What would the nurse incorporate into the teaching plan for this client about the action of the drug?
Inhibits an enzyme to delay glucose absorption
A nurse is presenting an educational event at a local senior citizens' club about diabetes. What would the nurse tell the attendees at the event about diabetes?
It is a complicated disorder that alters the metabolism of glucose.
Which would be appropriate to include in teaching a client with type 2 diabetes?
It is possible with weight loss and exercise to discontinue the use of antidiabetic medication.
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?
It is related to fat and protein metabolism
The two major classifications of diabetes are type 1 and type 2. What is a distinguishing characteristic of type 1 diabetes?
Lifelong exogenous insulin is required.
The nurse is caring for a client with polycystic ovary syndrome. What antidiabetic drug would the nurse anticipate will be ordered?
Metformin
What antidiabetic agent is approved for the nurse to administer to children 10 years old and older with type 2 diabetes?
Metformin
Your client is scheduled to undergo diagnostic testing with the administration of parenteral radiographic contrast media containing iodine. Since your client is taking metformin, you know that:
Metformin should be discontinued at least 48 hours before and after diagnostic tests.
A client is prescribed sitagliptin. The nurse would expect to administer this drug by which route?
Oral
The nurse is caring for a client taking bromocriptine (Cycloset). What is an advantage of this medication?
Reduces risk of heart attack or stroke
A student asks the nursing instructor what insulin has the quickest therapeutic effect once administered. What would be the best response?
Regular (Humulin R)
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?
Regular insulin
A client is admitted to the emergency department in diabetic ketoacidosis (DKA). The physician orders an initial dose of 25 units insulin IV. Which type of insulin will be administered?
Regular insulin
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?
Regular insulin
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?
Subcutaneous injection
A client was diagnosed with type 2 diabetes several months ago and has presented for a scheduled follow-up appointment. Which stated behavior most clearly indicates that the client has established effective health maintenance?
The client frequently checks his/her blood glucose levels.
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?
The client jogs two miles in the morning before he goes to work.
A 4-year-old child with type 1 diabetes mellitus becomes angry and then lethargic. The parent should be taught that a change in behavior may indicate hypoglycemia. True or false?
True
The nurse instructs a client who has been prescribed extended-release metformin (Glucophage XR) to take the medication at what time?
With the evening meal
Which factor would prohibit the administration of glipizide?
allergy to sulfonamides
A nurse is caring for a client receiving metformin drug therapy to improve glycemic control. What adverse reaction to the drug should the nurse monitor the client for?
asthenia
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:
diaphoresis.
Heavy intake of which herb should be avoided by a client who is prescribed an antidiabetic medication?
garlic
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:
increasing insulin secretion from the pancreas.
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?
insulin glargine
A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse most likely administer?
insulin lispro
A client is admitted to the intensive care unit with diabetic ketoacidosis. The nurse knows that the client will be placed on an intravenous insulin drip. The only type of insulin that can be administered intravenously is:
regular
When considering the management of diabetic ketoacidosis (DKA), what type of insulin can be administered intravenously?
regular
What type of insulin will most likely be administered intravenously to a client with a blood glucose level over 600 mg/dL (33.33 mmol/L)?
regular insulin
The nurse should include what information when educating a client prescribed insulin regarding the characteristics of hypoglycemia? Select all that apply.
the onset of symptoms/signs is sudden affected by increased emotion triggered by missing a regular meal
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?
the past 3 or 4 months
The nurse is caring for a client taking insulin. The nurse realizes the client is experiencing symptoms of hypoglycemia when the client displays:
weakness, sweating, and decreased mentation.
