Pharmacology 9.2 Pretest/Posttest
The nurse is caring for an adult client who has type 2 diabetes mellitus. After reviewing the client's chart, which item(s) should concern the nurse?
Healthcare provider's choice of antidiabetic drug Client's medication to treat comorbidity Client's comorbidity
The nurse is caring for an adult client with a history of type 2 diabetes mellitus. In the past, the client has had multiple episodes of hyperglycemia. Currently, the client is receiving insulin via infusion pump, to be discontinued at bedtime. The client's most recent blood glucose level, at 4:00 p.m., was 57 mg/dL. (The normal range is 60-100 mg/dL.) What action should the nurse take?
Call to advise the healthcare provider of the most recent blood glucose level and discuss discontinuing the insulin infusion.
The nurse is educating an adult client who is newly diagnosed with diabetes mellitus. The teaching includes information about substances that can raise blood glucose levels. Which medication(s) can produce hyperglycemic effects?
Corticosteroids Diuretics Phenytoin (Dilantin)
A young adult with a history of type 1 diabetes presents to the emergency room with complaints of abdominal pain, nausea, and vomiting. A few days ago, he reduced his insulin dose because flu symptoms caused a decrease in appetite. The nurse's assessment reveals fruity breath odor, dry mucous membranes, and poor skin turgor. What condition does the nurse suspect?
Diabetic ketoacidosis (DKA)
The nurse in the emergency department is caring for a 45-year-old client with a history of type 2 diabetes mellitus. Which clinical manifestations are consistent with those the nurse can expect to observe?
Fasting blood glucose 165 mg/dL Client's report of increased food intake Client's complaint of a "pins and needles" sensation in the upper extremities
A client receives 15 units of isophane insulin (Humulin N) at 8:00 a.m. At 3:00 p.m., the nurse observes that the client is pale, diaphoretic, anxious, and restless. What action should the nurse take first?
Give the client 8 oz of skim milk.
In the emergency department, the nurse is caring for an unconscious adult client with a blood glucose level of 37 mg/dL. (Normal blood glucose is 60-100 mg/dL.) What medication does the nurse expect to see ordered?
Glucagon (GlucaGen)
During discharge teaching, the nurse explains to a client diagnosed with type 2 diabetes that lab testing will be done to check his overall management of the disease. Which test does the nurse say to expect in about 8-12 weeks?
HbA1C (hemoglobin A1C)
In the emergency room, glucagon (GlucaGen) is administered to an unresponsive client with severe hypoglycemia. What potential adverse effect is most critical for the nurse to monitor?
Hyperglycemia
The nurse is preparing to administer tolazamide (Tolinase) to a client with type 2 diabetes, as prescribed by the healthcare provider. For what adverse effect does the nurse need to monitor?
Hypoglycemia
The clinic nurse receives a mid-morning telephone call from the mother of a 7-year-old child who was recently diagnosed with type 1 diabetes mellitus. The mother states that her child's most recent finger-stick blood glucose level is 54 mg/dL (normal: 80-120 mg/dL). Which symptom is consistent with those the nurse can expect the mother to report of the child?
Irritability
The nurse is assessing a diabetic client who has a blood glucose level of 799 mg/dL (normal: 60-100 mg/dL), and is unresponsive. What finding leads the nurse to suspect diabetic ketoacidosis?
Rapid, deep respirations
The nurse is preparing to administer insulin to a client with type 1 diabetes mellitus. What action(s) does the nurse recognize as important to do during administration?
Rotate the site of administration Monitor the client's dietary intake Check the client's blood glucose level
The nurse is caring for a teenaged client who is newly diagnosed with type 1 diabetes mellitus. Which statement made by the client indicates that further teaching is necessary?
"I will have to take my pill just once a day."
The nurse administers 20 units of isophane insulin (Humulin N) at 7:00 a.m. to a client with insulin-dependent diabetes mellitus. What time should the nurse observe the client for signs of hypoglycemia?
3:00 p.m.
The nurse asks a client with type 2 diabetes to explain what he should do if his finger-stick blood glucose is 55 mg/dL on the sliding scale. (The lowest blood glucose on the scale is 60 mg/dL.) Which client response indicates that further teaching is necessary?
I will inject three units of insulin.
