Pharmacology Chapter 32 Antidiabetic Drugs - evolve

Which long-acting insulin mimics natural, basal insulin with no peak action and a duration of 24 hours? A. Insulin glargine (Lantus) B. Insulin glulisine (Apidra) C. Regular insulin (Humulin R) D. NPH insulin

(Lantus) Correct Insulin glargine has a duration of action of 24 hours with no peaks, mimicking the natural, basal insulin secretion of the pancreas.

Which long-acting insulin mimics natural, basal insulin with no peak action and a duration of 24 hours? A. insulin glargine (Lantus) B. insulin glulisine (Apidra) C. regular insulin (Humulin R) D. NPH insulin

.A. insulin glargine (Lantus) Correct Insulin glargine has a duration of action of 24 hours with no peaks, mimicking the natural, basal insulin secretion of the pancreas.

The patient is prescribed 30 units regular insulin and 70 units NPH insulin subcutaneously every morning. The nurse will provide which instruction to the patient? A. "Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin." B. "Mixing insulins will help increase insulin production." C. "Rotate sites at least once weekly." D. "Use a 23- to 25-gauge syringe with a 1-inch needle for maximum absorption."

A. "Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin." Correct Drawing up the regular insulin into the syringe first prevents accidental mixture of NPH insulin into the vial of regular insulin, which could cause an alteration in the onset of action of the regular insulin.

When caring for a pregnant patient with gestational diabetes, the nurse should question a prescription for which drug? A. Insulin glargine (Lantus) B. Glipizide (Glucotrol) C. Insulin glulisine (Apidra) D. NPH insulin

A. Glipizide (Glucotrol) Correct Oral antidiabetic drugs are classified as pregnancy B or C drugs and are generally not recommended for pregnant patients.

The nurse will instruct the patient to treat hypoglycemia with which drug? A. Acarbose (Precose) B. Propranolol (Inderal) C. Glucagon (GlucaGen) D. Bumetanide (Bumex)

A. Glucagon (GlucaGen) Correct Glucagon stimulates glycogenolysis, raising serum glucose levels.

Which information should be included in a teaching plan for patients taking oral hypoglycemic drugs? (Select all that apply.) A. Limit your alcohol consumption. B. Report symptoms of anorexia and fatigue. C. Take your medication only as needed. D. Notify your physician if blood glucose levels rise above the level set for you.

A. Limit your alcohol consumption. Correct B. Report symptoms of anorexia and fatigue. Correct D. Notify your physician if blood glucose levels rise above the level set for you.Correct Oral hypoglycemic drugs must be taken on a daily scheduled basis to maintain euglycemia and prevent long-term complications of diabetes. All other options are correct.

The nurse is preparing a patient for a computed tomography scan using iodine contrast media. Which medication should the nurse question if prescribed one day before the scheduled procedure? A. Acarbose (Precose) B. Pioglitazone (Actos) C. Repaglinide (Prandin) D. Metformin (Glucophage) Correct

A. Metformin (Glucophage) Correct The concurrent use of metformin with iodinated (iodine-containing) radiologic contrast media has been associated with both acute renal failure and lactic acidosis. Therefore, metformin should be discontinued the day of the test and for at least 48 hours after the patient undergoes any radiologic study that requires the use of such contrast media.

Pramlintide (Symlin) is prescribed as supplemental drug therapy to the treatment plan for a patient with type 1 diabetes mellitus. What information should the nurse include when teaching the patient about the action of this medication? A. Pramlintide slows gastric emptying. B. Pramlintide increases glucagon excretion. C. Pramlintide stimulates glucose production. D. Pramlintide corrects insulin receptor sensitivity.

A. Pramlintide slows gastric emptying. Correct Pramlintide is a synthetic form of the naturally occurring hormone amylin. It works by slowing gastric emptying, suppressing glucagon secretion and hepatic glucose production, and increasing satiety (sense of having eaten enough). It is only administered via subcutaneously injection.

Pramlintide (Symlin) is added to the treatment plan for a patient with type 1 diabetes. What information about the action of this medication does the nurse include in the patient teaching? A. Pramlintide slows gastric emptying. B. Pramlintide increases glucagon excretion. C. Pramlintide works to prevent side effects of insulin. D. Pramlintide is an oral drug administered 15 minutes before meals.

A. Pramlintide slows gastric emptying. Correct Pramlintide is a synthetic form of the naturally occurring hormone amylin. It works by slowing gastric emptying, suppressing glucagon secretion, and centrally modulating appetite and satiety. It is only administered subcutaneously.

Which insulin can be administered by continuous intravenous (IV) infusion? A. Insulin glargine (Lantus) B. Insulin aspart (Novolog) C. Insulin detemir (Levemir) D. Regular insulin (Humulin R)

A. Regular insulin (Humulin R) Correct Regular insulin is the only insulin used for IV therapy.

Which oral hypoglycemic drug has a quick onset and short duration of action, enabling the patient to take the medication 30 minutes before eating and skip the dose if he or she does not eat? A. Acarbose (Precose) B. Metformin (Glucophage) C. Repaglinide (Prandin) D. Pioglitazone (Actos)

A. Repaglinide (Prandin) Correct Repaglinide is known as the "Humalog of oral hypoglycemic drugs." The drug's very fast onset of action allows patients to take the drug with meals and skip a dose when they skip a meal.

Which actions describe the beneficial effects produced by sulfonylurea oral hypoglycemics? (Select all that apply.) A. Stimulate insulin secretion from beta cells B. Increase hepatic glucose production C. Enhance action of insulin in various tissues D. Inhibit breakdown of insulin by liver

A. Stimulate insulin secretion from beta cells Correct C. Enhance action of insulin in various tissues Correct D. Inhibit breakdown of insulin by liver Correct The sulfonylureas stimulate insulin secretion from the beta cells of the pancreas; enhance the actions of insulin in muscle, liver, and adipose tissue; and prevent the liver from breaking insulin down as fast as it ordinarily would (reduced hepatic clearance). Increased hepatic glucose production would serve to

Which actions describe the beneficial effects produced by sulfonylurea oral hypoglycemics? (Select all that apply.) A. Stimulate insulin secretion from beta cells B. Increase hepatic glucose production C. Enhance action of insulin in various tissues D. Inhibit breakdown of insulin by liver

A. Stimulate insulin secretion from beta cells Correct C. Enhance action of insulin in various tissues Correct D. Inhibit breakdown of insulin by liver Correct The sulfonylureas stimulate insulin secretion from the beta cells of the pancreas; enhance the actions of insulin in muscle, liver, and adipose tissue; and prevent the liver from breaking insulin down as fast as it ordinarily would (reduced hepatic clearance). Increased hepatic glucose production would serve to increase serum glucose levels, the opposite effect of oral hypoglycemic drugs.

When teaching a patient about insulin glargine (Lantus), which statement by the nurse about this drug is correct? A. "You can mix this insulin with NPH insulin to enhance its effects on glucose metabolism." B. "You cannot mix this insulin with regular insulin and thus will have to take two injections." Correct C. "It is often combined with regular insulin to decrease the number of insulin injections per day." D. "The duration of action for this insulin is 8 to10 hours, so you will need to take it twice a day." Insulin glargine is a long-acting insulin with duration of action up to 24 hours. It should not be mixed with any other insulins. It is usually dosed once daily, but it may be dosed every 12 hours depending on the patient's glycemic response.

B. "You cannot mix this insulin with regular insulin and thus will have to take two injections." Correct Insulin glargine is a long-acting insulin with duration of action up to 24 hours. It should not be mixed with any other insulins. It is usually dosed once daily, but it may be dosed every 12 hours depending on the patient's glycemic response.

The nurse is providing education to a patient about the time to take glipizide (Glucotrol). For maximum benefit, the nurse will tell the patient to administer glipizide at which time? A. In the morning B. 30 minutes before a meal C. 15 minutes postprandial D. At bedtime

B. 30 minutes before a meal Correct Glipizide works best if given 30 minutes before meals. This allows the timing of the insulin secretion induced by the glipizide to correspond to the elevation in the blood glucose level induced by the meal.

Which is a rapid-acting insulin with an onset of action of less than 15 minutes? A. Insulin glargine (Lantus) B. Insulin aspart (NovoLog) C. Insulin detemir (Levemir) D. Regular insulin (Humulin R)

B. Insulin aspart (NovoLog) Correct Insulin aspart is a rapid-acting insulin. Insulin glargine and insulin detemir are long-acting insulins. Regular insulin is short acting.

Which information should the nurse include in a teaching plan for patients taking oral hypoglycemic drugs? (Select all that apply.) A. Take your medication only as needed. B. Report symptoms of anorexia and fatigue. C. Explain dietary changes are not necessary. D. Advise to avoid smoking and alcohol consumption. E. Instruct that it is okay to skip breakfast 1 to 2 times per week.

B. Report symptoms of anorexia and fatigue. Correct D. Advise to avoid smoking and alcohol consumption. Corre long-term complications of diabetes. Skipping meals can cause low blood glucose levels and should be avoided. Patients with type 2 diabetes mellitus are managed with lifestyle changes. All other options are correct.

When caring for a patient newly diagnosed with gestational diabetes, the nurse would question an order for which drug? A. insulin glargine (Lantus) B. glipizide (Glucotrol) C. insulin glulisine (Apidra) D. NPH insulin

B. glipizide (Glucotrol) Correct Oral antidiabetic drugs are generally not recommended for pregnant patients.

The nurse will advise the patient to treat hypoglycemia with which drug? A. propranolol (Inderal) B. glucagon C. acarbose (Precose) D. bumetanide (Bumex)

B. glucagon Correct Glucagon stimulates glycogenolysis, raising serum glucose levels.

1. Which is a rapid-acting insulin with an onset of action of less than 15 minutes? A. insulin glargine (Lantus) B. insulin aspart (NovoLog) C. regular insulin (Humulin R) D. insulin detemir (Levemir)

B. insulin aspart (NovoLog) Correct Insulin aspart is a rapid-acting insulin. Insulin glargine and insulin detemir are long-acting insulins. Regular insulin is short acting.

The nurse is caring for a patient scheduled to undergo a cardiac catheterization procedure utilizing iodine-based contrast material. The nurse would question an order for which medication to be given to this patient the day before the scheduled procedure? A. acarbose (Precose) B. metformin (Glucophage) C. repaglinide (Prandin) D. pioglitazone (Actos) The concurrent use of

B. metformin (Glucophage) Correct The concurrent use of metformin and iodinated (iodine-containing) radiologic contrast media has been associated with both acute renal failure and lactic acidosis. Therefore metformin should be discontinued at least 48 hours prior to any radiologic study requiring such contrast media and should be held for at least 48 hours after the procedure.

Assuming the patient eats breakfast at 8:30 AM, lunch at noon, and dinner at 6:00 PM, he or she is at highest risk of hypoglycemia after an 8:00 AM dose of NPH insulin at what time? A. 10:00 AM B. 2:00 PM C. 5:00 PM D. 8:00 PM

C. 5:00 PM Correct Breakfast eaten at 8:30 AM would cover the onset of NPH insulin, and lunch will cover the 2 PM time frame. However, if the patient does not eat a mid-afternoon snack, the NPH insulin may be peaking just before dinner without sufficient glucose on hand to prevent hypoglycemia.

Assuming the patient eats breakfast at 8:30 AM, lunch at noon, and dinner at 6:00 PM, he or she is at highest risk of hypoglycemia following an 8:00 AM dose of NPH insulin at what time? A. 10:00 AM B. 2:00 PM C. 5:00 PM D. 8:00 PM

C. 5:00 PM Correct Breakfast eaten at 8:30 AM would cover the onset of NPH insulin, and lunch will cover the 2 PM time frame. However, if the patient does not eat a mid-afternoon snack, the NPH insulin may be peaking just before dinner without sufficient glucose on hand to prevent hypoglycemia.

Which insulin can be administered by continuous intravenous infusion? A. insulin glargine (Lantus) B. insulin aspart (Novolog) C. regular insulin (Humulin R) D. insulin detemir (Levemir)

C. regular insulin (Humulin R) Correct Regular insulin is the only insulin used for intravenous therapy.

Which oral hypoglycemic drug has a quick onset and short duration of action, enabling the patient to take the medication 30 minutes before eating and skip the dose if he or she does not eat? A. acarbose (Precose) B. metformin (Glucophage) C. repaglinide (Prandin) D. pioglitazone (Actos)

C. repaglinide (Prandin) Correct Repaglinide is known as the "Humalog of oral hypoglycemic drugs." The drug's very fast onset of action allows patients to take the drug with meals and skip a dose when they skip a meal.

The patient is prescribed 30 units of regular insulin and 70 units of insulin isophane suspension (NPH insulin) subcutaneously every morning. The nurse should provide which instruction to the patient for insulin administration? A. "Inject the needle at a 30-degree angle." B. "Rotate sites at least once or twice a week." C. "Use a 23- to 25-gauge syringe with a 1-inch needle to increase insulin absorption." D. "Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin."

D. "Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin." Correct When insulins are mixed, withdraw the regular insulin (clear) first, followed by withdrawing the NPH insulin (cloudy).

The nurse would include which statement when teaching a patient about insulin glargine? A. "You should inject this insulin just before meals because it is very fast acting." B. "The duration of action for this insulin is approximately 8 to10 hours, so you will need to take it twice a day." C. "You can mix this insulin with NPH insulin to enhance its effects." D. "You cannot mix this insulin with regular insulin and thus will have to take two injections."

D. "You cannot mix this insulin with regular insulin and thus will have to take two injections." Correct Insulin glargine is a long-acting insulin with duration of action up to 24 hours. It should not be mixed with any other insulins.

The nurse is providing education to a patient for the prescription glipizide (Glucotrol). The nurse explains this medication is more effective when administered at which time? A. At bedtime B. In the morning C. 15 minutes postprandial D. 30 minutes before a meal

D. 30 minutes before a meal Correct Glipizide works best if given 30 minutes before meals. This allows the timing of the insulin secretion induced by the glipizide to correspond to the elevation in the blood glucose level induced by the meal.