PN119 PrepU Chapter 42

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.

T/F: Patients with type 2 diabetes have nonfunctioning beta pancreatic cells.

False

A nurse at a health care facility is caring for a patient who has been prescribed insulin for the first time. Which preadministration assessment should be performed by the nurse before the first dose of insulin is given?

General assessment of the skin

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."

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."

A patient at a healthcare facility has been prescribed 8 mg of rosiglitazone maleate (Avandia) daily to improve glycemic control. On-hand availability of the drug is in the form of 2 mg tablets. How many tablets of the drug should the nurse administer to the patient?

4 tablets

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.

Your client is being evaluated for diabetes. He asks you what the blood glucose results mean. Your best response is:

A fasting blood sugar result of 126 mg/dL or more on two separate occasions is diagnostic of diabetes.

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

Allergy to sulfonamides

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.

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

A patient is diagnosed with type 1 diabetes. What distinguishing characteristic is associated with type 1 diabetes?

Exogenous insulin is required for life.

The two major classifications of diabetes are type 1 and type 2. What is a distinguishing characteristic of type 1 diabetes?

Exogenous insulin is required for life.

A hospital patient's medication administration record specifies a dose of NPH insulin to be administered subcutaneously at 8 AM. The nurse has checked the patient's blood glucose level prior to administering the drug and it is 55 mg/dl. How should the nurse respond to this assessment finding?

Hold the dose of insulin and consult with the patient's primary care provider.

Which of the following insulin is always clear? (Choose one)

Humulin R

The physician 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 patient?

Hypoglycemia

Which is an example of long acting insulin?

Insulin glargine (Lantus)

What is an example of rapid acting insulin?

Insulin lispro (Humalog)

Which of the following represent the American Diabetes Association recommended HbA1c goal? (Choose one)

Less than 7%

The nurse is preparing to administer insulin lispro (Humalog) to a client at 7 AM. What is the nurse's top priority intervention related to this medication?

Make sure the client's breakfast is available in the next 5-10 minutes.

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

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 patient is prescribed sitagliptin. The nurse would expect to administer this drug by which route?

Oral

The physician prescribes glyburide for Tim, a newly diagnosed type 2 diabetic. The nurse knows that this medication acts by which mechanism?

Produces hypoglycemia by increasing insulin secretion from the pancreas

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

A student asks the nursing instructor what insulin has the quickest therapeutic effect once administered. What would be the best response?

Regular (Humulin R)

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

James, age 35, begins the administration of glyburide for treatment of diabetes mellitus type 2. As the nurse caring for John, you instruct him about the medication. Which statement would NOT be appropriate advice for James?

The medication can be taken at dinner time.

Glycosylated hemoglobin measures average blood glucose over what time period?

The past 3 or 4 months

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 patient jogs two miles in the morning before he goes to work.

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.

The nurse educator works at the diabetes clinic. When talking to a class of adolescent diabetics, the educator tells the students that the most recognized signs of diabetes are:

hyperglycemia and glycosuria.

A male patient is to begin glyburide (Diabeta) for type 2 diabetes. Before the drug therapy begins, a priority action by the nurse will be to assess the patient's

use of alcohol.

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.

A diabetic patient is taking regular and NPH insulin to manage his diabetes. What is the best evaluation tool to measure the overall patient response to the insulin therapy?

Glycosylated hemoglobin (HbAlc) levels

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

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.

A patient is admitted to the Emergency Department in diabetic ketoacidosis (DKA) with a blood glucose level of 33 mmol/L. The physician orders an initial dose of 25 U insulin IV. Which type of insulin will be administered?

Regular insulin

A patient 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

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