PHARM EXAM 4 (*ANTIDIABETICS QUESTIONS)

Has a fasting glucose level of 180 mg/dl.

The best candidate for oral antidiabetic therapy is the client who:

Hypoglycemia caused by hyperinsulinism.

The best candidate for treatment with Diazoxide (Proglycem) is the client who is experiencing:

Can use the prepared amount of regular and NPH units

The best candidate for treatment with a combination insulin such as Humulin 70/30 is the client who:

Reduced absorption of glucose from the small intestine

The client has been started on Metformin (Glucophage). What would be a positive outcome for this client as a result of the medication he is taking?

Life-threatening reaction to

The client is being treated with Glipizide. She begins to exhibit difficulty breathing. The nurse recognizes that this may be indicative of a(n) ________ the medication.

Decreased effect from the Humulin N

The client is being treated with Humulin N. She also takes an oral contraceptive. The nurse anticipates that the interaction of these two medications will result in which effect?

Potentiated hypoglycemia.

The client is being treated with Metformin. He is also receiving furosemide. The nurse anticipates that the interaction of the two medications will result in:

9:00 PM

The client is ordered to be treated with glargine (Lantus) insulin. Because of the type of insulin that the client is receiving, the nurse plans a dosage schedule that administers the medication at which time(s)?

Liver function tests

The client is scheduled to begin treatment with Metformin. The nurse plans to closely monitor which laboratory values?

Make sure patient eats by 5 PM

The nurse administers NPH insulin at 8 AM. What intervention is essential for the nurse to perform?

Nervousness and tremors

The nurse assesses a client for evidence of hypoglycemic reaction. The highest priority nursing intervention is to assess for:

9:00 AM to 11:00 AM

The nurse is monitoring a client for evidence of a hypoglycemic reaction. The client received Humulin R insulin at 7 AM. The nurse anticipates that the client will need to be most closely monitored for evidence of a hypoglycemic reaction at which time?

Flatulence, hypoglycemia, and diarrhea

The nurse is providing patient teaching for the drug miglitol for the patient with a diagnosis of type 2 diabetes. Which group of side effects should the nurse include in the patient teaching?

"Draw up the regular insulin first."

The nurse is teaching a patient about home administration of insulin. The patient will receive regular (Humulin R) and NPH (Humulin NPH) insulin at 0700 every day. What is important to teach this patient?

Subcutaneously with the needle at a 45- to 60-degree angle.

The nurse is teaching a patient how to administer insulin. The patient is thin with very little body fat. The nurse will suggest injecting insulin

"You will need to be sure you eat as soon as you take this medication."

The nurse is teaching a patient who has been prescribed repaglinide. Which information will the nurse include in the teaching plan?

"I will not be concerned about a raised knot under my skin from injecting insulin."

The nurse is teaching a patient who is newly diagnosed with type 1 diabetes mellitus about insulin administration. Which statement by the patient indicates a need for further teaching?

100-unit insulin

The nurse is teaching the client the proper procedure for administration of insulin. The nurse should direct the client to use a _____ syringe.

"For the most consistent absorption, inject the insulin into the abdomen."

The nurse is teaching the patient how to administer insulin. What information is essential to include in the plan?

Clarify the insulin type and route

The nurse receives the following order for insulin: IV NPH (Humulin NPH) 10 units. The nurse will perform which action?

Subcutaneous

The nurse will administer parenteral insulin to a patient who will receive a mixture of NPH (Humulin NPH) and regular (Humulin R). The nurse will give this medication via which route?

"You cannot mix this insulin with any other insulin in the same syringe."

The nurse would include which statement when teaching a patient about insulin glargine?

To send a snack with the child to eat just prior to exercise.

The parent of a junior high-school child who has type 1 diabetes asks the nurse if the child can participate in sports. The nurse will tell the parent

"Some combination pens do not require refrigeration."

The patient asks the nurse about storing insulin. Which response by the nurse is correct?

"This medication has a duration of action of 24 h."

The patient newly diagnosed with type 2 diabetes mellitus has been ordered insulin glargine. What information is essential for the nurse to teach this patient?

"Sulfonylurea increases beta-cell stimulation to secrete insulin, and with your type of diabetes, the beta cells do not contain insulin. This medication will not work for you."

The patient with type 1 diabetes mellitus asks, "Why can't I take a sulfonylurea like my friend who has diabetes?" What is the nurse's best response?

"This medication will delay the absorption of carbohydrates from the intestines."

What information will the nurse teach the patient who has been prescribed an alpha glucosidase inhibitor?

Administer glucagon

What is the nurse's best action when finding a patient with type 1 diabetes mellitus unresponsive, cold, and clammy?

Inform the patient that it is better to take the medication 30 min before a meal.

Which is the most appropriate action for the nurse who is told that a patient typically takes his glipizide with food?

"I will still need to monitor serum glucose."

Which statement by a patient who will begin using an external insulin pump indicates understanding of this device?

"I will take the medication only when I need it."

Which statement indicates to the nurse that the patient needs additional teaching on oral hypoglycemic agents?

Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin.

Which technique is most appropriate regarding mixing insulin when the patient must administer 30 units regular insulin and 70 units NPH insulin in the morning?

May be used since this patient meets criteria.

A 45-year-old patient who is overweight has had a diagnosis of type 2 diabetes for 2 years. The patient uses 20 units of insulin per day. The patient's fasting blood glucose (FBG) is 190 mg/dL. The patient asks the nurse about using an oral antidiabetic agent. The nurse understands that oral antidiabetic agents

Administer glucagon

A client is found unconscious with a Medic-Alert bracelet indicating type 1 diabetes mellitus. What is the highest priority nursing intervention?

Does not peak

A client is ordered to receive insulin glargine (Lantus) insulin. The nurse plans the client's care based on the fact that Lantus:

5 minutes before

A client is to receive Humalog (Lispro) insulin at breakfast. The nurse plans to administer the insulin _____ breakfast.

Infection temporarily increases the need for insulin

A client with type 2 diabetes mellitus is admitted to the hospital with an infection. The client was taking oral hypoglycemic agents and is prescribed insulin in the hospital. What is the highest priority instruction that the nurse can give the client regarding insulin administration?

"Surgery can produce stress, which can produce stress; an additional small amount of insulin helps provide a constant glucose level."

A male patient 24 h post-op tells the nursing student that his nurse "gave him an extra shot of insulin and there must be some mistake." The nursing student verifies the patient received a sliding scale dose of insulin. What information should the nursing student provide to the patient?

Is often related to heredity and obesity.

A patient develops type 2 diabetes mellitus. The nurse will explain that this type of diabetes

Give the patient orange juice.

A patient has administered regular insulin 30 minutes prior but has not received a breakfast tray. The patient is experiencing nervousness and tremors. What is the nurse's first action?

5 minutes before eating

A patient is ordered to receive insulin lispro at mealtimes. The nurse will instruct this patient to administer the medication at which time?

5:00pm

A patient is receiving a daily dose of NPH insulin at 7:30am. The nurse expects the peak effect of this drug to occur at what time?

Lispro

A patient is to receive insulin before breakfast and the time of the breakfast tray is variable. The nurse knows that this insulin should not be administered until the tray has arrived and the patient is ready to eat

Renal failure

A patient who has been taking a sulfonylurea antidiabetic medication will begin taking metformin (Glucophage). The nurse understands that this patient is at increased risk for which condition?

Increase the insulin dose.

A patient who has insulin-dependent diabetes mellitus must take a glucocorticoid medication for osteoarthritis. When teaching this patient, the nurse will explain that there may be a need to

Depends on individual insulin needs

A patient who has type 1 diabetes mellitus asks the nurse about using a combination insulin product such as Humalog 75/25. The nurse will tell the patient that use of this product

Has a longer duration of action

A patient who has type 2 diabetes mellitus asks the nurse why the provider has changed the oral antidiabetic agent from tolbutamide (Orinase) to glipizide (Glucotrol). The nurse will explain that Glipizide

Prediabetes

A patient who is overweight is being evaluated for diabetes. The patient has a blood glucose level of 160 mg/dL and a hemoglobin A1c of 5.8%. The nurse understands that this patient has which condition?

Glucagon.

A patient who is unconscious and has a pulse is brought to the emergency department. The patient is wearing a Medic-Alert bracelet indicating type 1 diabetes mellitus. The nurse will anticipate an order to administer

Make sure the patient eats breakfast immediately.

A patient with type 1 diabetes mellitus has been ordered insulin aspart 10 units at 7:00 AM. What nursing intervention will the nurse perform after administering this medication?

Subcutaneous

In administering an insulin injection to a client, the nurse anticipates that the injection of NPH (Humulin N) and regular (Humulin R) insulins will be administered via the _____ route.