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.