Pathopharm quiz 8
Stimulates growth
ghrelin
When _________ levels increase so does insulin levels.
glucose
A test that measures the level of hemoglobin A1c in the blood as a means of determining the average blood sugar concentrations for the preceding two to three months. Level between 4.0-5.6.
hemoglobin a1c
fasting blood glucose over ______ would be considered diabetic.
126
1. A client with a diagnosis of diabetes is prescribed pramlintide. How will this drug assist in controlling the client's blood sugar? A) It slows gastric emptying. B) It blocks the absorption of food. C) It is absorbed by insulin. D) It increases the release of insulin.
A
11. Heavy intake of which herb should be avoided by a client who is prescribed an antidiabetic medication? A) garlic B) anise C) basil D) oregano
A
19. Which condition must be met in order for glyburide treatment to be effective? A) The client must have functioning pancreatic beta cells. B) The client must have hemoglobin A1C of £7%. C) The client must not have hyperglycemia. D) The client must be able to self-administer the medication.
A
5. Which statement by the nurse represents the most appropriate response to the question why a quick-acting sugar given by mouth is better in the regulation of insulin than the use of intravenous glucose for a low blood sugar? A) "The ingestion of food allows the digestive tract to stimulate vagal activity and the release of incretins." B) "The combination of insulin and food will yield a higher blood sugar than intravenous glucose." C) "Both food and intravenous glucose will produce changes similarly in the gastrointestinal tract to increase blood sugar." D) "You are mistaken. The intravenous glucose yields a higher blood glucose through the release of incretins."
A
9. A client who regularly takes metformin has developed a severe infection. How will the infection change the established diabetic regimen? A) Metformin is contraindicated in the presence of an infection. B) Metformin will be given more frequently to decrease blood sugar. C) Metformin will result in better regulation of blood sugar. D) Metformin will allow the client to decrease the absorption of glucose.
A
A client being evaluated for diabetes asks the nurse how a blood glucose test is used to diagnose this disease. What is the nurse's best response? A. ''A fasting blood sugar result of 126 mg/dL (6.99 mmol/L) or more on two separate occasions is diagnostic of diabetes.'' B. ''A fasting blood sugar result of 100 mg/dL (5.55 mmol/L) or more on two separate occasions is diagnostic of diabetes.'' C. ''Two consecutive hemoglobin A1C results of 6% or more are diagnostic of diabetes.'' D. ''A fasting blood sugar result of 100 mg/dL (5.55 mmol/L) or more and an A1C of more than 6 on two separate occasions are diagnostic of diabetes.''
A
A client diagnosed with diabetic ketoacidosis has been admitted to the intensive care unit. The client is prescribed an intravenous insulin drip, so the nurse knows that what type of insulin will be administered? A. Regular B. Isophane insulin (NPH) C. Lispro D. Insulin glargine
A
A client diagnosed with type 1 diabetes suddenly reports feeling weak, shaky, and dizzy. What should be the nurse's initial response? A. Perform a blood sugar analysis. B. Have the client drink a 4-ounce (120-mL) glass of orange juice. C. Administer 10 units of regular insulin subcutaneously. D. Administer 1 ampule of 50% dextrose intravenously.
A
A client diagnosed with type 2 diabetes several months ago has presented for a scheduled follow-up appointment. Which stated behavior most clearly indicates that the client has established effective health maintenance? A. The client frequently checks blood glucose levels. B. The client can describe the differences between type 1 and type 2 diabetes. C. The client exercises two to three times per week. D. The client reports having gone on a diet.
A
The stress response triggered by illness will result in the increase secretion of what hormones? Select all that apply. A. Glucagon B. Epinephrine C. Thyroxine D. Growth D. Cortisol
A,B,D,E
10. What is the expected action of sitagliptin on type 2 diabetes? A) It blocks the S phase of the cell cycle. B) It slows the rate of inactivation of the incretin hormones. C) It is a synthetically prepared monosodium salt. D) It inhibits hydrogen, potassium, and ATPase.
B
14. A client, who is 42 years old and newly diagnosed with type 2 diabetes, has attended educational sessions to provide insight into the diagnosis. Which of the client's statements should prompt the nurse to provide further teaching? A) "I don't like getting this diagnosis, but I know that treatment now can prevent future health consequences." B) "I'm disappointed, but I take some solace in the fact that I won't ever have to have insulin injections." C) "People always tried to encourage me to lose weight, and I suppose they might have been right." D) "From what I've learned, I know that the basic problem is that my pancreas can't keep up with my insulin needs."
B
15. A nurse educator, explaining the pathophysiology of diabetes to a newly diagnosed client, should provide what explanation for the client's "constant, insatiable thirst"? A) "The excess glucose in your blood accumulates in your blood vessels and neurons, including the neurons that control thirst." B) "Excess glucose pulled more water through your kidneys and the increased urination caused thirst." C) "Increased thirst is your body's attempt to dilute your blood because it contains too much glucose." D) "When your body cells are starved for useful glucose, they signal your body to increase food and fluid intake."
B
2. What distinguishing characteristic is associated with type 1 diabetes? A) Blood glucose levels can be controlled by diet. B) Exogenous insulin is required for life. C) Oral agents can control blood sugar. D) The disease always starts in childhood.
B
6. A 58-year-old client, diagnosed with diabetes at age 14, reports having pain in both feet and hands. What is this pain most likely a result of? A) a diabetes-related infectious process B) peripheral neuropathy C) an autoimmune disorder D) hypertension resulting from diabetes
B
A client has been newly diagnosed with type 2 diabetes. What statement would be appropriate for the nurse to include in the teaching? A. ''If you drink alcohol, it may be necessary for you to increase your oral antidiabetic medication.'' B. ''Regular exercise makes your body better able to use the insulin it produces.'' C. ''Clients with type 2 diabetes always progress to insulin injections if they do not follow dietary guidelines.'' D. ''Until you need to start insulin injections, you do not have to check your blood sugar.''
B
A client who began treatment for type 2 diabetes 8 months ago is now meeting with a diabetic nurse for a scheduled follow-up. How can the nurse best assess the client's glycemic control since beginning treatment? A. Arrange to have the client's random blood glucose measured. B. Assess the most recent hemoglobin A1C levels. C. Dialogue with the client about implemented management strategies. D. Review and discuss the data contained in the client's written blood glucose log.
B
The client is scheduled to get a breakfast tray at 07:00. At what time should the client receive a prescribed dose of insulin lispro? A. 6:20 B. 6:45 C. 7:00 D. 6:00
B
16. A hospital client with a diagnosis of type 1 diabetes is prescribed Humulin R on a sliding scale. Based on the client's blood glucose reading, the nurse administered 8 units of insulin at 07:45. The nurse should consequently check the client's blood glucose level at what time to monitor peak effectiveness of the medication? A) 08:15 B) between 08:45 and 09:45 C) between 09:45 and 10:45 D) between 11:15 and 11:45
C
18. The nurse knows that the lunch trays are usually distributed at approximately 12:15. The nurse should plan to administer the client's prescribed 4 units of regular insulin at what time? A) 12:15 B) 12:10 C) 11:45 D) 11:15
C
4. During a teaching session on the care of the diabetic client, the nurse should make which statement to explain the differences in insulin? A) "Insulin is prescribed based on the insurer's criteria for reimbursement." B) "Insulin is prescribed based on the client's age." C) "Insulins have different onsets and durations of action." D) "Insulin type is matched with the appropriate oral hypoglycemic agent."
C
7. Which factor would contraindicate the administration of glipizide? A) a diagnosis of hypertension B) the ingestion of carbohydrates C) allergy to sulfonamides D) increase in alkaline phosphatase
C
8. A client has been prescribed acarbose. What is the advantage of acarbose over alternative drugs? A) It can replace the use of insulin. B) The client does not have to limit food intake. C) It delays the digestion of complex carbohydrates. D) It prevents alkalosis.
C
Rosiglitazone is being considered for the treatment of diabetes in an adult client. Before the initiation of rosiglitazone therapy, the nurse should review what laboratory work recently drawn? A. D-dimer B. Creatinine C. Liver enzymes D. Platelet count
C
The nurse is caring for a client who is taking insulin. The nurse suspects the client is experiencing hypoglycemia when the client displays what signs? A. Increased thirst and increased urine output B. Decreased respiratory rate and hot, dry skin C. Weakness, sweating, and decreased mentation D. Increased pulse rate and fruity smelling breath
C
The nurse is reviewing a prescription for metformin. The nurse should immediately contact the prescribing health care provider to report a contraindication if the prescription is for which client? A. A 50-year-old client who underwent surgery 2 weeks ago B.A 37-year-old woman who takes oral contraceptives C. An 82-year-old client diagnosed with type 2 diabetes D. A 16-year-old client with a diagnosis of anorexia nervosa
C
12. A client, who experienced hypoglycemia twice in the past week, states that he/she eats one meal per day and snacks the rest of the day. What client education will the nurse provide for a client who reports regularly experiencing hypoglycemic symptoms? A) A alcohol should be limited and taken only with meals. B) Daily caloric intake should be increase by 200 calories. C) Daily snacks should increase protein intake. D) Meals should be eaten at regular times.
D
13. An 8-month-old infant admitted with a new diagnosis of diabetes is to receive 1 unit of regular insulin. How will that 1 unit be administered? A) orally B) intravenously C) with a TB syringe D) dilution strength of U-10
D
17. Before administering a prescribed 20 units of NPH insulin to a client, the nurse should implement which intervention? A) Massage the chosen injection site. B) Assess the client's understanding of diabetes. C) Assess the client's urine for the presence of glucose. D) Have a colleague confirm the dosage.
D
3. What type of insulin will most likely be administered intravenously to a client with a blood glucose level is over 600 mg/dL? A) NPH insulin B) Lente insulin C) Ultralente insulin D) regular insulin
D
A client diagnosed with type 2 diabetes has been prescribed a meglitinide. The nurse should inform the client that the medication should be taken at what time relative to meals? A. At least 1 hour before the meal B. Within 1 hour following the meal C. With the meal D. No more than 30 minutes before the meal
D
A client who has been prescribed metformin is scheduled to undergo diagnostic testing with the administration of parenteral radiographic contrast media containing iodine. What fact should direct the nurse's plan of care for this client? A. The client will be prescribed an extra dose of metformin to address the contrast media effect on the body. B. The client needs to be encouraged to drink 1 to 2 L of water to flush the contrast media out the kidneys. C. Insulin will be temporarily substituted for the metformin to address the risk of potential kidney failure. D. Metformin should be discontinued at least 48 hours before and after diagnostic tests that use contrast media.
D
A client's current condition requires rapid reduction of blood sugar levels. Which type of insulin will have the most rapid onset of action? A. NPH 70%, regular 30% B. Regular insulin C. Isophane (NPH) D. Insulin lispro
D
__________________ operates in a negative feedback system.
Insulin
______________ insulin has a rapid onset and is given to patients in DKA.
Regular
You would not want to give insulin in a ______________ shot.
TB
§ Insulin dependent § Autoimmune § Destroying pancreatic beta cells § Ketones expected in the urine
Type 1 Diabetes
Why would oral glucose be more effective than IV for a hypoglycemia?
You metabolize sugar in the mouth
gestational diabetes
a form of diabetes mellitus that occurs during some pregnancies
20. An older adult client has been prescribed metformin for the treatment of type 2 diabetes for several years. Which change in the client's laboratory values may demonstrate a need to discontinue the medication? A) a decrease in hemoglobin and hematocrit B) an increase in serum lactate C) a decrease in potassium accompanied by an increase in sodium D) an increase in white blood cells
b
What cells secrete insulin?
beta cells
Metformin causes ___________ in persons older than 80 years old.
lactic acidosis
Why do we rotate insulin injection sites?
lipodystrophy
§ 90-95% of all the diabetes § Falls into a metabolic syndrome § Fasting blood sugar of 100 § HDLs under 50 in men and 40 in women
type 2 diabetes
