Pharm Exam 4 Chapter 38

What would alert the nurse to suspect that a client is developing ketoacidosis?

Fruity breath odor

A man is brought to the emergency department. He is nonresponsive, and his blood glucose level is 32 mg/dL. Which would the nurse expect to be ordered?

Glucagon The client is significantly hypoglycemic and needs emergency treatment. Glucagon would be the agent of choice to raise the client's glucose level because it can be given intravenously and has an onset of approximately 1 minute

When considering the management of diabetic ketoacidosis (DKA), what type of insulin can be administered intravenously?

regular

What type of insulin will most likely be administered intravenously to a client with a blood glucose level over 600 mg/dL (33.33 mmol/L)?

regular insulin

Currently, the medical management of diabetes mellitus is aimed at

regulating blood glucose levels.

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."

What statement would be appropriately included in the teaching concerning type 2 diabetes?

"Regular exercise makes your body better able to use the insulin it produces."

The long-term alterations in fat, carbohydrate, and protein metabolism associated with diabetes mellitus result in

. thickening of the capillary basement membrane.

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?

06:45

A nurse is preparing a syringe that contains regular and NPH insulin. To ensure effectiveness, the nurse would administer the insulins within which time frame?

15 minutes

The nurse is educating a newly diagnosed diabetic who must learn how to give himself insulin injections. The nurse tells the client that insulin is absorbed fastest from which area of injection?

Abdomen

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?

Assess the most recent hemoglobin A1C levels.

A nurse is assigned to administer glargine to a patient at a health care facility. What precaution should the nurse take when administering glargine?

Avoid mixing glargine with other insulin.

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

The nurse is interviewing a client who was diagnosed with type 2 diabetes four months ago. The client does not records glucometer readings but reports no concerns. What laboratory test does the nurse anticipate the health care provider will order for this client?

HbA1c

The health care provider 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 client?

Hypoglycemia

When describing the effects of incretins on blood glucose control to a group of students, which would an instructor include?

Increases insulin release

When administering insulin, what would be most appropriate?

Insert the needle at a 45-degree angle for injection.

A client newly diagnosed with type 1 diabetes asks the nurse why the client cannot just take a pill. The nurse would incorporate what knowledge when responding to this client?

Insulin is needed because the beta cells of the pancreas are no longer functioning.

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.

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

Lifelong exogenous insulin is required.

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

Which would be the first choice for a newly diagnosed client with diabetes mellitus type II who does not have any other health problems?

Metformin

A nurse is caring for a patient with diabetes mellitus who is receiving an oral antidiabetic drug. Which of following ongoing assessments should the nurse perform when caring for this patient?

Observe the patient for hypoglycemic episodes.

The nurse monitoring a client receiving insulin glulisine (Apidra) notices the client has become confused, diaphoretic, and nauseated. The nurse checks the client's blood glucose and it is 60 mg/dL (3.33 mmol/L). Which can a nurse give to treat a client with a hypoglycemic episode? (Select all that apply.)

Orange or other fruit juice Glucose tablets Hard candy

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

Regular (Humulin R)

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 nurse is preparing an in-service presentation for a group of staff members on diabetes. Which would the nurse include as the primary delivery system for insulin?

Subcutaneous injection

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

As the first-line treatment, a client with type 2 diabetes has tried diet and exercise. When these fail, what may be added as monotherapy or in combination with metformin to control their disease process?

Thiazolidinediones

The nurse is providing care for several clients who have diabetes. Which client should the nurse monitor most closely for signs and symptoms of hypoglycemia?

a client who received 12 units of Humulin R 45 minutes ago

A client is recently diagnosed with diabetes. In reviewing his past history, which would be early indicators of the problem?

a. Lethargy f. Getting up often at night to go to the bathroom

Treatment of diabetes may include which?

a. Replacement therapy with insulin b. Control of glucose absorption through the GI tract c. Drugs that stimulate insulin release or increase sensitivity of insulin receptor sites e. Slowing of gastric emptying f. Diet and exercise programs

Which factor would prohibit the administration of glipizide?

allergy to sulfonamides

Because of the risk for lactic acidosis, metformin is contraindicated in which client?

an 82-year-old diagnosed with type 2 diabetes

Miglitol differs from the sulfonylureas in that it

delays the absorption of glucose, leading to lower glucose levels.

Teaching subjects for the patient with diabetes should include

diet and exercise changes that are needed.

Heavy intake of which herb should be avoided by a client who is prescribed an antidiabetic medication?

garlic

After reviewing information about different insulin preparations, a nursing student demonstrates understanding of the information when the student identifies which medication as an example of a long-acting insulin?

insulin glargine

A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse most likely administer?

insulin lispro

The HbA1c blood test is a good measure of overall glucose control because

it reflects a 3-month average glucose level in the body.

Insulin is available in several forms or suspensions, which differ in their

onsets and durations of action.

A patient with hyperglycemia will often present with

polyuria, polydipsia, and polyphagia.

The demonstration of what symptom would suggest that an insulin-dependent client is experiencing a hypoglycemic reaction? Select all that apply.

weakness diaphoresis mental confusion increased pulse rate

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.