Med surg endocrine: 47, 48, 49
What are two effects of hypokalemia on the endocrine system? a. Decreased insulin and aldosterone release b. Decreased glucagon and increased cortisol release c. Decreased release of ANP and increased ADH release d. Decreased release of parathyroid hormone and increased calcitonin release
a. Decreased insulin and aldosterone release
Why are the hormones cortisol, glucagon, epinephrine, and growth hormone referred to as counter regulatory hormones? a. Decrease glucose production b. Stimulate glucose output by the liver c. Increase glucose transport into the cells d. Independently regulate glucose level in the blood
b. Stimulate glucose output by the liver
Which endocrine gland secretes cortisol in a diurnal pattern? a. Ovaries b. Thyroid c. Adrenal cortex d. Adrenal medulla
c. Adrenal cortex
From where is the hormone glucagon secreted? a. F cells of the islets of Langerhans b. Beta cells of the islets of Langerhans c. Alpha cells of the islets of Langerhans d. Delta cells of the islets of Langerhans
c. Alpha cells of the islets of Langerhans
Common nonspecific manifestations that may alert the nurse to endocrine dysfunction include a. goiter and alopecia. b. exophthalmos and tremors. c. weight loss, fatigue, and depression. d. polyuria, polydipsia, and polyphagia.
c. weight loss, fatigue, and depression.
The home care nurse should intervene to correct a patient whose insulin administration includes a. warming a profiled refrigerated syringe in the hands before administration. b. storing syringes profiled with NPH and regular insulin needle-up in the refrigerator. c. placing the insulin bottle currently in use in a small container on the bathroom countertop. d. mixing an evening dose of regular insulin with insulin glargine in one syringe for administration.
d. mixing an evening dose of regular insulin with insulin glargine in one syringe for administration.
The home care nurse should intervene to correct a patient whose insulin administration includes a. warming a prefilled refrigerated syringe in the hands before administration. b. storing syringes prefilled with NPH and regular insulin needle-up in the refrigerator. c. placing the insulin bottle currently in use in a small container on the bathroom countertop d. mixing an evening dose of regular insulin with insulin glargine in one syringe for administration.
d. mixing an evening dose of regular insulin with insulin glargine in one syringe for administration.
Individualized nutrition therapy for patients using conventional, fixed insulin regimens should include teaching the patient to a. eat regular meals at regular times. b. restrict calories to promote moderate weight loss. c. eliminate sucrose and other simple sugars from the diet. d. limit saturated fat intake to 30% of dietary calorie intake.
a. eat regular meals at regular times.
Individualized nutrition therapy for patients using conventional, fixed insulin regimens should include teaching the patient to a. eat regular meals at regular times. b. restrict calories to promote moderate weight loss. c. elem i ate sucrose and other simple sugars from the diet. d. limit saturated fat intake to 30% of dietary calorie intake.
a. eat regular meals at regular times.
Priority Decision: When caring for a patient with metabolic syndrome, the nurse should give the highest priority to teaching the patient about which treatment plan? a. Achieving a normal weight b. Performing daily aerobic exercise c. Eliminating red meat from the diet d. Monitoring the blood glucose periodically
a. Achieving a normal weight
Which hormones are secreted by the anterior pituitary gland (select all that apply) ? a. Prolactin b. Melatonin c. Somatostatin d. Parathyroid hormone e. Growth hormone (GH) f. Gonadotropin hormones g. Antidiuretic hormone (ADH) h. Melanocyte-stimulating hormone i. Thyroid-stimulating hormone (TSH) j. Adrenocorticotropic hormone (ACTH)
a. Prolactin e. Growth hormone (GH) f. Gonadotropin hormones i. Thyroid-stimulating hormone (TSH) j. Adrenocorticotropic hormone (ACTH)
Which patient should the nurse plan to teach how to prevent or delay the development of diabetes? a. An obese 40-year-old hispanic woman b. A child whose father has type 1 diabetes c. A 34-year-old woman whose parents both have type 2 diabetes d. A 12-year-old boy whose father has maturity-onset diabetes of the young (MODY)
c. A 34-year-old woman whose parents both have type 2 diabetes
What are the manifestations of diabetic ketoacidosis (DKA) (select all that apply)? a. Thirst b. Ketonuria c. Dehydration d. Metabolic acidosis e. Kussmaul respirations f. Sweet, fruity breath odor
a. Thirst b. Ketonuria c. Dehydration d. Metabolic acidosis e. Kussmaul respirations f. Sweet, fruity breath odor
When teaching the patient with type 1 diabetes, what should the nurse emphasize as the major advantage of using an insulin pump? a. Tight glycemic control can be maintained. b. Errors in insulin dosing are less likely to occur. c. Complications of insulin therapy are prevented. d. Frequent blood glucose monitoring in unnecessary.
a. Tight glycemic control can be maintained.
When teaching the patient with diabetes about insulin administration, the nurse should include which instruction for the patient? a. Pull back on the plunger after inserting the needle to check for blood. b. Consistently use the same size of insulin syringe to avoid dosing errors. c. Clean the skin at the injection site with alcohol swab before each injection. d. Rotate injection sites from arms to thighs to abdomen with each injection to prevent lipodystrophies.
b. Consistently use the same size of insulin syringe to avoid dosing errors.
In type 1 diabetes there is an osmotic effect of glucose when insulin deficiency prevents the use of glucose for energy. Which classic symptom is caused by the osmotic effect of glucose? a. Fatigue b. Polydipsia c. Polyphagia d. Recurrent infections
b. Polydipsia
Priority Decision: A patient taking insulin has recorded fasting glucose levels above 200 mg/dL (11.1 mmol/L) on awakening for the last five mornings. What should the nurse advise the patient to do first? a. Increase the evening insulin dose to prevent the dawn phenomenon. b. Use a single-dose insulin regimen with an intermediate-acting insulin. c. Monitor the glucose level at bedtime, between 2 am and 4 am, and on arising. d. Decrease the evening insulin dosage to prevent night hypoglycemia and the Somogyi effect.
c. Monitor the glucose level at bedtime, between 2 am and 4 am, and on arising.
A patient with diabetes is found unconscious at home and a family member calls the clinic. After determining that a glucometer is not available, what should the nurse advise the family member to do? a. Have the patient drink some orange juice. b. Administer 10 U of regular insulin subcutaneously. c. Call for an ambulance to transport the patient to a medical facility. d. Administer glucagon 1 mg intramuscularly (IM) or subcutaneously
d. Administer glucagon 1 mg intramuscularly (IM) or subcutaneously
To ensure accurate results of a fasting blood glucose analysis, the nurse instructs the patient to fast for at least how long ? a. 2 hours b. 4 hours c. 8 hours d. 12 hours
c. 8 hours
A patient with type 1 diabetes uses 20 U of Novolin 70/30 (NPH/regular) in the morning and at 6:00 pm. When teaching the patient about this regimen, what should the nurse emphasize? a. Hypoglycemia is most likely to occur before the noon meal. b. A set meal pattern with a bedtime snack is necessary to prevent hypoglycemia. c. Flexibility in food intake is possible because insulin is available 24 hours a day. d. Premeal glucose checks are required to determine needed changes in daily dosing.
b. A set meal pattern with a bedtime snack is necessary to prevent hypoglycemia.
Two days following a self-managed hypoglycemic episode at home, the patient tells the nurse that his blood glucose levels since the episode have been between 80 and 90 mg/dL. Which is the best response by the nurse ? a. "That is a good range for your glucose levels. " b. "You should call your health care provider because you need to have your insulin increased. " c. "That level is too low in view of your recent hypoglycemia and you should increase your food intake." d. "You should take only half of your insulin dosage for the next few days to get your glucose level back to normal."
a. "That is a good range for your glucose levels. "
Patient-Centered Care: The patient with type 2 diabetes is being put on acarbose (Precose) and wants to know about taking it. What should the nurse include in this patient's teaching (select all that apply)? a. Take it with the first bite of each meal. b. It is not used in patients with heart failure. c. Endogenous glucose production is decreased d. Effectiveness is measured by 2-hour postprandial glucose. e. It delays glucose absorption from the GI tract.
a. Take it with the first bite of each meal. d. Effectiveness is measured by 2-hour postprandial glucose. e. It delays glucose absorption from the GI tract.
Teamwork and Collaboration: The following interventions are planned for a patient with diabetes. Which intervention can the nurse delegate to unlicensed assistive personnel (UAP)? a. Discuss complications of diabetes. b. Check that the bath water is not too hot. c. Check the patient's technique for drawing up insulin. d. Teach the patient to use a mater for self-monitoring of blood glucose.
b. Check that the bath water is not too hot.
Lispro insulin (Humalog) with NPH (Humulin N) insulin is ordered for a patient with newly diagnosed type 1 diabetes. The nurse knows when lispro insulin is used, when should it be administered? a. Only once daily b. 1 hour before meals c. 30 to 45 minutes before meals d. At mealtime or within 15 minutes of meals
d. At mealtime or within 15 minutes of meals
The patient with type 2 diabetes has had trouble controlling his blood glucose with several OAs but wants to avoid the risks of insulin. The HCP told him a medication will be prescribed that will increase insulin synthesis and release from the pancreas, inhibit glucagon secretion, and slow gastric emptying. The nurse knows this is which medication that will have to be injected ? a. Dopamine receptor agonist, bromocriptine (Cycloset) b. Dipeptidyl peptidase-4 (DPP-4) inhibitor, sitagliptin (Januvia) c. Sodium-glucose co-transporter 2 (SGLT2) inhibitor, canagliflozin (Invokana) d. Glucagon-like peptide-1 receptor agonist, exenatide extended release (Bydureon)
d. Glucagon-like peptide-1 receptor agonist, exenatide extended release (Bydureon)
The nurse is teaching the patient with prediabetes ways to prevent or delay the development of type 2 diabetes. What information should be included (select all that apply)? a. Maintain a healthy weight b. Exercise for 60 minutes each day c. Have blood pressure checked regularly d. Assess for visual changes on a monthly basis e. Monitor for polyuria, polyphagia, and polydipsia
a. Maintain a healthy weight e. Monitor for polyuria, polyphagia, and polydipsia
In a patient with an elevated serum cortisol, what should the nurse expect other laboratory findings to reveal? a. Hypokalemia b. Hyponatremia c. Hypoglycemia d. Decreased serum triglycerides
a. Hypokalemia
What manifestations of endocrine problems in the older adult are commonly attributed to the aging process ? a. Tremors and paresthesia b. Fatigue and mental impairment c. Hyperpigmentation and oily skin d. Fluid retention and hypertension
b. Fatigue and mental impairment
Which tissues require insulin to enable movement of glucose into the tissue cells (select all that apply)? a. Liver b. Brain c. Adipose d. Blood cells e. Skeletal muscle
c. Adipose e. Skeletal muscle
During routine health screening, a patient is found to have fasting plasma glucose (FPG) of 132 mg/dL (7.33 mmol/L). At a follow-up visit, a diagnosis of diabetes would be made based on which laboratory results (select all that apply)? a. A1C of 7.5% b. Glycosuria of 3+ c. FPG >=127 mg/dL (7.0 mmol/L) d. Random blood glucose of 126 mg/dL (7.0 mmol/L) e. A 2-hour oral glucose tolerance test (OGTT) of 190 mg/dL (10.5 mmol/L)
a. A1C of 7.5% c. FPG >=127 mg/dL (7.0 mmol/L)
During a routine health screening, a patient is found to have fasting plasma glucose (FPG) of 132 mg/dL (7.33 mmol/L). At a follow-up visit, a diagnosis of diabetes would be made based on which laboratory results (select all that apply)? a. A1C of 7.5% b. Glycosuria of 3+ c. FPG >=127 mg/dL (7.0 mmol/L). d. Random blood glucose of 126 mg/dL (7.0 mmol/L) e. A 2-hour oral glucose tolerance test (OGTT) of 152 mg/dL (10.5 mmol/L)
a. A1C of 7.5% c. FPG >=127 mg/dL (7.0 mmol/L).
Priority Decision: When caring for a patient with metabolic syndrome, the nurse should give the highest priority to teaching the patient about which treatment plan? a. Achieve a normal weight b. Performing daily aerobic exercise c. Eliminating red meat from the diet d. Monitoring the blood glucose periodically
a. Achieve a normal weight
What characterizes type 2 diabetes (select all that apply)? a. Beta-cell exhaustion b. Insulin resistance c. Genetic predisposition d. Altered production of adipokines e. Inherited defect in insulin receptors f. Inappropriate glucose production by the liver
a. Beta-cell exhaustion b. Insulin resistance c. Genetic predisposition d. Altered production of adipokines e. Inherited defect in insulin receptors f. Inappropriate glucose production by the liver
The patient with diabetes has a blood glucose level of 248 mg/dL. Which manifestations in the patient would the nurse understand as being related to this blood glucose level (select all that apply)? a. Headache b. Unsteady gait c. Abdominal cramps d. Emotional changes e. Increase in urination f. Weakness and fatigue
a. Headache c. Abdominal cramps e. Increase in urination f. Weakness and fatigue
Patient-Centered Care: The patient with type 2 diabetes is being put on acarbose (Precose) and wants to know about taking it. What should the nurse include in this patient's teaching (select all that apply)? a. Take it with the first bite of each meal. b. It is not used in patients with heart failure. c. Endogenous glucose production is decreased. d. Effectiveness is measured by 2-hour postprandial glucose. e. It delays glucose absorption from the gastrointestinal (GI) tract.
a. Take it with the first bite of each meal. d. Effectiveness is measured by 2-hour postprandial glucose. e. It delays glucose absorption from the gastrointestinal (GI) tract.
A patient with type 1 diabetes uses 20 U of Novolin 70/30 (NPH/regular) in the morning and at 6:00 PM. When teaching the patient about this regimen, what should the nurse emphasize? a. Hypoglycemia is most likely to occur before the noon meal. b. A set meal pattern with a bedtime snack is necessary to prevent hypoglycemia. c. Flexibility in food intake is possible because insulin is available 24 hours a day. d. Permeable glucose checks are required to determine needed changes in daily dosing.
b. A set meal pattern with a bedtime snack is necessary to prevent hypoglycemia.
Which class of oral glucose-lowering agents (OA) is most commonly used for people with type 2 diabetes because it reduces hepatic glucose production and enhances tissue uptake of glucose? a. Insulin b. Biguanide c. Meglitinide d. Sulfonylurea
b. Biguanide
Which class of oral glucose-lowering agents is most commonly used for people with type 2 diabetes because it reduces hepatic glucose production and enhances tissue uptake of glucose? a. Insulin b. Biguanide c. Meglitinide d. Sulfonylurea
b. Biguanide
Teamwork and Collaboration: The following interventions are planned for a patient with diabetes. Which intervention can the nurse delegate to unlicensed assistive personnel (UAP)? a. Discuss complications of diabetes. b. Check that the bath water is not too hot. c. Check the patients technique for drawing up insulin. d. Teach the patient to use a meter for self-monitoring of blood glucose.
b. Check that the bath water is not too hot.
When teaching the patient with diabetes about insulin administration, the nurse should include which instruction for the patient? a. Pull back on the plunger after inserting the needle to check for blood. b. Consistently use the same size insulin syringe to avoid dosing errors. c. Clean the skin at the injection site with an alcohol swab before each injection. d. Rotate injection sites from arms to thighs to abdomen with each injection to prevent lipodystrophies.
b. Consistently use the same size insulin syringe to avoid dosing errors.
Patient Centered Care: A 30-yr-old female patient was brought to the emergency department (ED) after a seizure at work. During the assessment she mentions hair loss and menstrual irregularities. What diagnostic tests would be helpful to determine if endocrine problems are a cause of her problem (select all that apply) ? a. Thyroglobulin b. Luteinizing hormone (LH) c. Parathyroid hormone (PTH) d. Follicle-stimulating hormone (FSH) e. Magnetic resonance imaging (MRI) of the head f. Adrenal corticotropic hormone (ACTH) suppression
b. Luteinizing hormone (LH) d. Follicle-stimulating hormone (FSH) e. Magnetic resonance imaging (MRI) of the head
The nurse assess the technique of the patient with diabetes for self-monitoring of blood glucose (SMBG) 3 months after initial instruction. Which error i'm the performance of SMBG noted by the nurse requires intervention? a. Doing the SMBG before and after exercising b. Puncturing the finger on the side of the finger pad c. Cleaning the puncture site with alcohol before the puncture d. Holding the hand down for a few minutes before the puncture
c. Cleaning the puncture site with alcohol before the puncture
The nurse should observe the patient for symptoms of ketoacidosis when a. illness causing nausea and vomiting lead to bicarbonate loss with body fluids. b. glucose levels become so high that osmotic diuresis promotes fluid and electrolyte loss. c. an insulin deficit causes the body to metabolize large amounts of fatty acids rather than glucose for energy. d. the patient skips meals after taking insulin, leading to rapid metabolism of glucose and breakdown of fats for energy.
c. an insulin deficit causes the body to metabolize large amounts of fatty acids rather than glucose for energy.
What describes the primary differences in treatment for diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS)? a. DKA requires administration of bicarbonate to correct acidosis. b. Potassium replacement is not necessary in management of HHS. c. HHS requires greater fluid replacement to correct the dehydration. d. Administration of glucose is withheld in HHS until the blood glucose reaches a normal level
c. HHS requires greater fluid replacement to correct the dehydration.
Priority Decision: A patient taking insulin has recorded fasting glucose levels above 200 mg/dL (11.1 mmol/L) on awakening for the last five mornings. What should the nurse advise the patient to do first? a. Increase the evening insulin dose to prevent the dawn phenomenon. b. Use a single-dose insulin regimen with an intermediate-acting insulin. c. Monitor the glucose level at bedtime, between 2:00 am and 4:00 am, and on arising. d. Decrease the evening insulin dosage to prevent night hypoglycemia and the Somogyi effect.
c. Monitor the glucose level at bedtime, between 2:00 am and 4:00 am, and on arising.
Priority Decision: The nurse is assessing a newly admitted patient with diabetes. Which observation should be addressed as the priority by the nurse? a. Bilateral numbness of both hands b. Stage II pressure ulcer on the right heel c. Rapid respirations with deep inspiration d. Areas of lumps and dents on the abdomen
c. Rapid respirations with deep inspiration
Lispro insulin (Humalog) with NPH (Humulin N) insulin is ordered for a patient with newly diagnosed type 1 diabetes. The nurse knows that when lispro insulin is used, when should it be administered? a. Only once a day b. 1 hour before meals c. 30 to 45 minutes before meals d. At mealtime or within 15 minutes of meals
d. At mealtime or within 15 minutes of meals
Which statement about the adrenal medulla hormones is accurate? a. Overproduction of androgens may cause masculinization in women. b. Both the adrenal medulla and the thyroid gland have a negative feedback system to the hypothalamus. c. Cortisol levels would be altered in a person who normally works a night shift from 11:00 pm to 7:00 am and sleeps from 8:00 am to 3:00 pm d. Catecholamines are considered hormones when they are secreted by the adrenal medulla and neurotransmitters when they are secreted by nerve cells.
d. Catecholamines are considered hormones when they are secreted by the adrenal medulla and neurotransmitters when they are secreted by nerve cells.
The female patient is admitted with a new diagnosis of Cushing syndrome with elevated serum and urine cortisol levels. Which assessment findings should the nurse expect to see in this patient? a. Hair loss and moon face b. Decreased weight and hirsutism c. Decreased muscle mass and thick skin d. Elevated blood pressure and blood glucose
d. Elevated blood pressure and blood glucose
Which laboratory results would indicate that the patient has prediabetes? a. Glucose tolerance result of 132 mg/dL (7.3 mmol/L) b. Glucose tolerance result of 240 mg/dL (13.3 mmol/L) c. Fasting blood glucose result of 80 mg/dL (4.4 mmol/L) d. Fasting blood glucose result of 120 mg/dL (6.7 mmol/L)
d. Fasting blood glucose result of 120 mg/dL (6.7 mmol/L)
The nurse determines that a patient with a 2-hour OGTT of 152 mg/dL has a. diabetes b. elevated A1C c. impaired fasting glucose d. impaired glucose tolerance
d. impaired glucose tolerance
The nurse determines that a patient with a 2-hour OGTT of 152 mg/dL has a. diabetes. b. elevated A1C. c. impaired fasting glucose. d. impaires glucose tolerance.
d. impaires glucose tolerance.
What accurately demonstrates that hormones of one gland influence the function of hormones of another gland? a. Increased insulin levels inhibit the secretion of glucagon. b. Increased cortisol levels stimulate the secretion of insulin. c. Increased testosterone levels inhibit the release of estrogen. d. Increased atrial natriuretic peptide (ANP) levels inhibit the secretion of aldosterone.
d. Increased atrial natriuretic peptide (ANP) levels inhibit the secretion of aldosterone.
In addition to promoting the transport go glucose from the blood into the cells, what does insulin do? a. Enhances the breakdown of adipose tissue for energy b. Stimulates hepatic glycogenolysis and gluconeogenesis c. Prevents the transport or triglycerides into adipose tissue d. Increases amino acid transport into cells and protein synthesis
d. Increases amino acid transport into cells and protein synthesis
To prevent hyperglycemia or hypoglycemia related to exercise, what should the nurse teach the patient using glucose-lowering agents about the best time for exercise? a. Plan activity and food intake related to blood glucose levels b. When blood glucose is greater than 250 mg/dL and ketones are present c. When glucose monitoring reveals that the blood glucose is in the normal range d. When blood glucose levels are high, because exercise always has a hypoglycemic effect
a. Plan activity and food intake related to blood glucose levels
To prevent hyperglycemia or hypoglycemia related to exercise, what should the nurse teach the patient using glucose-lowering agents about the best time for exercise? a. Plan activity and food intake related to blood glucose levels b. When blood glucose is greater than 250 mg/dL and ketones are present c. When glucose monitoring reveals that the blood glucose is in the normal range d. When blood glucose levels are high, because exercise always has a hypoglycemic effect
a. Plan activity and food intake related to blood glucose levels
A patient has a low serum T3 level. The HCP orders measurement of the TSH level. If the TSH level is elevated, what does this indicate? a. The cause of the low T3 level is most likely primary hypothyroidism b. The negative feedback system is failing to stimulate the anterior pituitary gland. c. The patient has an underactive thyroid gland that is not receiving TSH stimulation d. A tumor on the anterior pituitary gland that is causing increased production of TSH.
a. The cause of the low T3 level is most likely primary hypothyroidism
A patient with diabetes is learning to mix regular insulin and NPH insulin in the same syringe. The nurse determines that additional teaching is needed when the patient does what? a. Withdraws the NPH does into the syringe first b. Injects air equal to the NPH does into the NPH vial c. Removes any air bubbles after withdrawing the first insulin d. Adds air equal to the insulin does into he regulate vial and withdraws the dose.
a. Withdraws the NPH does into the syringe first
What should the goals of nutrition therapy for the patient with type 2 diabetes include ? a. Ideal body weight b. Normal serum glucose and lipid levels c. A special diabetic diet using diabetic foods d. Five small meals per day with a bedtime snack
b. Normal serum glucose and lipid levels
What is released in the normal response to increased serum osmolality? a. Aldosterone from the adrenal cortex, which stimulates sodium excretion by the kidney b. ADH from the posterior pituitary gland, which stimulates the kidney to reabsorb water c. Mineralocorticoids from the adrenal gland, which stimulate the kidney to excrete potassium d. Calcitonin from the thyroid gland, which increases bone resorption and decrease serum calcium levels
b. ADH from the posterior pituitary gland, which stimulates the kidney to reabsorb water
A nurse working in an outpatient clinic plans a screening program for diabetes. What recommendations for screening should be included ? a. OGTT for all minority populations every year b. FPG for all individuals at age 45 then every three years c. testing people under the age of 21 for islet cell antibodies d. Testing for type 2 diabetes in all overweight or obese individuals
b. FPG for all individuals at age 45 then every three years
What should the goal of nutrition therapy for the patient with type 2 diabetes include? a. Ideal body weight b. Normal serum glucose and lipid level c. A special diabetic diet using diabetic foods d. Five small meals per day with a bedtime snack
b. Normal serum glucose and lipid level
what is a potential adverse effect of palpation of an enlarged thyroid gland ? a. Carotid artery obstruction b. Damage to the cricoid cartilage c. Release of excessive thyroid hormone into circulation d. Hoarseness from pressure on the recurrent laryngeal nerve
c. Release of excessive thyroid hormone into circulation
How do hormones respond following the ingestion of a high-protein, carbohydrate-free meal? a. Both insulin and glucagon are inhibited because blood glucose levels are unchanged. b. Insulin in inhibited by low glucose levels, and glucagon is released to promote gluconeogenesis. c. Insulin is released to facilitate the breakdown of amino acids into glucose, and glucagon is inhibited. d. Glucagon is released to promote gluconeogenesis, and insulin is released to facilitate movement of amino acids into muscle cells.
d. Glucagon is released to promote gluconeogenesis, and insulin is released to facilitate movement of amino acids into muscle cells.
The patient with type 2 diabetes has had trouble controlling his blood glucose with several OAs but wants to avoid the risks of insulin. The HCP told him a medication will be prescribed that will increase insulin synthesis and release from the pancreas, inhibit glucagon secretion, and slow gastric emptying. The nurse knows this is which medication that will have to be injected? a. Dopamine receptor agonist, bromocriptine (Cycloset) b. Dipeptidyl peptidase-4 (DPP-4) inhibitor, sitagliptin (Januvia) c. Sodium-glucose co-transporter 2 (SGLT2) inhibitor, canagliflozin (Invokana) d. Glucagon-like peptide-1 receptor agonist, exenatide extended release (Bydureon)
d. Glucagon-like peptide-1 receptor agonist, exenatide extended release (Bydureon)
The patient with type 1 diabetes mallorie is in the clinic to check his long-term glycemic control. Which test should be used? a. Water deprivation test b. Fasting blood glucose test c. Oral glucose tolerance test d. Glycosylated hemoglobin (A1C)
d. Glycosylated hemoglobin (A1C)
Priority Decision: A patient with diabetes calls the clinic because she is experiencing nausea and flu-like symptoms. Which advice from the nurse will be the best for this patient? a. Administer the usual insulin dose b. Hold fluid intake until the nausea subsides c. Come to the clinic immediately for evaluation and treatment d. Monitor the blood glucose every 1 to 2 hours and call if it rises over 150 mg/dL (8.3 mmol/L).
a. Administer the usual insulin dose
When teaching the patient with type 1 diabetes, what should the nurse emphasize as the major advantage of using an insulin pump? a. Tight glycemic control can be maintained. b. Errors in insulin dosing are less likely to occur. c. Complications of insulin therapy are prevented. d. Frequent blood glucose monitoring is unnecessary.
a. Tight glycemic control can be maintained.
A patient with diabetes is learning to mix regular insulin and NPH insulin in the same syringe. The nurse determines that additional teaching is needed when the patient does what? a. Withdraws the NPH dose into the syringe first b. Injects air equal to the NPH dose into the NPH vial first c. Removes any air bubbles after withdrawing the first insulin d. Adds air equal to the insulin dose into the regular vial and withdraws the dose
a. Withdraws the NPH dose into the syringe first
Which abnormal assessment findings are related to thyroid dysfunction (select all that apply)? a. Tetanic muscle spasms with hypofunction b. Heat intolerance caused by hyperfunction c. Exophthalmos associated with excessive secretion d. Hyperpigmentation associated with hypofunction e. A goiter with either hyperfunction or hypofunction f. Increase in hand and foot size associated with excessive secretion
b. Heat intolerance caused by hyperfunction c. Exophthalmos associated with excessive secretion e. A goiter with either hyperfunction or hypofunction
