PrepU Pharm Assignment 10

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."

The nurse is discussing diabetes with a group of individuals who are at risk for the disease. Which statement by a participant indicates an understanding of the role of insulin in the disease?

"Insulin assists glucose molecules to enter the cells of muscle and fat tissues."

What instructions would be important to give to a 50-year-old client with type 2 diabetes who has been switched from glyburide (DiaBeta), a sulfonylurea, to repaglinide, a meglitinide?

"It stimulates insulin production, so you need to eat soon after taking the medication."

The nurse assesses a patient's blood glucose level after administering insulin. Which result would the nurse interpret as indicative of severe hypoglycemia?

34 mg/dL

Insulin analogs are synthesized in the laboratory by altering the type or sequence of amino acids in insulin molecules. Which of the following insulin analogs is a short-acting product?

All the above

A patient is to be administered glipizide (Glucotrol). Which factor would prohibit the administration of glipizide (Glucotrol) to this patient?

Allergy to sulfonamides

The nurse's assessment of a patient who has presented to the emergency department reveals hyperglycemia. Which type of insulin will have the most rapid effect on the patient's blood sugar levels?

Aspart

A nurse is caring for a 48-year-old woman who has been hospitalized after injecting the wrong type of insulin. Which sign of hypoglycemia will the nurse be careful to observe for?

Blurred vision

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

A patient is diagnosed with type 1 diabetes. What distinguishing characteristic is associated with type 1 diabetes?

Exogenous insulin is required for life.

When learning about type 1 diabetes, what would the student nurses learn is a distinguishing characteristic of this disease?

Exogenous insulin is required for life.

Patients with type 2 diabetes have nonfunctioning beta pancreatic cells.

False

A diabetic patient is taking regular and NPH insulin to manage his diabetes. What is the best evaluation tool to measure the overall patient response to the insulin therapy?

Glycosylated hemoglobin (HbAlc) levels

The nurse is interviewing a client who was diagnosed with type 2 diabetes about four months ago. The client never records glucometer readings but says that everything is just fine. What laboratory test does the nurse anticipate the health care provider will order for this client?

HbA1c

Which of the following insulin is always clear? (Choose one)

Humulin R

The physician 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 patient?

Hypoglycemia

Which is an example of long acting insulin?

Insulin glargine (Lantus)

What is an example of rapid acting insulin?

Insulin lispro (Humalog)

A nurse is presenting an educational event at a local senior citizens' club about diabetes. What would the nurse tell the attendees at the event about diabetes?

It is a complicated disorder that alters the metabolism of glucose.

As a diabetic educator, the nurse is teaching a newly diagnosed diabetic about aspects of the disease process. What would the nurse tell the patient about the body's control of glucose?

It is related to fat and protein metabolism

The nurse admits a client who has been diagnosed with diabetic ketoacidosis, and will look for what assessment findings consistent with this diagnosis? (Select all that apply.)

Ketones in the urine Flushed, dry skin

Which of the following represent the American Diabetes Association recommended HbA1c goal? (Choose one)

Less than 7%

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

A patient is prescribed sitagliptin. The nurse would expect to administer this drug by which route?

Oral

The physician prescribes glyburide for Tim, a newly diagnosed type 2 diabetic. The nurse knows that this medication acts by which mechanism?

Produces hypoglycemia by increasing insulin secretion from the pancreas

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

Regular (Humulin R)

A patient is admitted to the Emergency Department in diabetic ketoacidosis (DKA) with a blood glucose level of 33 mmol/L. The physician orders an initial dose of 25 U insulin IV. Which type of insulin will be administered?

Regular insulin

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

Glycosylated hemoglobin measures average blood glucose over what time period?

The past 3 or 4 months

An insulin dependent diabetic male client is having trouble with hypoglycemia late in the morning. During the health history, the nurse becomes aware of the most likely cause. What would cause the late morning hypoglycemia?

The patient jogs two miles in the morning before he goes to work.

A 4-year-old child with type 1 diabetes mellitus becomes angry and then lethargic. The parent should be taught that a change in behavior may indicate hypoglycemia. True or false?

True

Glycosylated hemoglobin levels provide reliable evidence of blood glucose control.

True

You are the nurse educator at the diabetes clinic. When talking to a class of adolescent diabetics, you tell them that the main methods of self-monitoring glycemic control are testing of

blood glucose and urine ketone levels.

The pathophysiology class is studying diabetes. A student asks the instructor what is considered a sign of a hypoglycemic reaction. The instructor's response would be:

diaphoresis.

The nurse educator works at the diabetes clinic. When talking to a class of adolescent diabetics, the educator tells the students that the most recognized signs of diabetes are:

hyperglycemia and glycosuria.

Insulin is a hormone released by the pancreatic beta cells in response to a rise in glucose levels and what else?

incretins

The client is scheduled to get her breakfast tray at 0700. At what time should she receive her prescribed dose of NPH insulin?

0630 (6:30 am)

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 nurse is preparing to administer insulin lispro (Humalog) to a client at 7 AM. What is the nurse's top priority intervention related to this medication?

Make sure the client's breakfast is available in the next 5-10 minutes.

A patient is in diabetic ketoacidosis. The patient blood glucose level is over 600. The physician has ordered the patient to receive an initial dose of 25 units of insulin. What type of insulin will be administered intravenously?

Regular insulin

The brother of a client who uses insulin for management of type 1 diabetes will be prefilling the client's insulin syringes. The nurse knows that these prefilled syringes may be kept in the refrigerator for how long?

one week

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.

A patient is admitted to the emergency department in diabetic ketoacidosis (DKA). The physician orders an initial dose of 25 units insulin IV. Which type of insulin will be administered?

Regular insulin