35, 46, 47
A registered nurse is teaching how to plan nutrient-rich meals using MyPlate guidelines at a community healthcare event. Which statement made by a participant indicates a need for further education? -"I can include dairy products or a calcium supplement in my diet." -"I should include more red meat in my diet." -"I should include more vegetables than fruit in my diet." - "Fruit, vegetables, and proteins should make up half of my meal."
"I should include more red meat in my diet."
The registered nurse is teaching a nursing student about the uses of aloe. Which statement made by the nursing student indicates the need for further education? -"It is used in toothpaste." -"It is also available in the form of tinctures." -"It may have hypoglycemic effects when taken orally." -"It helps prevent diarrhea when taken in capsule form."
"It helps prevent diarrhea when taken in capsule form."
A patient newly diagnosed with diabetes asks what is the goal of insulin therapy. Which response by the nurse is best? -"To compensate for inadequate dietary control of glucose" -"To maintain blood glucose levels consistently within normal range" -"To prevent the breakdown of protein for use as energy in the body" -"To make certain there is sufficient insulin to allow glucose from foods to be metabolized"
"To maintain blood glucose levels consistently within normal range"
A patient received 15 units of regular (Humulin R) insulin at 7 AM. At what time does the patient experience the greatest risk for hypoglycemia from this dose of insulin? -8 AM -10 AM -2 PM -4 PM
2 PM
The nurse administers lispro (Humalog) as ordered at 12:30 PM. Which time is best for the patient's response to be evaluated? -12:45 PM -2 PM -4 PM -6:15 PM
2 PM
What percentage of the diabetic population is afflicted with type 1 diabetes mellitus? a) 5 to 10% b) 10 to 20% c) 30 to 40% d) 40 to 50%
5 to 10%
What percentage of the diabetic population is afflicted with type 2 diabetes mellitus? a) 5 to 10% b) 50 to 75% c) 60 to 80% d) 90 to 95%
90 to 95%
Most diabetes-related deaths are the result of: a) cardiovascular disease. b) respiratory disease. c) gastrointestinal disease. d) renal disease.
A-cardiovascular disease
Which statement best describes the action of miglitol (Glyset)? -There is an increased production of insulin. -This drug blocks the breakdown of glucagons. -There is increased sensitivity of the cells to insulin. -Absorption of carbohydrates from the intestines is delayed.
Absorption of carbohydrates from the intestines is delayed.
A patient taking chlorpropamide (Diabinese) for diabetes drinks one beer per day. Which education should this patient receive from the nurse? -Alcohol may increase ketoacidosis. -Alcohol decreases the effectiveness of hypoglycemic agents. -Chlorpropamide will increase the sedating effects of alcohol. -Alcohol combined with chlorpropamide may cause Antabuse-like reactions.
Alcohol combined with chlorpropamide may cause Antabuse-like reactions.
Which vitamin B is important for fetal growth and development? -B3 (niacin) -B1 (thiamine) -B2 (riboflavin) -B6 (pyridoxine)
B2 (riboflavin)
A patient who is prescribed furosemide (Lasix) is concerned about developing hypokalemia. Which food does the nurse encourage the patient to eat? -Poultry -Bananas -Egg yolks -Green leafy vegetables
Bananas
Which type of monitoring does the nurse expect to be part of the patient's plan of care during the initiation of total parenteral nutrition? -Electrocardiogram (ECG) daily -Blood glucose every 4 to 6 hours -Serum electrolytes every 8 hours -Pancreatic amylase every 12 hours
Blood glucose every 4 to 6 hours
Which laboratory value does the nurse monitor in a patient taking glimepiride (Amaryl) for blood sugar control? -Creatinine levels -Triglyceride levels -Sedimentation rate -Complete blood count (CBC)
Complete blood count (CBC)
The patient has a nasojejunal (NJ) tube which is used for enteral feedings. Which method of enteral feeding does the nurse anticipate administering? -Bolus -Intermittent -Alternate hour -Continuous drip
Continuous drip
Which action of Ginkgo biloba extract requires it to be used with caution in certain patients? -Free radical activation -Peripheral vasoconstriction -Decreased platelet aggregation -Central nervous system (CNS) stimulation
Decreased platelet aggregation
Which information does the nurse give to a diabetic patient who asks if it is okay to drink an alcoholic beverage while taking insulin? -Distilled liquor is not advisable, but beer or wine with insulin is okay. -Alcohol induces hyperglycemia, requiring insulin or dietary adjustments. -Alcohol inactivates the insulin, increasing the risk of complications of diabetes. -Diabetic patients may have alcohol but should follow the guidelines of no more than 2 drinks per day for men and 1 for women since it does affect blood sugar.
Diabetic patients may have alcohol but should follow the guidelines of no more than 2 drinks per day for men and 1 for women since it does affect blood sugar.
Which medication should be avoided when taking valerian? -Penicillin -Milk of Magnesia (MOM) -Acetaminophen (Tylenol) -Diphenhydramine (Benadryl)
Diphenhydramine (Benadryl)
Which herbal supplement is thought to work as an antiemetic? -Garlic -Ginger -Ginseng -Green tea
Ginger
An unresponsive diabetic patient diagnosed with hypoglycemia is admitted to the emergency department. Which medication does the nurse anticipate will be ordered for this patient? -Atropine -Glucagon -Lidocaine (Xylocaine) -Epinephrine (Adrenalin)
Glucagon
Glyburide (Diabeta, Micronase) is prescribed for a patient diagnosed with diabetes. Which adverse effect might the nurse expect in this patient? -Tachycardia -Hypotension -Hepatotoxicity -Increased urine output
Hepatotoxicity
A patient with diabetes mellitus has been prescribed pramlintide (Symlin). Which information does the nurse include in the patient's teaching plan? (Select all that apply.) -Administer pramlintide in the upper arm. -If a dose is missed, give an additional injection. -Do not take pramlintide if blood glucose is low. -Mix insulin and pramlintide in the same syringe. -Discard opened vials of pramlintide after 45 days. -If planning to skip a meal, pramlintide should not be taken.
If a dose is missed, give an additional injection. If planning to skip a meal, pramlintide should not be taken.
Which term describes the action of echinacea? -Antimicrobial -Decongestant -Bronchodilator -Immunomodulator
Immunomodulator
Which laboratory value is the nurse concerned about for a patient taking a thiazolidinedione? -Decreased bleeding time -Increased creatinine levels -Decreased hemoglobin levels -Increased aminotransferase levels
Increased aminotransferase levels
Which clinical manifestations of hypoglycemia does the nurse instruct a patient with diabetes to recognize? -Confusion, irritability, and vomiting -Hunger, double vision, and apprehension -Weakness, increased heart rate, and hot dry skin -Increased heart rate, abnormal breathing, and fruity odor to the breath
Increased heart rate, abnormal breathing, and fruity odor to the breath
A patient starting on metformin (Glucophage) informs the nurse that he runs 5 miles a day. Which adverse reaction to metformin is of most concern to the nurse? -Lactic acidosis -Increased abdominal pain -Increased hyperglycemia with exercise -Increased low-density lipoprotein (LDL) levels
Lactic acidosis
Which medication when given with metformin (Glucophage) may decrease its therapeutic effects? -Vancomycin -Digoxin (Lanoxin) -Phenytoin (Dilantin) -Nifedipine (Procardia)
Nifedipine (Procardia)
The nurse is caring for a patient who takes all nutrition and oral medications through a gastric feeding tube. Which medication, if ordered in the oral route, would the nurse hold and call the provider for a different form? -Digoxin (Lanoxin) -Furosemide (Lasix) -Amoxycillin (Amoxil) -Nitroglycerin (Nitro Dur)
Nitroglycerin (Nitro Dur)
Which enteral formula works well in patients with respiratory disorders? -Ensure -Glucerna -NovoSource Renal -Nutren Pulmonary
Nutren Pulmonary
Which food is recommended for a patient deficient in vitamin D? -Poultry -Oily fish -Whole-grain cereals -Green leafy vegetables
Oily fish
Which patient might benefit most by the use of black cohosh? -Teenager with leukemia -Perimenopausal woman -Man with prostate cancer -Older adult on chemotherapy
Perimenopausal woman
Which formula is designed for patients with severe malabsorption? -Isomil -Similac -Phenex 1 -Pregestimil
Pregestimil
Which interaction may occur in a patient who is taking both regular insulin (Humulin R) and propranolol (Inderal)? -Propranolol may increase insulin's hypoglycemic effects. -Cellular resistance to insulin is increased with propranolol. -Regular insulin decreases the effectiveness of propranolol. -Propranolol increases the incidence of diabetic ketoacidosis.
Propranolol may increase insulin's hypoglycemic effects.
Which type of allergy increases the risk of hypersensitivity reactions to chamomile? -Grass -Peanut -Ragweed -Animal dander
Ragweed
Which type of insulin has the most rapid onset and shortest duration of action? -Aspart (Novolog) -Glargine (Lantus) -Regular (Humulin R) -Extended insulin zinc suspension (Humulin U, Ultralente)
Regular (Humulin R)
Which type of insulin is the only one that may be given intravenously? -Lispro (Humalog) -Regular (Humulin R) -Isophane insulin suspension (NPH) -Extended insulin zinc suspension (Humulin U Ultralente)
Regular (Humulin R)
Which herbal supplement may be used for osteoarthritis and fibromyalgia? -Melatonin -St. John's wort -Coenzyme Q10 -S-adenosylmethionine (SAM-e)
S-adenosylmethionine (SAM-e)
A registered nurse (RN) is observing a newly employed licensed practical nurse (LPN) administer isophane insulin suspension (NPH) to a patient. Which action by the LPN requires the RN to immediately intervene? -Administering NPH before breakfast -Administering NPH into the abdomen -Storing the NPH at room temperature -Shaking the vial of NPH before administration
Shaking the vial of NPH before administration
Which order is appropriate to mix two types of insulin in one syringe? -Long-acting insulin should be drawn up before short acting. -Long-acting insulin should be drawn up before intermediate acting. -Short-acting insulin should be drawn up before intermediate acting. -Either long-acting or short-acting insulin can be drawn up first; the order does not matter.
Short-acting insulin should be drawn up before intermediate acting.
A patient has been prescribed exenatide (Byetta) for the management of diabetes mellitus. Which time is best for the patient to take this medication? -With meals; timing is unimportant -Fifteen minutes before all meals and snacks -Thirty minutes after morning and evening meals -Sixty minutes before morning and evening meals
Sixty minutes before morning and evening meals
What is the expected effect of administering pramlintide (Symlin) to a patient with type 2 diabetes mellitus? -Increased appetite -Increased gastric emptying time -Increased glucose output from the liver -Suppressed glucagon secretion from the liver
Suppressed glucagon secretion from the liver
Which factor must the nurse consider when planning care for a patient receiving intermittent enteral feedings? -The feeding must be gradually warmed to body temperature before administering. -The patient must be in high Fowler's position for at least 30 minutes before the feeding. -The patient will need to be assisted to the bathroom immediately following the feeding. -The tube must be flushed with a small amount of water between each medication given.
The tube must be flushed with a small amount of water between each medication given.
A patient with diabetes mellitus is prescribed sitagliptin (Januvia). For which adverse effect does the nurse monitor the patient? -Hirsutism -Hypertension -Urinary retention -Upper respiratory infection
Upper respiratory infection
Which adverse effect might occur in a patient taking melatonin ? -Lethargy -Constipation -Photosensitivity -Urinary retention
Urinary retention
Which instruction does the nurse give to a patient who is taking St. John's wort? -Maintain a low-cholesterol diet. -Avoid foods that are high in tyramine. -Use sunscreen when exposed to the sun. -Take an additional dose of the herb if feeling more depressed.
Use sunscreen when exposed to the sun.
A patient has been prescribed acarbose (Precose). Which adverse effect might the nurse assess in this patient? -Fever -Anxiety -Diarrhea -Weight gain
Weight gain
Which is the best time for the nurse to instruct a patient beginning acarbose (Precose) therapy to take this medication? -At bedtime -30 minutes before each meal -With the first bite of each meal -30 minutes after eating the first meal of the day
With the first bite of each meal
The only biguanide available in the United States is: a) metformin (Glucophage). b) glyburide (Micronase). c) glipizide (Glucotrol). d) pioglitazone (Actos).
a) metformin (Glucophage)
Glucose levels higher than 240 mg/dL and ketones present in the urine are early indications of: a) dehydration. b) diabetic ketoacidosis. c) peripheral vascular disease. d) renal disease.
b) diabetic ketoacidosis
The type of diabetes that is characterized by a decrease in beta cell activity, insulin resistance, or an increase in glucose production by the liver is: a) type 1 diabetes mellitus. b) type 2 diabetes mellitus. c) diabetes insipidus. d) senile diabetes.
b) type 2 diabetes mellitus
A patient will be diagnosed with diabetes mellitus if their A1Clevel is: a) less than 2%. b) 2.9 to 5.0%. c) 5.7-6.4%. d) greater than 6.5%.
c) 5.7-6.4%
Gestational diabetes mellitus is reserved for women who show abnormal glucose tolerance: a) after menopause. b) before puberty. c) during pregnancy. d) due to cystic fibrosis.
c) during pregnancy.
Numbness or tingling of the extremities is referred to as: a) normal. b) hyperglycemia. c) paresthesia. d) hypoglycemia.
c) paresthesia