ch. 23

A client has a blood glucose level of 276 mg/dL, with standing orders to self-administer insulin on a sliding scale. The scale calls for 5 units of insulin for a glucose level of 200 to 250 mg/dL, 8 units for a glucose level of 251 to 300 mg/dL, and 12 units for a blood glucose level of 301 to 350 mg/dL. How much insulin should the client administer? a. 8 units. b. 12 units. c. 5 units. d. 10 units.

a. 8 units.

When is insulin required for clients who have diabetes? a. As replacement therapy in type 1 diabetes and in clients with type 2 diabetes whose blood glucose is not controlled with diet or when illnesses develop. b. Only in clients who have type 1 diabetes. c. For clients who have type 2 diabetes. d. All clients with a diagnosis of diabetes, regardless of the type.

a. As replacement therapy in type 1 diabetes and in clients with type 2 diabetes whose blood glucose is not controlled with diet or when illnesses develop.

When educating a client who has been prescribed long-term corticosteroids, which of the following should the health care practitioner caution the client about? a. Avoiding abrupt discontinuation. b. Skin thickening. c. Eating yogurt cultures. d. Getting too much sleep.

a. Avoiding abrupt discontinuation.

A client with diabetes has arrived at the clinic for their regularly scheduled medication management appointment. They tell the health care practitioner that they have been extremely thirsty, have been urinating frequently, and has flu-like symptoms. The health care practitioner notes a fruity odor to their breath. What physical condition is this client most likely experiencing? a. Hyperglycemia. b. Influenza. c. Alcoholism. d. Hypoglycemia.

a. Hyperglycemia.

A client diagnosed with myxedema has been placed on thyroid replacement therapy. Which of these statements is TRUE? a. Prescribed dosage should be taken on an empty stomach 30 to 60 minutes before meals. b. Prescribed dosage should be adjusted daily according to a sliding scale. c. Prescribed dosage should be taken with food or milk. d. Prescribed dosage should be taken 30 minutes after meals.

a. Prescribed dosage should be taken on an empty stomach 30 to 60 minutes before meals.

A client has been prescribed an antithyroid agent to relieve the symptoms of hyperthyroidism in preparation for surgery. What rare but serious side effect of antithyroid agents should the health care practitioner educate the client to report? a. Rash. b. Tremors. c. Alopecia. d. Palpitations

a. Rash.

A client who is obese tells the health care provider that her friend was recently placed on thyroid medication and lost weight. She asks the nurse if she can take thyroid agents to help her lose weight. Which statement is the health care provider's BEST response? a. The use of thyroid agents for weight reduction is contraindicated, ineffective, and dangerous. b. The use of thyroid agents is successfully used in most weight-reduction programs. c. Try your friend's medication, and if it works, perhaps the doctor will order it for you. d. Ask your friend if she has had any adverse side effects from the medication.

a. The use of thyroid agents for weight reduction is contraindicated, ineffective, and dangerous.

A client with type 2 diabetes has been taking chlorpropamide (Diabinese), a first-generation sulfonylurea oral hypoglycemic agent, for many years with good effect. Recently, the client was started on a 6-month course of isoniazid for a positive PPD test. Which of these statements is TRUE about taking isoniazid while receiving sulfonylureas? a. This client should be closely monitored for loss of diabetic control. b. The client will have to switch to insulin until the course of isoniazid is completed. c. The client will have to stop taking the sulfonylurea until the isoniazid course of therapy is completed. d. The sulfonylurea is not known to interact with isoniazid.

a. This client should be closely monitored for loss of diabetic control.

A client receiving thyroid replacement therapy came to the health clinic with complaints of heart palpitations, menstrual irregularity, and insomnia. The health care practitioner notes that she has exophthalmos. What could these signs of hyperthyroidism possibly indicate? a. This is an indicator of an overdosage of thyroid. b. This could indicate a return to normal thyroid function. c. This may be related to lack of sleep. d. This most likely indicates noncompliance with the medication regime.

a. This is an indicator of an overdosage of thyroid.

A client has been prescribed levothyroxine (Synthroid) for hormone replacement therapy. Which of these advices does the health care provider know would be MOST useful in preventing errors in administering this medication? a. Use caution with decimal point placement. b. Perform lab tests to determine therapeutic blood levels. c. Only ask a certified physician about administration. d. Only use the generic form of this medication.

a. Use caution with decimal point placement.

A client is taking metformin (Glucophage), a biguanide oral antidiabetic agent, to treat type 2 diabetes. Which symptom below are known side effects of drugs in this class? a. Metabolic alkalosis. b. Anorexia, weight loss, and hypoglycemia. c. Respiratory acidosis. d. Constipation.

b. Anorexia, weight loss, and hypoglycemia.

A client with a history of diabetes has been placed on a thyroid agent. Which of the following statements is accurate regarding the interaction of thyroid and insulin? a. The client cannot take insulin when taking thyroid medication. b. Dosage adjustment of insulin may be necessary. c. The insulin may cause the client to have toxic effects from the thyroid medication. d. There is no known drug interaction between thyroid and insulin.

b. Dosage adjustment of insulin may be necessary.

A client has come to the health medical center experiencing an acute allergic response to poison ivy exposure. Which of the following medications would MOST likely be administered? a. Amiodarone. b. Methylprednisolone dose pack. c. Fluvoxamine. d. Metformin.

b. Methylprednisolone dose pack.

A health care practitioner is caring for a client with a known diagnosis of diabetes mellitus. When the health care practitioner enters the client's room, they note that the client is perspiring, irritable, confused, and acting in a bizarre manner. The health care practitioner suspects these may be symptoms of hypoglycemia and offers the client four ounces of orange juice, followed by a protein bar. Which of the following situations would NOT result in hypoglycemia? a. Excessive exercise. b. Overeating. c. Overdose in insulin. d. Change in type of insulin

b. Overeating.

A client diagnosed with myxedema has been placed on thyroid replacement therapy. Which of the following statements is TRUE? a. Prescribed dosage should be taken 30 min after meals. b. Prescribed dosage should be taken on an empty stomach 30 to 60 minutes before meals. c. Prescribed dosage should be taken with food or milk. d. Prescribed dosage should be adjusted daily according to a sliding scale.

b. Prescribed dosage should be taken on an empty stomach 30 to 60 minutes before meals.

A client is taking metformin (Glucophage), a biguanide oral antidiabetic agent, to treat type 2 diabetes. Which symptoms below are known side effects of drugs in this class? a. Respiratory acidosis. b. Constipation. c. Anorexia, weight loss, and hypoglycemia. d. Metabolic alkalosis.

c. Anorexia, weight loss, and hypoglycemia.

A client diagnosed with an acute exacerbation of ulcerative colitis has been prescribed corticotropin hormone (ACTH) for its anti-inflammatory action. Which route of administration does the health care practitioner know is used to administer this medication? a. Inhalation. b. Intradermal. c. IM. d. PO.

c. IM.

A client who is obese tells the health care practitioner that their friend was recently placed on thyroid medication and lost weight. They ask the health care practitioner if they can take thyroid agents to help them lose weight. Which statement is the health care practitioner's BEST response? a. The use of thyroid agents is successfully used in most weight-reduction programs. b. Try your friend's medication, and if it works, perhaps the doctor will order it for you. c. The use of thyroid agents for weight reduction is contraindicated, ineffective, and dangerous. d. Ask your friend if they have had any adverse side effects from the medication.

c. The use of thyroid agents for weight reduction is contraindicated, ineffective, and dangerous.

A client with type 2 diabetes has been taking chlorpropamide, a first-generation sulfonylurea oral hypoglycemic agent, for many years with good effect. Recently, the client was started on a six-month course of isoniazid for a positive PPD test. Which of the following statements is TRUE about taking isoniazid while receiving sulfonylureas? a. The sulfonylurea is not known to interact with isoniazid. b. The client will have to stop taking the sulfonylurea until the isoniazid course of therapy is completed. c. This client should be closely monitored for loss of diabetic control. d. The client will have to switch to insulin until the course of isoniazid is completed.

c. This client should be closely monitored for loss of diabetic control.

A client receiving thyroid replacement therapy came to the health clinic with complaints of heart palpitations, menstrual irregularity, and insomnia. The nurse notices that she has exophthalmos. What could these signs of hyperthyroidism possibly indicate? a. This may be related to lack of sleep. b. This could indicate a return to normal thyroid function. c. This is an indicator of an overdosage of thyroid. d. This most likely indicates noncompliance with the medication regime.

c. This is an indicator of an overdosage of thyroid.

A client with a history of diabetes has been placed on a thyroid agent. Which of these statements is accurate regarding the interaction of thyroid and insulin? a. The insulin may cause the client to have toxic effects from the thyroid medication. b. The client cannot take insulin when taking thyroid medication. c. There is no known drug interaction between thyroid and insulin. d. Dosage adjustment of insulin may be necessary.

d. Dosage adjustment of insulin may be necessary.

What is the only type of insulin that can be administered intramuscularly, intravenously, and subcutaneously? a. Garline (Lantus). b. Isophane (NPH). c. Lente. d. Regular.

d. Regular.

What is the only type of insulin that can be administered intramuscularly, intravenously, and subcutaneously? a. Isophane (NPH). b. Garlgine (Lantus). c. Lente. d. Regular.

d. Regular.

Which type of insulin acts rapidly for a short duration of time? a. Isophane (NPH). b. Ultralente. c. Glargine (Lantus). d. Regular.

d. Regular.

A client has been prescribed levothyroxine (Synthroid) for hormone replacement therapy. Which advice does the health care practitioner know would be MOST useful in preventing errors in administering this medication? a. Only ask a certified physician about administration. b. Only use the generic form of this medication. c. Perform lab tests to determine therapeutic blood. d. Use caution with decimal point placement.

d. Use caution with decimal point placement.