Chapter 32 Evolve Questions
The nurse is providing education to a patient for the prescription glipizide (Glucotrol). The nurse explains this medication is more effective when administered at which time?
30 minutes before a meal Glipzide works best if given 30 minutes before meals. This allows the timing of the insulin secretion induced by the glipizide to correspond to the elevation in the blood glucose level induced by the meal.
Assuming the patient eats breakfast at 8:30 AM, lunch at noon, and dinner at 6:00 AM, he or she is at highest risk of hypoglycemia after an 8:00 AM dose of NPH insulin at what time?
5:00 p.m. Breakfast eaten at 8:30 am would cover the onset of NPH insulin, and lunch will cover 2 pm time frame. However, if the patient doesn't eat a mid-afternoon snack, the NPH insulin may be peaking just before dinner without sufficient glucose on hand to prevent hypoglycemia.
When caring for a pregnant patient with gestational diabetes, the nurse should question a prescription for which drug?
Glipizide (Glucotrol) Oral antidiabetic drugs are classified as pregnancy B or C drugs and are generally not recommended for pregnant patients.
The nurse will instruct the patient to treat hypoglycemia with which drug?
Glucagon (GlucaGen) Glucagon stimulates glycogenolysis, raising serum glucose levels.
The patient is prescribed 30 units of regular insulin and 70 units of insulin isophane suspension (NPH insulin) subcutaneously every morning. The nurse should provide which instruction to the patient for insulin administration? A. "Inject the needle at a 30-degree angle." B. "Rotate sites at least once or twice a week." C. "Use a 23- to 25-gauge syringe with a 1-inch needle to increase insulin absorption." D. "Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin."
"Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin." When insulins are mixed, withdraw the regular insulin (clear) first, followed by withdrawing the NPH insulin (cloudy)
When teaching a patient about insulin glargine (Lantus), which statement by the nurse about this drug is correct? A. "You can mix this insulin with NPH insulin to enhance its effects on glucose metabolism." B. "You cannot mix this insulin with regular insulin and thus will have to take two injections." Correct C. "It is often combined with regular insulin to decrease the number of insulin injections per day." D. "The duration of action for this insulin is 8 to10 hours, so you will need to take it twice a day."
"You cannot mix this insulin with regular insulin and thus will have to take two injections." Insulin glargine is a long-acting insulin with duration of action up to 24 hours. It should not be mixed with any other insulins. It is usually dosed once daily, but it may be dosed every 12 depending on the patient's glycemic response.
Which is a rapid-acting insulin with an onset of action of less than 15 minutes?
Insulin Aspart (NovoLog) Insulin aspart is a rapid-acting insulin. Insulin glargine and insulin determir are long-acting insulins. Regular insulin is short acting.
Which long-acting insulin mimics natural, basal insulin with no peak action and a duration of 24 hours?
Insulin Glargine (lantus) Insulin glargine has a duration of action of 24 hours with no peaks, mimicking the natural, basal insulin secretion of the pancreas.
The nurse is preparing a patient for a computed tomography scan using iodine contrast media. Which medication should the nurse question if prescribed one day before the scheduled procedure?
Metformin (Glucophage) The concurrent use of metformin with iodinated (iodine-containing) radiologic contrast media has been associated with both acute renal failure and lactic acidosis. Therefore, metformin should be discontinued the day of the test and for at least 48 hours after the patient undergoes any radiologic study that requires the use of such contrast media.
Pramlintide (Symlin) is prescribed as supplemental drug therapy to the treatment plan for a patient with type 1 diabetes mellitus. What information should the nurse include when teaching the patient about the action of this medication
Pramlintide slows gastric emptying Pramlintide is a synthetic form of the naturally occurring hormone amylin. It works by slowing gastric emptying, suppressing glucagon secretion and hepatic glucose production, and increasing satiety (sense of having eaten enough). It's only administered via subcutaneously injection.
Which insulin can be administered by continuous intravenous (IV) infusion?
Regular Insulin (Humulin R) Regular insulin is the only insulin used for IV therapy
Which oral hypoglycemic drug has a quick onset and short duration of action, enabling the patient to take the medication 30 minutes before eating and skip the dose if he or she does not eat?
Repaglinide (Prandin) Repaglinide is known as the "Humalog of oral hypoglycemia drugs." The drug's very fast onset of action allows patients to take the drug with meals and skip a dose when they skip a meal.
Which information should the nurse include in a teaching plan for patients taking oral hypoglycemic drugs? (Select all that apply.) A. Take your medication only as needed. B. Report symptoms of anorexia and fatigue. C. Explain dietary changes are not necessary. D. Advise to avoid smoking and alcohol consumption. E. Instruct that it is okay to skip breakfast 1 to 2 times per week
Report symptoms of anorexia and fatigue & Advise to avoid smoking and alcohol consumption. Oral hypoglycemia drugs must be taken on a daily scheduled basis to maintain euglycemia and prevent long-term complications of diabetes. Skipping meals can cause low blood glucose levels and should be avoided. Patients with type 2 diabetes mellitus are managed with lifestyle changes. All other options are correct.
