week 11 pharm quiz
A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned? a. The beta blocker can mask the symptoms of hypoglycemia. b. Using the two agents together increases the risk of ketoacidosis. c. Propranolol increases insulin requirements because of receptor blocking. d. The beta blocker can cause insulin resistance.
a
The nurse assesses a newly diagnosed patient for short-term complications of diabetes. What does this assessment include? a. Evaluation for hyperglycemia, hypoglycemia, and ketoacidosis b. Auscultation of the carotids for bruits associated with atherosclerosis c. Pedal pulse palpation for arterial insufficiency d. Cranial nerve testing for peripheral neuropathy
a
An elderly patient who has type 2 diabetes has a history of severe hypoglycemia. The patient's spouse asks the nurse what the optimum A1c level is for the patient. Which is correct? a. Between 7.0 and 8.5 b. Below 7.0 c. Below 8.0 d. Between 6.5 and 7.0
c
A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to administer? a. No insulin should be administered. b. 70/30 mix c. NPH d. Lispro [Humalog]
d
An adolescent patient recently attended a health fair and had a serum glucose test. The patient telephones the nurse and says, "My level was 125 mg/dL. Does that mean I have diabetes?" What is the nurse's most accurate response? a. "This level is conclusive evidence that you have diabetes." b. "At this level, you probably have diabetes. You will need an oral glucose tolerance test this week." c. "This level is conclusive evidence that you do not have diabetes." d. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes."
d
What is the most reliable measure for assessing diabetes control over the preceding 3-month period? a. Glycosylated hemoglobin level b. Patient's report c. Fasting blood glucose level d. Self-monitoring blood glucose (SMBG) graph report
a
A patient newly diagnosed with diabetes expresses concern about losing her vision. Which interventions should be included in the plan of care to reduce this risk? (Select all that apply.) a. Emphasis on the importance of taking antihypertensive drugs consistently b. Ways to reduce hyperglycemic episodes c. Smoking cessation d. Initiation of reliable contraception to prevent pregnancy e. Use of a prokinetic drug (eg, metoclopramide)
a b c
A patient with type 1 diabetes recently became pregnant. The nurse plans a blood glucose testing schedule for her. What is the recommended monitoring schedule? a. In the morning for a fasting level and at 4:00 PM for the peak level b. Six or seven times a day c. Three times a day, along with urine glucose testing d. Before each meal and before bed
b
The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients who were just admitted. Which patient should the nurse assess first? a. The patient with a pulse of 58 beats per minute who is about to receive digoxin [Lanoxin] b. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin c. The patient with a blood pressure of 136/92 mm Hg who complains of having a headache d. The patient with an allergy to penicillin who is receiving an infusion of vancomycin [Vancocin]
b
Which statement is correct about the contrast between acarbose and miglitol? a. Miglitol has no gastrointestinal side effects. b. Miglitol has not been associated with hepatic dysfunction. c. Miglitol is less effective in African Americans. d. With miglitol, sucrose can be used to treat hypoglycemia.
b
A nurse counsels a patient with diabetes who is starting therapy with an alpha-glucosidase inhibitor. The patient should be educated about the potential for which adverse reactions? (Select all that apply.) a. Hypoglycemia b. Flatulence c. Elevated iron levels in the blood d. Diarrhea e. Fluid retention
b d
A patient with type 1 diabetes reports mixing NPH and regular insulin to allow for one injection. What should the nurse tell the patient? a. NPH insulin should only be mixed with insulin glargine. b. Mixing these two forms of insulin may increase the overall potency of the products. c. This is an acceptable practice. d. These two forms of insulin are not compatible and cannot be mixed.
c
A nurse is educating the staff nurses about ketoacidosis. To evaluate the group's understanding, the nurse asks, "Which sign or symptom would not be consistent with ketoacidosis?" The group gives which correct answer? a. Blood glucose level of 600 mg/dL b. Ketones in the urine c. Acidosis d. Blood glucose level of 60 mg/dL
d
A nurse provides dietary counseling for a patient newly diagnosed with type 1 diabetes. Which instruction should be included? a. "Most of the calories you eat should be in the form of protein to promote fat breakdown and preserve muscle mass." b. "Your total caloric intake should not exceed 1800 calories in a 24-hour period." c. "You may eat any foods you want and cover the glucose increase with sliding scale, regular insulin." d. "You should use a carbohydrate counting approach to maintain glycemic control."
d
A patient who has type 2 diabetes will begin taking glipizide [Glucotrol]. Which statement by the patient is concerning to the nurse? a. "I will need to check my blood sugar once daily or more." b. "It is safe to drink grapefruit juice while taking this drug." c. "I will begin by taking this once daily with breakfast." d. "I may continue to have a glass of wine with dinner."
d
nsulin glargine is prescribed for a hospitalized patient who has diabetes. When will the nurse expect to administer this drug? a. After meals and at bedtime b. Approximately 15 to 30 minutes before each meal c. In the morning and at 4:00 PM d. Once daily at bedtime
d