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40 Cards in this Set
- Front
- Back
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The onset of NPH is approximately a. 30 to 60 minutes. b. 1 to 1.5 hours. c. 1 to 2.5 hours. d. 4 to 8 hours. |
b
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Regular insulin is effective for approximately a. 3 to 4 hours. b. 8 to 12 hours. c. 24 hours. d. more than 36 hours. |
b
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The peak effect of long-acting insulin glargine (Lantus) occurs approximately _____after administration? a. It has no dened peak b. 7 to 15 hours c. 4 to 12 hours d. 2 to 4 hours |
a
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Which of the following types of insulin can be given intravenously?
a. Regular b. Intermediate-acting c. Long-acting d. Any of the above |
a
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To decrease the potential for lipodystrophy, the patient should a. monitor glucose levels. b. dip urine for ketones daily. c. rotate injection sites. d. trim toenails evenly. |
c
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Ingestion of alcohol with insulin therapy may result in a. hyperglycemia. b. hypoglycemia. c. Both a and b. d. Neither a nor b. |
c
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Which of the following insulin preparations may be used in an insulin pump delivery system? (Mark all that apply) a. NPH b. Aspart c. Regular d. Detemir |
b, c
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Maximal effects of glyburide (DiaBeta) occur within a. 40 to 60 minutes. b. 10 to 25 minutes. c. 2 hours. d. 3 to 4 hours. |
d
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Sulfonylurea drugs are contraindicated for use in patients with an allergy to a. insulin. b. sulfonamides. c. aminoglycosides. d. penicillin. |
b
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Which of the following drugs should be used for type 2 diabetes during pregnancy? a. Glyburide (DiaBeta) b. Glucagon c. Insulin d. Rosiglitazone (Avandia) |
c
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Which of the following statements is correct concerning repaglinide (Prandin)? a. It is unsuitable for use in elderly patients b. It is contraindicated for patients with renal insufciency c. It has an extremely long half-life and duration of action d. It can be omitted when the patient skips a meal |
d
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The effects of metformin (Glucophage) include a. suppression of hepatic glucose production. b. lowering of triglyceride levels. c. enhancement of insulin sensitivity. d. All of the above |
d
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Metformin (Glucophage) should be administered a. with morning and evening meals. b. 1 hour before meals. c. 2 hours after meals. d. at bedtime. |
a
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Which of the following adverse effects is specic to metformin (Glucophage) therapy? a. Hypoglycemia b. GI distress c. Lactic acidosis d. Diarrhea |
c
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Acarbose (Precose) works by a. sensitizing insulin receptors. b. decreasing carbohydrate absorption from the small intestine. c. increasing insulin secretion from the pan-creas. d. decreasing hepatic production of glucose. |
b
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Acarbose (Precose) is contraindicated for use in patients with a. diverticulitis. b. hepatic insufciency. c. anemia. d. chronic obstructive pulmonary disease (COPD). |
a
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Thiazolidinedione antiglycemics such as rosi-glitazone (Avandia) work by a. enhancing insulin production. b. sensitizing insulin receptors. c. decreasing hepatic production of glucose. d. inhibiting carbohydrate absorption from the small intestine. |
b
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Rosiglitazone (Avandia) may be given concur-rently with a. metformin (Glucophage). b. glyburide (DiaBeta). c. acarbose (Precose). d. All of the above |
b
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The duration of action of glucagon is approximately a. 24 hours. b. 5 to 10 minutes. c. 1 to 2 hours. d. 6 to 12 hours. |
c
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Glucagon is administered via the _____ route. (Mark all that apply) a. subcutaneous b. intramuscular c. intravenous d. oral |
a
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Sitagliptin (Januvia) lowers blood glucose by a. protecting the endogenous incretin hor-mones and enhancing their actions. b. blocking gluconeogenesis. c. increasing the sensitivity of insulin receptors. d. blocking the uptake of carbohydrates from the intestine. |
a
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In addition to lowering blood glucose, pram-lintide (Symlin) also a. increases gastric emptying time. b. causes weight gain. c. promotes satiety. d. increases the secretion of glucagon. |
c
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Your 38-year-old patient has type 1 diabe-tes and takes regular insulin. The patient is hospitalized for pneumonia. As you enter the patient’s room, you note that the patient is trembling and tachycardic. The patient reports having a headache and feeling nervous. You suspect that this patient is experiencing a. hyperglycemia. b. hypoglycemia. c. hyperosmolar hyperglycemic states. d. None of the above |
b
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Your patient has type 1 diabetes. The patient’s regimen is changing to include lispro (Huma-log) insulin. What instructions should be given to this patient regarding the administra-tion of this medication? a. Administer the medication 1 hour before meals b. Administer the medication1 hour after meals c. Administer the medication 10 to 15 min-utes before a meal d. Administer the medication only at bedtime |
c
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Your 22-year-old patient with diabetes takes NPH insulin twice a day. NPH was admin-istered to your patient at 7:30 AM . At what time is this patient most likely to experience a hypoglycemic episode? a. 8:30 to 9:00 AM b. 9:30 to 11:30 AM c. 11:30 AM to 7:30 PM d. 10:30 AM to 12:00 noon |
c
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Your patient has newly diagnosed type 1 diabetes. The patient is prescribed a combina-tion of regular and intermediate-acting insu-lin. When preparing this combination, this patient should be taught to draw up which medication rst? a. Regular insulin b. Intermediate-acting insulin c. It does not matter |
a
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Your 43-year-old patient has type 2 diabetes. The patient has taken glyburide (DiaBeta) but experiences hypoglycemia frequently. Which of the following drugs would be helpful in treating this patient’s diabetes? a. Metformin (Glucophage) b. Regular insulin c. Repaglinide (Prandin) d. Tolbutamide (Tolinase) |
a
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Your patient takes metformin (Glucophage) for diabetes. Which of the following interven-tions would be necessary throughout therapy? a. Serial CBC b. Electrocardiogram (ECG) c. Periodic hepatic and renal function studies d. Arterial blood gas |
c
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Your patient is hospitalized for complications of a tubal ligation. She has a history of type 2 diabetes and takes acarbose (Precose). The patient is experiencing a hypoglycemic epi-sode. Which of the following interventions would be appropriate? a. Orange juice b. Hard candy c. Milk and crackers d. Oral glucose tablet |
d
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Your patient has been hospitalized for brittle type 1 diabetes. Upon entering the patient’s room, you nd the patient unconscious, with a glucometer reading of 32. Which of the following drugs would be most appropriate to treat this? a. IV glucose b. Glucagon IM c. Diazoxide d. dissolved glucose tablets |
a
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A patient’s daughter calls and tells you that her mother had an insulin reaction and was found unconscious. The daughter also states that she gave her mother a glucagon injec-tion 20 minutes ago, and she woke up but is still groggy and does not make sense. Which of the following instructions would you give? a. “Let her wake up on her own, then give her something to eat.” b. “Place a couple of hard candies in her mouth.” c. “Just let her sleep. She needs the rest.” d. “Give her another injection and call the paramedics.” |
d
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Your patient’s mother reports that she has administered glucagon to her child ve times in the past month. The nurse should obtain additional information regarding (Mark all that apply) a. current medications b. smoking or recreational drug use c. routine diet d. daily insulin use e. latest glycosylated hemoglobin result f. recent stress |
a, c, d
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Which of these statements, if made by a patient who takes insulin detemir would indicate a need for further teaching? a. “I will give myself a shot in a different place every day.” b. “I will save money by putting both detemir and aspart in the same syringe.” c. “I will not put it in my insulin pump.” d. “I will check my glucose daily.” |
b
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Your 66-year-old female patient has type 2 diabe-tes that has not been well controlled with met-formin. Today the health care provider prescribes pioglitazone (Actos). Which of the following should be included in your patient teaching? a. Aseptic technique for subcutaneous administration b. Separate administration of these two medications by at least 12 hours c. Fall-proong her home d. Checking her blood glucose at least 4 times a day |
c
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When taking a history from a patient who has just been prescribed exenatide (Byetta), which of the following questions would be most important for the nurse to ask? a. “How long have you had diabetes?” b. “Do you take any other medications?” c. “Are you afraid of needles?” d. “Do you have any allergies to foods?” |
b
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Which of these statements, if made by a patient who is prescribed both insulin and pramlintide (Symlin), would indicate a need for further teaching? a. “I will wash my hands before I give myself a shot.” b. “I will keep a supply of glucose tablets in my car.” c. “I will combine both drugs in the same syringe.” d. “I will stop driving my car if I feel weak or dizzy.” |
c
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Your patient receives 30 units NPH every morning at 7:30 AM . When are they most likely to become hypoglycemic? a. 9 AM b. 3 PM c. 11 PM d. 7 AM the next morning |
b
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Which of the following insulins is appropri-ate to use for nutritional doses? a. NPH b. Glargine c. Detemir d. Aspart |
d
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Your patient receives a combination of NPH and regular insulin at 5:30 PM . At 11 PM the patient is found diaphoretic and confused. The best initial action of the nurse is to a. administer more regular insulin b. administer 4 ounces of water with 4 pack-ets of sugar (4 teaspoons of sugar) c. assess pulse oximetry d. assess neuro status |
b
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Your patient is ordered a basal dose of insulin with glargine in the AM and a correctional dose of insulin with aspart before each meal and at bedtime. The glargine comes in a vial and the aspart in a prelled injection pen. Both medications are due before breakfast. The nurse should a. withdraw the aspart from the injection pen into a syringe and then draw up the glargine into the same syringe. b. draw up the glargine into a syringe and then withdraw the aspart from the injec-tion pen into the same syringe. c. administer the aspart via the injection pen and the glargine separately via a syringe. d. administer the glargine now via a syringe but hold the aspart to administer later. |
c
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