Deck 17: Drug Therapy for Diabetes

Question 1

How does acarbose (Precose) prevent blood glucose levels from rising too high?

A)It limits the intestinal enzyme that converts complex carbohydrates into glucose.
B)It blocks the absorption of carbohydrates and glucose in the intestines.
C)It enhances the binding of insulin to its membrane receptors.
D)It releases more insulin from pancreatic beta cells.

Answer 1

It limits the intestinal enzyme that converts complex carbohydrates into glucose.

Question 2

You are teaching a patient who has been prescribed a sodium-glucose cotransport inhibitor for the treatment of diabetes mellitus type 2. The patient asks you to explain how this drug works. What is your best response?

A)"This drug works by inactivating normal gut hormones."
B)"This drug works by preventing the kidney from reabsorbing glucose."
C)"This drug works by making insulin receptors more sensitive to insulin."
D)"This drug works by preventing enzymes from breaking down starches into glucose."

Answer 2

"This drug works by preventing the kidney from reabsorbing glucose."

Question 3

A patient taking metformin (Glucophage) is scheduled for a radiographic scan with contrast dye. What instructions should you provide to this patient?

A)"Take the metformin as soon as the scan is completed."
B)"Stop taking the metformin at least 24 h before your scan."
C)"Stop taking the metformin for 3 days before and after the scan."
D)"Take your metformin the night before the scan, and resume after the test is completed."

Answer 3

"Stop taking the metformin at least 24 h before your scan."

Question 4

Which complaint by a patient taking a DPP-4 inhibitor would alert you to a potential complication from this drug?

A)Diarrhea
B)Abdominal pain
C)Nasopharyngitis
D)Swelling of the lower extremities

Question 5

You are preparing to discuss a newly prescribed insulin stimulator with a patient. What condition would need to be present for this drug to work effectively for a diabetic patient?

A)The patient would need to be able to self-inject the drug.
B)The patient would need to be in ketoacidosis to begin this drug.
C)The patient would need to have diabetes mellitus type 2 to use this drug.
D)The patient needs to have some functioning beta cells for this drug to work.

Question 6

A patient is taking a sodium-glucose cotransport inhibitor for the treatment of diabetes. Which of the following laboratory values should you monitor in this patient?

A)Serum potassium
B)Serum amylase and lipase
C)Hemoglobin and hematocrit
D)Cholesterol and triglycerides

Question 7

In what way does insulin work to lower blood glucose levels?

A)Enhancing the enzymes that break down glucose
B)Helping glucose to move from the blood into cells
C)Converting glucose into proteins in the liver and brain
D)Converting glycogen into glucose in the liver and brain

Question 8

Which hormone has an action opposite to the action of insulin?

A)Glycogen
B)Glucagon
C)Hemoglobin A1c
D)Adenosine triphosphate

Question 9

A patient with diabetes mellitus type 2 is prescribed glipizide (Glucotrol). Which of the following nursing actions would be the best action when giving this drug?

A)Give this drug with milk.
B)Give this drug with a meal.
C)Assess the patient for signs of pancreatitis.
D)Take the patient's pulse before giving this drug.

Question 10

You are teaching a patient prescribed rosiglitazone about this drug. Which statement should you include in the patient's teaching plan?

A)"Call if you develop swelling of the legs, or weight gain."
B)"If you miss a dose of this drug, take two tablets for your next dose."
C)"You will not need to check your blood sugar when using this drug."
D)"Vision changes are expected with this drug, and are not of a concern."

Question 11

A young, female patient with diabetes mellitus who is taking an oral antidiabetic drug comes in for a regularly scheduled clinic appointment. She tells you that is currently taking an oral contraceptive agent for birth control. What is your best response?

A)"Oral contraceptives are contraindicated for diabetics."
B)"Oral contraceptives can be taken only if you are on insulin."
C)"Oral contraceptives can be safely taken with oral antidiabetic agents."
D)"Oral contraceptives reduce their effectiveness of oral antidiabetic agents."

Question 12

For which patient would a biguanide antidiabetic drug be contraindicated?

A)A female patient who is pregnant
B)A newly diagnosed type 2 diabetic
C)A patient with known kidney disease
D)A diabetic patient with some functioning pancreatic beta cells

Question 13

What is the main role of insulin in the body?

A)Conversion of complex carbohydrates into glucose
B)Movement of glucose from blood into the cells
C)Prevention of kidney excretion of glucose
D)Prevention of the formation of fat cells

Question 14

Which statement regarding diabetes mellitus (DM) type 2 is true?

A)Some people with DM type 2 will need insulin.
B)This type of diabetes is found in children less than 1 year of age.c.Drug therapy for DM type 2 eliminates the need for diet and exercise.d.DM type 2 is characterized by sudden, complete shutdown of the pancreas.

Question 15

You are about to give miglitol (Glyset) to a patient with diabetes mellitus type 2. Which nursing action is most important for this patient?

A)Rotate the injection site on a weekly basis.
B)Give this drug with the first bite of a meal."
C)Do not mix this drug in the same syringe as insulin.
D)Assess the patient for signs and symptoms of heart failure.

Question 16

Which precaution is most important to teach patients who have any type of diabetes about alcohol use?

A)"Be sure to take your antidiabetic drug or drugs 15 min before drinking any alcohol.
B)"Only drink alcohol right before bedtime because it will make you drowsy."
C)"Increase your water intake whenever you drink alcohol."
D)"Only drink alcohol with a meal or shortly after a meal."

Question 17

Which oral antidiabetic drug belongs to the biguanide class?

A)Acarbose (Precose)
B)Nateglinide (Starlix)
C)Pioglitazone (Actos)
D)Metformin (Glucophage)

Question 18

Which term means an elevated blood sugar (glucose) level?

A)Glycogen
B)Euglycemia
C)Hypoglycemia
D)Hyperglycemia

Question 19

A patient who is taking dapagliflozin (Farxiga) for diabetes mellitus type 2 has also been prescribed furosemide (Lasix) for another condition. What potential risk should you monitor for on this patient?

A)Risk for infection
B)Risk for bleeding
C)Risk of dehydration
D)Risk for fluid retention

Question 20

What is the main reason that insulin is needed as drug therapy for people who have type 1 diabetes?

A)The beta cells of the pancreas no longer make insulin.
B)The alpha cells of the pancreas no longer make insulin.
C)The beta cells of the pancreas make too much glucagon.
D)The alpha cells of the pancreas make too much glucagon.

Question 21

What makes insulin a "high-alert" drug?

A)Many people are very allergic to insulin.
B)Serious harm can occur if the wrong dose is given.
C)If too much insulin is given, the respiratory system is depressed.
D)If too much insulin is given, the blood glucose level could climb to dangerously high levels.

Question 22

A patient is taking insulin each morning. When the insulin peaks, the patient should be observed for which signs of hypoglycemia?

A)Tachycardia and acetone breath
B)Nervousness, hunger, weakness, pallor, and confusion
C)Tachycardia, loss of consciousness, and Kussmaul respirations
D)Serum glucose greater than 150 mg/dL hunger, and confusion

Question 23

Which condition is the most dangerous adverse effect of insulin?

A)Hypoglycemia
B)Hyperglycemia
C)Severe hypotension
D)Development of insulin allergy

Question 24

A patient is started on exenatide (Byetta), an injectable incretin mimetic. The patient asks you how this drug will help lower blood glucose. Which is your best response?

A)"This drug restores insulin secretion."
B)"This drug increases insulin secretion."
C)"This drug works to increase the duration of insulin."
D)"This drug works by increasing the action of glucagon."

Question 25

You are taking the history of a new clinic patient whom you suspect of having undiagnosed diabetes. Which of the following symptoms would you expect this patient to report? (Select all that apply.)

A)Petechiae
B)Increased thirst
C)Increased hunger
D)Increased urination
E)Decreased blood pressure

Question 26

A patient has been admitted to the hospital with a potential hypoglycemic reaction to an insulin stimulator. What symptoms would you expect to observe in this patient? (Select all that apply.)

A)Headache
B)Clammy skin
C)Slow heart rate
D)Lack of appetite
E)Anxiety and confusion
F)Nervousness and tremors

Question 27

Which of the following conditions are associated with poorly controlled diabetes? (Select all that apply.)

A)Stroke
B)Blindness
C)Kidney failure
D)Cognitive deficits
E)Deep vein thrombosis
F)Cardiovascular disease

Question 28

Why is insulin only given by injection and not as an oral drug?

A)Injected insulin works faster than oral drugs to lower blood glucose levels.
B)Insulin is a small protein that is destroyed by stomach acids and intestinal enzymes.
C)Insulin is a "high-alert drug" and be easily be abused if it were available as an oral agent.
D)Oral insulin has a high "first pass loss" rate in the liver and would require very high dosages to be effective.

Question 29

Which precaution is most important to teach patients who have any type of diabetes about alcohol use?

A)"Be sure to take your antidiabetic drug or drugs 15 minutes before drinking any alcohol."
B)"Only drink alcohol right before bedtime because it will make you drowsy."
C)"Increase your water intake whenever you drink alcohol."
D)"Only drink alcohol with a meal or shortly after a meal."

Question 30

You are preparing to teach a patient about the use of short-acting insulin. Which instruction should be stressed to the patient regarding this drug?

A)"Place pressure on the injection site for 5 full minutes."
B)"You should always aspirate before injecting this drug."
C)"You may store your insulin for 6 months at room temperature."
D)"You should eat a meal within 15 minutes of giving yourself the injection."