Question 1

The nurse is teaching a patient who is newly diagnosed with type 1 diabetes mellitus about insulin administration. Which statement by the patient indicates a need for further teaching?&#10;A) &#34;I should rotate my injection sites.&#34;&#10;B) &#34;I should give each injection a knuckle length away from a previous injection.&#34;&#10;C) &#34;I will not be concerned about a raised knot under my skin from injecting insulin.&#34;&#10;D) &#34;Insulin is absorbed better from subcutaneous sites on my abdomen.&#34;

Accepted Answer

A raised knot or lump under the skin from insulin injections can indicate lipodystrophy, which is a thickening and loss of fatty tissue at the injection site. This can affect insulin absorption and lead to variations in blood glucose levels. Patients should be advised to rotate injection sites and avoid using the same site repeatedly to prevent lipodystrophy.

Question 2

A patient reports that they are taking a rapid-acting insulin with meals, but can't remember the name. Which of the following products is a rapid-acing insulin?&#10;A) Regular insulin (Novolin R)&#10;B) Insulin glargine (Lantus)&#10;C) Insulin lispro (Humalog)&#10;D) Insulin degludec (Tresiba)

Accepted Answer

Insulin lispro (Humalog) is a rapid-acting insulin that is taken with meals. Novolin R is a short-acting insulin, Lantus is a long-acting insulin, and Tresiba is an ultra-long-acting insulin.

Question 3

The nurse receives the following order for insulin: IV NPH (Humulin NPH) 10 units. The nurse will perform which action?&#10;A) Administer the dose as ordered.&#10;B) Clarify the insulin type and route.&#10;C) Give the drug subcutaneously.&#10;D) Question the insulin dose.

Accepted Answer

The nurse should clarify the insulin type and route as NPH insulin is typically given subcutaneously and not intravenously. Additionally, the dose may need to be adjusted depending on the patient's blood glucose level and other factors.

Question 4

A patient was administered regular insulin 30 minutes ago, but has not received a breakfast tray. The patient is experiencing nervousness and tremors. What is the nurse's first action?&#10;A) Administer glucagon.&#10;B) Give the patient orange juice.&#10;C) Notify the kitchen to deliver the tray.&#10;D) Perform bedside glucose testing.

Accepted Answer

The patient is likely experiencing hypoglycemia due to the insulin administration without food intake. Giving orange juice provides a quick source of sugar to raise blood glucose levels.

Question 5

A patient develops type 2 diabetes mellitus. The nurse will explain that this type of diabetes:&#10;A) is generally triggered by medications.&#10;B) is not as common as type 1 diabetes.&#10;C) is often related to heredity and obesity.&#10;D) will not require insulin therapy.

Accepted Answer

Type 2 diabetes is often related to heredity and obesity.

Question 6

A patient who has type 2 diabetes mellitus asks the nurse why the provider has changed the oral antidiabetic agent from tolbutamide (Orinase) to glipizide (Glucotrol). The nurse will explain that glipizide

A) has a longer duration of action.
B) has fewer gastrointestinal side effects.
C) may be taken on an as-needed basis.
D) does not cause hypoglycemia.

Accepted Answer

Glipizide has a longer duration of action compared to tolbutamide, which means that it can be taken once a day rather than multiple times a day. This may improve medication adherence and glycemic control.

Question 7

A patient who is overweight is being evaluated for diabetes. The patient has a blood glucose level of 160 mg/dL and a hemoglobin A_1c of 5.8%. The nurse understands that this patient has which condition?

A) Diabetes mellitus
B) Hypoglycemia
C) Normal blood levels
D) Prediabetes

Accepted Answer

A hemoglobin A1c level between 5.7% and 6.4% indicates prediabetes, which means the patient is at high risk for developing diabetes. A blood glucose level of 160 mg/dL also suggests impaired glucose tolerance, which is a characteristic of prediabetes. However, a diagnosis of diabetes mellitus requires more than just one elevated blood glucose reading or hemoglobin A1c level. Further evaluation and monitoring is needed to confirm a diagnosis of diabetes. Hypoglycemia refers to low blood glucose levels, which is not the case here. Normal blood levels would be a hemoglobin A1c level less than 5.7% and a blood glucose level less than 140 mg/dL.

Question 8

The patient asks the nurse about storing insulin. Which response by the nurse is correct?&#10;A) &#34;All insulin vials must be refrigerated before and during use.&#34;&#10;B) &#34;Insulin will last longer if kept in the freezer.&#34;&#10;C) &#34;Opened vials of insulin must be discarded after first use.&#34;&#10;D) &#34;Some insulin products do not require refrigeration during use.&#34;

Accepted Answer

Some insulin products do not require refrigeration during use. However, it is important to follow the manufacturer's instructions for storage and use of each specific insulin product. Opened vials of insulin should be discarded after the recommended time period, which is usually 28 days for most insulin products. Freezing insulin can damage it, so it should never be stored in the freezer.

Question 9

A 45-year-old patient who is overweight has had a diagnosis of type 2 diabetes for 2 years. The patient uses 20 units of long-acting insulin per day. The patient's fasting blood glucose (FBG) is 190 mg/dL. The patient asks the nurse about using an oral antidiabetic agent. The nurse understands that oral antidiabetic agents:

A) cannot be used if the patient is overweight.
B) cannot be used once a patient requires insulin.
C) may be used in patients with type 2 diabetes in combination with insulin.
D) may not be used since this patient's fasting blood glucose is too high.

Accepted Answer

Oral antidiabetic agents may be used in patients with type 2 diabetes in combination with insulin. Being overweight does not necessarily exclude the use of oral antidiabetic agents, and they can still be used even if a patient requires insulin. With a FBG of 190 mg/dL, there may be a need to adjust the current insulin regimen or add an oral antidiabetic agent to improve glycemic control.

Question 10

The nurse is teaching a patient how to administer insulin. The patient is thin with very little body fat. The nurse will suggest injecting insulin:&#10;A) by pinching up the skin and injecting straight down.&#10;B) in the abdomen only with the needle at a 90-degree angle.&#10;C) subcutaneously with the needle at a 45- to 60-degree angle.&#10;D) using the thigh and buttocks areas exclusively.

Accepted Answer

Subcutaneous injection of insulin should be given at a 45- to 60-degree angle in patients who are thin with very little body fat. This allows for proper absorption of insulin and reduces the risk of injecting into muscle tissue. Additionally, rotating injection sites between the abdomen, thigh, and buttocks can reduce the risk of developing lipohypertrophy.

Question 11

The nurse will administer parenteral insulin to a patient who will receive a mixture of NPH (Humulin NPH) and regular (Humulin R). The nurse will give this medication via which route?&#10;A) Intradermal&#10;B) Intramuscular&#10;C) Intravenous&#10;D) Subcutaneous

Accepted Answer

The answer of The nurse will administer parenteral insulin to...

Question 12

Which statement by a patient who will begin using an insulin pump indicates understanding of this device?&#10;A) &#34;I will have an increased risk for hypoglycemia.&#34;&#10;B) &#34;I will leave this on when bathing or swimming.&#34;&#10;C) &#34;I will not need to count carbohydrates anymore.&#34;&#10;D) &#34;I will still need to monitor serum glucose.&#34;

Accepted Answer

The answer of Which statement by a patient who will...

Question 13

The parent of a junior high school child who has type 1 diabetes asks the nurse if the child can participate in sports. The nurse will tell the parent:&#10;A) that strenuous exercise is not recommended for children with diabetes.&#10;B) that the child must be monitored for hyperglycemia while exercising.&#10;C) to administer an extra dose of regular insulin prior to exercise.&#10;D) to send a snack with the child to eat just prior to exercise.

Accepted Answer

The answer of The parent of a junior high school...

Question 14

A patient who is unconscious and has a pulse is brought to the emergency department. The patient is wearing a Medic-Alert bracelet indicating type 1 diabetes mellitus. The nurse will anticipate an order to administer:

A) cardiopulmonary resuscitation (CPR).
B) glucagon.
C) insulin.
D) orange juice.

Accepted Answer

The answer of A patient who is unconscious and has...

Question 15

The nurse is teaching a group of nursing students about diabetes. The nurse explains that which type of diabetes is the most common?&#10;A) Type 1 diabetes mellitus&#10;B) Type 2 diabetes mellitus&#10;C) Diabetes insipidus&#10;D) Secondary diabetes

Accepted Answer

The answer of The nurse is teaching a group of...

Question 16

A patient is ordered to receive insulin lispro at mealtimes. The nurse will instruct this patient to administer the medication at which time?&#10;A) 10-15 min before eating&#10;B) 15 min after eating&#10;C) 30 min before eating&#10;D) 10 min after eating

Accepted Answer

The answer of A patient is ordered to receive insulin...

Question 17

A patient who has type 1 diabetes mellitus must take a glucocorticoid medication for osteoarthritis. When teaching this patient, the nurse will explain that there may be a need to:&#10;A) decrease the glucocorticoid dose.&#10;B) decrease the insulin dose.&#10;C) increase the glucocorticoid dose.&#10;D) increase the insulin dose.

Accepted Answer

The answer of A patient who has type 1 diabetes...

Question 18

A patient who has type 1 diabetes mellitus asks the nurse about using a combination insulin product such as Humalog 70/30. The nurse will tell the patient that use of this product:&#10;A) depends on individual insulin needs.&#10;B) is useful for patients with severe insulin resistance.&#10;C) means less rotation of injection sites.&#10;D) requires refrigeration at all times.

Accepted Answer

The answer of A patient who has type 1 diabetes...

Deck 47: Antidiabetics