Deck 45: Drugs for Diabetes Mellitus

Question 1

The client receives metformin (Glucophage). What will the best plan by the nurse include with regard to patient education with this drug?

A) It decreases sugar production in the liver.
B) It inhibits absorption of carbohydrates.
C) It stimulates the pancreas to produce more insulin.
D) It reduces insulin resistance.
E) It increases energy use.

Answer 1

It decreases sugar production in the liver.
It reduces insulin resistance.

Question 2

The nurse makes a home visit to a client with diabetes mellitus. During the visit, the nurse notes that the client's 3-month supply of insulin vials that were delivered a week ago are not refrigerated. What is the best action by the nurse at this time?

A) Instruct the client that the insulin should be stored away from direct sunlight or excessive heat.
B) Have the client discard the vials.
C) Instruct the client to label each vial with the date when opened.
D) Tell the client this is too much insulin to have on hand.

Answer 2

Instruct the client that the insulin should be stored away from direct sunlight or excessive heat.

Question 3

Insulin is released when

A) blood glucose stays the same.
B) blood glucose increases.
C) blood glucose decreases.
D) glucagon increases.

Answer 3

blood glucose increases.

Question 4

The physician writes orders for the client with diabetes mellitus. Which order would the nurse validate with the physician?

A) Lantus insulin 20U BID
B) Administering regular insulin 30 minutes prior to meals
C) 5 units of Humalog/10 units NPH daily
D) Metformin (Glucophage) 1000 mg per day in divided doses

Question 5

The mechanism of action of regular insulin is to

A) stimulate the pancreas to produce insulin.
B) promote entry of glucose into the cells.
C) promote the entry of glucose into the bloodstream.
D) stimulate the pancreas to secrete more insulin.

Question 6

The client has type 1 diabetes mellitus and receives insulin. Which laboratory test will the nurse assess?

A) Potassium
B) Serum amylase
C) AST (aspartate aminotransferase)
D) Sodium

Question 7

The client has type 2 diabetes mellitus. The nurse has taught the client about the illness and evaluates that learning has occurred when the client makes which statement?

A) "My beta cells just cannot produce enough insulin for my cells."
B) "My peripheral cells have increased sensitivity to insulin."
C) "My cells have increased their receptors, but there is not enough insulin."
D) "My cells cannot use the insulin my pancreas makes."

Question 8

What is the primary function of the islets of Langerhans in the pancreas?

A) Secretion of enzymes
B) Acting as exocrine
C) Secretion of glucagon and insulin
D) Absorption of insulin

Question 9

The client has been diagnosed with type 1 diabetes mellitus. He asks the nurse what this means. What is the best response by the nurse?

A) "The exocrine function of your pancreas is to secrete insulin, and it is not working."
B) "Without insulin you will develop ketoacidosis (DKA)."
C) "The endocrine function of your pancreas is to secrete insulin, but it isn't working."
D) "Your alpha cells should be able to secrete insulin, but cannot."
E) "It means your pancreas cannot secrete insulin."

Question 10

The client has type 1 diabetes mellitus and receives insulin. He asks the nurse why he can't just take pills instead. What is the best response by the nurse?

A) "I know it is tough, but you will get used to the shots soon."
B) "Have you talked to your doctor about taking pills instead?"
C) "Insulin can't be in a pill because it is destroyed in stomach acid."
D) "Insulin must be injected because it needs to work quickly."

Question 11

The client injects his insulin as prescribed but then gets busy and forgets to eat. What is the nurse's most likely assessment finding?

A) The client will be very thirsty.
B) The client will need to urinate.
C) The client will have moist skin.
D) The client will complain of nausea.

Question 12

The nurse has finished teaching a client with diabetes mellitus how to administer insulin. The nurse evaluates that learning has occurred when the client makes which statement?

A) "I should only use a calibrated insulin syringe for the injections."
B) "I should check my blood sugar immediately prior to the administration."
C) "I should use the abdominal area only for insulin injections."
D) "I should provide direct pressure over the site following the injection."

Question 13

A client with diabetes mellitus is taking oral agents and is scheduled for a diagnostic test that requires him to be NPO (nothing by mouth) and to have contrast dye. What is the best plan by the nurse with regard to giving the client his oral medications?

A) Notify the diagnostic department and request orders.
B) Notify the physician and request orders.
C) Administer the oral agents immediately after the test.
D) Administer the oral agents with a sip of water before the test.

Question 14

The nurse teaches a class for the public about diabetes mellitus. Which individual does the nurse assess as being at highest risk for developing diabetes?

A) The 38-year-old client who smokes one pack of cigarettes per day
B) The 42-year-old client who is 50 pounds overweight
C) The 50-year-old client who does not get any physical exercise
D) The 56-year-old client who drinks three glasses of wine each evening

Question 15

A client with diabetes mellitus type 1 is found unresponsive in the clinical setting. Which nursing action is a priority?

A) Call a code.
B) Treat the client for hypoglycemia.
C) Call the physician STAT.
D) Assess the client's vital signs.

Question 16

The client has type 1 diabetes mellitus and receives insulin for glycemic control. The client tells the nurse that she likes to have a glass of wine with dinner. What will the best plan by the nurse for client education include?

A) The alcohol could cause pancreatic disease and decrease insulin production.
B) The alcohol could predispose you to hypoglycemia.
C) The alcohol could cause serious liver disease.
D) The alcohol could predispose you to hyperglycemia.

Question 17

Which sign or symptom is most typical of an untreated client with type 1 diabetes?

A) Increased energy
B) Weight gain
C) Fatigue
D) Decreased hunger

Question 18

The physician orders insulin lispro (Humalog), 10 units for the client. When will the nurse administer this medication?

A) Thirty minutes before meals
B) Five minutes before a meal
C) When the meal trays arrive on the floor
D) Fifteen minutes after meals

Question 19

The nurse understands that which following drug falls under the classification of biguanides?

A) Metformin HCI (Glucophage)
B) Repaglinide (Prandin)
C) Tolbutamide (Orinase)
D) Acarbose (Precose)

Question 20

The physician orders intravenous (IV) insulin for the client with a blood sugar of 56
1) The nurse used the correct insulin.
2) The nurse should have contacted the physician prior to administration.
3) The nurse administers insulin lispro (Humalog) intravenously (IV). What does the best evaluation by the nurse reveal?
3) The nurse should have used regular insulin (Humulin R).
4) The nurse could have given the insulin subcutaneously.

Question 21

A patient was prescribed chlorpropamide (Diabinese) for treatment of type 2 diabetes mellitus. One week after therapy was initiated, the patient comes to the clinic with report of nausea, flushing, and palpitations. The nurse prioritizes which assessment question?

A) "Have you taken your medication as directed?"
B) "Did you eat or drink anything new this week?"
C) "Have you increased the amount of fiber in your diet?"
D) "Did you drink any alcoholic beverages this week?"

Question 22

A nurse is reviewing the blood work of a client who has recently begun treatment for type 2 diabetes. Which results would indicate that the client is on target with therapy?

A) HBA1C level is 8.4%.
B) HBA1C level is 6.3%.
C) Fasting blood glucose is 130 g/dL.
D) Fasting blood glucose is 100 g/dL.
E) Fasting blood glucose is 68 g/dL.

Question 23

A nurse has provided education regarding type 2 diabetes mellitus to a newly diagnosed client. Which statements would the nurse interpret as indicating need for additional education?

A) "Well, at least the medications I will be on will help me lose weight."
B) "I can take an oral medication and will never have to inject myself."
C) "I can increase my body's ability to use the insulin I make by exercising regularly."
D) "I have several lifestyle changes to make."
E) "I don't run the risk of blindness and kidney disease like type 1 diabetics."

Question 24

A patient who has recently been diagnosed with type 1 diabetes mellitus will require insulin therapy. The patient states, "I guess I will have to give up the half bottle of wine I drink at dinner." Which information should the nurse provide?

A) "Wine is not permitted on your diet."
B) "You can drink as much wine as you would like but avoid hard liquor."
C) "Limit your wine to a time when you are eating a complete meal."
D) "Limit your wine to one glass a day."
E) "Milk is a better choice for you so substitute it for wine."

Question 25

The mother of a 4-year-old boy states, "I can't believe my son has type 1 diabetes. We eat well and I was so careful during the pregnancy. What could have caused this?" How should the nurse respond?

A) "There must have been something you were exposed to during your pregnancy that caused it."
B) "Are there others in your family who have type 1 diabetes?"
C) "He must have been allowed to eat too much sugar."
D) "We are not certain what causes type 1 diabetes."
E) "It is thought to be a combination of factors."

Question 26

The diabetes educator would teach a patient that different types of insulin have different onsets of action. Arrange these types of insulin in order of the onset starting with the quickest onset.
1) Insulin detemir (Levemir)
2) Insulin glulisine (Apidra)
3) Insulin lispro (Humalog)
4) Regular insulin (Humulin R)
5) Insulin isophane (NPH)
Standard Text: Click and drag the options below to move them up or down.

Question 27

A client has been prescribed exenatide (Byetta). What medication education should the nurse provide?

A) "Drink an 8-ounce glass of water with this pill."
B) "You should take this medication twice each day."
C) "You may experience dryness of the mouth while taking this drug."
D) "You may develop diarrhea while taking this drug."
E) "This drug will help you secrete more insulin."

Question 28

A patient with type 1 diabetes mellitus is maintained on insulin. The patient has decided to participate in a sports tournament at work. Which information would the nurse provide regarding diet and insulin?

A) "Do not take your insulin the morning of a game."
B) "Plan on eating a big meal after your game."
C) "Take an oral hypoglycemic agent on game days rather than insulin."
D) "Eat something before the game and drink a sports drink during the game."

Question 29

A patient who takes insulin states, "My blood glucose has been low the last few mornings." Which statement would the nurse evaluate as a possible cause of this change?

A) "I have been taking a garlic supplement to prevent colds."
B) "I have been taking St. John's wort to help with my memory."
C) "I have been taking extra vitamin C since so many people have influenza."
D) "I have been taking vitamin D to help build up my bones."

Question 30

A client, newly diagnosed with type 1 diabetes, says, "I have heard this is a bad disease. What complications could I have?" How should the nurse respond?

A) "Problems with arteries can occur that may cause such problems as heart disease, stroke, kidney disease, or blindness."
B) "Let's not talk about that now, but rather focus on keeping you healthy."
C) "You could have nerve problems that lead to numbness or tingling in your feet or hands."
D) "One of the most serious complications is diabetic ketoacidosis."
E) "You may experience inability to think and difficulty with memory."