Deck 35: Drugs Used to Treat Diabetes Mellitus

Question 1

Which instruction is most important for the nurse to teach a patient with diabetes who is receiving metformin?

A) Take the medication before meals.
B) This medication will cause the pancreas to secrete more insulin.
C) Stop taking the drug 24 to 48 hours prior to radiopaque dye procedures.
D) There may be an increase in the triglyceride level.

Answer 1

Stop taking the drug 24 to 48 hours prior to radiopaque dye procedures.

Question 2

A patient with type 2 diabetes mellitus,which was previously controlled with an oral antidiabetic agent,is hospitalized for treatment of a leg ulcer.The health care provider has ordered sliding scale insulin coverage with regular insulin for hyperglycemia.The nurse brings the injection into the room,and the patient becomes upset,stating "I don't want to start taking that drug! I'll need it the rest of my life." What is the nurse's best response?

A) "This is the same drug as the oral medication you were taking. It's a stronger dose while you are in the hospital."
B) "Don't worry. You shouldn't need this too often. As you feel better, your blood glucose level will drop."
C) "Your body is under stress right now, which raises your blood glucose level. This does not mean you will be on this drug permanently. Once you're feeling better, your provider will determine if your oral medication is all you will need."
D) "Your disease is progressing and your pancreas is producing less insulin. I know this is a hard time for you. Do you want to talk about it?"

Answer 2

"Your body is under stress right now, which raises your blood glucose level. This does not mean you will be on this drug permanently. Once you're feeling better, your provider will determine if your oral medication is all you will need."

Question 3

It is 2:00 PM and a patient who has been NPO since 12:00 AM for a bronchoscopy is complaining of a headache and shakiness and is extremely irritable.Vital signs are within normal limits,and a one touch glucose reads 50 mg/dL.Which action is most important for the nurse to take?

A) Have the patient eat a snack and drink milk.
B) Administer glucagon subcutaneously.
C) Call the bronchoscopy room to follow up with the delay.
D) Obtain an A1c test.

Answer 3

Administer glucagon subcutaneously.

Question 4

Which statement(s)regarding gestational diabetes would be true?

A) It is diagnosed in about 2% of all pregnancies in the United States.
B) It includes diabetic women who become pregnant.
C) Fetal development may be complicated as a result of gestational diabetes.
D) The risk of developing diabetes after pregnancy is increased.
E) Most women with gestational diabetes have normal glucose tolerance postpartum.
F) Women need to be reevaluated postpartum to determine their classification with respect to glucose tolerance.

Question 5

A 65-year-old man is diagnosed with type 2 diabetes mellitus.Which patient symptom(s)would indicate type 1 diabetes mellitus and not type 2?

A) Impotence
B) Increased thirst over the past week
C) A 10-pound weight loss within the past month
D) Polyphagia
E) Ketoacidosis

Question 6

After a blood glucose reading,it is determined that the patient should receive 4 units of Lispro and 8 units of NPH.Which action will the nurse take to administer these medications?

A) Draw up each insulin in separate syringes and administer two injections.
B) Draw up the NPH first and then the Lispro using the same syringe.
C) Administer the Lispro before the meal and the NPH after the meal.
D) Draw up the Lispro first and then the NPH using the same syringe.

Question 7

What laboratory test is the preferred screening test for diabetes in children and nonpregnant adults?

A) FPG
B) ECG
C) GTT
D) A1c

Question 8

Which instruction by the nurse is accurate to include when providing teaching to a patient recently diagnosed with diabetes who has been prescribed insulin?

A) Beta blockers can mask symptoms of hypoglycemia.
B) Lipodystrophy increases the absorption of insulin.
C) Infection will decrease the need for insulin.
D) Excessive exercise will increase the need for insulin.

Question 9

The nurse is administering sulfonylurea drugs to four different patients diagnosed with type 2 diabetes.Which patient should not receive the medication as ordered?

A) A 42-year-old man with hypertension
B) A 50-year-old woman with shingles
C) An 80-year-old woman with an allergy to sulfa
D) A 37-year-old man with a blood glucose level of 140

Question 10

What test determines glycemic control over the previous 8 to 10 weeks?

A) 24-hour glucose clearance test (GTT)
B) Fructosamine test
C) Fasting blood sugar (FBS)
D) A1c test

Question 11

Which dietary control measures are used in the management of diabetes mellitus?

A) Specific daily caloric requirements
B) Consistent carbohydrate diabetes meal plan
C) 50% intake of carbohydrates daily
D) Adjustments to daily meals according to age, metabolic stress, pregnancy, and advanced age and/or older adults
E) 20% intake of proteins daily

Question 12

The patient asks the nurse how sulfonylureas normalize glucose levels.Which response by the nurse is correct?

A) By stimulating pancreatic secretion of insulin
B) By inhibiting secretion of insulin by the pancreas
C) By increasing glucose production in the liver
D) By increasing insulin metabolism in the liver

Question 13

A third subclass of diabetes mellitus includes additional types of diabetes that are part of other diseases having features not generally associated with the diabetic state.Which disorder(s)may have an associated diabetic component?

A) Patients receiving high-dose corticosteroid therapy for disease maintenance
B) Cushing's syndrome
C) Alzheimer's disease
D) Acromegaly
E) Malnutrition

Question 14

When is the best time for the nurse to administer Lispro?

A) After the patient has started eating
B) Within 10 to 15 minutes of eating
C) 30 minutes before a meal
D) 45 to 60 minutes before a meal

Question 15

The nurse is educating a patient with diabetes mellitus regarding urine testing for ketones.Information provided will include that ketone testing should be done

A) when illness occurs.
B) during pregnancy.
C) before and after physical exercise.
D) when blood glucose is above usual range.
E) every morning upon awakening.

Question 16

The nurse is instructing a patient about insulin administration.Which statement by the patient indicates a need for further teaching?

A) "I may need more insulin if I have surgery."
B) "Once I open my insulin, I will store it in the refrigerator."
C) "I will date the insulin bottle when I open it."
D) "I will keep a spare bottle of insulin on hand."

Question 17

A patient received the evening dose of Lispro subcutaneously at 16:30.What time will symptoms of hypoglycemia likely occur?

A) 19:00
B) 18:30
C) 01:30
D) 06:00

Question 18

Which statement(s)regarding type 2 diabetes mellitus would be correct?

A) Type 2 diabetes is more prevalent in overweight people older than 45 years.
B) A genetic predisposition exists for the development of type 2 diabetes mellitus.
C) Type 2 diabetes requires lifelong insulin replacement.
D) Type 2 diabetes is often diagnosed after complications have resulted.
E) Women have a higher incidence of type 2 diabetes.

Question 19

Which is most important for the successful management of diabetes mellitus?

A) A network of community resources
B) The level of self-management
C) Preventative education
D) Frequent follow-up with the health care provider

Question 20

The nurse is caring for a patient with a new diagnosis of type 1 diabetes mellitus.When assisting with the plan of care,which goal set by the patient will require revision?

A) Patient will participate in 20 minutes of cardiovascular exercise 5 days a week.
B) Patient will discontinue insulin use within 1 year.
C) Patient will consume 20% of caloric intake from fat.
D) Patient will demonstrate accurate self-glucose testing skills.