Deck 66: Pharmacotherapy of Diabetes Mellitus

Question 1

A client is acutely confused,sweating,and complaining of a headache.The nurse suspects hypoglycemia.The nurse's next action is to obtain:

A)a serum blood glucose.
B)a glucose tolerance test.
C)serum electrolytes.
D)a capillary blood glucose level.

Answer 1

a capillary blood glucose level.

Question 2

When teaching a client about a prescribed second-generation sulfonylurea for blood glucose control,the nurse explains that the advantage of this medication is that it:

A)exhibits fewer drug-drug interactions.
B)does not cause hypoglycemia.
C)can be administered in smaller doses.
D)causes fewer adverse effects.

Answer 2

exhibits fewer drug-drug interactions.

Question 3

The nurse,preparing medications for a client with diabetes,recognizes that what percentage of adults with diabetes take oral agents only?

A)60-70%
B)30-40%
C)50-60%
D)40-50%

Answer 3

50-60%

Question 4

A client with diabetes is experiencing polyuria.The nurse explains that polyuria is caused by:

A)inflammation of the glomerulus.
B)excessive fluid intake.
C)lack of albumin.
D)osmotic diuresis.

Question 5

When instructing a client with diabetes about glucose balance,the nurse explains that following a meal,glucose that is not needed for immediate energy needs is stored as:

A)muscle tissue.
B)glycogen.
C)fat.
D)glucagon.

Question 6

The nurse is instructing a client on the effects of insulin.What will the nurse include as the primary adverse effect?

A)Somogyi phenomenon
B)Swollen lymph glands
C)Hypoglycemia
D)Urticaria

Question 7

A client is scheduled for a hemoglobin A1c laboratory test.The nurse explains to the client that this test monitors:

A)the percentage of glucagon in the blood.
B)the level of hemoglobin over time.
C)the percentage of glucose present in the blood.
D)the level of glucose over time.

Question 8

The nurse should instruct a client to avoid which substance while taking a sulfonylurea medication?

A)Antacids
B)Calcium products
C)Alcohol
D)Antibiotics

Question 9

What should the nurse instruct a client who is diagnosed with diabetes?
Select all that apply.

A)Have eye examinations every 2 to 3 years.
B)Monitor blood pressure carefully.
C)Check feet daily for signs of irritation.
D)Maintain glucose control.
E)Quit smoking.

Question 10

The nurse explains that the difference between diabetic ketoacidosis (DKA)and hyperosmolar hyperglycemic state (HHS)is that clients with HHS:

A)do not manifest ketoacidosis.
B)are dehydrated.
C)are confused.
D)have elevated glucose levels.

Question 11

Prior to administering glyburide,the nurse will review a client's allergies because this medication is contraindicated in clients who are allergic to:

A)urea.
B)milk products.
C)eggs.
D)sulfa drugs.

Question 12

A client is prescribed insulin via the intravenous (IV)route.Which insulin will the nurse administer to this client?

A)Glulisine
B)Regular
C)Aspart
D)Lispro

Question 13

Even though the normal range for serum glucose is 60-100 mg/dL,the body usually tightly regulates this level to:

A)90-100 mg/dL.
B)80-90 mg/dL.
C)60-70 mg/dL.
D)70-80 mg/dL.

Question 14

What will the nurse describe to a client as risk factors for developing type 2 diabetes?
Select all that apply.

A)Ethnicity
B)Age below 45
C)Obesity
D)Race
E)Family history

Question 15

The nurse,instructing a group of community members on chronic health problems,explains that the leading cause of blindness in the United States is:

A)glaucoma.
B)cataracts.
C)hypertension.
D)diabetic retinopathy.

Question 16

When caring for a client with diabetes,the nurse knows that the client is experiencing a breakdown of fatty acids for fuel because of which serum laboratory finding?

A)Leukocytes
B)Protein
C)Glucose
D)Ketones

Question 17

A client is prescribed the insulin with the least rapid onset.Which insulin will the nurse administer to this client?

A)Glulisine
B)Regular
C)Aspart
D)Lispro

Question 18

Which body tissue or organ cannot synthesize glucose for its energy supply?

A)The kidneys
B)The lungs
C)The heart
D)The brain

Question 19

When instructing a client,the nurse explains that the primary factor contributing to the development of type 2 diabetes is:

A)age.
B)ethnicity.
C)a sedentary lifestyle.
D)obesity.

Question 20

Which drug would alter a client's ability to recognize the symptoms of hypoglycemia?

A)beta blockers
B)antibiotics
C)diuretics
D)oral hypoglycemic agents

Question 21

What dietary instructions should the nurse provide a client who is prescribed repaglinide (Prandin)?
Select all that apply.

A)Do not take with grapefruit juice.
B)Avoid using garlic.
C)Drink decaffeinated beverages only.
D)Avoid green leafy vegetables.
E)Limit the intake of milk products.

Question 22

Which client statements indicate to the nurse that instruction about type 2 diabetes mellitus and insulin resistance has been effective?
Select all that apply.

A)Exercise will improve insulin resistance."
B)Eating a healthy diet will reverse insulin resistance."
C)Exercise will cure type 2 diabetes mellitus."
D)Eating a healthy diet will cure type 2 diabetes mellitus."
E)I can eat anything I want as long as I exercise afterwards."

Question 23

What should the nurse include when teaching a client about insulin?
Select all that apply.

A)Rotate injection sites.
B)Recognize the signs of hypoglycemia.
C)Store insulin in the freezer.
D)Carry a readily available supply of sugar.
E)Wear a medic alert bracelet that explains the client has diabetes.

Question 24

The nurse knows that the prescribed dose of insulin should not be administered in to a client whose blood glucose is lower than:

A)70 mg/dL.
B)80 mg/dL.
C)90 mg/dL.
D)100 mg/dL.

Question 25

The nurse decides to withhold a prescribed dose of metformin to a client after reviewing the medical record.For which conditions is this medication contraindicated or used with caution?
Select all that apply.

A)Impaired renal function
B)Congestive heart failure
C)Hyperthyroidism
D)Septicemia
E)Sleep apnea

Question 26

Which statements indicate that instruction provided to a client with type 1 diabetes mellitus regarding exercise has been effective?
Select all that apply.

A)I should start any new exercise regimen slowly."
B)I should exercise an hour after a meal."
C)I should have a snack of 10 to 15 grams of carbohydrate before exercising."
D)I should take 10- to 15-gram carbohydrate snacks with me to the gym if I plan to exercise longer than 30 minutes."
E)I should withhold my routine insulin dose if I plan to exercise that day."

Question 27

The nurse is concerned that a client is at risk for developing gestational diabetes after collecting which assessment data?
Select all that apply.

A)Family history
B)Obesity
C)Previous spontaneous abortion
D)Sedentary lifestyle
E)Diagnosis of hypertension

Question 28

The nurse is planning care for a client with diabetic ketoacidosis.What interventions will the nurse most likely perform for this client?
Select all that apply.

A)Administer intravenous fluids as prescribed
B)Administer a loading dose of intravenous insulin as prescribed
C)Administer electrolyte replacements as prescribed
D)Administer intravenous antibiotics as prescribed
E)Administer nebulized bronchodilators as prescribed

Question 29

After an assessment,the nurse suspects that a client is experiencing signs of type 2 diabetes mellitus.What did the nurse assess in this client?
Select all that apply.

A)Excessive urination
B)Excessive thirst
C)Blurred vision
D)Tingling of the fingers and toes
E)Itchy skin rash

Question 30

What should the nurse teach a client with diabetes about how to reduce the risk of cardiovascular complications from the disorder?
Select all that apply.

A)Stop smoking.
B)Follow a low-fat diet.
C)Take blood pressure medication as prescribed.
D)Keep blood glucose levels within normal limits.
E)Prevent constipation.

Question 31

The nurse is instructing a client on the role of the pancreas in controlling blood glucose levels.When does the pancreas excrete glucagon to maintain an adequate amount of glucose in the blood?
Select all that apply.

A)During periods of fasting
B)During exercise
C)When drinking alcohol
D)After eating a large meal
E)When fighting an infection

Question 32

When administering insulin to a client,the nurse will rotate injection sites primarily to prevent:

A)systemic absorption of insulin.
B)lipodystrophy.
C)abscess development.
D)ineffective dosing.

Question 33

When reviewing a client's current medications,the nurse is concerned that the insulin dose will need to be adjusted because the client is currently prescribed which medications?
Select all that apply.

A)Beta blocker
B)Monoamine oxidase inhibitor
C)Angiotensin-converting enzyme inhibitor
D)Cardiac glycoside
E)Nonsteroidal anti-inflammatory agents