Deck 44: Drugs for Diabetes Mellitus

Question 1

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?
1)The 38-year-old client who smokes one pack of cigarettes per day
2)The 42-year-old client who is 50 pounds overweight
3)The 50-year-old client who does not get any physical exercise
4)The 56-year-old client who drinks three glasses of wine each evening

Answer 1

2

Question 2

Insulin is released when
1)blood glucose stays the same.
2)blood glucose increases.
3)blood glucose decreases.
4)glucagon increases.

Answer 2

2

Question 3

A client has been prescribed exenatide (Byetta).What medication education should the nurse provide? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"Drink an 8 ounce glass of water with this pill."
2)"You should take this medication twice each day."
3)"You may experience dryness of the mouth while taking this drug."
4)"You may develop diarrhea while taking this drug."
5)"This drug will help you secrete more insulin."

Answer 3

2,4,5

Question 4

The physician writes orders for the client with diabetes mellitus.Which order would the nurse validate with the physician?
1)Lantus insulin 20U BID
2)Administering regular insulin 30 minutes prior to meals
3)5 units of Humalog/10 units NPH daily
4)Metformin (Glucophage)1000 mg per day in divided doses

Question 5

The physician orders insulin lispro (Humalog),10 units for the client.When will the nurse administer this medication?
1)Thirty minutes before meals
2)Five minutes before a meal
3)When the meal trays arrive on the floor
4)Fifteen minutes after meals

Question 6

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?
1)"I should only use a calibrated insulin syringe for the injections."
2)"I should check my blood sugar immediately prior to the administration."
3)"I should use the abdominal area only for insulin injections."
4)"I should provide direct pressure over the site following the injection."

Question 7

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? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"There must have been something you were exposed to during your pregnancy that caused it."
2)"Are there others in your family that have type 1 diabetes?"
3)"He must have been allowed to eat too much sugar."
4)"We are not certain what causes type 1 diabetes."
5)"It is thought to be a combination of factors."

Question 8

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?
1)Have the client place the insulin vials in the refrigerator.
2)Have the client discard the vials.
3)Instruct the client to label each vial with the date when opened.
4)Tell the client this is too much insulin to have on hand.

Question 9

A client with diabetes mellitus type 1 is found unresponsive in the clinical setting.Which nursing action is a priority?
1)Call a code.
2)Treat the client for hypoglycemia.
3)Call the physician STAT.
4)Assess the client's vital signs.

Question 10

Which sign or symptom is most typical of an untreated client with type 1 diabetes?
1)Increased energy
2)Weight gain
3)Fatigue
4)Decreased hunger

Question 11

The client has type 1 diabetes and receives insulin.He asks the nurse why he can't just take pills instead.What is the best response by the nurse?
1)"I know it is tough,but you will get used to the shots soon."
2)"Have you talked to your doctor about taking pills instead?"
3)"Insulin can't be in a pill because it is destroyed in stomach acid."
4)"Insulin must be injected because it needs to work quickly."

Question 12

The client receives metformin (Glucophage).What will the best plan by the nurse include with regard to patient education with this drug? Credit will be given only if all correct choices and no incorrect choices are selected.
1)It decreases sugar production in the liver.
2)It inhibits absorption of carbohydrates.
3)It stimulates the pancreas to produce more insulin.
4)It reduces insulin resistance.
5)It increases energy use.

Question 13

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? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"Problems with arteries can occur that may cause such problems as heart disease,stroke,kidney disease,or blindness."
2)"Let's not talk about that now,but rather focus on keeping you healthy."
3)"You could have nerve problems that lead to numbness or tingling in your feet or hands."
4)"One of the most serious complications is diabetic ketoacidosis."
5)"You may experience inability to think and difficulty with memory."

Question 14

What is the primary function of the islets of Langerhans in the pancreas?
1)Secretion of enzymes
2)Acting as exocrine
3)Secretion of glucagon and insulin
4)Absorption of insulin

Question 15

The client has type 1 diabetes mellitus and receives insulin.Which laboratory test will the nurse assess?
1)Potassium
2)Serum amylase
3)AST (aspartate aminotransferase)
4)Sodium

Question 16

The client has diabetes type 1 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?
1)The alcohol could cause pancreatic disease and decrease insulin production.
2)The alcohol could predispose you to hypoglycemia.
3)The alcohol could cause serious liver disease.
4)The alcohol could predispose you to hyperglycemia.

Question 17

The mechanism of action of regular insulin is to
1)stimulate the pancreas to produce insulin.
2)promote entry of glucose into the cells.
3)promote the entry of glucose into the bloodstream.
4)stimulate the pancreas to secrete more insulin.

Question 18

The client injects his insulin as prescribed,but then gets busy and forgets to eat.What is the nurse's most likely assessment finding?
1)The client will be very thirsty.
2)The client will need to urinate.
3)The client will have moist skin.
4)The client will complain of nausea.

Question 19

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?
1)Notify the diagnostic department and request orders.
2)Notify the physician and request orders.
3)Administer the oral agents immediately after the test.
4)Administer the oral agents with a sip of water before the test.

Question 20

The nurse understands that which of the following drugs falls under the classification of biguanides?
1)Metformin HCI (Glucophage)
2)Repaglinide (Prandin)
3)Tolbutamide (Orinase)
4)Acarbose (Precose)

Question 21

A nurse has provided education regarding type 2 diabetes to a newly diagnosed client.Which statements would the nurse interpret as indicating need for additional education? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"Well,at least the medications I will be on will help me lose weight."
2)"I can take an oral medication and will never have to inject myself."
3)"I can increase my body's ability to use the insulin I make by exercising regularly."
4)"I have several lifestyle changes to make."
5)"I don't run the risk of blindness and kidney disease like type 1 diabetics."