Deck 49: Drugs Affecting Conditions of the Pancreas

Question 1

The nurse expects that a dose of NPH insulin will have an onset of action in approximately

A) 30 minutes.
B) 3 hours.
C) 6 hours.
D) 9 hours.

Answer 1

3 hours.

Question 2

A client with diabetes mellitus receives a breakfast tray from the dietary unit at 07:30.If the client has an order for a morning dose of insulin lispro (Humalog),the nurse should plan to administer the dose at which of the following optimal times?

A) 06:45
B) 07:00
C) 07:30
D) 08:15

Answer 2

07:30

Question 3

The nurse explains to a client that synthesized human insulin is preferred for treatment of insulin-dependent diabetes mellitus because it has which of the following characteristics?

A) Longer duration of action
B) Slower absorption rate
C) Less antigenicity
D) Greater resistance

Answer 3

Less antigenicity

Question 4

Type 1 diabetes is generally characterized by

A) morbid obesity.
B) insulin deficiency.
C) chronic osmotic diarrhea.
D) persistent oliguria.

Question 5

The nurse would assess a client with diabetes for which of the following early signs and symptoms of hypoglycemia during times of peak insulin action?

A) Anorexia
B) Headache
C) Restlessness
D) Diaphoresis

Question 6

The nurse anticipates that a pregnant client will receive which of the following drugs to control diabetes?

A) Glucotrol
B) Diabinese
C) Insulin
D) Micronase

Question 7

The physician writes an order for the following: 10 units regular insulin with 40 units NPH at 0700.When administering the insulins,the nurse is careful to

A) draw the regular or unmodified insulin into the syringe first.
B) inform the client that mixing insulins will help increase insulin production.
C) rotate sites at least once weekly and label the sites used on a diagram.
D) use a 23- to 25-gauge syringe with a 1-inch needle for maximal absorption.

Question 8

The nurse would place highest priority on monitoring the results of which of the following serum electrolytes during initial treatment of diabetic ketoacidosis with regular intravenous insulin?

A) Sodium
B) Potassium
C) Calcium
D) Magnesium

Question 9

The nurse explains during a teaching session with a diabetic client that insulin has which of the following drug effects?

A) It increases free fatty acid catabolism
B) It minimizes amino acid catabolism
C) It enhances carbohydrate metabolism
D) It decreases protein metabolism

Question 10

A 79-year-old woman with type 2 diabetes has recently been placed on glipizide (Glucotrol)5 mg by mouth four times a day.She needs to receive instructions about which of the following drug interactions?

A) Acetaminophen (Tylenol)
B) Sodium warfarin (Coumadin)
C) Tetracycline
D) Erythromycin (EES)

Question 11

The nurse would administer glipizide (Glucotrol)tablets cautiously to which of the following clients?

A) An older adult client
B) A client with type 2 diabetes
C) A client with a blood urea nitrogen level of 12
D) A middle-aged client with type 2 diabetes

Question 12

Significant drug interactions to be alert for while administering insulin to clients include which of the following?

A) Aspirin
B) $\beta$ -adrenergic blockers
C) $\alpha$ -agonists
D) Codeine

Question 13

The nurse would look to which of the following laboratory tests as the most comprehensive evaluation of diabetic control?

A) Urine glucose
B) Serum glucose
C) Hemoglobin
D) Hemoglobin A1c

Question 14

The nurse would assess a client with diabetes for which of the following possible adverse effects of glipizide (Glucotrol)?

A) Nervousness
B) Increased appetite
C) Euphoria
D) Photosensitivity

Question 15

A 62-year-old client was newly diagnosed with diabetes within the last 2 weeks.The home health nurse making a follow-up visit determines that the client has reached an optimal degree of diabetic control when which fasting blood glucose result is obtained?

A) 70 mg/dL
B) 92 mg/dL
C) 118 mg/dL
D) 130 mg/dL

Question 16

The nurse who hears that a client with diabetes will be receiving a long-acting insulin expects to see a new order for which of the following drugs?

A) Human insulin (Humulin N)
B) Insulin aspart (NovoLog)
C) Insulin lispro (Humalog)
D) Insulin glargine (Lantus)

Question 17

A client is receiving intravenous regular insulin to treat diabetic ketoacidosis.The nurse determines that the client is having the safest rate of decline of blood glucose if the level drops no more than what amount in 1 hour?

A) 25 mg/dL
B) 50 mg/dL
C) 100 mg/dL
D) 200 mg/dL

Question 18

The nurse suspects that a client receiving diazoxide (Proglycem)has which of the following health problems?

A) Non-insulin-dependent diabetes mellitus
B) Insulin-dependent diabetes mellitus
C) Islet cell carcinoma
D) Pancreatitis

Question 19

A client with diabetes mellitus is admitted to the emergency department in diabetic ketoacidosis with a serum glucose level of 635 mg/dL.The nurse plans to hang which of the following intravenous solutions immediately according to protocol?

A) 0.9% sodium chloride (normal saline)
B) 0.45% sodium chloride (half normal saline)
C) 5% dextrose in 0.45% sodium chloride
D) 5% dextrose in water

Question 20

The nurse teaches a client with diabetes that sugar-free prescriptions and over-the-counter medications are often available.Which of the following would the nurse use as an example of a product that does not have a sugar-free preparation?

A) Antacids
B) Antipyretics
C) Antitussives
D) Diuretics

Question 21

A client with diabetes newly admitted to the hospital needs to receive an insulin injection at 08:00.The client states that the previous morning's dose was given in the abdomen.The nurse plans to give this morning's dose in which of the following locations?

A) Left arm
B) Right arm
C) Either thigh
D) Abdomen

Question 22

To prevent the development of a serious adverse drug effect,the nurse would question the physician about withholding metformin (Glucophage)for a client who has which of the following circumstances?

A) Having an angiogram
B) Going for radiographs
C) Scheduled for morning blood work
D) Awaiting cataract surgery

Question 23

The nurse would do which of the following to administer a dose of insulin properly to a client with diabetes mellitus?

A) Use an insulin syringe with a ³/₈- to ⁵/₈-inch needle
B) Aspirate before injecting the dose
C) Inject the dose at a 15-degree angle
D) Rub the site after injection

Question 24

The nurse is caring for a Muslim client.The nurse would withhold the newly ordered insulin dose and telephone the prescriber after noting an order for which of the following types of insulin?

A) Insulin glargine
B) Insulin aspart
C) Human NPH insulin
D) Pork insulin

Question 25

The nurse needs to prepare a dose of NPH insulin mixed with regular insulin.The nurse should do which of the following steps first to prepare the dose?

A) Inject air into the regular insulin
B) Inject air into the NPH insulin
C) Withdraw the regular insulin
D) Withdraw the NPH insulin

Question 26

A client has an order for a dose of regular insulin (Humulin R)in the morning and another in the late afternoon.If the client's supper tray generally arrives on the unit at 17:15,the nurse should plan to administer the afternoon dose at which of the following times?

A) 16:30
B) 17:00
C) 17:30
D) 18:00

Question 27

The nurse explains to a client beginning drug therapy with nateglinide (Starlix)that the drug acts in which of the following ways?

A) Stimulates the pancreas to produce insulin
B) Increases sensitivity of cells to insulin
C) Decreases glucose production in the liver
D) Delays digestion and absorption of carbohydrates

Question 28

The nurse is assigned to the care of a client receiving glyburide (Micronase).The nurse assesses this client for which most common side effect?

A) Hyperglycemia
B) Hypoglycemia
C) Photosensitivity rash
D) Muscle cramping

Question 29

The nurse explains to a client beginning drug therapy with miglitol (Glyset)that the drug acts in which of the following ways?

A) Stimulates the pancreas to produce insulin
B) Increases sensitivity of cells to insulin
C) Decreases glucose production in the liver
D) Delays digestion and absorption of carbohydrates

Question 30

A client with newly diagnosed diabetes mellitus who was hospitalized for pneumonia is being switched from insulin to an oral hypoglycemic agent.The nurse writes in the care plan to monitor the blood glucose at which of the following times during the transition?

A) Morning and night
B) Before each meal
C) One hour after each meal
D) Every morning

Question 31

A client newly diagnosed with diabetes mellitus is being visited by the home health nurse.The nurse explains that which of the following places should not be used to store the newly obtained,unopened insulin vials?

A) Medicine cabinet
B) Kitchen shelf
C) Refrigerator
D) Freezer

Question 32

The nurse would question an order for metformin (Glucophage)in a client with which of the following active health problems?

A) Peptic ulcer
B) Gallstones
C) Renal insufficiency
D) Hypothyroidism

Question 33

The nurse is preparing to draw up a dose of NPH insulin.Which of the following actions should the nurse take before drawing the dose into the syringe?

A) Run the vial under hot water
B) Rotate the vial between the hands
C) Shake the vial
D) Tap the vial against the palm of the hand

Question 34

The nurse teaches a client who is new to insulin therapy to self-assess for which of the following early signs of hypoglycemia?

A) Headache
B) Weakness
C) Sweating
D) Nervousness

Question 35

A client with diabetes mellitus will begin drug therapy with acarbose (Precose).The nurse plans to include in a teaching plan that the most common side effect of this drug is which of the following?

A) Lactic acidosis
B) Weight gain
C) Hypoglycemia
D) Abdominal cramping

Question 36

A client with diabetes has a history of glaucoma.After noting drug orders for NPH insulin and timolol (Timoptic)on the client's medication administration record,the nurse would ensure that the client understands how to recognize which of the following?

A) Hyperglycemia
B) Hypoglycemia
C) Increased intraocular pressure
D) Detached retina

Question 37

The nurse teaches a client beginning drug therapy with pioglitazone (Actos)that the drug acts in which of the following ways?

A) Stimulates the pancreas to produce insulin
B) Increases sensitivity of cells to own insulin
C) Decreases glucose production in the liver
D) Delays digestion and absorption of carbohydrates

Question 38

The nurse would question a new drug order for rosiglitazone (Avandia)in a client with which of the following health problems?

A) Glaucoma
B) Cirrhosis of the liver
C) Kidney stones
D) Hypertension

Question 39

The nurse has conducted a routine assessment of a client receiving glyburide (Micronase).The nurse is most concerned about the development of which adverse drug effect?

A) Jaundice
B) Headache
C) Diarrhea
D) Anorexia

Question 40

A client with diabetes is beginning drug therapy with repaglinide (Prandin).The nurse explains that which of the following is the most common side effect of this drug?

A) Dizziness
B) Hypoglycemia
C) Joint pain
D) Upper respiratory infection

Question 41

The nurse administering a dose of glucagon to a client realizes that it may not be as effective as planned if the client has which of the following health problems?

A) Hypertension
B) Emphysema
C) Adrenal insufficiency
D) Parkinson's disease

Question 42

A client with hypoglycemia requires treatment with an intravenous injection of dextrose 50%.The nurse anticipates that the ordered dose will be

A) 2 to 4 g.
B) 5 to 10 g.
C) 12.5 to 25 g.
D) 25 to 50 g.

Question 43

The nurse notes that a client is receiving diazoxide (Proglycem).The nurse checks the client's medical history for documentation of which suspected health problem?

A) Type 1 diabetes mellitus
B) Type 2 diabetes mellitus
C) Stress-induced hyperglycemia
D) Pancreatic cancer