Question 1

The nurse is teaching a patient how to administer insulin.The patient is thin with very little body fat.The nurse will suggest injecting insulin

Accepted Answer

In a thin person,with little fatty tissue,the needle is inserted at a 45- to 60-degree angle.In other patients,a 45- to 90-degree angle is acceptable.There is no recommendation for preferring one site over another.

Question 2

The parent of a junior high-school child who has type 1 diabetes asks the nurse if the child can participate in sports.The nurse will tell the parent

Accepted Answer

Patients generally need less insulin with increased exercise,so the child should consume a snack to prevent hypoglycemia.Exercise is an integral part of diabetes management.Hypoglycemia is more likely to occur,and extra insulin is not indicated.

Question 3

The nurse is teaching a patient about home administration of insulin.The patient will receive regular (Humulin R)and NPH (Humulin NPH)insulin at 0700 every day.What is important to teach this patient?

Accepted Answer

Patients should be instructed to draw up regular insulin first so that NPH is not mixed into the vial of regular insulin.It is not necessary to use separate syringes.Patients do not mix the medications in a vial.

Question 4

A patient has administered regular insulin 30 minutes prior but has not received a breakfast tray.The patient is experiencing nervousness and tremors.What is the nurse's first action?

Accepted Answer

The patient is symptomatic and has hypoglycemia.The nurse should give orange juice.Glucagon is given for patients unable to ingest carbohydrates.The kitchen should be notified,and bedside glucose testing should be performed,but only after the patient is given carbohydrates.

Question 5

The nurse is teaching a patient who is newly diagnosed with type 1 diabetes mellitus about insulin administration.Which statement by the patient indicates a need for further teaching?

Accepted Answer

Lipohypertrophy is a raised lump or knot on the skin surface caused by repeated injections into the same site,and this can interfere with insulin absorption.Patients are encouraged to use the same site for a week,giving each injection a knuckle length away from the previous injection.Insulin absorption is greater when given in abdominal areas.

Question 6

A patient who is unconscious and has a pulse is brought to the emergency department.The patient is wearing a Medic-Alert bracelet indicating type 1 diabetes mellitus.The nurse will anticipate an order to administer

Accepted Answer

This patient is most likely hypoglycemic and will need a carbohydrate.Glucagon is given parenterally if patients are unable to ingest a carbohydrate,such as orange juice.CPR is not indicated.Insulin will compound the hypoglycemia.

Question 7

The patient asks the nurse about storing insulin.Which response by the nurse is correct?

Accepted Answer

Some combination pens do not require refrigeration after first use.Storing insulin in the freezer is not recommended.Opened vials may either be kept at room temperature for a month or refrigerated for 3 months.

Question 8

A patient who is overweight is being evaluated for diabetes.The patient has a blood glucose level of 160 mg/dL and a hemoglobin A1c of 5.8%.The nurse understands that this patient has which condition?

Accepted Answer

Patients with a hemoglobin A1c between 5.7% and 6.4% are considered to have prediabetes.A level of 6.5% or more indicates diabetes.The patient is hyperglycemic.

Question 9

A 45-year-old patient who is overweight has had a diagnosis of type 2 diabetes for 2 years.The patient uses 20 units of insulin per day.The patient's fasting blood glucose (FBG)is 190 mg/dL.The patient asks the nurse about using an oral antidiabetic agent.The nurse understands that oral antidiabetic agents

Accepted Answer

Patients who require less than 40 units of insulin per day and who have a fasting blood glucose less than or equal to 200 mg/dL are candidates for oral antidiabetic agents.Being overweight is an indication,not a contraindication.

Question 10

A patient who has type 2 diabetes mellitus asks the nurse why the provider has changed the oral antidiabetic agent from tolbutamide (Orinase)to glipizide (Glucotrol).The nurse will explain that glipizide

Accepted Answer

Glipizide is a second-generation oral antidiabetic agent.It has a longer duration of action than the first-generation antidiabetic agents such as tolbutamide.It has many gastrointestinal side effects.It is taken once daily,not as needed.It has greater hypoglycemic activity than first-generation antidiabetics.

Question 11

The nurse is teaching a group of nursing students about diabetes.The nurse explains that which type of diabetes is the most common?

Accepted Answer

Type 2 diabetes mellitus is the most common type of diabetes.

Question 12

A patient who has insulin-dependent diabetes mellitus must take a glucocorticoid medication for osteoarthritis.When teaching this patient,the nurse will explain that there may be a need to

Accepted Answer

Glucocorticoids can cause hyperglycemia,so the insulin dose may need to be increased.Changing the glucocorticoid dose is not recommended.Decreasing the insulin dose will only compound the hyperglycemic effects.

Question 13

A patient is ordered to receive insulin lispro at mealtimes.The nurse will instruct this patient to administer the medication at which time?

Accepted Answer

Lispro acts faster than other insulins,and patients should be taught to give this medication not more than 5 minutes before eating.

Question 14

A patient who has type 1 diabetes mellitus asks the nurse about using a combination insulin product such as Humalog 75/25.The nurse will tell the patient that use of this product

Accepted Answer

Combination products are convenient because the patient does not have to mix insulin,but the products depend on individual needs,since the doses are fixed.They are not used for patients with insulin resistance.Patients must continue to rotate injection sites.They do not require refrigeration after first use.

Question 15

Which statement by a patient who will begin using an external insulin pump indicates understanding of this device?

Accepted Answer

Patients using an insulin pump will still monitor serum glucose and count carbohydrates.The advantage of the pump is that it is programmed to deliver continuous rapid-acting insulin in varying amounts at different times throughout the day.Changes in food intake can alter the risk for hypoglycemia if the pump is not adjusted accordingly.They must be removed when bathing or swimming.

Question 16

The nurse will administer parenteral insulin to a patient who will receive a mixture of NPH (Humulin NPH)and regular (Humulin R).The nurse will give this medication via which route?

Accepted Answer

Insulin is given by the subcutaneous route.Only regular insulin may be given IV.

Question 17

The nurse receives the following order for insulin: IV NPH (Humulin NPH)10 units.The nurse will perform which action?

Accepted Answer

Only regular insulin can be given intravenously.The nurse should clarify the order.It is not correct to give Humulin NPH insulin IV.The nurse should not administer the drug by a different route without first discussing with the provider.

Question 18

A patient develops type 2 diabetes mellitus.The nurse will explain that this type of diabetes

Accepted Answer

Type 2 diabetes is often caused by obesity and hereditary factors.Secondary diabetes is triggered by medications.Type 2 diabetes is the most common type of diabetes.Patients with type 2 diabetes may become insulin-dependent.

Question 19

A patient who has been taking a sulfonylurea antidiabetic medication will begin taking metformin (Glucophage).The nurse understands that this patient is at increased risk for which condition?

Accepted Answer

Metformin can lead to renal failure.It does not produce hypoglycemia or hyperglycemia.It does not increase the risk of respiratory distress.

Quiz 30: Macrolides, Tetracyclines, Aminoglycosides, and Fluoroquinolones