Chapter 39 practice questions- PrepU

After teaching a group of students about sulfonylureas, the instructor determines that the teaching was successful when the students identify which agent as a second-generation sulfonylurea? (Select all that apply.)

Pramlintide
Repaglinide
Glimepiride
Glyburide
Tolazamide

Glimepiride
Glyburide

Which is an example of long acting insulin?

Isophane insulin suspension (Humulin N)
Insulin lispro (Humalog)
Insulin aspart (Apidra)
Insulin glargine (Lantus)

Insulin glargine (Lantus)

A patient is in diabetic ketoacidosis. The patient blood glucose level is over 600. The physician has ordered the patient to receive an initial dose of 25 units of insulin. What type of insulin will be administered intravenously?

Regular insulin
NPH insulin
Lente insulin
Ultralente insulin

Regular insulin

The nurse has just completed discharge instructions to a client who will be using a pen device to deliver his insulin dose. What statement by the client indicates a need for further instruction?

“I need to turn the dial on the pen and listen for the locking ring before administering my insulin.”

“I determine my dosage by the number of clicks that I hear.”

“This will make it easier for me to give my own insulin because of my poor eyesight.”

“If I forget to take my insulin pen, I will be able to use the one that my wife uses.”

“If I forget to take my insulin pen, I will be able to use the one that my wife uses.”

A client newly diagnosed with type 1 diabetes asks the nurse why the client cannot just take a pill. The nurse would incorporate what knowledge when responding to this client?

Insulin is needed because the beta cells of the pancreas are no longer functioning.

The insulin is more effective in establishing control of blood glucose levels initially.

The client most likely does not exercise enough to control his glucose levels.

More insulin is needed than that which the client can produce naturally.

Insulin is needed because the beta cells of the pancreas are no longer functioning.

The nurse is caring for a client taking insulin. The nurse realizes the client is experiencing symptoms of hypoglycemia when the client displays:

decreased respiratory rate and hot, dry skin.

increased pulse rate and fruity smelling breath.

weakness, sweating, and decreased mentation.

increased thirst and increased urine output.

weakness, sweating, and decreased mentation.

Glycosylated hemoglobin levels provide reliable evidence of blood glucose control.
T/F?
True

A nurse is assigned to administer glargine to a patient at a health care facility. What precaution should the nurse take when administering glargine?

Shake the vial vigorously before withdrawing insulin.

Administer insulin that has been refrigerated.

Administer glargine via IV route.

Avoid mixing glargine with other insulin.

Avoid mixing glargine with other insulin.

Amylin is a peptide hormone secreted with insulin by the beta cells of the pancreas and is important in the regulation of glucose control during the postprandial period. True or false?

T/F?

True

A patient is diagnosed with type 1 diabetes. What distinguishing characteristic is associated with type 1 diabetes?

It always starts in childhood.

Oral agents can control blood sugar.

Exogenous insulin is required for life.

Blood glucose levels can be controlled by diet.

Exogenous insulin is required for life.

A client is admitted to the intensive care unit with diabetic ketoacidosis. The nurse knows that the client will be placed on an intravenous insulin drip. The only type of insulin that can be administered intravenously is:

NPH.
Regular.
Lente.
Ultralente.

Regular

Insulin is produced by which organ in the human body?

Liver
Spleen
Kidney
Pancreas

Pancreas

The nurse is preparing to administer insulin lispro (Humalog) to a client at 7 AM. What is the nurse’s top priority intervention related to this medication?

Make sure the client’s breakfast is available in the next 5-10 minutes.

Monitor the client for a hypoglycemic reaction at noon.

Cleanse the administration site with soap and water before administration.

Have the client lie quietly for 45 minutes.

Make sure the client’s breakfast is available in the next 5-10 minutes.

The nurse is educating a client who will be adding an injection of pramlintide to his insulin regimen. What information is most important for the nurse to share with this client to ensure safe medication administration?

Do not give pramlintide in the same site where insulin is administered.

Pramlintide should only be injected in the hip.

Inject pramlintide in the same site where insulin is administered.

Mix pramlintide in the same syringe with insulin.

Do not give pramlintide in the same site where insulin is administered.

A nurse is preparing an in-service presentation for a group of staff members on diabetes. Which would the nurse include as the primary delivery system for insulin?

External pump
Insulin pen
Jet injector
Subcutaneous injection

Subcutaneous injection

Which would be appropriate to include in teaching a client with type 2 diabetes?

It is possible with weight loss and exercise to discontinue the use of antidiabetic medication.

Clients with type 2 diabetes always progress to insulin injections if they do not follow dietary guidelines.

Until you need to start insulin injections, you do not have to check your blood sugar.

If you drink alcohol, it may be necessary to increase your oral antidiabetic medication.

It is possible with weight loss and exercise to discontinue the use of antidiabetic medication.

Patients with type 2 diabetes have nonfunctioning beta pancreatic cells.
T/F?

How about type 1??

Type 2: False, has functioning beta cells, there is just an insulin resistance.

Type 1: True

What is an example of rapid acting insulin?

Insulin Glargine (Lantus)

Isophane insulin suspension (Humulin N)

Insulin detemir (Levemir)

Insulin lispro (Humalog)

Insulin lispro (Humalog)

A 42-year-old male client is prescribed glargine insulin for management of his type 2 diabetes mellitus. The nurse caring for the client develops a teaching plan regarding glargine insulin therapy. Which statement made by the client indicates that the client needs additional teaching?

“I should not administer the insulin if it is cloudy.”

“The insulin is given only once per day, at night.”

“I must give this insulin alone and not mix with other insulins.”

“The medication will peak in 3 hours.”

“The medication will peak in 3 hours.”

The nurse is interviewing a client who was diagnosed with type 2 diabetes about four months ago. The client never records glucometer readings but says that everything is just fine. What laboratory test does the nurse anticipate the health care provider will order for this client?

Stat urine for glucose

Fasting blood glucose in the AM

HbA1c

Insulin level

HbA1c

Regular insulin may be administered intravenously or intramuscularly in an emergency situation.
T/F?
True

Glycosylated hemoglobin measures average blood glucose over what time period?

The past 12 to 24 hours

The past 1 or 2 months

The past 7 to 10 days

The past 3 or 4 months

The past 3 or 4 months…
From the book.. “a blood glucose marker that provides a 3-month average of blood glucose levels.”
AKA.. HgA1C

A nurse at a health care facility is assigned to administer insulin to the patient. Which intervention should the nurse perform before administering each insulin dose?

Do not administer insulin kept at room temperature.

Keep prefilled syringes horizontally.

Check for symptoms of myalgia or malaise.

Inspect the previous injection site for inflammation.

Inspect the previous injection site for inflammation.

The nurse is discussing diabetes with a group of individuals who are at risk for the disease. Which statement by a participant indicates an understanding of the role of insulin in the disease?

“Insulin is used to move carbohydrate particles from the gastrointestinal system to the liver.”

“Insulin is stimulated by the liver to break down proteins and provide the body with nutrients.”

“Insulin causes fat to be broken down to provide energy for the body.”

“Insulin assists glucose molecules to enter the cells of muscle and fat tissues.”

“Insulin assists glucose molecules to enter the cells of muscle and fat tissues.”

Which would a nurse identify as an example of a sulfonylurea?

Metformin
Miglitol
Glyburide
Acarbose

Glyburide

A patient is to be administered glipizide (Glucotrol). Which factor would prohibit the administration of glipizide (Glucotrol) to this patient?

The ingestion of carbohydrates

Increase in alkaline phosphatase

Allergy to sulfonamides

A diagnosis of hypertension

Allergy to sulfonamides

The nurse admits a client who has been diagnosed with diabetic ketoacidosis, and will look for what assessment findings consistent with this diagnosis? (Select all that apply.)

Blood glucose 191 mg/dL

Flushed, dry skin

Ketones in the urine

Lack of thirst

Rectal pressure

Ketones in the urine
Flushed, dry skin

A female client visits the physician’s office after routine labs are drawn. The nurse notes that her A1C is 9. How does the nurse interpret this finding?

Client is in good glycemic control.

Client’s blood glucose levels are not consistent.

Client’s blood glucose demonstrates longstanding hypoglycemia.

Client’s average blood glucose is above normal.

Client’s average blood glucose is above normal.

Which would be least appropriate when administering insulin by subcutaneous injection?

Inserting the needle at a 45-degree angle

Massaging the site after removing the needle

Using a 25 gauge 1/2-inch needle

Injecting the insulin slowly

Massaging the site after removing the needle

A client is to receive glargine (Lantus) insulin in addition to a dose of aspart (NovoLog). When the nurse checks the blood glucose level at the bedside, it is greater than 200 mg/dl. How should the nurse administer the insulins? …

A newly diagnosed DM Type I client has been stabilized with daily insulin injections. A nurse prepares a discharge teaching plan regarding the insulin and plans to reinforce which of the following concenpts? a. always keep insulin vials refrigerated b. …

Type 1 diabetes is also called Insulin -dependent or Juvenile The alpha cells of the pancreas secrete Glucagon WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE Write my sample Hormone that stimulates …

The nurse is caring for a client who has normal glucose levels at bedtime, hypoglycemia at 2am and hyperglycemia in the morning. What is this client likely experiencing? Answers: A. Dawn phenomenon B. Somogyi effect C. An insulin spike D. …

A 54-year-old patient admitted with type 2 diabetes asks the nurse what “type 2” means. What is the most appropriate response by the nurse? A. “With type 2 diabetes, the body of the pancreas becomes inflamed.” B. “With type 2 …

A client presents to the health care facility with a 2-week history of persistent dry, hacky cough, chest tightness, and shortness of breath with activity. The client admits to a 1-pack-per-day history of cigarette smoking for 20 years. The nurse …

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