Question 1

The nurse is reviewing the lab results and nursing care plan of a patient with type 2 diabetes mellitus. The nurse notes the patient\'s glycosylated hemoglobin A1c (HbA1c) is 10%. The nurse should make which addition to the nursing care plan?

Accepted Answer

Refer the patient to a diabetes educator because the result reflects poor glycemic control

Question 2

Which information should the nurse include in the teaching plan for a patient who has been prescribed repaglinide (Prandin)?

Accepted Answer

You will need to be sure you eat as soon as you take this medication

Question 3

Which drug interacts with insulin and increases the risk for unrecognized hypoglycemia in a patient?

Accepted Answer

Beta-adrenergic blockers

Question 4

A patient is taking glipizide [Glucotrol] and a propranolol. A nurse is teaching hypoglycemia awareness and should warn the patient about the absence of which symptom caused by the propranolol?

Accepted Answer

Tachycardia

Question 5

Which is the most appropriate action for the nurse who is told that a patient typically takes his glipizide (Glucotrol) with food?

Accepted Answer

Inform the patient that it is better to take the medication 30 minutes before a meal

Question 6

What should the nurse instruct a patient who is prescribed repaglinide (Parandin) for type 2 diabetes?

Accepted Answer

You need to eat a meal after each dose

Question 7

A patient who has type 2 diabetes is taking nateglinide [Starlix]. The nurse understands this medication helps to control blood glucose levels through which mechanism?

Accepted Answer

Promotion of insulin secretion

Question 8

An operating room nurse prepares a patient who has type 2 diabetes for surgery. Which type of insulin should the nurse administer?

Accepted Answer

Regular insulin (Humulin R)

Question 9

Which site should be used for injecting insulin for the most consistent absorption?

Accepted Answer

Abdomen

Question 10

Which patient may receive insulin lispro (Humalog)?

Accepted Answer

A patient with type 2 diabetes mellitus who take metformin (Glucophage)

Question 11

Which instruction should the nurse give when a patient receiving metformin [Glucophage] therapy will undergo angiography?

Accepted Answer

Do not take your metformin on the day of the test

Question 12

The nurse finds that a patient with type 2 diabetes mellitus who is taking glipizide [Glucotrol] is also prescribed sitagliptin [Januvia]. Which action should the nurse take?

Accepted Answer

Notify the prescribing primary healthcare provider

Question 13

Which clinical findings may indicate diabetes mellitus in a patient? Select all that apply.

Accepted Answer

-Hemoglobin A1C level greater than 6.5% -Fasting plasma glucose level of 126 mg/dL or higher

Question 14

How should the nurse instruct a patient who takes neutral protamine Hagedorn (NPH) insulin?

Accepted Answer

You must agitate the suspension before administration

Question 15

Which are rapid-acting insulins that can be administered to patients with diabetes mellitus? Select all that apply.

Accepted Answer

-Lispro (Humalog) -Aspart (Novolog) -Glulisine (Apidra)

Question 16

A patient newly diagnosed with diabetes asks, \"How does insulin normally work in my body?\" Which response by the nurse is correct?

Accepted Answer

It promotes the passage of glucose into cells for energy

Question 17

The nurse is teaching a patient who has type 1 diabetes mellitus how to prevent hypoglycemia. Which clinical indicators of hypoglycemia should the nurse identify for the patient and family? Select all that apply.

Accepted Answer

-sweating -headache -tachycardia

Question 18

Which long-acting insulin mimics natural, basal insulin with its duration of 24 hours?

Accepted Answer

Insulin glargine (Lantus)

Question 19

Which oral drug is used in patients with type 2 diabetes who have not had success with metformin [Glucophage] or glipizide [Glucotrol]?

Accepted Answer

Pioglitazone (Actos)

Question 20

Which patient instructions should the nurse provide for a pregnant woman with gestational diabetes?

Accepted Answer

You must take insulin injection as prescribed

Question 21

The nurse administers insulin to a patient at 8:30 AM and knows it will peak about 2.5 hours after administration. Which insulin did the nurse administer?

Accepted Answer

Regular insulin (Humulin R)

Question 22

What should the nurse assess in a patient who is prescribed metformin [Glucophage] for treatment of type 2 diabetes?

Accepted Answer

Renal function

Question 23

Which statement by a nursing student about insulin glargine [Lantus] indicates effective learning?

Accepted Answer

You cannot mix this insulin in the same syringe with regular insulin

Question 24

The nurse administers repaglinide [Prandin] to a patient at 8:00 AM. When is the patient at the highest risk for hypoglycemia?

Accepted Answer

9:00 AM

Question 25

Which statement made by a patient about type 1 diabetes mellitus indicates effective learning?

Accepted Answer

Patients with type 1 diabetes mellitus require exogenous insulin

Question 26

A patient is scheduled to start taking insulin glargine [Lantus]. Which information should the nurse give the patient regarding this medication?

Accepted Answer

This medication provides blood glucose control for 24 hours

Question 27

A patient newly diagnosed with type 2 diabetes mellitus has been ordered insulin glargine [Lantus]. Which information is essential for the nurse to teach this patient?

Accepted Answer

This medication has a duration of action of 24 hours

Question 28

Which instruction should the nurse provide when teaching a patient to mix regular insulin and neutral protamine Hagedorn (NPH) insulin in the same syringe?

Accepted Answer

Draw up the clear regular insulin first, followed by the cloudy NPH insulin

Question 29

Which information should the nurse teach a patient who has been prescribed an alpha-glucosidase inhibitor?

Accepted Answer

This medication will delay the absorption of carbohydrates from the intestines

Question 30

Which condition is seen in a patient with hyperosmolar nonketotic syndrome (HHNS)?

Accepted Answer

Extreme hyperglycemia

Question 31

The laboratory results for a diabetic patient indicate markedly elevated blood glucose levels. After assessing the patient, the nurse obtains a prescription for intravenous insulin therapy from the primary healthcare provider. Which other assessment finding is likely present in the patient\'s reports?

Accepted Answer

Presence of ketones in the serum

Question 32

The nurse administers neutral protamine hagedorn (NPH) insulin at 8 AM. Which intervention is essential for the nurse to perform?

Accepted Answer

Make sure the patient eats by 5pm

Question 33

The nurse observes that A1C levels are elevated in a patient who is taking metformin [Glucophage] for type 2 diabetes. Which class of drugs is likely to be prescribed to this patient?

Accepted Answer

Sulfonylureas

Question 34

Which hormones play a role in the regulation of glucose homeostasis? Select all that apply.

Accepted Answer

-Insulin  -Glucagon

Question 35

Which technique is most appropriate regarding mixing insulin when a patient must administer 30 units regular insulin and 70 units neutral protamine Hagedorn (NPH) insulin in the morning?

Accepted Answer

Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin.

Question 36

Which precautions should the nurse take before administering isophane insulin, also known as neutral protamine hagedorn (NPH) insulin suspension to a patient? Select all that apply

Accepted Answer

-Verify that insulin syringes are used -Rotate the injection locations every week -Monitor the patients fasting serum glucose level

Question 37

Before administering metformin [Glucophage], the nurse should notify the prescriber about which laboratory value?

Accepted Answer

Creatinine (Cr) level of 2.1 mg/dL

Question 38

The nurse should include which statement when teaching a patient about insulin glargine [Lantus]?

Accepted Answer

You cannot mix this insulin with any other insulin in the same syringe

Question 39

A patient receives isophane suspension, also known as neutral protamine Hagedorn (NPH) insulin at 8:00 AM. The patient eats breakfast at 8:30 AM, lunch at noon, and dinner at 6:00 PM. At what time is this patient at the highest risk for hypoglycemia?

Accepted Answer

5:00 PM

Question 40

What should the nurse assess for in a patient who is prescribed pioglitazone [Actos], insulin, and a sulfonylurea?

Accepted Answer

Symptoms of congestive heart failure

Question 41

A nurse assesses a patient who is taking pramlintide [Symlin] with mealtime insulin. Which finding requires immediate follow-up by the nurse?

Accepted Answer

Sweating

Question 42

Which statement indicates that the patient needs additional teaching on oral hypoglycemic agents?

Accepted Answer

I will take the medication only when I need it

Question 43

A patient with type 1 diabetes mellitus asks, \"Why can\'t I take a sulfonylurea like my friend who has diabetes?\" What is the nurse\'s best response?

Accepted Answer

\"Sulfonylurea increases beta-cell stimulation to secrete insulin, and your beta cells do not contain insulin.\"

Question 44

A nurse caring for a patient who has diabetic ketoacidosis recognizes which characteristics in the patient? Select all that apply.

Accepted Answer

-Triggered by acute illness -Altered fat metabolism leading to ketones  -Plasma osmolality of 300 mOsm/L to 320 mOsm/L

Question 45

he patient has been prescribed lispro [Humalog] for treatment of type 1 diabetes mellitus. The nurse should give the patient which instruction?

Accepted Answer

Inject this insulin with meals because it is very fast acting

Question 46

A patient with type 1 diabetes mellitus has been ordered insulin aspart [NovoLog] 10 units at 7:00 AM. Which nursing intervention should the nurse perform after administering this medication?

Accepted Answer

Make sure the patient eats breakfast immediately

Question 47

Which lifestyle changes should the nurse instruct a patient to implement in order to successfully manage diabetes mellitus? Select all that apply.

Accepted Answer

-Reduce the amount of alcohol you consume  -Incorporate daily physical exercise into your life -Decrease the amount of carbohydrates in your diet

Question 48

A patient is prescribed nateglinide [Starlix] for the treatment of type 2 diabetes. On assessment, the nurse finds that the patient has erratic eating habits. Which is the most important instruction for this patient?

Accepted Answer

Skip the dose when you skip a meal

Question 49

Which early symptoms of hypoglycemia should the nurse instruct a patient\'s family to treat with a fast-acting carbohydrate source? Select all that apply.

Accepted Answer

-Tremor -Irritability  -Sweating -Confusion

Question 50

Which is the nurse\'s best action when finding a patient with type 1 diabetes mellitus unresponsive, cold, and clammy?

Accepted Answer

Administer intravenous glucose

Question 51

Which laboratory test would give the most accurate evidence of a diabetic patient\'s treatment compliance and glucose management over the past few months?

Accepted Answer

Glycosylated hemoglobin (HbA1c)

Question 52

Which assessment findings in a patient with diabetes mellitus are indicative of diabetic ketoacidosis? Select all that apply.

Accepted Answer

-Ketones in the urine -Isotonic dehydration  -Electrolyte imbalances  -Exteme hyperglycemia

Question 53

A patient with type 2 diabetes mellitus receives a prescription for metformin [Glucophage]. Which finding should the nurse recognize as a contraindication to therapy?

Accepted Answer

Creatinine 1.6 mg/dL

Question 54

The nurse is caring for a patient who has been taking metformin [Glucophage] for several months. The patient reports abdominal pain. Upon assessment, the nurse detects an irregular heartbeat. What else should the nurse assess to determine the severity of the patient\'s condition?

Accepted Answer

Renal function

Question 55

A patient with a history of inflammatory bowel disease is prescribed insulin therapy and acarbose [Precose] for the treatment of high postprandial glucose levels. Which nursing action is a priority in this case?

Accepted Answer

Consult the primary healthcare provider before administering acarbose (Precose)

Question 56

A patient has a serum glucose concentration of 375 mg/dL, urine output of 450 mL/hr, and an arterial pH of 7.1. The sliding scale requires intravenous insulin for a blood glucose concentration of more than 350 mg/dL. Which type of insulin is the nurse most likely to administer?

Accepted Answer

Regular insulin (Novolin R)

Question 57

A patient who is obese is newly diagnosed with type 2 diabetes and is instructed to make dietary changes and perform aerobic exercises daily. The patient insists on insulin therapy for prompt management of diabetes. However, the patient is prescribed oral medications for lowering glucose levels. Which is the most likely reason for delaying insulin therapy?

Accepted Answer

insulin therapy is initiated when other methods have failed

Question 58

A patient newly diagnosed with type 1 diabetes asks a nurse, \"How does insulin normally work in my body?\" The nurse should base his or her response on which understanding of the mechanism of insulin?

Accepted Answer

it promotes the passage of glucose into cells

Question 59

A patient who took neutral protamine Hagedorn (NPH) insulin at 8:00 AM reports feeling weak and tremulous at 5:00 PM. Which action should the nurse take first?

Accepted Answer

Check the patients capillary blood sugar

Question 60

What should the nurse teach a patient who takes metformin [Glucophage] for type 2 diabetes?

Accepted Answer

You should take the medication with food

Question 61

Which insulin should the nurse administer to supplement basal insulin to imitate the pancreatic surge of insulin that accompanies eating?

Accepted Answer

Insulin glulisine (Apidra)

Chapter 57: Drugs for Diabetes – Flashcards

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