Download Karch's Focus on Pharmacology 8th Ed. Chapter 38 Exam Questions with Answers and more Exams Pharmacology in PDF only on Docsity!
Karch's Focus on
Pharmacology 8th Ed. |
Chapter 38 Exam Questions
with Answers
The nurse is explaining the action of exenatide to a patient. Which would the nurse include? - Correct Answers: Increase insulin resistance A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse most likely administer? - Correct Answers: Insulin lispro 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? - Correct Answers: Inspect the previous injection site for inflammation. The nurse is preparing to administer insulin intravenously to a client with a blood glucose level over 600 mg/dL (33.33 mmol/L). What type of insulin will the nurse most likely give? - Correct Answers: Regular insulin 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? - Correct Answers: Subcutaneous injection When considering the management of diabetic ketoacidosis (DKA), what type of insulin can be administered intravenously? - Correct Answers: Regular A client, being evaluated for diabetes, asks how a blood glucose test is used to diagnosis this disease. What is the nurse's best response? - Correct Answers: "A fasting blood sugar result of 126 mg/dL (6. mmol/L) or more on two separate occasions is diagnostic of diabetes." A client who began treatment for type 2 diabetes 8 months ago is now meeting with a diabetic nurse for a scheduled follow-up. How can the nurse best assess the client's glycemic control since beginning treatment? - Correct Answers: Assess the most recent hemoglobin A1C levels.
When administering insulin, what would be most appropriate? - Correct Answers: Insert the needle at a 45-degree angle for injection. A client is prescribed sitagliptin. The nurse would expect to administer this drug by which route? - Correct Answers: Oral A client is receiving metformin therapy at a health care facility. The client is also prescribed glucocorticoids. The nurse would be alert for which adverse reaction due to the interaction of these two drugs? - Correct Answers: increased risk of lactic acidosis A student asks the nursing instructor what insulin has the quickest therapeutic effect once administered. What would be the best response? - Correct Answers: Regular (Humulin R) Which is the best indicator of overall diabetic control? - Correct Answers: Glycosylated hemoglobin levels (A1C) The nurse monitoring a client receiving insulin glulisine notices the client has become confused, diaphoretic, and nauseated. The nurse checks the client's blood glucose and it is 60 mg/dL (3. mmol/L). Which can a nurse give to treat a client with a hypoglycemic episode? (Select all that apply.) - Correct Answers: Hard candy Glucose tablets Orange or other fruit juice A patient with type 1 diabetes has come to the clinic for a routine follow-up appointment. While assessing the patient's skin, the nurse observes brown spots on his lower legs. What might these spots indicate? - Correct Answers: Widespread changes in the blood vessels A female client is a newly diagnosed diabetic. She is a stay-at-home mother and responsible for meal planning and management of the home. What will the home care nurse teach this client? (Select all that apply.) - Correct Answers: Watch the client draw up and administer her insulin. Reinforce instructions on dealing with hypoglycemia.
A client was diagnosed with type 2 diabetes several months ago and has presented for a scheduled follow-up appointment. Which stated behavior most clearly indicates that the client has established effective health maintenance? - Correct Answers: The client frequently checks his/her blood glucose levels. Because of the risk for lactic acidosis, metformin is contraindicated in which client? - Correct Answers: an 82-year-old diagnosed with type 2 diabetes Rosiglitazone is being considered for the treatment of diabetes in an adult male client. Before the initiation of rosiglitazone therapy, the nurse should review what laboratory work recently drawn? - Correct Answers: liver enzymes As the nurse caring for a young child is diagnosed with type 1 diabetes (IDDM), you know that they become at high risk for what and you include assessment and management of this in their care plan? - Correct Answers: Delayed growth and development The nurse educator works at the diabetes clinic. When talking to a class of adolescent diabetics, the educator tells the students that the most recognized signs of diabetes are: - Correct Answers: hyperglycemia and glycosuria. A nurse must recognize the duration of insulin as to not cause harm to the client with administration of the improper type of insulin. Which insulins are long-acting insulin? (Select all that apply.) - Correct Answers: Insulin glargine (Lantus) Insulin detemir (Levemir) A patient at a health care facility has been prescribed diazoxide for hypoglycemia due to hyperinsulinism. What adverse reactions to the drug should the nurse monitor for in the patient? - Correct Answers: Tachycardia A nurse is caring for a 48-year-old woman who has been hospitalized after injecting the wrong type of insulin. Which sign of hypoglycemia will the nurse be careful to observe for? - Correct Answers: Blurred vision
The health care provider has ordered a change of prescription from rapid-acting insulin to an intermediate-acting type. Which adverse effect must the nurse closely monitor for in the client? - Correct Answers: Hypoglycemia A female client is prescribed metformin to decrease her blood glucose levels associated with diabetes mellitus type 2. Which statement accurately describes the action of metformin? - Correct Answers: It decreases intestinal absorption of glucose and improves insulin sensitivity. Insulin binds with and activates receptors on cell membranes. Once insulin-receptor binding occurs, the membranes become highly permeable to glucose. Which action does this enable? - Correct Answers: Entry of glucose into the cells The nurse is caring for an older adult client who has type 2 diabetes and chronic kidney disease. Which drugs will be used with great caution in this client? (Select all that apply.) - Correct Answers: Metformin (Glucophage) Acarbose (Precose) Miglitol (Glyset) The nurse is providing discharge instructions to a client who has just been diagnosed with type 1 diabetes. What instructions are most important for the client to follow related to diet? (Select all that apply.) - Correct Answers: Avoid drinking beer, wine, or liquor. Use artificial sweeteners instead of sugar in tea and coffee. Read food labels carefully to look for hidden sources of sugar. Which would be least appropriate when administering insulin by subcutaneous injection? - Correct Answers: Massaging the site after removing the needle The nurse is instructing a client how to take a prescribed pramlintide. Which would be most appropriate? - Correct Answers: "Give it by subcutaneous injection immediately before your major meals." The nurse is providing care for several clients who have diabetes. Which client should the nurse monitor most closely for signs and symptoms of hypoglycemia? - Correct Answers: a client who received 12 units of Humulin R 45 minutes ago
nurse's immediate intervention for this client? - Correct Answers: Place glucose gel between the gums and cheek. A 54-year-old male client is diagnosed with chronic renal failure and hyperglycemia. He asks if he can be prescribed sulfonylurea because it works well for his friend. If he were to be given sulfonylurea, this client's renal impairment may lead to what effect? - Correct Answers: Accumulation and hypoglycemia The nurse is caring for a client who is taking a thiazide diuretic, a corticosteroid, and estrogens. The nurse understands that this client is at risk for what condition? - Correct Answers: Hyperglycemia Rationale: Renal insufficiency may increase risks of adverse effects with antidiabetic drugs, and treatment with thiazide diuretics, corticosteroids, estrogens, and other drugs may cause hyperglycemia, thereby increasing dosage requirements for antidiabetic drugs. The nurse admitted a 4-year-old child with type 1 diabetes mellitus. The nurse educates the parents that hypoglycemia can occur as an adverse effect of insulin. The nurse helps the parents to understand that in young children, hypoglycemia may manifest as what signs or symptoms? (Select all that apply.) - Correct Answers: Impaired mental functioning Lethargy Irritability The nurse is caring for a client who is taking glyburide as treatment for type 2 diabetes mellitus. The health care provider has added a corticosteroid to this client's medication regimen for treatment of a severe allergic reaction. The nurse knows that this drug combination may cause what adverse effect on this client? - Correct Answers: hyperglycemia After teaching a group of students about the various insulin preparations, the instructor determines that the teaching was successful when the students identify that which type of insulin cannot be mixed with other types? - Correct Answers: Detemir The nurse is caring for a client with diabetes and administered the client's scheduled dose of regular insulin and NPH insulin at 08:00. At 09:30 the nurse checks the client's blood glucose level, which is 140 mg/dL. What is the nurse's best action? - Correct Answers: Document the finding and check the client's blood glucose level in one hour
A client newly diagnosed with diabetes reports "constant, insatiable thirst." When providing teaching to the client, how should the nurse explain the symptom? - Correct Answers: "Excess glucose pulled more water through your kidneys and the increased urination caused thirst." A client has refused a scheduled dose of metformin, stating that he/she is worried about inducing hypoglycemia because his/her blood glucose level is currently 66 mg/dL (3.66 mmol/L). The nurse should convey what teaching points to the client? - Correct Answers: Metformin does not cause hypoglycemia. Rationale: Since metformin does not directly stimulate insulin secretion, hypoglycemia risk may be lower than for that of other oral antidiabetes drugs. However, hypoglycemia in patients using metformin may occur in association with strenuous physical activity or fasting. Which strategy will NOT increase the therapeutic effect of insulin? - Correct Answers: All insulin should be stored in a refrigerator but never frozen. Rationale: Store opened vials of regular insulin at room temperature. Extra supplies are stored in the refrigerator, not the freezer. Extreme temperatures (<2°C or >30°C) should be avoided to prevent the loss of maximum function. Administer regular insulin with an insulin syringe into an appropriate subcutaneous site. Regular insulin is administered about 30 to 60 minutes before eating. To promote regular absorption, one anatomic area should be selected for regular insulin injections (e.g., the abdomen). Frequent monitoring of blood glucose by fingersticks and periodic determinations of hemoglobin A1C levels help determine the therapeutic effect of insulin and overall consistency of diabetic control.
