Chapter 52: Antidiabetics Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 52: Antidiabetics

Test Bank

MULTIPLE CHOICE

1. The nurse is teaching the client the proper procedure for administration of insulin. The nurse should direct the client to use a _____ syringe.

a.

2-mL

b.

5-mL

c.

40-unit insulin

d.

100-unit insulin

ANS: D

A 100-unit insulin syringe is the only insulin syringe currently used.

DIF: Cognitive Level: Application REF: p. 782

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

2. A clients insulin is administered at 7:00 AM daily. The client is to receive regular and NPH (Humulin N) insulins. The nurse is teaching the client how to prepare the syringe before injection. In preparing the syringe, the client should be taught to:

a.

withdraw each medication in a separate syringe.

b.

draw up regular insulin first.

c.

draw up NPH insulin first.

d.

recognize that order of medication withdrawal is not a priority.

ANS: B

The nurse or client draws up the regular insulin and then the NPH.

DIF: Cognitive Level: Application REF: pp. 782-783

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

3. In administering an insulin injection to a client, the nurse anticipates that the injection of NPH (Humulin N) and regular (Humulin R) insulins will be administered via the _____ route.

a.

intradermal

b.

subcutaneous

c.

intramuscular

d.

intravenous

ANS: B

Insulin is injected into the subcutaneous tissue.

DIF: Cognitive Level: Application REF: p. 782

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

4. The nurse is monitoring a client for evidence of a hypoglycemic reaction. The client received Humulin R insulin at 7 AM. The nurse anticipates that the client will need to be most closely monitored for evidence of a hypoglycemic reaction at which time?

a.

9:00 AM to 11:00 AM

b.

Noon to 3:00 PM

c.

3:00 PM to 6:00 PM

d.

8:00 PM to Midnight

ANS: A

Regular insulin peaks in 2 to 4 hours.

DIF: Cognitive Level: Application REF: pp. 782-783

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

5. The nurse assesses a client for evidence of hypoglycemic reaction. The highest priority nursing intervention is to assess for:

a.

nervousness and tremors.

b.

polyuria and polydipsia.

c.

dry skin.

d.

extreme thirst.

ANS: A

Signs and symptoms of hypoglycemia include nervousness and tremors.

DIF: Cognitive Level: Application REF: p. 786

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

6. The nurse notes an order for insulin to be administered intravenously. The nurse recognizes that which insulin is the only type that can safely be administered intravenously?

a.

Regular (Humulin R)

b.

Lente (Humulin L)

c.

NPH (Humulin N)

d.

Insulin glargine (Lantus)

ANS: A

Only regular insulin can be given intravenously.

DIF: Cognitive Level: Comprehension REF: pp. 782-783

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

7. The best candidate for treatment with a combination insulin such as Humulin 70/30 is the client who:

a.

can use the prepared amount of regular and NPH units.

b.

can adjust the amount of regular and NPH dosages.

c.

has difficulty mixing insulins.

d.

needs to learn how to administer insulins.

ANS: A

Clients must be able to take the predosed combinations since they may be required to mix a prescribed proportion.

DIF: Cognitive Level: Analysis REF: pp. 782-783

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

8. A client is ordered to receive insulin glargine (Lantus) insulin. The nurse plans the clients care based on the fact that Lantus:

a.

does not peak.

b.

is less expensive.

c.

is short acting.

d.

requires multiple injections per day.

ANS: A

Lantus is evenly distributed over a 24-hour duration of action; thus, it is administered once a day, usually at bedtime.

DIF: Cognitive Level: Application REF: pp. 782-783

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

9. The client is ordered to be treated with glargine (Lantus) insulin. Because of the type of insulin that the client is receiving, the nurse plans a dosage schedule that administers the medication at which time(s)?

a.

7:00 AM

b.

7:00 AM and 11:00 AM

c.

11:00 AM and 9:00 PM

d.

9:00 PM

ANS: D

Lantus is evenly distributed over a 24-hour duration of action; thus, it is administered once a day, usually at bedtime.

DIF: Cognitive Level: Application REF: pp. 782-783

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

10. The client is scheduled to begin treatment with Metformin. The nurse plans to closely monitor which laboratory values?

a.

Cardiac enzymes

b.

Liver function tests

c.

Complete blood count

d.

Respiratory function tests

ANS: B

Metformin tends to create alteration in the clients liver function tests.

DIF: Cognitive Level: Application REF: p. 792

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

11. The client is being treated with Humulin N. She also takes an oral contraceptive. The nurse anticipates that the interaction of these two medications will result in which effect?

a.

Anaphylactic reaction

b.

Increased effect from the Humulin N

c.

Decreased effect from the Humulin N

d.

Neurological damage

ANS: C

The combination of Humulin N and an oral contraceptive will result in decreased hypoglycemia effect.

DIF: Cognitive Level: Application REF: p. 784

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

12. The best candidate for oral antidiabetic therapy is the client who:

a.

has a fasting glucose level of 180 mg/dl.

b.

has had a diagnosis of diabetes for 10 years.

c.

is 10 pounds under his optimal body weight.

d.

requires 60 units of insulin per day.

ANS: A

Criteria for use of oral antidiabetic drugs include onset of diabetes mellitus at age 40 years or older, diagnosis of diabetes for less than 5 years, normal weight or overweight, fasting blood glucose equal to or less than 200 mg/dl, fewer than 40 units of insulin required per day, and normal renal and hepatic function.

DIF: Cognitive Level: Application REF: p. 792

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

13. The client has been started on Metformin (Glucophage). What would be a positive outcome for this client as a result of the medication he is taking?

a.

Increased serum glucose level following a meal

b.

Decreased serum glucose level following a meal

c.

Increased absorption of glucose form the small intestine

d.

Reduced absorption of glucose from the small intestine

ANS: D

Metformin is designed to reduce the absorption of glucose from the small intestine.

DIF: Cognitive Level: Application REF: p. 792

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pathophysiology

14. The best candidate for treatment with Diazoxide (Proglycem) is the client who is experiencing:

a.

a hypoglycemic reaction.

b.

diabetic ketoacidosis.

c.

hypoglycemia caused by hyperinsulinism.

d.

insulin resistance reaction.

ANS: C

Diazoxide (Proglycem) is used to treat hypoglycemia caused by hyperinsulinism.

DIF: Cognitive Level: Comprehension REF: p. 794

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

15. A client with type 2 diabetes mellitus is admitted to the hospital with an infection. The client was taking oral hypoglycemic agents and is prescribed insulin in the hospital. What is the highest priority instruction that the nurse can give the client regarding insulin administration?

a.

Once the client begins to take insulin, she will always be on insulin.

b.

Infection temporarily increases the need for insulin.

c.

Hospitalized clients are always prescribed insulin.

d.

Oral hypoglycemics tend to interact with antibiotics.

ANS: B

Insulin needs increase in the presence of an infection.

DIF: Cognitive Level: Application REF: p. 793

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

16. A client is to receive Humalog (Lispro) insulin at breakfast. The nurse plans to administer the insulin _____ breakfast.

a.

30 minutes before

b.

5 minutes before

c.

with

d.

after

ANS: B

Lispro has an onset of 5 minutes.

DIF: Cognitive Level: Application REF: p. 784

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

17. A client is found unconscious with a Medic-Alert bracelet indicating type 1 diabetes mellitus. What is the highest priority nursing intervention?

a.

Administer insulin.

b.

Feed the client orange juice.

c.

Administer glucagon.

d.

Perform CPR.

ANS: C

Glucagon is given to unconscious patients in order to stimulate an increase in blood sugar level.

DIF: Cognitive Level: Application REF: p. 794

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

18. The client is being treated with Metformin. He is also receiving furosemide. The nurse anticipates that the interaction of the two medications will result in:

a.

acute kidney failure.

b.

potentiated hypoglycemia.

c.

dawn phenomenon.

d.

potentiated hyperglycemia.

ANS: B

The interaction of Metformin and furosemide will result in potentiated hypoglycemia.

DIF: Cognitive Level: Application REF: pp. 785-786

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

19. The client is being treated with Glipizide. She begins to exhibit difficulty breathing. The nurse recognizes that this may be indicative of a(n) ________ the medication.

a.

expected side effect of

b.

anaphylactic reaction to

c.

symptom that is not related to

d.

life-threatening reaction to

ANS: D

Life-threatening reactions to Glipizide include seizures, coma, and respiratory depression.

DIF: Cognitive Level: Application REF: p. 791

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

20. The client is being treated with rosiglitazone maleate (Avandia). The highest priority instruction to the client based on treatment with this medication is for the client to:

a.

increase the intake of calcium.

b.

use birth control.

c.

keep a food diary.

d.

use a respiratory inhaler.

ANS: B

The drug can cause increase resumption of ovulation in premenopausal women.

DIF: Cognitive Level: Application REF: pp. 789-790

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

OTHER

1. A client is ordered to receive insulin subcutaneously. What is the order of administration?

  1. Draw up the insulin.

  2. Clean the skin with alcohol.

  3. Insert the needle.

  4. Count to five.

  5. Pinch the skin.

  6. Remove the needle.

  7. Inject the medication.

8. Verify the doctors ordered dosage.

ANS:

8, 1, 2, 5, 3, 7, 4, 6

DIF: Cognitive Level: Analysis REF: p. 782

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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