Mastery EAQ Ch. 32

A  Extreme hypoglycemia

B  High levels of endogenous insulin

C  Increased weight

D  Presence of ketones in the serum

A  Lispro, Aspart, Glulisine

B  Glargine, Regular insulin, Aspart

C  Glargine, Lispro, Regular insulin

D  Glulisine, Regular insulin, Glargine

A  Severe hypothermia, Isotonic dehydration, Electrolyte imbalances, Extreme hyperglycemia

B  Ketones in the urine, Isotonic dehydration, Electrolyte imbalances, Extreme hyperglycemia

C  Ketones in the urine, Severe hypothermia, Electrolyte imbalances, Extreme hyperglycemia

D  Ketones in the urine, Isotonic dehydration, Severe hypothermia, Extreme hyperglycemia

A  Adverse effects if combined with other antidiabetic agents

B  Stimulation of pancreatic insulin release

C  Increased sensitivity of insulin receptor sites

D  Delayed absorption of carbohydrates from the intestines

A  Inform the patient to take the medication 15 minutes after a meal.

B  Immediately check the patient’s blood glucose level.

C  Inform the patient to take the medication 30 minutes before a meal.

D  Immediately call the health care provider.

A  “Sulfonylurea will lower your blood sugar too much, and you will be hypoglycemic.”

B  “You must be mistaken. If your friend has diabetes mellitus, she is taking insulin.”

C  “Sulfonylurea increases beta-cell stimulation to secrete insulin, and your beta cells do not contain insulin.”

D  “You are unable to store glucose because you do not have insulin, and sulfonylurea helps with glucose storage.”

A  “It stimulates the liver to convert glycogen to glucose.”

B  “It promotes the passage of glucose into cells for energy.”

C  “It stimulates the pancreas to reabsorb glucose.”

D  “It promotes synthesis of amino acids.”

A  A patient with type 2 diabetes who has renal failure

B  A patient with diabetes who takes sulfasalazine for arthritis

C  A patient with type 1 diabetes at risk for hypoglycemia

D  A patient who is also prescribed sitagliptin

A  Decrease the oral dose of glipizide.

B  Notify the prescribing primary health care provider.

C  Administer both medications simultaneously.

D  Give both drugs and check the patient’s blood glucose.

A  Alpha-glucosidase inhibitors

B  Sulfonylureas

C  Incretin mimetics

D  Dipeptidyl peptidase IV inhibitors

A  Tremor, Sweating, Coma, Irritability

B  Tremor, Sweating, Confusion, Irritability

C  Tremor, Coma, Confusion, Irritability

D  Tremor, Sweating, Confusion, Coma

A  Carbamazepine

B  Fluconazole

C  Rifampin

D  Phenytoin

A  Lactic acidosis

B  Increased blood glucose levels

C  Increased metformin effects

D  Decreased blood glucose levels

A  Low pH, Low serum HCO3 level, High serum sodium level

B  High serum sodium level, Serum osmolality of 380 mOsm/kg, Serum glucose level over 600 mg/dL

C  Serum glucose level over 600 mg/dL, Low pH, Low serum HCO3 level

D  Low pH, Serum osmolality of 380 mOsm/kg, Low serum HCO3 level

A  Identify the intramuscular injection site.
Shake the drug vial gently for some time.
Rotate the injection locations every week.

B  Identify the intramuscular injection site.
Verify that insulin syringes are used.
Shake the drug vial gently for some time.

C  Verify that insulin syringes are used.
Rotate the injection locations every week.
Monitor the patient’s fasting serum glucose level.

D  Monitor the patient’s fasting serum glucose level.
Shake the drug vial gently for some time.
Identify the intramuscular injection site.

A  Sitagliptin

B  Pramlintide

C  Exenatide

D  Acarbose

A  Glucagon

B  Insulin

C  Liraglutide

D  Exenatide

A  Diarrhea, Abdominal pain, Bloating

B  Muscle pain, Abdominal pain, Cold, clammy skin

C  Diarrhea, Bloating, Cold, clammy skin

D  Bloating, Diarrhea, Muscle pain

A  Assess for hyperglycemia by 10:00 a.m.

B  Monitor fingerstick at 2:00 p.m.

C  Administer the insulin via IV pump.

D  Make sure patient eats by 5:00 p.m.

A  “You need to eat three to four meals every day.”

B  “Take a dose before bedtime every night.”

C  “You need to change your eating habits.”

D  “Skip the dose when you skip a meal.”

A  Neutral protamine Hagedorn (NPH) insulin

B  Regular insulin

C  Insulin glargine

D  Insulin lispro

A  Assess blood glucose levels before administering insulin.

B  Ask the patient about allergic reactions to any drugs.

C  Assess the patient’s weight before administering the drug.

D  Consult the primary health care provider before administering acarbose.

A  Reduce the needed pramlintide dose by 50%.

B  Give insulin an hour after administering pramlintide.

C  Reduce the needed insulin dose by 50%.

D  Obtain a new prescription to change the medication.

A  Fasting blood glucose 131 mg/dL

B  Creatinine clearance 1.8 mg/dL

C  Arterial blood pH 7.4

D  Alanine aminotransferase 55 U/L

A  Second-generation sulfonylureas

B  Lack of sleep at night

C  Poor glycemic control of blood sugars

D  Large weight gain

A  Insulin therapy may cause heart failure to develop.

B  It is ineffective without initial oral drug therapy.

C  It is not generally prescribed for patients with obesity.

D  Insulin therapy is initiated when other methods have failed.

A  “Restrict sodium in your diet.”
“Reduce the amount of alcohol you consume.”
“Include rest periods between physical activities.”

B  “Incorporate daily physical exercise into your life.”
“Restrict sodium in your diet.”
“Include rest periods between physical activities.”

C  “Reduce the amount of alcohol you consume.”
“Incorporate daily physical exercise into your life.”
“Decrease the amount of carbohydrates in your diet.”

D  “Decrease the amount of carbohydrates in your diet.”
“Include rest periods between physical activities.”
“Restrict sodium in your diet.”

A  A patient with type 2 diabetes mellitus who is taking glipizide

B  A patient with type 2 diabetes mellitus who takes metformin

C  A 2-year-old child who was recently diagnosed with type 1 diabetes mellitus

D  A breastfeeding mother who is at high risk for developing diabetes mellitus

A  5:00 p.m.

B  8:00 p.m.

C  2:00 p.m.

D  10:00 a.m.

A  “You will have a decreased risk of lactic acidosis.”

B  “You should report any nausea immediately.”

C  “If you miss a meal, you should skip the dose.”

D  “You should take the medication with food.”

A  “Your blood glucose levels need to be reevaluated.”

B  “You can take the medication an hour after the test.”

C  “There are chances of renal failure after the test.”

D  “Do not take your metformin on the day of the test.”

A  Renal function

B  Edema

C  Cholesterol level

D  Weight gain

A  Glycogen, Dextrose

B  Insulin, Glucagon

C  Ketones, Dextrose

D  Ketones, Glycogen

A  “I will report symptoms of fatigue and loss of appetite.”

B  “I will limit my alcohol consumption.”

C  “I will take the medication only when I need it.”

D  “I will monitor my blood sugar daily.”

A  Nateglinide, Pioglitazone

B  Miglitol, Acarbose

C  Nateglinide, Glipizide

D  Glipizide, Pioglitazone

A  Glipizide

B  Metformin

C  Glimepiride

D  Humalog insulin

A  Insulin glargine

B  Insulin glulisine

C  Neutral protamine Hagedorn (NPH) insulin

D  Insulin detemir

A  Rosiglitazone

B  Troglitazone

C  Glimepiride

D  Pioglitazone

A  “You can mix this insulin with lente insulin to enhance its effects.”

B  “You cannot mix this insulin in the same syringe with regular insulin.”

C  “This insulin is injected just before meals because it is very fast acting.”

D  “The duration of action of this insulin is about 8 to 10 hours.”

A  Insulin glulisine

B  Insulin aspart

C  Regular insulin

D  Insulin lispro

A  “You need to obtain your blood glucose levels every hour.”

B  “Unused vials can be stored in the refrigerator for 5 months.”

C  “Discontinue insulin if you are undergoing diagnostic studies.”

D  “You should eat 30 to 45 minutes before taking the NPH insulin.”

A  Use the Z-track method for administration.

B  Draw the medication into two separate syringes but inject it into the same spot.

C  Administer these insulins at least 10 minutes apart so that you will know when they are working.

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

A  Perform a fingerstick blood glucose test.

B  Make sure the patient eats breakfast immediately.

C  Have the patient void and dipstick the urine.

D  Flush the IV.

A  “You can mix this insulin with NPH insulin to enhance its effects.”

B  “You should inject this insulin just before meals, because it is very fast-acting.”

C  “The duration of action for this insulin is approximately 8 to 10 hours, so you will need to take it twice a day.”

D  “You cannot mix this insulin with any other insulin in the same syringe.”

A  Glimepiride, Metformin, Pioglitazone

B  Glyburide, Metformin, Pioglitazone

C  Metformin, Pioglitazone, Glipizide

D  Glipizide, Glyburide, Glimepiride

A  Insulin glargine

B  Insulin zinc suspension

C  Regular insulin

D  Isophane insulin suspension (NPH insulin)

A  Recurrent headaches

B  Extreme hyperglycemia

C  Acute pancreatitis

D  Insidious weight gain

A  Endogenous insulin levels are elevated early in the disease.

B  Type 1 diabetes mellitus leads to developing acute hypoglycemia.

C  Type 1 diabetes mellitus accounts for 90% of all cases of diabetes.

D  Patients with type 1 diabetes mellitus require exogenous insulin.

A  Ultralente insulin

B  Insulin glargine

C  Regular insulin

D  Insulin aspart

A  Biguanides

B  Thiazolidinediones

C  Sulfonylureas

D  Glinides

A  Sulfonylureas

B  Glinides

C  Biguanides

D  Thiazolidinediones

A  Neutral protamin Hagedorn

B  Lantus

C  Afrezza

D  Humulin R

A  Above 6.5

B  Between 6 and 6.4

C  Less than 5.7

D  Between 5.7 and 6

A  Carbamazepine

B  Fluconazole

C  Cimetidine

D  Erythromycin

A  Myocardial infarction

B  Diabetic gastroparesis

C  Complete blindness

D  Bladder dysfunction

A  Assists in the conversion of glucose into glycogen

B  Helps to keep the kidney free from glucose

C  Initiates the glycogenolysis process

D  Stimulates carbohydrate metabolism in adipose tissue

A  Anabolic steroids

B  Salicylates

C  Diuretics

D  Sulfa antibiotics

A  2-Hour postprandial blood glucose

B  Serum albumin

C  Fasting serum glucose level

D  Glycosylated hemoglobin (HbA1C)

A  Tresiba

B  Levemir

C  Afrezza

D  Humulin R

A  Deltoid

B  Vastus lateralis

C  Abdomen

D  Gluteus maximus

A  11:00 a.m.

B  9:00 a.m.

C  10:00 a.m.

D  Noon

A  The patient’s weight

B  Renal function

C  Vitamin B12 levels

D  Blood glucose levels

A  Presence of high levels of endogenous insulin

B  Occurs due to autoimmune destruction of beta-cell

C  Treated with oral hypoglycemic

D  Caused by multifactorial genetic defects