Mastery EAQ Ch. 32

A  Increased weight

B  Presence of ketones in the serum

C  High levels of endogenous insulin

D  Extreme hypoglycemia

A  Glargine, Regular insulin, Aspart

B  Lispro, Aspart, Glulisine

C  Glargine, Lispro, Regular insulin

D  Glulisine, Regular insulin, Glargine

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

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

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

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

A  Adverse effects if combined with other antidiabetic agents

B  Delayed absorption of carbohydrates from the intestines

C  Increased sensitivity of insulin receptor sites

D  Stimulation of pancreatic insulin release

A  Immediately check the patient’s blood glucose level.

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

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

D  Immediately call the health care provider.

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

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

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

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

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

B  “It stimulates the pancreas to reabsorb glucose.”

C  “It promotes synthesis of amino acids.”

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

A  A patient with type 2 diabetes who has renal failure

B  A patient who is also prescribed sitagliptin

C  A patient with diabetes who takes sulfasalazine for arthritis

D  A patient with type 1 diabetes at risk for hypoglycemia

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

B  Decrease the oral dose of glipizide.

C  Notify the prescribing primary health care provider.

D  Administer both medications simultaneously.

A  Sulfonylureas

B  Dipeptidyl peptidase IV inhibitors

C  Incretin mimetics

D  Alpha-glucosidase inhibitors

A  Tremor, Sweating, Coma, Irritability

B  Tremor, Sweating, Confusion, Irritability

C  Tremor, Sweating, Confusion, Coma

D  Tremor, Coma, Confusion, Irritability

A  Fluconazole

B  Rifampin

C  Phenytoin

D  Carbamazepine

A  Decreased blood glucose levels

B  Increased blood glucose levels

C  Lactic acidosis

D  Increased metformin effects

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

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

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

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

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

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

A  Acarbose

B  Sitagliptin

C  Exenatide

D  Pramlintide

A  Insulin

B  Glucagon

C  Exenatide

D  Liraglutide

A  Bloating, Diarrhea, Muscle pain

B  Muscle pain, Abdominal pain, Cold, clammy skin

C  Diarrhea, Abdominal pain, Bloating

D  Diarrhea, Bloating, Cold, clammy skin

A  Monitor fingerstick at 2:00 p.m.

B  Administer the insulin via IV pump.

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

D  Assess for hyperglycemia by 10:00 a.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  Insulin glargine

C  Insulin lispro

D  Regular insulin

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

B  Consult the primary health care provider before administering acarbose.

C  Assess blood glucose levels before administering insulin.

D  Ask the patient about allergic reactions to any drugs.

A  Obtain a new prescription to change the medication.

B  Reduce the needed insulin dose by 50%.

C  Reduce the needed pramlintide dose by 50%.

D  Give insulin an hour after administering pramlintide.

A  Arterial blood pH 7.4

B  Creatinine clearance 1.8 mg/dL

C  Alanine aminotransferase 55 U/L

D  Fasting blood glucose 131 mg/dL

A  Poor glycemic control of blood sugars

B  Lack of sleep at night

C  Large weight gain

D  Second-generation sulfonylureas

A  It is not generally prescribed for patients with obesity.

B  Insulin therapy may cause heart failure to develop.

C  Insulin therapy is initiated when other methods have failed.

D  It is ineffective without initial oral drug therapy.

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

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

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

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

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

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

C  A patient with type 2 diabetes mellitus who takes metformin

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

A  8:00 p.m.

B  5:00 p.m.

C  10:00 a.m.

D  2:00 p.m.

A  “You should report any nausea immediately.”

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

C  “You should take the medication with food.”

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

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

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

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

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

A  Edema

B  Renal function

C  Cholesterol level

D  Weight gain

A  Ketones, Glycogen

B  Insulin, Glucagon

C  Glycogen, Dextrose

D  Ketones, Dextrose

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, Glipizide

B  Nateglinide, Pioglitazone

C  Glipizide, Pioglitazone

D  Miglitol, Acarbose

A  Glimepiride

B  Glipizide

C  Metformin

D  Humalog insulin

A  Insulin detemir

B  Neutral protamine Hagedorn (NPH) insulin

C  Insulin glulisine

D  Insulin glargine

A  Pioglitazone

B  Rosiglitazone

C  Troglitazone

D  Glimepiride

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

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

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

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

A  Insulin glulisine

B  Regular insulin

C  Insulin aspart

D  Insulin lispro

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

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

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

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  Flush the IV.

B  Perform a fingerstick blood glucose test.

C  Have the patient void and dipstick the urine.

D  Make sure the patient eats breakfast immediately.

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

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

A  Metformin, Pioglitazone, Glipizide

B  Glyburide, Metformin, Pioglitazone

C  Glimepiride, Metformin, Pioglitazone

D  Glipizide, Glyburide, Glimepiride

A  Regular insulin

B  Insulin zinc suspension

C  Isophane insulin suspension (NPH insulin)

D  Insulin glargine

A  Acute pancreatitis

B  Extreme hyperglycemia

C  Insidious weight gain

D  Recurrent headaches

A  Type 1 diabetes mellitus leads to developing acute hypoglycemia.

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

C  Endogenous insulin levels are elevated early in the disease.

D  Patients with type 1 diabetes mellitus require exogenous insulin.

A  Insulin aspart

B  Ultralente insulin

C  Insulin glargine

D  Regular insulin

A  Sulfonylureas

B  Biguanides

C  Glinides

D  Thiazolidinediones

A  Glinides

B  Thiazolidinediones

C  Biguanides

D  Sulfonylureas

A  Humulin R

B  Afrezza

C  Neutral protamin Hagedorn

D  Lantus

A  Between 5.7 and 6

B  Between 6 and 6.4

C  Above 6.5

D  Less than 5.7

A  Carbamazepine

B  Fluconazole

C  Erythromycin

D  Cimetidine

A  Complete blindness

B  Myocardial infarction

C  Diabetic gastroparesis

D  Bladder dysfunction

A  Helps to keep the kidney free from glucose

B  Assists in the conversion of glucose into glycogen

C  Initiates the glycogenolysis process

D  Stimulates carbohydrate metabolism in adipose tissue

A  Diuretics

B  Anabolic steroids

C  Sulfa antibiotics

D  Salicylates

A  Fasting serum glucose level

B  Glycosylated hemoglobin (HbA1C)

C  Serum albumin

D  2-Hour postprandial blood glucose

A  Afrezza

B  Tresiba

C  Humulin R

D  Levemir

A  Abdomen

B  Gluteus maximus

C  Deltoid

D  Vastus lateralis

A  10:00 a.m.

B  9:00 a.m.

C  11:00 a.m.

D  Noon

A  Vitamin B12 levels

B  Renal function

C  The patient’s weight

D  Blood glucose levels

A  Caused by multifactorial genetic defects

B  Presence of high levels of endogenous insulin

C  Treated with oral hypoglycemic

D  Occurs due to autoimmune destruction of beta-cell