Mastery EAQ Ch. 32

A  Increased weight

B  Extreme hypoglycemia

C  High levels of endogenous insulin

D  Presence of ketones in the serum

A  Glargine, Lispro, Regular insulin

B  Glargine, Regular insulin, Aspart

C  Lispro, Aspart, Glulisine

D  Glulisine, Regular insulin, Glargine

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

A  Stimulation of pancreatic insulin release

B  Increased sensitivity of insulin receptor sites

C  Delayed absorption of carbohydrates from the intestines

D  Adverse effects if combined with other antidiabetic agents

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

B  Immediately call the health care provider.

C  Immediately check the patient’s blood glucose level.

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

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

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

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

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

A  “It promotes synthesis of amino acids.”

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

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

D  “It stimulates the pancreas to reabsorb glucose.”

A  A patient who is also prescribed sitagliptin

B  A patient with type 2 diabetes who has renal failure

C  A patient with type 1 diabetes at risk for hypoglycemia

D  A patient with diabetes who takes sulfasalazine for arthritis

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

B  Notify the prescribing primary health care provider.

C  Decrease the oral dose of glipizide.

D  Administer both medications simultaneously.

A  Sulfonylureas

B  Incretin mimetics

C  Dipeptidyl peptidase IV inhibitors

D  Alpha-glucosidase inhibitors

A  Tremor, Sweating, Confusion, Coma

B  Tremor, Sweating, Coma, Irritability

C  Tremor, Coma, Confusion, Irritability

D  Tremor, Sweating, Confusion, Irritability

A  Phenytoin

B  Rifampin

C  Carbamazepine

D  Fluconazole

A  Lactic acidosis

B  Increased blood glucose levels

C  Decreased blood glucose levels

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

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

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

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

A  Exenatide

B  Acarbose

C  Pramlintide

D  Sitagliptin

A  Glucagon

B  Liraglutide

C  Exenatide

D  Insulin

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  Assess for hyperglycemia by 10:00 a.m.

B  Monitor fingerstick at 2:00 p.m.

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

D  Administer the insulin via IV pump.

A  “You need to change your eating habits.”

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

C  “Take a dose before bedtime every night.”

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

A  Neutral protamine Hagedorn (NPH) insulin

B  Insulin lispro

C  Regular insulin

D  Insulin glargine

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

B  Ask the patient about allergic reactions to any drugs.

C  Consult the primary health care provider before administering acarbose.

D  Assess blood glucose levels before administering insulin.

A  Reduce the needed pramlintide dose by 50%.

B  Obtain a new prescription to change the medication.

C  Give insulin an hour after administering pramlintide.

D  Reduce the needed insulin dose by 50%.

A  Fasting blood glucose 131 mg/dL

B  Arterial blood pH 7.4

C  Alanine aminotransferase 55 U/L

D  Creatinine clearance 1.8 mg/dL

A  Poor glycemic control of blood sugars

B  Large weight gain

C  Second-generation sulfonylureas

D  Lack of sleep at night

A  It is not generally prescribed for patients with obesity.

B  Insulin therapy may cause heart failure to develop.

C  It is ineffective without initial oral drug therapy.

D  Insulin therapy is initiated when other methods have failed.

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

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

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

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

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

B  A patient with type 2 diabetes mellitus who takes metformin

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

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

A  5:00 p.m.

B  10:00 a.m.

C  2:00 p.m.

D  8:00 p.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  “Do not take your metformin on the day of the test.”

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

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

A  Renal function

B  Cholesterol level

C  Edema

D  Weight gain

A  Insulin, Glucagon

B  Ketones, Dextrose

C  Ketones, Glycogen

D  Glycogen, Dextrose

A  “I will monitor my blood sugar daily.”

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

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

D  “I will limit my alcohol consumption.”

A  Glipizide, Pioglitazone

B  Miglitol, Acarbose

C  Nateglinide, Glipizide

D  Nateglinide, Pioglitazone

A  Metformin

B  Glipizide

C  Humalog insulin

D  Glimepiride

A  Neutral protamine Hagedorn (NPH) insulin

B  Insulin detemir

C  Insulin glulisine

D  Insulin glargine

A  Troglitazone

B  Rosiglitazone

C  Pioglitazone

D  Glimepiride

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 lispro

B  Regular insulin

C  Insulin glulisine

D  Insulin aspart

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

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

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

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

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

B  Use the Z-track method for administration.

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

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

A  Make sure the patient eats breakfast immediately.

B  Perform a fingerstick blood glucose test.

C  Flush the IV.

D  Have the patient void and dipstick the urine.

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  Glipizide, Glyburide, Glimepiride

C  Glimepiride, Metformin, Pioglitazone

D  Glyburide, Metformin, Pioglitazone

A  Insulin zinc suspension

B  Insulin glargine

C  Isophane insulin suspension (NPH insulin)

D  Regular insulin

A  Extreme hyperglycemia

B  Insidious weight gain

C  Recurrent headaches

D  Acute pancreatitis

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

B  Endogenous insulin levels are elevated early in the disease.

C  Type 1 diabetes mellitus leads to developing acute hypoglycemia.

D  Patients with type 1 diabetes mellitus require exogenous insulin.

A  Regular insulin

B  Insulin glargine

C  Ultralente insulin

D  Insulin aspart

A  Biguanides

B  Glinides

C  Sulfonylureas

D  Thiazolidinediones

A  Thiazolidinediones

B  Sulfonylureas

C  Biguanides

D  Glinides

A  Humulin R

B  Lantus

C  Afrezza

D  Neutral protamin Hagedorn

A  Between 5.7 and 6

B  Between 6 and 6.4

C  Above 6.5

D  Less than 5.7

A  Erythromycin

B  Fluconazole

C  Cimetidine

D  Carbamazepine

A  Myocardial infarction

B  Complete blindness

C  Bladder dysfunction

D  Diabetic gastroparesis

A  Stimulates carbohydrate metabolism in adipose tissue

B  Assists in the conversion of glucose into glycogen

C  Initiates the glycogenolysis process

D  Helps to keep the kidney free from glucose

A  Diuretics

B  Anabolic steroids

C  Sulfa antibiotics

D  Salicylates

A  Glycosylated hemoglobin (HbA1C)

B  2-Hour postprandial blood glucose

C  Serum albumin

D  Fasting serum glucose level

A  Levemir

B  Humulin R

C  Tresiba

D  Afrezza

A  Vastus lateralis

B  Deltoid

C  Gluteus maximus

D  Abdomen

A  10:00 a.m.

B  11:00 a.m.

C  Noon

D  9:00 a.m.

A  The patient’s weight

B  Blood glucose levels

C  Renal function

D  Vitamin B12 levels

A  Occurs due to autoimmune destruction of beta-cell

B  Presence of high levels of endogenous insulin

C  Treated with oral hypoglycemic

D  Caused by multifactorial genetic defects