Nurs 615 Exam IV Questions With All Correct Detailed Answers A+ Pass
Study online at https://quizlet.com/_hgx4zk
1. How will you prescribe lipase, protease, and amylase components?: Pa-
tients with cystic fibrosis are often prescribed enzyme replacement for pancreatic
secretions each replacement drug has amylase, lipase and protease components,
however the drug is prescribed in units of lipase
2. What is the medication of choice for hypertensive crisis with pheochro-
mocytoma?: Surgical resection of the tumor is the first treatment of choice either
my open laparotomy or laparoscopy either surgical option requires prior treatment
of nonspecific irreversible adrenergic adraonoreceptor blocker phenoxybenzamine
or a shorter acting alpha antagonists, prazosin, terazosin, and doxazosin. Mainly
use phenozibenamine in practice. Doing so promotes the surgery to proceed while
minimizing the likelihood of severe intraoperative hypertension which is likely when
the tumor is manipulated.
3. What is the onset of action, peak of action, and duration of action of each
insulin preparation?: (Intermediate Acting) NPH
Onset-60-90 min after administration,
Peak 48 hrs
Duration 10-18 hrs.
(Short Acting) Regular Onset 30-60 min
Peak 2-4 hrs
Duration 6-10 hrs
(Long Acting) Aspart, Lispro, Glulisine
Onset less than 15 min
Peak 1-2 hrs
Duration 3-6 hrs
(Long Acting) Glargine, Detemir
Onset 1-2 hrs
Peak NO PEAK
Duration 24 hrs
4. Identify the symptoms of hypoglycemia, hyperglycemia, and ketoacidosis.-
: Hypoglycemia- dizziness, confusion, diaphoresis, tachycardia
Hyperglycemia- polyphagia, polydipsia, polyuria, blurred vision, and fatigue
Ketoacidosis- hallmark symptoms include acetone breath like nail polish remover or
fruity breath. Also abdominal pain, nausea, vomiting and sob.
5. When changing from NPH to glargine insulin, how will you adjust the
patient's dose?: The initial dose of glargine is reduced by 20% to prevent hypo-
glycemia.
, Nurs 615 Exam IV Questions With All Correct Detailed Answers A+ Pass
Study online at https://quizlet.com/_hgx4zk
6. How does metformin work?: Decreases hyperglycemia by decreasing hepatic
glucose production called hepatic gluconeogenesis. The average person with type 2
diabetes has three times the rate of gluconeogenesis, metformin treatment reduces
this by over 1/3rd. The molecular mechanism of metformin isn't completely under-
stood. In addition to suppressing hepatic glucose production, metformin increases
insulin sensitivity, enhances peripheral glucose uptake by inducing the phosphoril-
ization of glu4 enhancer factor, decreases insulin induced suppression of fatty acid
oxidation, and decreases absorption of glucose from the GI tract. Also of note**
Metformin helps reduce LDL cholesterol and triglyceride levels and is not associated
with weight gain, in some people it helps promote weight loss**
7. What diagnostic testing is required before and throughout therapy with
metformin?: Metformin is not metabolized, it is cleared from the body by tubular
secretion and is secreted unchanged in the urine. Metformin is undetectable in blood
plasma within 24 hrs of a single oral dose the average elimination half-life in plasma
is 6.2 hrs as it is secreted in the urine you should check a serum crt to assess renal
function.
8. What is the action of gliptin?: The mechanism of DDP-4 inhibitors is to increase
incretin levels incretin are GLP1 and GIP which inhibit glucagon release in which in
turn increases insulin secretion, decreases gastric emptying, and decreases blood
glucose levels
9. How do GLP agonists work?: They bind directly to a receptor in the pancreatic
beta cell. These agents work in the same pathway as the DPP-4 inhibitors as
mentioned above but are generally considered more potent.
10. When should exenatide be administered?: 60 minutes prior to the morning
and evening meal
11. How will you assess for granulocytopenia?: Signs of a Cold or flu including
fever and sore throat
12. What are the adverse effects of propylthiouracil?: Agranulocytosis, thrombo-
cytopenia, and fulminant liver failure as stated above, pt's on PTU when they develop
fever or sore throat, it would be important to check a CBC preferably with a smear
and a diff.
13. What are the adverse effects of levothyroxine?: Tachycardia and angina in
the elderly
14. A patient develops a toxic goiter. What is the recommended treatment?: -
Methimazole for one month then radioactive iodine (p. 641)
15. What are the adverse effects of PTU and methimazole?: PTU- Fatal agranu-
locytopenia look for fever and sore throat and TEMPORARY ALOPECIA
16. What is the action of biphosphonates?: Bone undergoes constant turnover
and is kept in balance by osteoblasts creating bone and osteoclasts destroying
Study online at https://quizlet.com/_hgx4zk
1. How will you prescribe lipase, protease, and amylase components?: Pa-
tients with cystic fibrosis are often prescribed enzyme replacement for pancreatic
secretions each replacement drug has amylase, lipase and protease components,
however the drug is prescribed in units of lipase
2. What is the medication of choice for hypertensive crisis with pheochro-
mocytoma?: Surgical resection of the tumor is the first treatment of choice either
my open laparotomy or laparoscopy either surgical option requires prior treatment
of nonspecific irreversible adrenergic adraonoreceptor blocker phenoxybenzamine
or a shorter acting alpha antagonists, prazosin, terazosin, and doxazosin. Mainly
use phenozibenamine in practice. Doing so promotes the surgery to proceed while
minimizing the likelihood of severe intraoperative hypertension which is likely when
the tumor is manipulated.
3. What is the onset of action, peak of action, and duration of action of each
insulin preparation?: (Intermediate Acting) NPH
Onset-60-90 min after administration,
Peak 48 hrs
Duration 10-18 hrs.
(Short Acting) Regular Onset 30-60 min
Peak 2-4 hrs
Duration 6-10 hrs
(Long Acting) Aspart, Lispro, Glulisine
Onset less than 15 min
Peak 1-2 hrs
Duration 3-6 hrs
(Long Acting) Glargine, Detemir
Onset 1-2 hrs
Peak NO PEAK
Duration 24 hrs
4. Identify the symptoms of hypoglycemia, hyperglycemia, and ketoacidosis.-
: Hypoglycemia- dizziness, confusion, diaphoresis, tachycardia
Hyperglycemia- polyphagia, polydipsia, polyuria, blurred vision, and fatigue
Ketoacidosis- hallmark symptoms include acetone breath like nail polish remover or
fruity breath. Also abdominal pain, nausea, vomiting and sob.
5. When changing from NPH to glargine insulin, how will you adjust the
patient's dose?: The initial dose of glargine is reduced by 20% to prevent hypo-
glycemia.
, Nurs 615 Exam IV Questions With All Correct Detailed Answers A+ Pass
Study online at https://quizlet.com/_hgx4zk
6. How does metformin work?: Decreases hyperglycemia by decreasing hepatic
glucose production called hepatic gluconeogenesis. The average person with type 2
diabetes has three times the rate of gluconeogenesis, metformin treatment reduces
this by over 1/3rd. The molecular mechanism of metformin isn't completely under-
stood. In addition to suppressing hepatic glucose production, metformin increases
insulin sensitivity, enhances peripheral glucose uptake by inducing the phosphoril-
ization of glu4 enhancer factor, decreases insulin induced suppression of fatty acid
oxidation, and decreases absorption of glucose from the GI tract. Also of note**
Metformin helps reduce LDL cholesterol and triglyceride levels and is not associated
with weight gain, in some people it helps promote weight loss**
7. What diagnostic testing is required before and throughout therapy with
metformin?: Metformin is not metabolized, it is cleared from the body by tubular
secretion and is secreted unchanged in the urine. Metformin is undetectable in blood
plasma within 24 hrs of a single oral dose the average elimination half-life in plasma
is 6.2 hrs as it is secreted in the urine you should check a serum crt to assess renal
function.
8. What is the action of gliptin?: The mechanism of DDP-4 inhibitors is to increase
incretin levels incretin are GLP1 and GIP which inhibit glucagon release in which in
turn increases insulin secretion, decreases gastric emptying, and decreases blood
glucose levels
9. How do GLP agonists work?: They bind directly to a receptor in the pancreatic
beta cell. These agents work in the same pathway as the DPP-4 inhibitors as
mentioned above but are generally considered more potent.
10. When should exenatide be administered?: 60 minutes prior to the morning
and evening meal
11. How will you assess for granulocytopenia?: Signs of a Cold or flu including
fever and sore throat
12. What are the adverse effects of propylthiouracil?: Agranulocytosis, thrombo-
cytopenia, and fulminant liver failure as stated above, pt's on PTU when they develop
fever or sore throat, it would be important to check a CBC preferably with a smear
and a diff.
13. What are the adverse effects of levothyroxine?: Tachycardia and angina in
the elderly
14. A patient develops a toxic goiter. What is the recommended treatment?: -
Methimazole for one month then radioactive iodine (p. 641)
15. What are the adverse effects of PTU and methimazole?: PTU- Fatal agranu-
locytopenia look for fever and sore throat and TEMPORARY ALOPECIA
16. What is the action of biphosphonates?: Bone undergoes constant turnover
and is kept in balance by osteoblasts creating bone and osteoclasts destroying
