NURSING 112-Chapter 32: Antidiabetic Drugs Lilley: Pharmacology and the Nursing Process, 8th Edition

NURSING 112-Chapter 32: Antidiabetic Drugs Lilley: Pharmacology and the Nursing Process, 8th Edition MULTIPLE CHOICE 1. The nurse is administering insulin lispro (Humalog) and will keep in mind that this insulin will start to have an effect within which time frame? a. 15 minutes b. 1 to 2 hours c. 80 minutes d. 3 to 5 hours ANS: A The onset of action for insulin lispro is 15 minutes. The peak plasma concentration is 1 to 2 hours; the elimination half-life is 80 minutes; and the duration of action is 3 to 5 hours. DIF: COGNITIVE LEVEL: Remembering (Knowledge) REF: p. 516 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 2. When teaching about hypoglycemia, the nurse will make sure that the patient is aware of the early signs of hypoglycemia, including: a. hypothermia and seizures. b. nausea and diarrhea. c. confusion and sweating. d. fruity, acetone odor to the breath. ANS: C Early symptoms of hypoglycemia include the central nervous system manifestations of confusion, irritability, tremor, and sweating. Hypothermia and seizures are later symptoms of hypoglycemia. The other options are incorrect. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 514 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Health Promotion and Maintenance 3. The nurse is teaching a group of patients about self-administration of insulin. What content is important to include? a. Patients need to use the injection site that is the most accessible. b. If two different insulins are ordered, they need to be given in separate injections. c. When mixing insulins, the cloudy (such as NPH) insulin is drawn up into the syringe first. d. When mixing insulins, the clear (such as regular) insulin is drawn up into the syringe first. ANS: D If mixing insulins in one syringe, the clear (regular) insulin is always drawn up into the syringe first. Patients always need to rotate injection sites. Mixing of insulins may be ordered. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 516 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 4. When monitoring a patient’s response to oral antidiabetic drugs, the nurse knows that which laboratory result would indicate a therapeutic response? a. Random blood glucose level 180 mg/dL b. Blood glucose level of 50 mg/dL after meals c. Fasting blood glucose level between 92 mg/dL d. Evening blood glucose level below 80 mg/dL ANS: C The American Diabetes Association recommends a fasting blood glucose level of between 80 and 130 mg/dL for diabetic patients. The other options are incorrect. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 504 TOP: NURSING PROCESS: Evaluation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. A 75-year-old woman with type 2 diabetes has recently been placed on glipizide (Glucotrol), 10 mg daily. She asks the nurse when the best time would be to take this medication. What is the nurse’s best response? a. “Take this medication in the morning, 30 minutes before breakfast.” b. “Take this medication in the evening with a snack.” c. “This medication needs to be taken after the midday meal.” d. “It does not matter what time of day you take this medication.” ANS: A Glipizide is taken in the morning, 30 minutes before breakfast. When taken at this time, it has a longer duration of action, causing a constant amount of insulin to be released. This may be beneficial in controlling blood glucose levels throughout the day. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 511 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 6. A patient who has type 2 diabetes is scheduled for an oral endoscopy and has been NPO (nothing by mouth) since midnight. What is the best action by the nurse regarding the administration of her oral antidiabetic drugs? a. Administer half the original dose. b. Withhold all medications as ordered. c. Contact the prescriber for further orders. d. Give the medication with a sip of water. ANS: C When the diabetic patient is NPO, the prescriber needs to be contacted for further orders regarding the administration of the oral antidiabetic drugs. The other options are incorrect.