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Chapter 35: Drugs Used to Treat Diabetes Mellitus Test
Bank
MULTIPLE CHOICE
1. A patient received the evening dose of Lispro subcutaneously at 1630. What time will
symptoms of hypoglycemia likely occur? a. 1900
b. 1830
c. 0130
d. 0600
ANS: B
The most rapid-acting insulin, Lispro, peaks within 1 to 2 hours after administration. The peak
time of insulin is when patients would most likely exhibit symptoms of hypoglycemia,
particularly if they have inadequate dietary intake. The time of 1900 would be past the peak
of action and after signs of hypoglycemia would have appeared. The times of 0130 and 0600
are long after the peak of action and the time when signs of hypoglycemia would have
appeared.
DIF: Cognitive Level: Application REF: p. 574 OBJ: 4 |6| 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
2. It is 2:00 PM and a patient who has been NPO since 12 AM for a bronchoscopy is
complaining of a headache and shakiness, and is extremely irritable. Vital signs are within
normal limits, and a one touch glucose reads 50 mg/dL. Which action is most important for
the nurse to take?
a. Have the patient eat a snack and drink milk.
b. Administer glucagon subcutaneously.
c. Call the bronchoscopy room to follow up with the delay.
d. Obtain an A1c test.
ANS: B
Irritability, nervousness, headache, tremors, dizziness, apprehension, sweating, cold and
clammy skin, and hunger are symptoms of hypoglycemia. The patient has not eaten since the
prior day. A blood glucose of 50 mg/dL is true hypoglycemia and needs to be dealt with
immediately. Glucagon is preferred over PO intake, given that an endoscopy is scheduled.
Having the patient eat a snack and drink milk, calling the bronchoscopy room, and obtaining
an A1c test are not appropriate responses.
DIF: Cognitive Level: Analysis REF: p. 571 OBJ: 2 | 6 | 7
TOP: Nursing Process Step: Diagnosis
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
3. After a blood glucose reading, it is determined that the patient should receive 4 units of
Lispro and 8 units of NPH. Which action will the nurse take to administer these medications?
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a. Draw up each insulin in separate syringes and administer two injections.
b. Draw up the NPH first and then the Lispro using the same syringe.
c. Administer the Lispro before the meal and the NPH after the meal.
d. Draw up the Lispro first and then the NPH using the same syringe.
ANS: D
Lispro, an insulin analogue, is the most rapid-acting insulin. Insulin analogues are compatible
with intermediate (NPH) or long-acting insulin. When combining two types of insulin, the
short acting insulin is drawn up before the intermediate acting insulin. There is no reason to
administer a second injection. The long-acting insulin is drawn up last when mixing. Insulin is
to be administered before meals.
DIF: Cognitive Level: Application REF: p. 578 OBJ: 4 | 6
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
4. A patient with type 2 diabetes mellitus, which was previously controlled with an oral
antidiabetic agent, is hospitalized for treatment of a leg ulcer. The health care provider has
ordered sliding scale insulin coverage with regular insulin for hyperglycemia. The nurse
brings the injection into the room, and the patient becomes upset, stating “I don’t want to
start taking that drug! I’ll need it the rest of my life.” What is the nurse’s best response?
a. “This is the same drug as the oral medication you were taking. It’s a stronger dose
while you are in the hospital.”
b. “Don’t worry. You shouldn’t need this too often. As you feel better, your blood
glucose level will drop.”
c. “Your body is under stress right now, which raises your blood glucose level. This
does not mean you will be on this drug permanently. Once you’re feeling better,
your provider will determine if your oral medication is all you will need.”
d. “Your disease is progressing and your pancreas is producing less insulin. I know this
is a hard time for you. Do you want to talk about it?”
ANS: C
Type 2 diabetes mellitus patients normally controlled with oral hypoglycemics may require
insulin during situations of increased physiologic and psychological stress. The stress
response stimulates epinephrine and norepinephrine, which raises the blood glucose level.
Examples of stressors include pregnancy, surgery, and infections.
DIF: Cognitive Level: Application REF: p. 562 OBJ: 4 | 6
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Psychological Integrity
5. What test determines glycemic control over the previous 8 to 10 weeks?
a. 24 hour glucose clearance test (GTT )
b. Fructosamine test
c. Fasting blood sugar (FBS)
d. A1c test
ANS: D
The A1c test measures the percentage of hemoglobin that has been irreversibly glycosylated
because of high blood sugar levels. This test reflects the average blood sugar level attained
This study source was downloaded by 100000761823232 from CourseHero.com on 04-12-2021 14:48:27 GMT -05:00
https://www.coursehero.com/file/19255140/ch36/
Downloaded by: Sophiie |
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Chapter 35: Drugs Used to Treat Diabetes Mellitus Test
Bank
MULTIPLE CHOICE
1. A patient received the evening dose of Lispro subcutaneously at 1630. What time will
symptoms of hypoglycemia likely occur? a. 1900
b. 1830
c. 0130
d. 0600
ANS: B
The most rapid-acting insulin, Lispro, peaks within 1 to 2 hours after administration. The peak
time of insulin is when patients would most likely exhibit symptoms of hypoglycemia,
particularly if they have inadequate dietary intake. The time of 1900 would be past the peak
of action and after signs of hypoglycemia would have appeared. The times of 0130 and 0600
are long after the peak of action and the time when signs of hypoglycemia would have
appeared.
DIF: Cognitive Level: Application REF: p. 574 OBJ: 4 |6| 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
2. It is 2:00 PM and a patient who has been NPO since 12 AM for a bronchoscopy is
complaining of a headache and shakiness, and is extremely irritable. Vital signs are within
normal limits, and a one touch glucose reads 50 mg/dL. Which action is most important for
the nurse to take?
a. Have the patient eat a snack and drink milk.
b. Administer glucagon subcutaneously.
c. Call the bronchoscopy room to follow up with the delay.
d. Obtain an A1c test.
ANS: B
Irritability, nervousness, headache, tremors, dizziness, apprehension, sweating, cold and
clammy skin, and hunger are symptoms of hypoglycemia. The patient has not eaten since the
prior day. A blood glucose of 50 mg/dL is true hypoglycemia and needs to be dealt with
immediately. Glucagon is preferred over PO intake, given that an endoscopy is scheduled.
Having the patient eat a snack and drink milk, calling the bronchoscopy room, and obtaining
an A1c test are not appropriate responses.
DIF: Cognitive Level: Analysis REF: p. 571 OBJ: 2 | 6 | 7
TOP: Nursing Process Step: Diagnosis
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
3. After a blood glucose reading, it is determined that the patient should receive 4 units of
Lispro and 8 units of NPH. Which action will the nurse take to administer these medications?
This study source was downloaded by 100000761823232 from CourseHero.com on 04-12-2021 14:48:27 GMT -05:00
https://www.coursehero.com/file/19255140/ch36/
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a. Draw up each insulin in separate syringes and administer two injections.
b. Draw up the NPH first and then the Lispro using the same syringe.
c. Administer the Lispro before the meal and the NPH after the meal.
d. Draw up the Lispro first and then the NPH using the same syringe.
ANS: D
Lispro, an insulin analogue, is the most rapid-acting insulin. Insulin analogues are compatible
with intermediate (NPH) or long-acting insulin. When combining two types of insulin, the
short acting insulin is drawn up before the intermediate acting insulin. There is no reason to
administer a second injection. The long-acting insulin is drawn up last when mixing. Insulin is
to be administered before meals.
DIF: Cognitive Level: Application REF: p. 578 OBJ: 4 | 6
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
4. A patient with type 2 diabetes mellitus, which was previously controlled with an oral
antidiabetic agent, is hospitalized for treatment of a leg ulcer. The health care provider has
ordered sliding scale insulin coverage with regular insulin for hyperglycemia. The nurse
brings the injection into the room, and the patient becomes upset, stating “I don’t want to
start taking that drug! I’ll need it the rest of my life.” What is the nurse’s best response?
a. “This is the same drug as the oral medication you were taking. It’s a stronger dose
while you are in the hospital.”
b. “Don’t worry. You shouldn’t need this too often. As you feel better, your blood
glucose level will drop.”
c. “Your body is under stress right now, which raises your blood glucose level. This
does not mean you will be on this drug permanently. Once you’re feeling better,
your provider will determine if your oral medication is all you will need.”
d. “Your disease is progressing and your pancreas is producing less insulin. I know this
is a hard time for you. Do you want to talk about it?”
ANS: C
Type 2 diabetes mellitus patients normally controlled with oral hypoglycemics may require
insulin during situations of increased physiologic and psychological stress. The stress
response stimulates epinephrine and norepinephrine, which raises the blood glucose level.
Examples of stressors include pregnancy, surgery, and infections.
DIF: Cognitive Level: Application REF: p. 562 OBJ: 4 | 6
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Psychological Integrity
5. What test determines glycemic control over the previous 8 to 10 weeks?
a. 24 hour glucose clearance test (GTT )
b. Fructosamine test
c. Fasting blood sugar (FBS)
d. A1c test
ANS: D
The A1c test measures the percentage of hemoglobin that has been irreversibly glycosylated
because of high blood sugar levels. This test reflects the average blood sugar level attained
This study source was downloaded by 100000761823232 from CourseHero.com on 04-12-2021 14:48:27 GMT -05:00
https://www.coursehero.com/file/19255140/ch36/
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