NURSING 6005 CHAPTER 57: DRUGS FOR DIABETES MELLITUS Test Bank

NURSING 6005 CHAPTER 57: DRUGS FOR DIABETES MELLITUS Test Bank MULTIPLE CHOICE 1. The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients who were just admitted. Which patient should the nurse assess first? a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin b. The patient with a pulse of 58 beats per minute who is about to receive digoxin (Lanoxin) c. The patient with a blood pressure of 136/92 mm Hg who complains of having a headache d. The patient with an allergy to penicillin who is receiving an infusion of vancomycin (Vancocin) ANS: A The NPO patient with hypoglycemia who just received 70/30 Novolin insulin takes priority, because this patient needs to consume a good source of glucose immediately or perhaps the NPO status will be discontinued for this shift. The digoxin may be withheld for the patient with a pulse of 58 beats per minute, but this is not a priority action. The patient with a headache needs to be followed up, but because the blood pressure is 136/92 mm Hg, the headache is probably not caused by hypertension. The patient with an allergy to penicillin will not have a reaction to the vancomycin. DIF: Cognitive Level: Application REF: Types of Insulin | Short Duration: Rapid Acting | Short Duration: Slower Acting | Intermediate Duration TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 2. A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The patient’s blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to administer? a. No insulin should be administered. b. NPH c. 70/30 mix d. Lispro (Humalog) ANS: D Regular insulin is indicated for sliding scale coverage. Insulin is definitely indicated for this high blood sugar level. NPH is used for scheduled insulin doses and is a longer acting insulin. A 70/30 mix is also used for scheduled insulin coverage. DIF: Cognitive Level: Application REF: Types of Insulin | Short Duration: Rapid Acting | Short Duration: Slower Acting | Intermediate Duration TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 3. A nurse is educating the staff nurses about ketoacidosis. To evaluate the group’s understanding, the nurse asks, “Which sign and symptoms would not be consistent with ketoacidosis?” The group gives which correct answer? a. Blood glucose level of 600 mg/dL b. Blood glucose level of 60 mg/dL c. Acidosis d. Ketones in the urine ANS: B A patient with diabetic ketoacidosis (DKA) has a high glucose level (at least 500 mg/dL or higher); therefore, a glucose level of 60 mg/dL would not be consistent with DKA. A blood glucose level of 600 mg/dL, acidosis, and ketones in the urine are consistent with DKA. DIF: Cognitive Level: Analysis REF: Acute Complications of Poor Glycemic Control | Diabetic Ketoacidosis TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 4. The nurse assesses a newly diagnosed patient for short-term complications of diabetes. What does this assessment include? a. Evaluation for hyperglycemia, hypoglycemia, and ketoacidosis b. Cranial nerve testing for peripheral neuropathy c. Pedal pulse palpation for arterial insufficiency d. Auscultation of the carotids for bruits associated with atherosclerosis ANS: A High blood sugar, low blood sugar, and ketoacidosis are short-term complications of diabetes. Microvascular and macrovascular complications, such as peripheral neuropathy, are long-term complications of diabetes. Arterial insufficiency and atherosclerosis also are long-term complications of diabetes. DIF: Cognitive Level: Application REF: Short-Term Complications of Diabetes TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 5. Which statement is accurate about the long-term complications of diabetes? a. Long-term complications are almost always the result of hypoglycemia and ketoacidosis. b. The complication rates for patients with tightly controlled type 2 diabetes are the same as for those whose disease is not tightly controlled. c. Tightly controlling type 1 diabetes produces excessive episodes of life-threatening hypoglycemia. d. Tightly controlling both types of diabetes reduces the risk of eye, kidney, and nerve damage. ANS: D In both types of diabetes, tightly controlling the disease slows the development of microvascular complications. Short-term complications are more apt to result from hypoglycemia and ketoacidosis. Patients with type 2 diabetes have fewer complications if their blood sugar level is tightly controlled. Hypoglycemia does not occur more frequently in patients with tightly controlled type 1 diabetes.