CLINICAL PHARMACOLOGY
TEST.
1. A client is receiving glipizide at a health care facility. The client is also prescribed
an anticoagulant. The nurse would be alert for which of the following related to the
interaction of these two drugs? A) Increased risk of lactic acidosis
B) Risk of acute renal failure
C) Increased risk for bleeding
D) Increased hypoglycemic effect Answer: D Response:
The nurse should observe for increased hypoglycemic effect in the client as the effect of
the interaction of sulfonylureas with the anticoagulants, chloramphenicol, clofibrate,
fluconazole, histamine-2 antagonists, methyldopa, monoamine oxidase inhibitors
(MAOIs), salicylates, sulfonamides, and tricyclic antidepressants. Increased risk of
lactic acidosis is an effect of the interaction of metformin with glucocorticoids.
Increased risk for bleeding is an effect of the interaction of oral anticoagulants with anti-
infective drugs. There is a risk of acute renal failure when iodinated contrast material
used for radiologic studies is administered with metformin.
2. A nurse is caring for a client with diabetes mellitus who is receiving an oral
antidiabetic drug. Which of following ongoing assessments should the nurse
perform when caring for this client?
a. Assess the skin for ulcers, cuts, and sores.
b. Observe the client for hypoglycemic episodes.
c. Monitor the client for lipodystrophy.
d. Document family medical history. Answer: B
Response:
As the ongoing assessment activity, the nurse should observe the client for
hypoglycemic episodes. Documenting family medical history and assessing the client's
skin for ulcers, cuts, and sores should be completed before administering the drug.
Lipodystrophy occurs if the sites of insulin injection are not rotated.
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, 3. A nurse is assigned to administer insulin glargine to a client at a health care facility.
What precaution should the nurse take when administering this drug? A)
Administer glargine via IV route.
B) Avoid mixing glargine with other insulin.
C) Shake the vial vigorously before withdrawing insulin.
D) Be sure the insulin has been refrigerated. Answer: B Response:
When administering insulin glargine to the client, the nurse should avoid mixing it with
other insulins or solutions. It will precipitate in the syringe when mixed. If glargine is
mixed with another solution, it will lose glucose control, resulting in decreased
effectiveness of the insulin. Glargine is administered via the subcutaneous route once
daily at bedtime. The nurse should not shake the vial vigorously before withdrawing
insulin. The vial should be gently rotated between the palms of the hands and tilted
gently end to end immediately before withdrawing the insulin. The nurse administers
insulin from vials at room temperature. Vials are stored in the refrigerator if they are to
be stored for about 3 months for later use.
4. A nurse at a health care facility is assigned to administer insulin to the client. Which
of the following interventions should the nurse perform before administering each
insulin dose?
a. Inspect the previous injection site for inflammation.
b. Keep prefilled syringes horizontally.
c. Check for symptoms of myalgia or malaise.
d. Mix the insulin with sterile water in the syringe. Answer: A Response:
The nurse should check the previous injection site before administering each insulin
dose. The injection sites should be rotated to prevent lipodystrophy. Prefilled syringes
should not be kept horizontally; they should be kept in a vertical or oblique position to
avoid plugging the needle. The nurse checks for symptoms of myalgia or malaise when
administration of metformin leads to lactic acidosis. Insulin should not be mixed with
other drugs in the syringe. Some types of insulin may be combined in one syringe, but
sterile water is never used.
5. A nurse is caring for a client who has developed a hypoglycemic reaction. Which of
the following interventions should the nurse perform if swallowing and gag reflexes
are present in the client?
a. Administer glucagon by the parenteral route.
b. Administer the insulin via insulin pump.
c. Administer oral antidiabetics to the client.
d. Give oral fluids or candy. Answer: D Response:
The nurse should administer oral fluids or candy to the hypoglycemic client with
swallowing and gag reflexes. If the client is unconscious, the nurse should administer
glucose or glucagon parenterally. The nurse should administer insulin through an insulin
pump for diabetic clients who are pregnant or have had a renal transwerplant. Oral
antidiabetic drugs are administered to clients with type 2 diabetes.
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TEST.
1. A client is receiving glipizide at a health care facility. The client is also prescribed
an anticoagulant. The nurse would be alert for which of the following related to the
interaction of these two drugs? A) Increased risk of lactic acidosis
B) Risk of acute renal failure
C) Increased risk for bleeding
D) Increased hypoglycemic effect Answer: D Response:
The nurse should observe for increased hypoglycemic effect in the client as the effect of
the interaction of sulfonylureas with the anticoagulants, chloramphenicol, clofibrate,
fluconazole, histamine-2 antagonists, methyldopa, monoamine oxidase inhibitors
(MAOIs), salicylates, sulfonamides, and tricyclic antidepressants. Increased risk of
lactic acidosis is an effect of the interaction of metformin with glucocorticoids.
Increased risk for bleeding is an effect of the interaction of oral anticoagulants with anti-
infective drugs. There is a risk of acute renal failure when iodinated contrast material
used for radiologic studies is administered with metformin.
2. A nurse is caring for a client with diabetes mellitus who is receiving an oral
antidiabetic drug. Which of following ongoing assessments should the nurse
perform when caring for this client?
a. Assess the skin for ulcers, cuts, and sores.
b. Observe the client for hypoglycemic episodes.
c. Monitor the client for lipodystrophy.
d. Document family medical history. Answer: B
Response:
As the ongoing assessment activity, the nurse should observe the client for
hypoglycemic episodes. Documenting family medical history and assessing the client's
skin for ulcers, cuts, and sores should be completed before administering the drug.
Lipodystrophy occurs if the sites of insulin injection are not rotated.
Page 9
, 3. A nurse is assigned to administer insulin glargine to a client at a health care facility.
What precaution should the nurse take when administering this drug? A)
Administer glargine via IV route.
B) Avoid mixing glargine with other insulin.
C) Shake the vial vigorously before withdrawing insulin.
D) Be sure the insulin has been refrigerated. Answer: B Response:
When administering insulin glargine to the client, the nurse should avoid mixing it with
other insulins or solutions. It will precipitate in the syringe when mixed. If glargine is
mixed with another solution, it will lose glucose control, resulting in decreased
effectiveness of the insulin. Glargine is administered via the subcutaneous route once
daily at bedtime. The nurse should not shake the vial vigorously before withdrawing
insulin. The vial should be gently rotated between the palms of the hands and tilted
gently end to end immediately before withdrawing the insulin. The nurse administers
insulin from vials at room temperature. Vials are stored in the refrigerator if they are to
be stored for about 3 months for later use.
4. A nurse at a health care facility is assigned to administer insulin to the client. Which
of the following interventions should the nurse perform before administering each
insulin dose?
a. Inspect the previous injection site for inflammation.
b. Keep prefilled syringes horizontally.
c. Check for symptoms of myalgia or malaise.
d. Mix the insulin with sterile water in the syringe. Answer: A Response:
The nurse should check the previous injection site before administering each insulin
dose. The injection sites should be rotated to prevent lipodystrophy. Prefilled syringes
should not be kept horizontally; they should be kept in a vertical or oblique position to
avoid plugging the needle. The nurse checks for symptoms of myalgia or malaise when
administration of metformin leads to lactic acidosis. Insulin should not be mixed with
other drugs in the syringe. Some types of insulin may be combined in one syringe, but
sterile water is never used.
5. A nurse is caring for a client who has developed a hypoglycemic reaction. Which of
the following interventions should the nurse perform if swallowing and gag reflexes
are present in the client?
a. Administer glucagon by the parenteral route.
b. Administer the insulin via insulin pump.
c. Administer oral antidiabetics to the client.
d. Give oral fluids or candy. Answer: D Response:
The nurse should administer oral fluids or candy to the hypoglycemic client with
swallowing and gag reflexes. If the client is unconscious, the nurse should administer
glucose or glucagon parenterally. The nurse should administer insulin through an insulin
pump for diabetic clients who are pregnant or have had a renal transwerplant. Oral
antidiabetic drugs are administered to clients with type 2 diabetes.
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