Chapter 21. Drugs Affecting the Endocrine System
____ 1. Both men and women experience bone loss with aging. The bones most
likely to demonstrate significant loss are:
1. Cortical bones
2. Femoral neck bones
3. Cervical vertebrae
4. Pelvic bones
____ 2. Bisphosphonates treat or prevent osteoporosis by:
1. Inhibiting osteoclastic activity
2. Fostering bone resorption
3. Enhancing calcium uptake in the bone
4. Strengthening the osteoclastic proton pump
,____ 3. Prophylactic use of bisphosphonates is recommended for patients with
early osteopenia related to long-term use of which of the following drugs?
1. Selective estrogen receptor modulators
2. Aspirin
3. Glucocorticoids
4. Calcium supplements
____ 4. Patients with cystic fibrosis are often prescribed enzyme replacement for
pancreatic secretions. Each replacement drug has lipase, protease, and amylase
components, but the drug is prescribed in units of:
1. Lipase
2. Protease
3. Amylase
4. Pancreatin
____ 5. Brands of pancreatic enzyme replacement drugs are:
1. Bioequivalent
2. About the same in cost per unit of lipase across brands
3. Able to be interchanged between generic and brand-name products to
reduce cost
4. None of the above
,____ 6. When given subcutaneously, how long until neutral protamine Hagedorn
insulin begins to take effect (onset of action) after administration?
1. 15 to 30 minutes
2. 60 to 90 minutes
3. 3 to 4 hours
4. 6 to 8 hours
____ 7. Hypoglycemia can result from the action of either insulin or an oral
hypoglycemic. Signs and symptoms of hypoglycemia include:
1. “Fruity” breath odor and rapid respiration
2. Diarrhea, abdominal pain, weight loss, and hypertension
3. Dizziness, confusion, diaphoresis, and tachycardia
4. Easy bruising, palpitations, cardiac dysrhythmias, and coma
____ 8. Nonselective beta blockers and alcohol create serious drug interactions
with insulin because they:
1. Increase blood glucose levels
2. Produce unexplained diaphoresis
3. Interfere with the ability of the body to metabolize glucose
4. Mask the signs and symptoms of altered glucose levels
____ 9. Lispro is an insulin analogue produced by recombinant DNA technology.
Which of the following statements about this form of insulin is NOT true?
1. Optimal time of preprandial injection is 15 minutes.
, 2. Duration of action is increased when the dose is increased.
3. It is compatible with neutral protamine Hagedorn insulin.
4. It has no pronounced peak.
____ 10. The decision may be made to switch from twice daily neutral protamine
Hagedorn (NPH) insulin to insulin glargine to improve glycemia control throughout
the day. If this is done:
1. The initial dose of glargine is reduced by 20% to avoid hypoglycemia.
2. The initial dose of glargine is 2 to 10 units per day.
3. Patients who have been on high doses of NPH will need tests for
insulin antibodies.
4. Obese patients may require more than 100 units per day.
____ 11. When blood glucose levels are difficult to control in type 2 diabetes some
form of insulin may be added to the treatment regimen to control blood glucose and
limit complication risks. Which of the following statements is accurate based on
research?
1. Premixed insulin analogues are better at lowering HbA1C and have
less risk for hypoglycemia.
2. Premixed insulin analogues and the newer premixed insulins are
associated with more weight gain than the oral antidiabetic agents.
3. Newer premixed insulins are better at lowering HbA1C and
postprandial glucose levels than long-acting insulins.
4. Patients who are not controlled on oral agents and have postprandial