C HAPTER 35: D RUGS U SED TO T REAT
D IABETES M ELLITUS
Willihnganz: Clayton’s Basic Pharmacology for Nurses, 19th Edition
MULTIPLE CHOICE
1. Which laboratory test is the preferred screening test for diabetes in
children and nonpregnant adults?
a. FPG
b. ECG
c. GTT
d. A1c
ANS: A
The fasting plasma glucose (FPG) is the preferred test used to screen for
diabetes in children and nonpregnant adults. Electrocardiograms (ECGs) are
used to monitor electrical activit y of the heart. The GTT is not recommended
for routine clinical use but may be required in the evaluation of patients with
impaired fasting glucose or when diabetes is still suspected, despite a normal
FPG, as with the postpartum evaluation of women with gestati onal diabetes
mellitus. theA1c test is used to monitor diabetes management over 90 -day
intervals, the life of a red blood cell.
DIF: Cognitive Level: Knowledge REF: p. 563 OBJ: 1
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Pro cess Step: Assessment
CON: Clinical Judgment | Glucose Regulation | Safet y | Development
,2. Which response by the nurse is correct when a patient asks the nurse how
sulfonylureas normalize glucose levels?
a. Stimulates pancreatic secretion of insulin
b. Inhibits secretion of insulin by the pancreas
c. Increases glucose production in the liver
d. Increases insulin metabolism in the liver
ANS: A
Sulfonylureas stimulate the pancreas to secrete more insulin. They also
diminish glucose production and metabolism of insu lin by the liver. the net
effect is a normalization of insulin and glucose levels. Sulfonylureas
decrease glucose production and hepatic metabolism of insulin.
DIF: Cognitive Level: Comprehension REF: p. 580 OBJ: 4
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Implementation
CON: Clinical Judgment | Glucose Regulation | Patient Education
3. Which statement by the patient indicates a need for further teaching about
insulin administration?
a. “I may need more insulin if I have surgery. ”
b. “Once I open m y insulin, I will store it in the refrigerator.”
c. “I will date the insulin bottle when I open it. ”
d. “I will keep a spare bottle of insulin on hand. ”
ANS: B
Once insulin is opened and being used, it can be stored at room temper ature
for up to 1 month. The patient may need more insulin if undergoing surgery,
should date the insulin bottle after opening, and should keep a spare bottle of
insulin on hand.
, DIF: Cognitive Level: Comprehension REF: p. 577 OBJ: 1 |
3
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Implementation
CON: Clinical Judgment | Glucose Regulation | Patient Education |
Safet y
4. Which instruction by the nurse is accurate to include when providing
teaching to a patient recent l y diagnosed with diabetes who has been
prescribed insulin?
a. Beta blockers can mask symptoms of hypogl ycaemia.
b. Lipodystrophy increases the absorption of insulin.
c. Infection will decrease the need for insulin.
d. Excessive exercise will increase the need for insulin.
ANS: A
Beta-adrenergic blocking agents (e.g., propranolol, timolol, nadolol,
pindolol) may mask many symptoms of hypogl ycaemia. Lipodystrophy does
not increase the absorption of insulin. Infection does not decrease the need
for insulin. Excess ive exercise does not increase the need for insulin.
DIF: Cognitive Level: Comprehension REF: p. 579 OBJ: 5
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Implementation
CON: Clinical Judgment | Glucose Regulation | Patient Education |
Safet y
5. Which instruction is most important for the nurse to teach a patient with
diabetes who is receiving metformin?
a. Take the medication before meals.
D IABETES M ELLITUS
Willihnganz: Clayton’s Basic Pharmacology for Nurses, 19th Edition
MULTIPLE CHOICE
1. Which laboratory test is the preferred screening test for diabetes in
children and nonpregnant adults?
a. FPG
b. ECG
c. GTT
d. A1c
ANS: A
The fasting plasma glucose (FPG) is the preferred test used to screen for
diabetes in children and nonpregnant adults. Electrocardiograms (ECGs) are
used to monitor electrical activit y of the heart. The GTT is not recommended
for routine clinical use but may be required in the evaluation of patients with
impaired fasting glucose or when diabetes is still suspected, despite a normal
FPG, as with the postpartum evaluation of women with gestati onal diabetes
mellitus. theA1c test is used to monitor diabetes management over 90 -day
intervals, the life of a red blood cell.
DIF: Cognitive Level: Knowledge REF: p. 563 OBJ: 1
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Pro cess Step: Assessment
CON: Clinical Judgment | Glucose Regulation | Safet y | Development
,2. Which response by the nurse is correct when a patient asks the nurse how
sulfonylureas normalize glucose levels?
a. Stimulates pancreatic secretion of insulin
b. Inhibits secretion of insulin by the pancreas
c. Increases glucose production in the liver
d. Increases insulin metabolism in the liver
ANS: A
Sulfonylureas stimulate the pancreas to secrete more insulin. They also
diminish glucose production and metabolism of insu lin by the liver. the net
effect is a normalization of insulin and glucose levels. Sulfonylureas
decrease glucose production and hepatic metabolism of insulin.
DIF: Cognitive Level: Comprehension REF: p. 580 OBJ: 4
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Implementation
CON: Clinical Judgment | Glucose Regulation | Patient Education
3. Which statement by the patient indicates a need for further teaching about
insulin administration?
a. “I may need more insulin if I have surgery. ”
b. “Once I open m y insulin, I will store it in the refrigerator.”
c. “I will date the insulin bottle when I open it. ”
d. “I will keep a spare bottle of insulin on hand. ”
ANS: B
Once insulin is opened and being used, it can be stored at room temper ature
for up to 1 month. The patient may need more insulin if undergoing surgery,
should date the insulin bottle after opening, and should keep a spare bottle of
insulin on hand.
, DIF: Cognitive Level: Comprehension REF: p. 577 OBJ: 1 |
3
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Implementation
CON: Clinical Judgment | Glucose Regulation | Patient Education |
Safet y
4. Which instruction by the nurse is accurate to include when providing
teaching to a patient recent l y diagnosed with diabetes who has been
prescribed insulin?
a. Beta blockers can mask symptoms of hypogl ycaemia.
b. Lipodystrophy increases the absorption of insulin.
c. Infection will decrease the need for insulin.
d. Excessive exercise will increase the need for insulin.
ANS: A
Beta-adrenergic blocking agents (e.g., propranolol, timolol, nadolol,
pindolol) may mask many symptoms of hypogl ycaemia. Lipodystrophy does
not increase the absorption of insulin. Infection does not decrease the need
for insulin. Excess ive exercise does not increase the need for insulin.
DIF: Cognitive Level: Comprehension REF: p. 579 OBJ: 5
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Implementation
CON: Clinical Judgment | Glucose Regulation | Patient Education |
Safet y
5. Which instruction is most important for the nurse to teach a patient with
diabetes who is receiving metformin?
a. Take the medication before meals.
