Unit 4 Q's

Question 1

L.S. is a 55-year-old male patient who is seeing his family physician today. The patient’s wife, who is a nurse, believes L.S. has type 2 diabetes. When the physician questions the patient about his symptoms, the patient reports that his wife commented on how much water he was drinking and that he had to urinate frequently. He has had an 8-lb weight loss as well. L.S.’s wife performed fingerstick blood glucose levels on the patient, and the results were 160 mg/dL and 180 mg/dL on separate days. Today his blood sugar is 176 mg/dL. The physician prescribes glimepiride (Amaryl).

The patient asks how a pill will lower his blood sugar. How will the nurse respond?

Answer 1

-Glimepiride (Amaryl) will stimulate cells in the pancreas to produce more insulin, which will reduce blood sugar

-The drug binds to specific receptors on beta cells within the pancreas to stimulate insulin release, and decrease glucagon secretion

Question 2

At the patient’s next visit, his A1C level is 6%. How will the nurse interpret this finding?

Answer 2

-Gone from diabetic to prediabetic, the medication is working and he is on the right track

-5.7-6.4= prediabetic A1C level ***technically normal

-A1C is an indicator of glycemic control for 3 months

Question 3

N.B., who has type 2 diabetes, is 26 weeks pregnant and placed on insulin therapy during pregnancy. She asks about why she is unable to take her oral medication as usual. What is the nurse’s best response?

Answer 3

-Since insulin is given intravenously, it only affects the mother

-Oral medications enter the GI tract and can affect mother and the baby

Question 4

N.B. is concerned about how her diabetes can affect her baby. What teaching points would the nurse provide?

Answer 4

-stillbirth
-preterm labor
-various birth defects (especially at the time of conception)
-formation of the heart, brain, spinal cord, urinary tract, and gastrointestinal system.
-gestational diabetes causes few birth defects because blood glucose levels are usually normal during the period that the above systems are being developed
-macrosomia- diabetes in the mother can cause larger babies after birth

Question 5

N.B. asks why her insulin dose continues to increase after 20 weeks of gestation and is worried something is wrong. What information should be provided to N.B.?

Answer 5

-Most people with type 2 diabetes need more insulin during pregnancy because the mother becomes resistant to the insulin as the pregnancy continues

-The placenta hormone, as well as high cortisol levels, causes the resistance

Question 6

The patient has a cold and is complaining of a “stuffy nose.” The healthcare provider suggests that the patient use an antihistamine. The nurse recognizes which of the following drugs is an antihistamine.

Answer 6

Loratadine

Question 7

Which of the following is needed for glucose to enter the cells?

Answer 7

Insulin

Question 8

When giving dextromethorphan, the nurse understands that this drug suppresses the cough reflex by which mechanism of action?

Answer 8

Having direct action on the cough center

Question 9

Mom reports that her 8-year-old child has not been growing and she is worried about her child’s height. The child is being treated with somatropin. In follow-up visits, the nurse will monitor for which expected outcome?

Answer 9

Increased growth

Question 10

A patient, newly diagnosed with hypothyroidism, receives a prescription for a thyroid hormone replacement drug (Levothyroxine). The nurse assesses for which potential contraindication to this drug?

Answer 10

Recent MI

Question 11

A patient is prescribed dextromethorphan and the nurse is explaining that the use of the drug is

Answer 11

Antitussive

Question 12

Before administering dextromethorphan, the nurse should monitor:

Answer 12

Cough

Question 13

Asthma is characterized by:

Answer 13

inflammation and bronchospasms

Question 14

Which of the following medications are given for asthma prophylaxis:

Answer 14

Montelukast

Question 15

Diphenhydramine is from which drug classification?

Answer 15

Antihistamine

Question 16

Beta 2 adrenergic agonist, a sympathomimetic, is an effective drug group to control asthma. The action of beta 2 adrenergic is to:

Answer 16

enhance bronchodilation

Question 17

A common adverse effect of bronchodilators is:

Answer 17

Tachycardia

Question 18

Which is the most common adverse effect of diphenhydramine?

Answer 18

drowsiness

Question 19

A patient with asthma asks which of the prescribed medications should be used in the event of an acute episode of bronchospasm. The nurse will instruct the patient to use:

Answer 19

Albuterol, a beta agonist bronchodilator, by inhalation

Question 20

When a patient is receiving vasopressin, the nurse will monitor for which therapeutic response?

Answer 20

Increased blood pressure

Medication being administered in ICU

Question 21

A patient’s medication order indicates that he is to receive a dose of vasopressin. The nurse is aware that this drug is indicated for which of the following conditions?

Answer 21

Diabetes insipidus
a rare disorder that causes the body to make too much urine

Question 22

A patient, newly diagnosed with hypothyroidism, has received a prescription for thyroid replacement therapy. The nurse will instruct the patient to take this medication at which time of day?

Answer 22

in the morning

Question 23

After receiving a nebulizer treatment with a beta agonist, the patient complains of feeling slightly nervous and wonders if her asthma is getting worse. What is the nurse’s best response?

Answer 23

“This is an expected adverse effect. Let me take your pulse.”

Question 24

The nurse is preparing to administer propylthiouracil to a patient. Before administration the nurse explains that propylthiouracil is used to treat:

Answer 24

Hyperthyroidism

Question 25

The nurse is preparing to educate her patient on adverse effects for the drug propylthiouracil. The nurse recognizes which of the following as an adverse effect for propylthiouracil:

Answer 25

liver and bone marrow toxicity

Question 26

The nurse is explaining the use of Levothyroxine to the patient. Which of the following is the correct use for Levothyroxine:

Answer 26

Thyroid gland is not functioning

Question 27

The nurse is explaining to a patient that codeine produces which of the following adverse effect:

Answer 27

Sedation

Question 28

The nurse is preparing to administer guaifenesin, and is looking up the mechanism of action. Which of the following indicates the mechanism of action for guaifenesin?

Answer 28

loosens and thins respiratory secretions.

Question 29

The nurse is administering insulin lispro (Humalog) and will keep in mind that this insulin will start to have an effect within which time frame?

Answer 29

15 min

Question 30

The nurse is providing teaching for long acting insulin. Which of the following is classified as a long acting insulin?

Answer 30

Lantus

Question 31

A client is asking the nurse how long the insulin will last. The nurse explains that the long acting insulin (Lantus, Levimir) will last:

Answer 31

24 hours

Question 32

The nurse instructs the patient that short acting insulin will last:

Answer 32

6-10 hours

Question 33

A patient has just been diagnosed with Type 2 diabetes, what should the nurse monitor?

Answer 33

Diet and blood glucose

Question 34

When teaching about hypoglycemia. The nurse will make sure that the patient is aware of the early signs of hypoglycemia, including:

Answer 34

confusion and sweating.

Question 35

When monitoring a patient’s response to oral antidiabetic drugs, the nurse knows which laboratory result would indicate a therapeutic response?

Answer 35

Fasting blood glucose level of 92 mg/dL

Question 36

A patient who has type 2 diabetes is scheduled for an oral endoscopy and has been NPO (nothing by mouth) since midnight. What is the best action by the nurse regarding the administration of her oral antidiabetic drugs?

Answer 36

Contact the prescriber for further orders.

Question 37

Which action is most appropriate regarding the nurse’s administration of a rapid-acting insulin to a hospitalized patient?

Answer 37

Give it within 15 minutes of mealtime

Question 38

After starting treatment for type 2 diabetes mellitus 6 months earlier, a patient is in the office for a follow-up examination. The nurse will monitor which laboratory test to evaluate the patient’s adherence to the antidiabetic therapy over the past few months?

Answer 38

Hemoglobin A1C level

Question 39

A patient in the emergency department was showing signs of hypoglycemia and had a fingerstick glucose level of 34 mg/dL. The patient has just become unconscious. What is the nurse’s next action?

Answer 39

Administer glucagon

Question 40

The nurse is preparing to administer insulin intravenously. Which statement about the administration of intravenous insulin is true?

Answer 40

Only regular insulin can be administered intravenously

Question 41

A patient with a history of chronic obstructive pulmonary disease (COPD) and type 2 diabetes has been treated for pneumonia for the past week. The patient has been receiving intravenous corticosteroids as well as antibiotics as part of his therapy. At this time, the pneumonia has resolved, but when monitoring the blood glucose levels, the nurse notices that the level is still elevated. What is the best explanation for this elevation?

Answer 41

The corticosteroids may cause an increase in glucose levels.

Question 42

When teaching a patient who is starting metformin (Glucophage), which instruction by the nurse is correct?

Answer 42

Take the medication with food to reduce gastrointestinal (GI) effects.

Question 43

The nurse is providing patient teaching about the oral bisphosphonate alendronate (Fosamax). Which statement by the patient indicates a good understanding of when this drug should be taken?

Answer 43

in the morning with an 8-ounce glass of water

Question 44

The nurse would question a prescription for somatropin in a patient with which condition?

Answer 44

Acromegaly

Question 45

The nurse is caring for a patient with diabetes insipidus (DI) who is receiving vasopressin. What therapeutic effect does the nurse anticipate with the use of this medication?

Answer 45

Decrease in urine output

Question 46

The nurse admitting a patient with acromegaly anticipates administering which medication?

Answer 46

Octreotide

Question 47

After administering somatropin to a patient, the nurse would assess for potential adverse effects of this medication by monitoring which laboratory test result?

Answer 47

Glucose

Question 48

A patient is being prescribed levothyroxine for the first time. Which statement by the patient indicates an understanding of discharge instructions given by the nurse?

Answer 48

“I will take this medication in the morning so it does not affect my sleep at night.”

Question 49

The nurse would suspect a patient is taking too much levothyroxine when the patient exhibits which adverse effect?

Answer 49

Irritability

Question 50

For a patient taking levothyroxine and warfarin concurrently, the nurse would closely monitor for which possible serious adverse effect?

Answer 50

Increased bruising

Question 51

A patient receiving propylthiouracil (PTU) asks the nurse, “How does this medication relieve symptoms?” What is the appropriate response by the nurse?

Answer 51

“PTU inhibits the formation of new thyroid hormone, thus returning your metabolism to normal.”

Question 52

Which patient statement demonstrates understanding of radioactive iodine (I-131) therapy?

Answer 52

“This drug will be taken up by the thyroid gland and destroys thyroid tissue.”

Question 53

The nurse is reviewing the adverse effects of antithyroid medications for a patient prescribed propylthiouracil (PTU). What potential serious adverse effects would the nurse discuss with the patient during discharge teaching?

Answer 53

Joint pain
Liver toxicity
Bone marrow toxicity

Question 54

Which is a rapid-acting insulin with an onset of action of less than 15 minutes?

Answer 54

Insulin aspart

Question 55

Which long-acting insulin mimics natural, basal insulin with no peak action and a duration of 24 hours?

Answer 55

Insulin glargine

Question 56

Assuming the patient eats breakfast at 8:30 A.M., lunch at noon, and dinner at 6:00 P.M., he or she is at highest risk of hypoglycemia after an 8:00 A.M. dose of NPH insulin at what time?

Answer 56

5:00 PM

Question 57

The nurse is preparing a patient for a computed tomography scan using iodine contrast media. What medication would the nurse question if prescribed 1 day before the scheduled procedure?

Answer 57

Metformin

Question 58

When caring for a pregnant patient with gestational diabetes, the nurse would question a prescription for which drug?

Answer 58

Glipizide

Question 59

What oral hypoglycemic drug has a quick onset and short duration of action, enabling the patient to take the medication 30 minutes before eating and skip the dose if he or she does not eat?

Answer 59

Repaglinide