Chapter 18 (4)

Question 1

Both men and women experience bone loss with aging. The bones most likely to demonstrate
significant loss are:

Answer 1

Femoral neck bones

Question 2

Bisphosphonates treat or prevent osteoporosis by:

Answer 2

Inhibiting osteoclastic activity

Question 3

Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to
long-term use of which of the following drugs?

Answer 3

Glucocorticoids

Question 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

Answer 4

Lipase

Question 5

Brands of pancreatic enzyme replacement drugs are:

Answer 5

About the same in cost per unit of lipase across brands

Question 6

When given subcutaneously, how long until neutral protamine Hagedorn insulin begins to take effect
(onset of action) after administration?

Answer 6

60 to 90 minutes

Question 7

Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and
symptoms of hypoglycemia include:

Answer 7

Dizziness, confusion, diaphoresis, and tachycardia

Question 8

Nonselective beta blockers and alcohol create serious drug interactions with insulin because they

Answer 8

Mask the signs and symptoms of altered glucose levels

Question 9

Lispro is an insulin analogue produced by recombinant DNA technology. Which of the following
statements about this form of insulin is NOT true?

Answer 9

Duration of action is increased when the dose is increased.

Question 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:

Answer 10

The initial dose of glargine is reduced by 20% to avoid hypoglycemia.

Question 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 ofthe
following statements is accurate based on research?

Answer 11

Newer premixed insulins are better at lowering HbA1C and postprandial glucose
levels than long-acting insulins.

Question 12

Metformin is a primary choice of drug to treat hyperglycemia in type 2 diabetes because it:

Answer 12

Decreases glycogenolysis by the liver

Question 13

Prior to prescribing metformin, the provider should:

Answer 13

Draw a serum creatinine to assess renal function

Question 14

The action of “gliptins” is different from other antidiabetic agents because they:

Answer 14

Act on the incretin system to indirectly increase insulin production

Question 15

Sitagliptin has been approved for:

Answer 15

.Both 1 and 2: Monotherapy in once-daily doses
2. Combination therapy with metformin

Question 16

GLP-1 agonists:

Answer 16

Directly bind to a receptor in the pancreatic beta cell

Question 17

Avoid concurrent administration of exenatide with which of the following drugs?

Answer 17

All of the above: Digoxin
Warfarin
Lovastatin

Question 18

Administration of exenatide is by subcutaneous injection:

Answer 18

60 minutes prior to the morning and evening meal

Question 19

Potentially fatal granulocytopenia has been associated with treatment of hyperthyroidism with
propylthiouracil. Patients should be taught to report:

Answer 19

Fever and sore throat

Question 20

Elderly patients who are started on levothyroxine for thyroid replacement should be monitored for:

Answer 20

Tachycardia and angina

Question 21

Which of the following is not an indication that growth hormone supplements should be
discontinued?

Answer 21

Complaints of mild bone pain

Question 22

Besides osteoporosis, IV bisphosphonates are also indicated for:

Answer 22

Paget’s Disease

Question 23

What is the role of calcium supplements when patients take bisphosphonates?

Answer 23

They must be taken in sufficient amounts to provide foundational elements for
bone growth.

Question 24

Which of the following statements about pancreatic enzymes is true?

Answer 24

Dosing may be titrated according to the decrease of steatorrhea.

Question 25

Besides cystic fibrosis, which other medical state may trigger the need for pancreatic enzymes?

Answer 25

Some bariatric surgeries
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