endocrine

Question 1

what disorder is define by glucose not being able to enter a persons cells because there is NO production of insulin?

Answer 1

type 1 diabetes

Question 2

what disorder is defined by glucose not being able to enter a prsons cells because their insulin receptors have beame resistant?

Answer 2

type 2 diabetes

Question 3

what are two lifestyle modifications a patient with type 2 diabetes can do to tx type 2 diabetes?

Answer 3

diet and exercise

Question 4

long term complications of diabetes

Answer 4

- heart disease
- stroke
- blindness
- renal failure
- neuropathy
- lower limb amputation
- erectile dysfunction
- gastroparesis

Question 5

what is the end result of diabetes mellitus?

Answer 5

inadequate control of blood glucose

Question 6

insulin is a high alert medication, true or false?

Answer 6

true

insulin is a high alert medication, preperation matters

Question 7

this insulin is a rapid acting insulin that starts to work within 5-10 minutes and peaks within 30-90 minutes

Answer 7

insulin lispro

Question 8

this insulin is a short acting insulin that starts to work within 30 minutes-1hour and peaks within 2-5 hours

Answer 8

regular insulin

Question 9

this insulin is a intermidiate acting insulin that starts to work within 1-2 hours and peaks within 4-12 hours

Answer 9

NPH insulin

Question 10

what are two long acting insulins that start to work within 1-2 hours and do NOT PEAK?

Answer 10

insulin glargine and insulin degludec

Question 11

what is the only insulin that should be administered iv?

Answer 11

regular insulin

Question 12

A patient on Insulin Glargine is about to order breakfast at 0730. What would should the nurse do?

a. administer the insulin now
b. wait until the patients breakfast arrives
c. wait until the patient has ate breakfast
d. wait until 1000 because this medication should be given the same time everyday.

Answer 12

a. administer the now

this is the BEST answer because insulin glargine and insulin Degludec are non peaking insulins and do not need food to be present for administration.

Question 13

A patient on Insulin Lispro is about to order breakfast at 0730. What would should the nurse do?

a. administer the insulin now
b. wait until the patients breakfast arrives
c. wait until the patient has ate breakfast
d. wait until 1000 because this medication should be given the same time everyday.

Answer 13

b. wait until the patient’s breakfast arrives

insulin lisopro is a rapid acting insulin and starts to work within 5-10 minutes and peaks within 30-minutes so their food needs to be present before administration.

Question 14

which of these insulin’s will appear cloudy?
a. insulin lispro
b. insulin degludec
c. NPH insulin
d. insulin Glulasine

Answer 14

c. NPH insulin

Question 15

what statement indicates the student nurse needs further teaching about Insulin Glargine and Insulin Degludec?

a. these are non peaking insulins, therefore the patient does not need food present to administer.
b. these insulins should not be mixed
c. hypoglycemia is very unlikely
d. it should be given twice a day

Answer 15

d. it should be given twice a day

These insulins should only be given once a day because of their long duration

Question 16

A patient is shakey, pale, sweaty, and clammy. The nurse assumes it is because of hypoglycemia. Is the nurse true or false?

Answer 16

True; shakey, pale, sweat, and clammy are signs of a hypoglycemic episode.

Question 17

An unconconcious diabetic patient is experiencing a hypoglycemic episode. The nurse should:

a. administer oxygen
b. give them candy, juice, or soda
c. check their blood pressure
d. administer IV dextrose
e. administer IV sodium chloride

Answer 17

d. administer IV dextrose

The patient is having a hypoglycemic episode and needs sugar. Dextrose is sugar. The patient is unconcious and should not recive anything by mouth. If the patient was awake the nurse could give the patient sugar in the form of candy, juice, or soda.

Question 18

It is important to roll NPH Insulin instead of shaking before drawing it up. True or false.

Answer 18

true.

Question 19

Diabetic patients who are on beta blockers need to to be on high alert for signs of hypoglycemia. True or false.

Answer 19

True. Hypoglycemia effects can be masked by beta blockers.

Question 20

A nurse should provide further teaching to the diabetic patient about which statement.

a. I should rotate my injection site to avoid lidoystrophy
b. I should practice proper foot care
c. I need to be careful because my wounds take longer to heal
d. I have a lower risk of infection because I take insulin

proper foot care:
- wearing the right size shoes; NOT ones that are to small or to tight
- avoiding heels
- drying off feet completely
- wearing shoes or slippers all the time
- informing the nail salon that you are diabetic

Answer 20

d. I have a lower risk of infection because I take insulin

All other answer choices are correct except (d.) because diabetic patients have an increase risk of infection.

Question 21

Glyburide, Repaglinide, Sitagliptin, and Exenatide can only be given to type 1 diabetics. True or false.

Answer 21

False.

Glyburide, Repaglinide, Sitagliptin, and Exenatide can only be given to type 2 diabetics because they require some level of a functioning pancreas. Insulin Lisopro, Regular Insulin, NPH Insulin, Insulin Glargine, and Insulin Degludec can be given to both type 1 & 2 patients. All listed meds increase insulin.

Question 22

A type 2 diabetic patient who is taking Glyburide to increase their insulin release is in the ER with complaints of nausea, vomiting, flusing, and a throbbing headache. What question should the nurse ask first?

a. Have you taken your insulin today?
b. Have you eaten today?
c. Have you consumed any alcohol lately?
d. Have you traveled out of the country recently?

Answer 22

C. Have you consumed any alcohol lately?

Gylyburide combined with alcohol can cause disulfiram-like reactions. Patients should be taught to avoid alcohol when on this medication.

Question 23

A patient with renal failure is now diagnosed with diabetes. What drug will the nurse anticipate will be prescribed to the patient to take within 30 minutes each meal.

a. Sitagliptin
b. Repaglinide
c. Sertraline
d. Ranitidine

Answer 23

b. Repaglinide

Repaglinide is safe in Renal function. BUT it is not safe with liver dysfunction, in that case the patient will receive a perscription for Nateglinide.

Question 24

A patient taking Sitagliptin and a sulfonylurea such as Glyburide should be aware of hypoglycemia symptoms. True or false.

Answer 24

True.

The risk of hypoglycemia is intensified for a patient taking both drugs.

Question 25

A type 2 diabetic patient taking a medication to promote glucose-dependent release of insulin Is in the ER with severe and persistent abdominal pain. Which drug will the nurse most likely expect is causing these symtoms. a. Sitagliptin b. Acarbose c. Pioglitazone d. metformin

Answer 25

a. Sitagliptin ## Footnote severe and persistent abdominal pain can cause pancreatitis in patients who are on Sitagliptin or EXENATIDE. If those symptoms occur and/or anaphylaxis and angioedema the patient should stop taking SITAGLIPTIN or EXENATIDE IMMEDIATELY.

Question 26

Acarbose is the **drug of choice** in type 2 diabetes to lower blood glucose. True or false.

Answer 26

False; METFORMIN ## Footnote Metformin is the drug of choice for initial therapy in type 2 diabetes

Question 27

The nurse can anticipate that a paient on Metformin may exerience all of the following adverse effects except? a. orange urine b. decreased apptite, nause, and diarrhea c. weight loss d. b-12 deficiency e. peripheral neuropathy f. lactic acidosis

Answer 27

a. orange urine

Question 28

A type 2 diabetic patient is experiencing heart failure secondary to fluid retention. What insulin would the nurse infer the patient is not on? a. Insulin Lispro b. pioglitazone c. metformin d. alphase

Answer 28

b. pioglitazone ## Footnote Piolitazone is contraindicated in patients with severe heart failure. signs of heart failure: dyspnea, edema, weight gain, fatigue

Question 29

A 27 year old female was newly diagnosed with type 2 diabetes and was started on Pioglitazone to increase her sensitivity to insulin by regulating glucose and lipid metabolism. What is the nurses priority to educate her about? a. Educate about contraceptive use b. Educate on signs of hepatoxicity (n/v, abdominal pain, dark urine, jaundice) c. Educate on signs of HF ( dyspnea, edema, weight gain, fatigue) d. Educate about the increase risk for fractures

Answer 29

a. Educate about contraceptive use | pioglitazone can stimulate ovulation causing unintended pregnancy ## Footnote ALL answers are correct. This is a **Priorty** for a women child brearing age because they neeed to use additional forms of contraceptive.

Question 30

What is the most unfavorable insulin that is used to delay intestinal absorption of carbohydrates causing gas, cramps, and diarrhea.

Answer 30

Acarbose

Question 31

A type 2 diabetic patient has recurently been seen at the urgent care down the road for increased urinary frequency and urinary tract infections. When asking about her medications shes been taking the nurse understands that it may be this medication she is taking. What do you anticipate the medication is? a. Acarbose b. Metformin c. Insulin Degludec d. Empagliflozin

Answer 31

d. Empagliflozin ## Footnote It reduces excess glucose by blocking reabsorption in the kidney therefore the patient is peeing the excess glucose out and bacteria loves sugar.

Question 32

A nurse can infer that a patient with hypothyroidism could have what disease?

Answer 32

Hasimoto's Disease ## Footnote LOW .. symptoms: dry hair, bradycardia, weight gain, low metabolism, constipation, cold intolerance, mix edema coma.

Question 33

A nurse can infer that a patient with hyperthyroidism could have what disease?

Answer 33

graves disease toxic nodular goiter thyroid storm ## Footnote HIGH .. symptoms: hair loss, bulging eyeballs, goiter, tachycardia, rapid weight loss, increased metabolism, diarrhea, heat intolerant.

Question 34

A patient ask the nurse to educate them about their new perscription, levothyroxine for hypothyroidism. What statements will the nurse include? a. It is a life long medication b. overdosing on levothyroxine can cause a thyroid storm c. chronic over treatment can lead to atrial fibrillation and bone loss d. your TSH levels will need to be checked annually e. levothyroxine is okay to take with other drugs

Answer 34

a. , b. , c. , d. ## Footnote E. is incorrect; levothyroxine is contraindicated to take with so many drugs that it is just safer NOT to take with any other drug for up to FOUR HOURS. For example: If levothyroxine was taken with warfarin it could intensify the bleeding efects of warfarin. It also sensitizes the heart to catecholamines.

Question 35

Levothyroxine should be take in the morning on an empty stomach 30-60 minutes before a meal. True or false?

Answer 35

True.

Question 36

Methimazole is a medication that immediately works to lower circulating levels of thyroid hormone. True or false?

Answer 36

False. ## Footnote Methimazole takes **3 to 12 weeks** to lower circulating levels of thyroid hormone in patients with hyperthyroidism. It should be taken the same time every day.

Question 37

A 28 year old female with hyperthyroidism is taking the throid reducing hormone, Methimazole, what are reasons she should stop taking this medication? Select all that apply. a. when monitoring T3 and T4 levels and they begin to show hypothyroidism b. she recently found out she was pregnant c. she began to have a sore throat and fever d. she doesn't feel the medication is working

Answer 37

a. , b. , c. ## Footnote Methimazole is not safe in first trimester patients. PTU is the medicatiions for females with hyperthyroidism and are pregnant. Sore throat and fever could be signs and symptoms of Agranulocytosis where WBC is low.

Question 38

Radioactive iodine is a very toxic drug and the patient should avoid close contact and shouldn't share anything. True or false.

Answer 38

true ## Footnote it releases radiation

Question 39

The medication Somatropin, allows for patients whom were diagnosed with stunted growth have a supplement for GH. They should start using this medication early and stop before their epiphyseal closes. True or False.

Answer 39

True ## Footnote Think about SHASBULLA

Question 40

Andre the Giant suffers from excessive growth hormone. What are some interventions that may be used? Select all that apply. a. surgery to the thyroid b. radiation to the thyroid c. exercise d. the use of Octreotide e. the use of Somatropin

Answer 40

a. , b. , d.

Question 41

Vasopression is an antidiuretic hormone that can cause water intoxication if the patient doesn't limit the amount of fluids they intake. What is not a sign/symptom of water intoxication? a. coughing b. drowsiness c. listlessness d. headache

Answer 41

a. couging

Question 42

A patient dx with Addison disease is begininning a new drug regime because of adrenal hormone insufficiency. The patient will be started on what mineralocorticoid combined with hydrocortisone, a glucocorticoid. a. cosyntropin b. dexamethasone c. fludrodortisone d. somatropin

Answer 42

c. fludrocortisone ## Footnote It is the only mineralocorticoid given in cases on insufficiency combined with a glucocorticoid, hydrocortisone. Cosyntropin is used to dx adrenal insufficiency. Dexamethasone is used to dx Cushing syndrome. Somatropin is used to stimulate GH.