Unit 4 Q's Flashcards
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?
-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
At the patient’s next visit, his A1C level is 6%. How will the nurse interpret this finding?
-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
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?
-Since insulin is given intravenously, it only affects the mother
-Oral medications enter the GI tract and can affect mother and the baby
N.B. is concerned about how her diabetes can affect her baby. What teaching points would the nurse provide?
-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
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.?
-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
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.
Loratadine
Which of the following is needed for glucose to enter the cells?
Insulin
When giving dextromethorphan, the nurse understands that this drug suppresses the cough reflex by which mechanism of action?
Having direct action on the cough center
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?
Increased growth
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?
Recent MI
A patient is prescribed dextromethorphan and the nurse is explaining that the use of the drug is
Antitussive
Before administering dextromethorphan, the nurse should monitor:
Cough
Asthma is characterized by:
inflammation and bronchospasms
Which of the following medications are given for asthma prophylaxis:
Montelukast
Diphenhydramine is from which drug classification?
Antihistamine
Beta 2 adrenergic agonist, a sympathomimetic, is an effective drug group to control asthma. The action of beta 2 adrenergic is to:
enhance bronchodilation
A common adverse effect of bronchodilators is:
Tachycardia
Which is the most common adverse effect of diphenhydramine?
drowsiness
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:
Albuterol, a beta agonist bronchodilator, by inhalation
When a patient is receiving vasopressin, the nurse will monitor for which therapeutic response?
Increased blood pressure
Medication being administered in ICU
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?
Diabetes insipidus
a rare disorder that causes the body to make too much urine
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?
in the morning
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?
“This is an expected adverse effect. Let me take your pulse.”
The nurse is preparing to administer propylthiouracil to a patient. Before administration the nurse explains that propylthiouracil is used to treat:
Hyperthyroidism
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:
liver and bone marrow toxicity
The nurse is explaining the use of Levothyroxine to the patient. Which of the following is the correct use for Levothyroxine:
Thyroid gland is not functioning
The nurse is explaining to a patient that codeine produces which of the following adverse effect:
Sedation
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?
loosens and thins respiratory secretions.
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?
15 min
The nurse is providing teaching for long acting insulin. Which of the following is classified as a long acting insulin?
Lantus
A client is asking the nurse how long the insulin will last. The nurse explains that the long acting insulin (Lantus, Levimir) will last:
24 hours
The nurse instructs the patient that short acting insulin will last:
6-10 hours
A patient has just been diagnosed with Type 2 diabetes, what should the nurse monitor?
Diet and blood glucose
When teaching about hypoglycemia. The nurse will make sure that the patient is aware of the early signs of hypoglycemia, including:
confusion and sweating.
When monitoring a patient’s response to oral antidiabetic drugs, the nurse knows which laboratory result would indicate a therapeutic response?
Fasting blood glucose level of 92 mg/dL
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?
Contact the prescriber for further orders.
Which action is most appropriate regarding the nurse’s administration of a rapid-acting insulin to a hospitalized patient?
Give it within 15 minutes of mealtime
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?
Hemoglobin A1C level
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?
Administer glucagon
The nurse is preparing to administer insulin intravenously. Which statement about the administration of intravenous insulin is true?
Only regular insulin can be administered intravenously
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?
The corticosteroids may cause an increase in glucose levels.
When teaching a patient who is starting metformin (Glucophage), which instruction by the nurse is correct?
Take the medication with food to reduce gastrointestinal (GI) effects.
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?
in the morning with an 8-ounce glass of water
The nurse would question a prescription for somatropin in a patient with which condition?
Acromegaly
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?
Decrease in urine output
The nurse admitting a patient with acromegaly anticipates administering which medication?
Octreotide
After administering somatropin to a patient, the nurse would assess for potential adverse effects of this medication by monitoring which laboratory test result?
Glucose
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?
“I will take this medication in the morning so it does not affect my sleep at night.”
The nurse would suspect a patient is taking too much levothyroxine when the patient exhibits which adverse effect?
Irritability
For a patient taking levothyroxine and warfarin concurrently, the nurse would closely monitor for which possible serious adverse effect?
Increased bruising
A patient receiving propylthiouracil (PTU) asks the nurse, “How does this medication relieve symptoms?” What is the appropriate response by the nurse?
“PTU inhibits the formation of new thyroid hormone, thus returning your metabolism to normal.”
Which patient statement demonstrates understanding of radioactive iodine (I-131) therapy?
“This drug will be taken up by the thyroid gland and destroys thyroid tissue.”
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?
Joint pain
Liver toxicity
Bone marrow toxicity
Which is a rapid-acting insulin with an onset of action of less than 15 minutes?
Insulin aspart
Which long-acting insulin mimics natural, basal insulin with no peak action and a duration of 24 hours?
Insulin glargine
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?
5:00 PM
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?
Metformin
When caring for a pregnant patient with gestational diabetes, the nurse would question a prescription for which drug?
Glipizide
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?
Repaglinide
