Diabetes Questions mostly on diabetes Drugs: NCLEX and PrepU Questions

Diabetes Questions mostly on diabetes Drugs: NCLEX and PrepU Questions

ScienceMedicine audrey_smith79 Save EXAM 3: Chapter 32: Anti-diabetic D...64 terms heatherjc1Preview Thyroid Disorders NCLEX Questions...12 terms erin_colmenero Preview Diabetes Mellitus NCLEX Style Ques...Teacher 36 terms ssandholmPreview Cushin 44 term alex A patient with a diagnosis of diabetes is prescribed pramlintide (Symlin). How will this drug assist in controlling the patient's blood sugar?

• It blocks the absorption of food.
• It is absorbed by insulin.
• It increases the release of insulin.
• It slows gastric emptying.

It slows gastric emptying.Pramlintide slows gastric emptying, helping to regulate the postprandial rise in blood sugar. Pramlintide does not block the absorption of food.Pramlintide is not absorbed by insulin. Pramlintide does not increase the release of insulin.

Polydipsia and polyuria related to diabetes mellitus are primarily due to:

• The release of ketones from cells during fat metabolism
• Fluid shifts resulting from the osmotic effect of hyperglycemia
• Damage to the kidneys from exposure to high levels of glucose
• Changes in RBCs resulting from attachment of excessive glucose to hemoglobin"
• Fluid shifts resulting from the osmotic effect of hyperglycemia (Rationale: The osmotic effect of glucose produces the manifestations of

polydipsia and polyuria.)

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

• insulin glargine (Lantus)
• insulin aspart (Novolog)
• regular insulin (Humulin R)
• insulin detemir (Levemir)

B Insulin aspart is a rapid-acting insulin.Insulin glargine and insulin detemir are long-acting insulins.Regular insulin is short acting.Which long-acting insulin mimics natural, basal insulin with no peak action and a duration of 24 hours?

• Insulin glulisine
• Insulin glargine
• Regular insulin
• NPH insulin

B Which insulin can be administered by continuous intravenous (IV) infusion?

• Insulin aspart
• Insulin detemir
• Insulin glargine
• Regular insulin

D The nurse caring for a patient hospitalized with diabetes mellitus would look for which laboratory test result to obtain information on the patient's past glucose control?

• Prealbumin level
• Urine ketone level
• Fasting glucose level
• Glycosylated hemoglobin level
• Glycosylated hemoglobin level

A glycosylated hemoglobin level detects the amount of glucose that is bound to red blood cells (RBCs). When circulating glucose levels are high, glucose attaches to the RBCs and remains there for the life of the blood cell, which is approximately 120 days. Thus the test can give an indication of glycemic control over approximately 2 to 3 months. The prealbumin level is used to establish nutritional status and is unrelated to past glucose control. The urine ketone level will only show that hyperglycemia or starvation is probably currently occurring. The fasting glucose level only indicates current glucose control.

T/F: All cells can use fatty acids interchangeably with glucose for energy.

False, Almost all cells

Which statement would be corrected for a patient with type 2 diabetes who was admitted to the hospital with pneumonia

• The patient must receive insulin therapy to prevent ketoacidosis
• The patient has islet cell antibodies that have destroyed the pancreas's ability to produce insulin
• The patient has minimal or absent endogenous insulin secretions and requires daily insulin injections
• The patient may have sufficient endogenous insulin to prevent kerosine but is risk for hyperosmolar hyperglycemia syndrome
• The patient may have sufficient endogenous insulin to prevent kerosine but is risk for hyperosmolar hyperglycemia syndrome

(Rationale: Hyperosmolar hyperglycemic syndrome (HHS) is a life-threatening syndrome that can occur in a patient with diabetes who is able to produce enough insulin to prevent diabetic ketoacidosis (DKA) but not enough to prevent severe hyperglycemia, osmotic diuresis, and extracellular fluid depletion.) A patient is diagnosed with type 1 diabetes. What distinguishing characteristic is associated with type 1 diabetes?

• The disease always starts in childhood.
• Oral agents can control blood sugar.
• Exogenous insulin is required for life.
• Blood glucose levels can be controlled by diet.

Exogenous insulin is required for life.Type 1 diabetes will result in eventual destruction of beta cells, and no insulin is produced. The blood glucose level can only be controlled by diet in type 2 diabetes. In type 2 diabetes, oral agents can be administered. Type 1 diabetes is diagnosed at many ages, not only in childhood.The nurse has just completed teaching a client newly diagnosed with type 1 diabetes about rapid-acting insulin. The nurse determines that

teaching was effective when the client selects:

-Lispro -Regular -NPH -Glargine Lispro --There are four principal types of insulin: short acting, rapid acting, intermediate acting, and long acting. Regular insulin is short-acting insulin whose effects begin within 30 minutes after subcutaneous injection and generally last for 5 to 8 hours. The rapid-acting insulins (lispro, aspart, and glulisine) have a more rapid onset, peak, and duration of action than short-acting regular insulin and are administered immediately before a meal. Intermediate- to long-acting insulins include NPH, glargine, and detemir. These insulins have slower onsets and a longer duration of action.-- Which long-acting insulin mimics natural, basal insulin with no peak action and a duration of 24 hours?

• insulin glargine (Lantus)
• insulin glulisine (Apidra)
• regular insulin (Humulin R)
• NPH insulin (Humulin N)

A Insulin glargine has a duration of action of 24 hours with no peaks, mimicking the natural, basal insulin secretion of the pancreas.

A patient is in diabetic ketoacidosis. The patient blood glucose level is over 600 mg/dL. The physician has ordered the patient to receive an initial dose of 25 units of insulin intravenously. What type of insulin will most likely be administered?

• Ultralente insulin
• Lente insulin
• Regular insulin
• NPH insulin

Regular insulin Regular insulin has rapid onset of action and can be given via IV. It is the drug of choice for acute situations, such as diabetic ketoacidosis.Isophane insulin (NPH) is used for long-term insulin therapy. Lente insulin is an intermediate-acting insulin. Ultralente insulin is a long-acting insulin.A nurse is evaluating patients for the risk of developing type 2 diabetes. Which of the following patients has the highest risk?-A 45-year-old obese woman with a sedentary lifestyle -A 10-year-old boy whose grandmother has type 2 diabetes -A 40-year-old man who has an active lifestyle -A 60-year-old woman with a history of gestational diabetes A 45-year-old obese woman with a sedentary lifestyle --The person most at risk for developing type 2 diabetes is the 45-year-old obese woman with a sedentary lifestyle. Other risk factors include family history, age older than 40, and history of gestational diabetes. The 10-year-old boy, despite family history, would be at low risk as long as obesity and sedentary lifestyle are avoided. The 60-year-old woman most likely would have developed type 2 diabetes within 20 years after the pregnancy.-- Analyze the following diagnostic findings for your patient with type 2 diabetes. Which result will need further assessment?

A. A1C 9%

B. BP 126/80

• FBG 130 mg/dL
• LDL cholesterol 100 mg/dL

A. A1C 9%

(Rationale: Lowering hemoglobin A1C (to less than 7%) reduces microvascular and neuropathic complications. Keeping blood glucose levels in a tighter range (normal hemoglobin A1C level, less than 6%) may further reduce complications but increases hypoglycemia risk.) T/F: Insulin is produced by the pancreatic beta cells in the islets of Langerhans.True The nurse is evaluating a 45-year-old patient diagnosed with type 2 diabetes mellitus. Which symptom reported by the patient is considered one of the classic clinical manifestations of diabetes?

• Excessive thirst
• Gradual weight gain
• Overwhelming fatigue
• Recurrent blurred vision
• Excessive thirst

The classic symptoms of diabetes are polydipsia (excessive thirst), polyuria, (excessive urine output), and polyphagia (increased hunger). Weight gain, fatigue, and blurred vision may all occur with type 2 diabetes, but are not classic manifestations.