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Mount St. Marys College - NURSING 30 Chapter 47: Antidiabetics 

MULTIPLE CHOICE

1)The nurse is teaching a group of nursing students about diabetes. The nurse explains that which type of diabetes is the most common?

1. 1. Type 1 diabetes mellitus
   2. Type 2 diabetes mellitus
   3. Diabetes insipidus
   4. Secondary diabetes
2. A patient develops type 2 diabetes mellitus. The nurse will explain that this type of diabetes
   1. is generally triggered by medications.
   2. is not as common as type 1 diabetes.
   3. is often related to heredity and obesity.
   4. will not require insulin therapy.
3. A patient who is overweight is being evaluated for diabetes. The patient has a blood glucose level of 160 mg/dL and a hemoglobin A_1c of 5.8%. The nurse understands that this patient has which condition?
   1. Diabetes mellitus
   2. Hypoglycemia
   3. Normal blood levels
   4. Prediabetes
4. The nurse is teaching a patient who is newly diagnosed with type 1 diabetes mellitus about insulin administration. Which statement by the patient indicates a need for further teaching?

1. “I may use a chosen site daily for up to a week.”
2. “I should give each injection a knuckle length away from a previous injection.”
3. “I will not be concerned about a raised knot under my skin from injecting insulin.”
4. “Insulin is absorbed better from subcutaneous sites on my abdomen.

5. The nurse is teaching a patient how to administer insulin. The patient is thin with very little body fat. The nurse will suggest injecting insulin
   1. by pinching up the skin and injecting straight down.
   2. in the abdomen only with the needle at a 90-degree angle.
   3. subcutaneously with the needle at a 45- to 60-degree angle.
   4. using the thigh and buttocks areas exclusively.
6. The nurse receives the following order for insulin: IV NPH (Humulin NPH) 10 units. The nurse will perform which action?
   1. Administer the dose as ordered.
   2. Clarify the insulin type and route.
   3. Give the drug subcutaneously.
   4. Question the insulin dose.
7. The nurse will administer parenteral insulin to a patient who will receive a mixture of NPH (Humulin NPH) and regular (Humulin R). The nurse will give this medication via which route?
   1. Intradermal
   2. Intramuscular
   3. Intravenous
   4. Subcutaneous
8. The nurse is teaching a patient about home administration of insulin. The patient will receive regular (Humulin R) and NPH (Humulin NPH) insulin at 0700 every day. What is important to teach this patient?
   1. “Draw up the medications in separate syringes.”
   2. “Draw up the NPH insulin first.”
   3. “Draw up the regular insulin first.”
   4. “Draw up the medications after mixing them in a vial.”
9. A patient is ordered to receive insulin lispro at mealtimes. The nurse will instruct this patient to administer the medication at which time?
   1. 5  min before eating
   2. 15  min after eating
   3. 30  min before eating
   4. 10  min after eating
10. The parent of a junior high school child who has type 1 diabetes asks the nurse if the child can participate in sports. The nurse will tell the parent
    1. that strenuous exercise is not recommended for children with diabetes.
    2. that the child must be monitored for hyperglycemia while exercising.
    3. to administer an extra dose of regular insulin prior to exercise.
    4. to send a snack with the child to eat just prior to exercise.
11. A patient has administered regular insulin 30 min prior but has not received a breakfast tray.

The patient is experiencing nervousness and tremors. What is the nurse’s first action?

11. 1. Administer glucagon.
    2. Give the patient orange juice.
    3. Notify the kitchen to deliver the tray.
    4. Perform bedside glucose testing.
12. A patient who has type 1 diabetes mellitus asks the nurse about using a combination insulin product such as Humalog 70/20. The nurse will tell the patient that use of this product
    1. depends on individual insulin needs.
    2. is useful for patient with insulin resistance.
    3. means less rotation of injection sites.
    4. requires refrigeration at all times.
13. The patient asks the nurse about storing insulin. Which response by the nurse is correct?
    1. “All insulin vials must be refrigerated.”
    2. “Insulin will last longer if kept in the freezer.”
    3. “Opened vials of insulin must be discarded.”
    4. “Some combination pens do not require refrigeration.”
14. A patient who has insulin-dependent diabetes mellitus must take a glucocorticoid medication for osteoarthritis. When teaching this patient, the nurse will explain that there may be a need to
    1. decrease the glucocorticoid dose.
    2. decrease the insulin dose.
    3. increase the glucocorticoid dose.
    4. increase the insulin dose.
15. Which statement by a patient who will begin using an external insulin pump indicates understanding of this device?
    1. “I will have an increased risk for hypoglycemia.”
    2. “I will leave this on when bathing or swimming.”
    3. “I will not need to count carbohydrates anymore.”
    4. “I will still need to monitor serum glucose.”
16. A patient who is unconscious and has a pulse is brought to the emergency department. The patient is wearing a Medic-Alert bracelet indicating type 1 diabetes mellitus. The nurse will anticipate an order to administer
    1. cardiopulmonary resuscitation (CPR).
    2. glucagon.
    3. insulin.
    4. orange juice.
17. A patient who has type 2 diabetes mellitus asks the nurse why the provider has changed the oral antidiabetic agent from tolbutamide (Orinase) to glipizide (Glucotrol). The nurse will explain that glipizide
    1. has a longer duration of action.
    2. has fewer gastrointestinal side effects.
    3. may be taken on an as-needed basis.
    4. results in less hypoglycemic potential.
18. A patient who has been taking a sulfonylurea antidiabetic medication will begin taking metformin (Glucophage). The nurse understands that this patient is at increased risk for which condition?
    1. Hypoglycemia
    2. Hyperglycemia
    3. Renal failure
    4. Respiratory distress