Question 1

A client with diabetes newly admitted to the hospital needs to receive an insulin injection at 08:00.The client states that the previous morning's dose was given in the abdomen.The nurse plans to give this morning's dose in which of the following locations?

Accepted Answer

It is recommended to rotate injection sites within the same general area to prevent lipodystrophy (changes in fat tissue) and absorption problems. However, injections should not be given in areas that are swollen, bruised or tender. Given that the client's previous dose was given in the abdomen, it is safe to assume that this site is suitable for insulin injections and can be used again.

Question 2

To prevent the development of a serious adverse drug effect,the nurse would question the physician about withholding metformin (Glucophage)for a client who has which of the following circumstances?

Accepted Answer

Metformin is usually withheld in patients undergoing procedures that involve the use of iodinated contrast material, such as an angiogram, due to the risk of lactic acidosis, especially in patients with reduced kidney function. Contrast used in angiograms can affect kidney function, which is crucial for metformin clearance.

Question 3

The nurse would do which of the following to administer a dose of insulin properly to a client with diabetes mellitus?

Accepted Answer

Insulin should be administered using an insulin syringe with the appropriate needle length and gauge. Aspiration should not be done before injecting insulin as it can increase the risk of hypoglycemia. The injection should be done at a 90-degree angle, unless otherwise instructed by the healthcare provider. The site should not be rubbed after injection as it can alter insulin absorption.

Question 4

The nurse is caring for a Muslim client.The nurse would withhold the newly ordered insulin dose and telephone the prescriber after noting an order for which of the following types of insulin?

Accepted Answer

Muslims are prohibited from consuming pork or any pork-derived product, including pork insulin. The nurse should withhold the newly ordered insulin dose and contact the provider to change the prescription to a permissible insulin type. Insulin glargine and insulin aspart are made using synthetic versions of human insulin, and NPH insulin is made from beef or pork pancreas but is considered permissible by most Muslim authorities.

Question 5

The nurse needs to prepare a dose of NPH insulin mixed with regular insulin.The nurse should do which of the following steps first to prepare the dose?

Accepted Answer

The first step in preparing the dose of NPH insulin mixed with regular insulin is to inject air into the NPH insulin to equal the amount of insulin needed. This is important to prevent mixing the insulins prematurely. Then, the nurse should inject air into the regular insulin and withdraw the needed amount. Finally, the nurse should add the regular insulin to the NPH insulin vial and gently mix the vial.

Question 6

A client has an order for a dose of regular insulin (Humulin R)in the morning and another in the late afternoon.If the client's supper tray generally arrives on the unit at 17:15,the nurse should plan to administer the afternoon dose at which of the following times?

Accepted Answer

Regular insulin (Humulin R) typically starts to work within 30 minutes to an hour. Administering it at 17:00 ensures it starts working by the time the client begins eating at 17:15, helping to manage blood glucose levels effectively during and after the meal.

Question 7

The nurse explains to a client beginning drug therapy with nateglinide (Starlix)that the drug acts in which of the following ways?

Accepted Answer

Nateglinide (Starlix) stimulates the pancreas to produce insulin, leading to a decrease in blood glucose levels.

Question 8

The nurse is assigned to the care of a client receiving glyburide (Micronase).The nurse assesses this client for which most common side effect?

Accepted Answer

Glyburide can cause hypoglycemia, which is the most common side effect. Therefore, the nurse should monitor the client for symptoms such as shakiness, sweating, anxiety, dizziness, hunger, and headache. If the client experiences these symptoms, the nurse should administer glucose or another form of sugar immediately.

Question 9

The nurse explains to a client beginning drug therapy with miglitol (Glyset)that the drug acts in which of the following ways?

Accepted Answer

Miglitol (Glyset) belongs to the class of medications called alpha-glucosidase inhibitors. It delays digestion and absorption of carbohydrates in the intestine, helping to lower blood sugar levels after meals.

Question 10

A client with newly diagnosed diabetes mellitus who was hospitalized for pneumonia is being switched from insulin to an oral hypoglycemic agent.The nurse writes in the care plan to monitor the blood glucose at which of the following times during the transition?

Accepted Answer

Monitoring blood glucose before each meal is crucial during the transition from insulin to an oral hypoglycemic agent to ensure that the medication is effectively managing the blood glucose levels and to adjust dosages as necessary.

Question 11

A client newly diagnosed with diabetes mellitus is being visited by the home health nurse.The nurse explains that which of the following places should not be used to store the newly obtained,unopened insulin vials?

Accepted Answer

Insulin vials should never be stored in the freezer as this can make them ineffective. They should always be stored in a refrigerator between 36-46°F.

Question 12

The nurse would question an order for metformin (Glucophage)in a client with which of the following active health problems?

Accepted Answer

Metformin is eliminated by the kidneys, so it is contraindicated in clients with renal insufficiency. This can lead to an increased risk of lactic acidosis. Peptic ulcer and gallstones are not contraindications to the use of metformin. Hypothyroidism can be a comorbidity in clients with diabetes and does not contraindicate the use of metformin.

Question 13

The nurse is preparing to draw up a dose of NPH insulin.Which of the following actions should the nurse take before drawing the dose into the syringe?

Accepted Answer

Rotating the vial between the hands will mix the insulin, as shaking or tapping the vial may cause frothing or clumping. Running the vial under hot water is not necessary for NPH insulin.

Question 14

The nurse teaches a client who is new to insulin therapy to self-assess for which of the following early signs of hypoglycemia?

Accepted Answer

The answer of The nurse teaches a client who is...

Question 15

A client with diabetes mellitus will begin drug therapy with acarbose (Precose).The nurse plans to include in a teaching plan that the most common side effect of this drug is which of the following?

Accepted Answer

The most common side effect of acarbose is abdominal cramping, bloating, and flatulence. This is because acarbose slows down the digestion of carbohydrates, which can lead to an increase in gas production in the intestines. Acarbose does not cause weight gain, hypoglycemia, or lactic acidosis.

Question 16

A client with diabetes has a history of glaucoma.After noting drug orders for NPH insulin and timolol (Timoptic)on the client's medication administration record,the nurse would ensure that the client understands how to recognize which of the following?

Accepted Answer

Timolol, a beta-blocker used in the treatment of glaucoma, can mask the symptoms of hypoglycemia, making it crucial for a client with diabetes to recognize signs of hypoglycemia. NPH insulin is used to control blood sugar in diabetes, which can lead to hypoglycemia if not properly managed.

Question 17

The nurse teaches a client beginning drug therapy with pioglitazone (Actos)that the drug acts in which of the following ways?

Accepted Answer

Pioglitazone (Actos) is from the thiazolidinediones class of drugs, which work by increasing the sensitivity of cells in the body to their own insulin. This helps the body use insulin more effectively and lowers blood sugar levels. Option A is incorrect because pioglitazone does not stimulate the pancreas to produce insulin. Option C is incorrect because pioglitazone does not decrease glucose production in the liver. Option D is incorrect because pioglitazone does not delay digestion and absorption of carbohydrates.

Question 18

The nurse would question a new drug order for rosiglitazone (Avandia)in a client with which of the following health problems?

Accepted Answer

Rosiglitazone is metabolized in the liver and should be avoided in clients with cirrhosis of the liver or active liver disease. It may increase the risk of liver failure. Clients with glaucoma may also need to be monitored closely if they receive rosiglitazone due to the potential for fluid retention and increased intraocular pressure. However, it is not a contraindication for its use. Kidney stones and hypertension are not contraindications for rosiglitazone use.

Question 19

The nurse has conducted a routine assessment of a client receiving glyburide (Micronase).The nurse is most concerned about the development of which adverse drug effect?

Accepted Answer

The nurse should be most concerned about the development of jaundice, as it is a symptom of liver dysfunction which can be a serious adverse effect of glyburide. Headache, diarrhea, and anorexia are all common side effects of glyburide but are not as concerning as liver dysfunction.

Question 20

A client with diabetes is beginning drug therapy with repaglinide (Prandin).The nurse explains that which of the following is the most common side effect of this drug?

Accepted Answer

The most common side effect of repaglinide is hypoglycemia, which can occur if the dose is too high or if the client skips a meal. Dizziness, joint pain, and upper respiratory infections are possible side effects but are less common than hypoglycemia.

Quiz 49: Drugs Affecting Conditions of the Pancreas

A client with diabetes newly admitted to the hospital needs to receive an insulin injection at 08:00.The client states that the previous morning's dose was given in the abdomen.The nurse plans to give this morning's dose in which of the following locations?

To prevent the development of a serious adverse drug effect,the nurse would question the physician about withholding metformin (Glucophage) for a client who has which of the following circumstances?

The nurse would do which of the following to administer a dose of insulin properly to a client with diabetes mellitus?

The nurse is caring for a Muslim client.The nurse would withhold the newly ordered insulin dose and telephone the prescriber after noting an order for which of the following types of insulin?

The nurse needs to prepare a dose of NPH insulin mixed with regular insulin.The nurse should do which of the following steps first to prepare the dose?

A client has an order for a dose of regular insulin (Humulin R) in the morning and another in the late afternoon.If the client's supper tray generally arrives on the unit at 17:15,the nurse should plan to administer the afternoon dose at which of the following times?

The nurse explains to a client beginning drug therapy with nateglinide (Starlix) that the drug acts in which of the following ways?

The nurse is assigned to the care of a client receiving glyburide (Micronase) .The nurse assesses this client for which most common side effect?

The nurse explains to a client beginning drug therapy with miglitol (Glyset) that the drug acts in which of the following ways?

A client with newly diagnosed diabetes mellitus who was hospitalized for pneumonia is being switched from insulin to an oral hypoglycemic agent.The nurse writes in the care plan to monitor the blood glucose at which of the following times during the transition?

A client newly diagnosed with diabetes mellitus is being visited by the home health nurse.The nurse explains that which of the following places should not be used to store the newly obtained,unopened insulin vials?

The nurse would question an order for metformin (Glucophage) in a client with which of the following active health problems?

The nurse is preparing to draw up a dose of NPH insulin.Which of the following actions should the nurse take before drawing the dose into the syringe?

The nurse teaches a client who is new to insulin therapy to self-assess for which of the following early signs of hypoglycemia?

A client with diabetes mellitus will begin drug therapy with acarbose (Precose) .The nurse plans to include in a teaching plan that the most common side effect of this drug is which of the following?

A client with diabetes has a history of glaucoma.After noting drug orders for NPH insulin and timolol (Timoptic) on the client's medication administration record,the nurse would ensure that the client understands how to recognize which of the following?

The nurse teaches a client beginning drug therapy with pioglitazone (Actos) that the drug acts in which of the following ways?

The nurse would question a new drug order for rosiglitazone (Avandia) in a client with which of the following health problems?

The nurse has conducted a routine assessment of a client receiving glyburide (Micronase) .The nurse is most concerned about the development of which adverse drug effect?

A client with diabetes is beginning drug therapy with repaglinide (Prandin) .The nurse explains that which of the following is the most common side effect of this drug?