Question 1

Why are oral antidiabetic drugs not effective in the management of type 1 diabetes?

Accepted Answer

Oral antidiabetic drugs are not insulin.Most just help the patient use his or her naturally-produced insulin more efficiently,although some drugs also prevent glucose from entering the blood too quickly.

Question 2

How does acarbose (Precose)prevent blood glucose levels from rising too high?

Accepted Answer

Acarbose is an alpha-glucosidase inhibitor.Drugs from this class work by slowing the digestion of dietary starches and other carbohydrates by inhibiting an enzyme that breaks them down into glucose.The result of this action is that blood glucose does not rise as far or as fast after a meal.

Question 3

Which fasting blood glucose level indicates to the nurse that the antidiabetic drug that has been prescribed for a patient with type 2 diabetes is effective at maintaining target blood glucose levels?

Accepted Answer

The most common target range of fasting blood glucose levels for a patient with type 2 diabetes is 70 to 110 mg/dL.The 40-mg level represents hypoglycemia,which is not the intention of therapy and can cause neurologic problems.Levels of 120 and 160 are considered hyperglycemia.

Question 4

Which assessment precaution is most important for the nurse to teach a patient who is prescribed pioglitazone (Actos)as his or her only antidiabetic drug?

Accepted Answer

Pioglitazone is a drug from the thiazolidinedione class.Drugs from this class are associated with heart failure.An early symptom of heart failure is fluid retention leading to weight gain.A weight gain of more than 3 lb in 1 week is an indication of fluid retention.

Question 5

A patient with type 2 diabetes is prescribed nateglinide (Starlix).Which statement indicates to the nurse that the patient has a correct understanding of this therapy?

Accepted Answer

Nateglinide causes beta cells of the pancreas to undergo depolarization and release a small amount of preformed insulin.The peak action occurs in about 20 minutes after ingestion.To have the best action and prevent hypoglycemia,patients are instructed to take the drug within 15 minutes before eating.

Question 6

Why are sulfonylurea oral antidiabetic drugs not recommended for women who are breastfeeding?

Accepted Answer

None of the oral antidiabetic drugs should be used by breastfeeding women because they enter the breast milk and induce side effects in the infant.Those drugs that cause hypoglycemia,such as the sulfonylureas,are especially dangerous to the infant and can lead to permanent brain damage.

Question 7

A patient is to receive 15 units of NPH insulin and 20 units of regular insulin in the same syringe.In what order does the nurse perform the steps to prepare this injection?

Accepted Answer

NPH insulin and regular insulin are compatible and can be given in the same syringe.NPH insulin already contains some regular insulin but regular insulin contains no NPH insulin.Insulin is a high-alert drug and the insulin types and concentrations must be carefully checked to prevent a medication error.The tops of both vials are cleaned separately to reduce contamination with microorganisms.The amount of air injected into each vial is equal to the amount of drug to be withdrawn from the vial.Always inject the air into the intermediate-acting insulin bottle first,then inject the correct air volume into the regular insulin vial.To prevent contaminating the regular insulin,it is drawn up first after air has been injected into both vials.Drawing up the regular insulin right after injecting air into the regular insulin vial reduces the number of times the vial is penetrated.Checking for air bubbles and eliminating them before drawing up the next insulin helps ensure an accurate dose.Drawing up the NPH insulin second prevents the accidental contamination of regular insulin with NPH insulin.Checking that the volume of insulin matches the volume of each insulin added together helps ensure an accurate dose."

Question 8

A patient who is prescribed glyburide (DiaBeta)asks if having a glass of wine once a week is okay.What is the nurse's best response?

Accepted Answer

Under normal circumstances,blood glucose levels will not be affected by moderate use of alcohol when diabetes is well controlled.When using insulin,two alcoholic beverages for men and one for women can be ingested in addition to the normal meal plan.Because alcohol can induce hypoglycemia,it should be ingested with or shortly after a meal.Although alcohol can lead to or worsen liver problems and should not be taken with drugs that affect the liver,glyburide does not appear to cause liver problems

Question 9

A patient who has been prescribed sitagliptin (Januvia)calls the clinic and reports swelling of the face,lips,and tongue.What is the nurse's best response?

Accepted Answer

The patient has symptoms of angioedema,an allergic reaction to the drug.The swelling can continue and eventually block the patient's airway.This is an emergency situation and the patient needs immediate attention.Once this reaction occurs with a drug,the patient should not take the drug or any other drug from the same class again.

Question 10

A patient is prescribed repaglinide (Prandin)3 mg.The drug available is repaglinide 0.5 mg per tablet.How many tablets does the nurse administer to the patient?
_____ tablet(s)

Accepted Answer

The answer of A patient is prescribed repaglinide (Prandin)3 mg.The...

Question 11

A patient who has been prescribed exenatide (Byetta)reports a weight loss of 11 lb in the last month.What is the nurse's best action?

Accepted Answer

The actions of exenatide include reducing the sensation of hunger and slowing the rate that food leaves the stomach.Both these actions help the patient eat less and lose weight,a desired outcome for patients with type 2 diabetes.An 11-lb pound weight loss in 1 month is not excessive and no action needs to be taken at this time.

Question 12

A patient who had been taking the oral antidiabetic agents glyburide and metformin is now prescribed only Glucovance.The patient asks why only one drug is needed.What is the nurse's best response?

Accepted Answer

Glucovance is composed of glyburide and metformin in commonly used dosages to increase the convenience of antidiabetic therapy with both drugs.

Question 13

What precaution does the nurse teach a patient who is prescribed to take an oral sulfonylurea agent to maintain control of blood glucose levels?

Accepted Answer

Nonsteroidal anti-inflammatory drugs (NSAIDs)potentiate the hypoglycemic effects of sulfonylurea agents.Patients should avoid these drugs altogether or use them with great caution.

Question 14

Which blood laboratory test result is most important for the nurse to check before administering the first prescribed dose of miglitol (Glyset)to a patient?

Accepted Answer

Miglitol is an alpha glucosidase inhibitor.Drugs from this class can cause liver impairment.They should not be prescribed for anyone who already had a change in liver function.A common test of liver function is blood levels of lactate dehydrogenase.Normal lactate dehydrogenase levels range between 115 and 225 international units per liter.

Question 15

A patient with type 2 diabetes and heart failure who is prescribed metformin extended release (Glucophage XR)once daily now has muscle aches,drowsiness,low blood pressure,and a slow irregular heartbeat.What is the nurse's best action?

Accepted Answer

The muscle aches,drowsiness,low blood pressure,and a slow irregular heartbeat are symptoms of lactic acidosis,an adverse reaction to metformin.The drug should be stopped and the prescriber notified so that steps can be taken to reduce the acidosis.

Question 16

A patient who has been taking metformin (Glucophage)for a year is seen in the clinic and has all of the following laboratory results.Which result does the nurse report to the prescriber immediately?

Accepted Answer

BUN levels are one measure of kidney health.The normal range is 10 to 20 mg/dL.An elevated BUN may indicate kidney problems or dehydration.Metformin can cause kidney problems,and the risk for lactic acidosis is increased in any patient taking metformin who has impairment of kidney function.The prescriber must be aware of the situation and explore the possibility of kidney impairment further.The drug may need to be changed to a different class of antidiabetic drug.

Question 17

A patient newly diagnosed with type 2 diabetes who is prescribed rosiglitazone (Avandia)has all the following health problems.For which problem does the nurse check with the prescriber to make certain rosiglitazone is an appropriate drug choice?

Accepted Answer

Rosiglitazone carries a black box warning because it can cause heart failure in some patients.Patients most at risk are those who have had a previous myocardial infarction.Although heart failure can worsen asthma,it is not worsened by rosiglitazone,nor does the drug cause hypertension or glaucoma.

Quiz 25: Drugs for Diabetes

Why are oral antidiabetic drugs not effective in the management of type 1 diabetes?

How does acarbose (Precose) prevent blood glucose levels from rising too high?

Which fasting blood glucose level indicates to the nurse that the antidiabetic drug that has been prescribed for a patient with type 2 diabetes is effective at maintaining target blood glucose levels?

Which assessment precaution is most important for the nurse to teach a patient who is prescribed pioglitazone (Actos) as his or her only antidiabetic drug?

A patient with type 2 diabetes is prescribed nateglinide (Starlix) .Which statement indicates to the nurse that the patient has a correct understanding of this therapy?

Why are sulfonylurea oral antidiabetic drugs not recommended for women who are breastfeeding?

A patient is to receive 15 units of NPH insulin and 20 units of regular insulin in the same syringe.In what order does the nurse perform the steps to prepare this injection?

A patient who is prescribed glyburide (DiaBeta) asks if having a glass of wine once a week is okay.What is the nurse's best response?

A patient who has been prescribed sitagliptin (Januvia) calls the clinic and reports swelling of the face,lips,and tongue.What is the nurse's best response?

A patient is prescribed repaglinide (Prandin)3 mg.The drug available is repaglinide 0.5 mg per tablet.How many tablets does the nurse administer to the patient? _____ tablet(s)

A patient who has been prescribed exenatide (Byetta) reports a weight loss of 11 lb in the last month.What is the nurse's best action?

A patient who had been taking the oral antidiabetic agents glyburide and metformin is now prescribed only Glucovance.The patient asks why only one drug is needed.What is the nurse's best response?

What precaution does the nurse teach a patient who is prescribed to take an oral sulfonylurea agent to maintain control of blood glucose levels?

Which blood laboratory test result is most important for the nurse to check before administering the first prescribed dose of miglitol (Glyset) to a patient?

A patient with type 2 diabetes and heart failure who is prescribed metformin extended release (Glucophage XR) once daily now has muscle aches,drowsiness,low blood pressure,and a slow irregular heartbeat.What is the nurse's best action?

A patient who has been taking metformin (Glucophage) for a year is seen in the clinic and has all of the following laboratory results.Which result does the nurse report to the prescriber immediately?

A patient newly diagnosed with type 2 diabetes who is prescribed rosiglitazone (Avandia) has all the following health problems.For which problem does the nurse check with the prescriber to make certain rosiglitazone is an appropriate drug choice?