Patho/Pharm Antidiabetic agents (Flash cards - evolve) Test 3

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RachelPeaches
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Patho/Pharm Antidiabetic agents (Flash cards - evolve) Test 3
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2012-04-14 18:52:00
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Patho Pharm Antidiabetic agents Flash cards evolve Test
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Patho/Pharm Antidiabetic agents (Flash cards - evolve) Test 3
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  1. Which of the following is a rapid-acting insulin with an onset of action of less than 15 minutes?
    A. insulin glargine (Lantus)
    B. regular insulin (Humulin R)
    C. insulin detemir (Levemir)
    D. insulin aspart (Novolog)
    D. insulin aspart (Novolog)
    (this multiple choice question has been scrambled)
  2. Which long-acting insulin mimics natural, basal insulin with no peak action and a duration of 24 hours?
    A. insulin glargine (Lantus)
    B. insulin glulisine (Apidra)
    C. regular insulin (Humulin R)
    D. NPH insulin (Humulin N)?
    A. insulin glargine (Lantus)
    (this multiple choice question has been scrambled)
  3. Which insulin can be administered by continuous intravenous infusion?
    A. insulin detemir (Levemir)
    B. regular insulin (Humulin R)
    C. insulin glargine (Lantus)
    D. insulin aspart (Novolog)
    B. regular insulin (Humulin R)
    (this multiple choice question has been scrambled)
  4. For the most complete absorption, the recommended site for insulin injection should be into which area of the body?
    A. Abdomen
    B. Arm
    C. Thigh
    D. Buttocks
    A. Abdomen
    (this multiple choice question has been scrambled)
  5. Assuming the patient eats breakfast at
    8:30 AM, lunch at noon, and dinner at 6:00 PM, he or she is at highest
    risk of hypoglycemia following an 8:00 AM dose of NPH insulin at
    A. 10:00 AM.
    B. 2:00 PM.
    C. 5:00 PM.
    D. 8:00 PM.
    • C. 5:00 PM.
    • Breakfast eaten at 8:30 AM would cover the onset of NPH insulin, and lunch will cover the 2 PM time frame. However, if the patient does not eat a mid-afternoon snack, the NPH insulin may be peaking just before
    • dinner without sufficient glucose on hand to prevent hypoglycemia.
  6. Which information should be included in a teaching plan for patients taking oral hypoglycemic drugs? (Select all that apply.)
    A. Limit your alcohol consumption.
    B. Report symptoms of anorexia and fatigue.
    C. Take your medication only as needed.
    D. Notify your physician if blood glucose levels rise above the level set for you.
    • A. B. D.
    • Oral hypoglycemic drugs must be taken on a daily scheduled basis to maintain euglycemia and prevent long-term complications of diabetes. All other options are correct.
  7. The nurse is caring for a patient
    scheduled to undergo a cardiac catheterization procedure utilizing
    iodine-based contrast material. The nurse would question an order for
    which medication to be given to this patient the day before the
    scheduled procedure?
    A. acarbose (Precose)
    B. metformin (Glucophage)
    C. repaglinide (Prandin)
    D. rosiglitazone (Avandia)
    • B. metformin (Glucophage)
    • The concurrent use of metformin iodinated (iodine-containing) radiologic contrast media has been associated with both acute renal failure and lactic acidosis. Therefore metformin should be discontinued at least 48 hours prior to any radiologic study requiring such contrast media and should be held for at least 48 hours after the procedure.
  8. Alpha-glucosidase inhibitors differ from the sulfonylureas in that they
    A. greatly stimulate pancreatic insulin release.
    B. greatly increase the sensitivity of insulin receptor sites.
    C. delay the absorption of glucose, leading to lower glucose levels.
    D. cannot be used in combination with other antidiabetic drugs.
    • C. delay the absorption of glucose, leading to lower glucose levels.
    • Alpha-glucosidase is an enzyme necessary for the absorption of glucose from the gastrointestinal tract. Inhibiting this enzyme inhibits glucose absorption, delaying rises in postprandial serum glucose levels.
  9. Which actions describe the beneficial effects produced by sulfonylurea oral hypoglycemics? (Select all that apply.)
    A. Stimulate insulin secretion from beta cells
    B. Increase hepatic glucose production
    C. Enhance action of insulin in various tissues
    D. Inhibit breakdown of insulin by liver
    • A. C. D.
    • The sulfonylureas stimulate insulin secretion from the beta cells of the pancreas; enhance the actions of insulin in muscle, liver, and adipose tissue; and prevent the liver from breaking insulin down as fast as it ordinarily would (reduced hepatic clearance). Increased hepatic glucose production would serve to increase serum glucose levels, the opposite effect of oral hypoglycemic drugs.
  10. Which 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?
    A. acarbose (Precose)
    B. metformin (Glucophage)
    C. repaglinide (Prandin)
    D. rosiglitazone (Avandia)
    • C.
    • Repaglinide is known as the “Humalog of oral
    • hypoglycemic drugs.” The drug’s very fast onset of action allows patients to take the drug with meals and skip a dose when they skip a meal.
  11. Pramlintide (Symlin) is added to the
    treatment plan for a patient with type 1 diabetes. When teaching the
    patient about this medication, the nurse recognizes that
    A. pramlintide slows gastric emptying.
    B. pramlintide increases glucagon excretion.
    C. pramlintide works to prevent side effects of insulin.
    D. pramlintide is an oral drug administered 15 minutes before meals.
    • A. pramlintide slows gastric emptying.
    • Pramlintide is a synthetic form of the naturally occurring hormone amylin. It works by slowing gastric emptying, suppressing glucagon secretion, and centrally modulating appetite and satiety. It is only administered subcutaneously.
  12. When administering 30 units regular insulin and 70 units NPH insulin, the nurse will perform which action?
    A. Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin.
    B. Inform the patient that mixing insulins will help increase insulin production.
    C. Rotate sites at least once weekly and label the sites used on a diagram.
    D. Use a 23- to 25-gauge syringe with a 1-inch needle for maximum absorption.
    • A. Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin.
    • Drawing up the regular insulin into the syringe first prevents accidental mixture of NPH insulin into the vial of regular insulin, which could cause an alteration in the onset of action of the regular insulin.
  13. he nurse would include which statement when teaching a patient about insulin glargine?
    A. “You should inject this insulin just before meals because it is very fast acting.”
    B. “The duration of action for this insulin is approximately 8 to10 hours, so you will need to take it twice a day.”
    C. “You can mix this insulin with NPH insulin to enhance its effects.”
    D. “You cannot mix this insulin with regular insulin and thus will have to take two injections.”
    • D. “You cannot mix this insulin with regular insulin and thus will have to take two injections.”
    • Insulin glargine is a long-acting insulin with duration of action up to 24 hours. It should not be mixed with any
    • other insulins.
  14. To achieve the most beneficial effect, the nurse plans to administer glipizide (Glucotrol)
    A. with food.
    B. 30 minutes before a meal.
    C. 15 minutes postprandial.
    D. at bedtime.
    • B. 30 minutes before a meal.
    • Glipizide works best if given 30 minutes before meals. This allows the timing of the insulin secretion induced by the glipizide to correspond to the elevation in the blood glucose level induced by the meal.
  15. Diabetic teaching includes treatment of hypoglycemia with which drug?
    A. propranolol (Inderal)
    B. glucagon
    C. acarbose (Precose)
    D. bumetanide (Bumex)
    • B. glucagon
    • Glucagon stimulates glycogenolysis, raising serum glucose levels.
  16. When caring for a patient newly diagnosed with gestational diabetes, the nurse would question an order for which drug?
    A. insulin glargine (Lantus)
    B. glipizide (Glucotrol)
    C. insulin glulisine (Apidra)
    D. NPH insulin (Humulin N)
    • B. glipizide (Glucotrol)
    • All currently available oral antidiabetic drugs are contraindicated for pregnant patients.

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