Chapter 38  Agents to Control Blood Glucose Levels

Chapter 38  Agents to Control Blood Glucose Levels

Complete Chapter Questions And Answers
 

Sample Questions

1. An type 1 (insulin-dependent) diabetic reports recurrent hypoglycemia late in the morning. After
collecting his health history what finding would the nurse suspect is causing the late morning
hypoglycemia?

A) The patient likes to nap after work before his evening meal.

B) The patient jogs 2 miles in the morning before he goes to work.

C) The patient likes to have an early lunch with his girlfriend.

D) The patient eats oatmeal early in the morning for breakfast.

Ans: B

Feedback:

Physical exercise, such as jogging, changes insulin requirements and may result in a delayed
hypoglycemic reaction. The fact that he likes to nap before dinner and has an early lunch is unrelated to
his hypoglycemia. The patient eating oatmeal early in the morning would help stabilize his blood
sugars until later in the morning, but the jogging would have a dramatic effect.

2. The nurse suspects the diabetic patient may be having a hypoglycemic reaction when what
manifestation is assessed?

A) Dry, flaky skin

B) Diaphoresis

C) Flushing of the face

D) Fruity breath

Ans: B

Feedback:

Diaphoresis and cool clammy skin are signs of hypoglycemia. A fruity breath is seen with ketoacidosis.
Flushing of the face is associated with hyperglycemia.

3. The nurse is preparing patient teaching for a diabetic patient who is to begin pramlintide acetate
(Symlin) therapy, which will be taken in addition to insulin. What is the priority nursing instruction to
include in this teaching plan?

Test Bank – Focus on Nursing Pharmacology (7th Edition by Amy Karch) 618

A) ​The drug is injected subcutaneously immediately before a major meal.​

B) ​The drug has a rapid onset of action.​

C) ​Inject the drug at least 2 inches away from any insulin injection site.​

D) ​Do not combine the drug with insulin in the same syringe.​

Ans: A

Feedback:

Pramlintide works to modulate gastric emptying after a meal, so correct timing of administration of this
drug is essential to its function. All options are appropriate instructions for this drug. However, making
sure that the patient understands that injecting the medication immediately before eating a major meal
is most important because it has a dramatic effect on the therapeutic action of the drug. If the
medication is not given at the correct time, the other options would be insignificant.

4. What type of insulin would the nurse administer if the fastest therapeutic effects are needed?

A) Lispro (Humalog)

B) Aspart (NovoLog)

C) Regular (Humulin R)

D) Glulisine (Apidra)

Ans: D

Feedback:

Glulisine has an onset of 2 to 5 minutes and peaks in 30 to 90 minutes so it has the fastest onset of
action. Lispro has an onset in <15 minutes and also peaks at 30 to 90 minutes. Aspart takes 10 to 20
minutes for onset and peeks in 1 to 3 hours. Regular insulin has a 30 to 60 minute onset and peaks in 2
to 4 hours.

5. When the nurse administers an oral combination drug called Metaglip, what doses of the two
medications are being administered?

A) 2.5 mg glipizide, 500 mg metformin

B) 1.25 mg glyburide, 250 mg metformin

C) 5 mg glipizide, 250 mg metformin

D) 4 mg rosiglitazone, 500 mg metformin

Ans: A

Feedback:

Metaglip is a combination of 2.5 mg glipizide with 250 or 500 mg metformin or 5 mg glipizide and 500
mg metformin. Glucovance is a combination of 1.25 mg glyburide with 250 mg metformin, 2.5 mg
glyburide with 500 mg metformin, and 5 mg glyburide with 500 mg of metformin. Avandamet is a
combination of 1, 2, or 4 mg rosiglitazone with 500 mg metformin.