Chapter 39 Drug Therapy for Diabetes Mellitus

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Chapter 39  Drug Therapy for Diabetes Mellitus

 

 

Complete chapter Questions And Answers
 

Sample Questions

 

 

1. A patient with a diagnosis of diabetes is prescribed pramlintide (Symlin). How will this drug assist in controlling the patient’s blood sugar?

  1. A)  It slows gastric emptying.
  2. B)  It blocks the absorption of food.
  3. C)  It is absorbed by insulin.
  4. D)  It increases the release of insulin.

Ans: A
Feedback:
Pramlintide slows gastric emptying, helping to regulate the postprandial rise in blood sugar. Pramlintide does not block the absorption of food. Pramlintide is not absorbed by insulin. Pramlintide does not increase the release of insulin.

2. A patient is diagnosed with type 1 diabetes. What distinguishing characteristic is associated with type 1 diabetes?

  1. A)  Blood glucose levels can be controlled by diet.
  2. B)  Exogenous insulin is required for life.
  3. C)  Oral agents can control blood sugar.
  4. D)  The disease always starts in childhood.

Ans: B
Feedback:
Type 1 diabetes will result in eventual destruction of beta cells, and no insulin is produced. The blood glucose level can only be controlled by diet in type 2 diabetes. In type 2 diabetes, oral agents can be administered. Type 1 diabetes is diagnosed at many ages, not only in childhood.

3. A patient is in diabetic ketoacidosis. The patient blood glucose level is over 600 mg/dL. The physician has ordered the patient to receive an initial dose of 25 units of insulin intravenously. What type of insulin will most likely be administered?

  1. A)  NPH insulin
  2. B)  Lente insulin
  3. C)  Ultralente insulin
  4. D)  Regular insulin

Ans: D
Feedback:
Regular insulin has rapid onset of action and can be given via IV. It is the drug of choice for acute situations, such as diabetic ketoacidosis. Isophane insulin (NPH) is used for long-term insulin therapy. Lente insulin is an intermediate-acting insulin. Ultralente insulin is a long-acting insulin.

Page 1

  1. During a teaching session on the care of the diabetic patient, a family member asks why her daughter has a different insulin than her best friend. The nurse should make which of the following statements to explain the differences in insulin?
    1. A)  “Insulin is prescribed based on the insurer’s criteria for reimbursement.”
    2. B)  “Insulin is prescribed based on the patient’s age.”
    3. C)  “Insulins have different onsets and durations of action.”
    4. D)  “Insulin type is matched with the appropriate oral hypoglycemic agent.”

    Ans: C
    Feedback:
    When insulin therapy is indicated, the physician may choose from several preparations that vary in composition, onset, duration of action, and other characteristics. Insulin is not prescribed based solely on cost. Insulin is not prescribed based solely on the patient’s age. Insulin is not usually matched with oral hypoglycemic agents.

  2. A patient asks the nurse why a quick-acting sugar given by mouth is better in the regulation of insulin than the use of intravenous glucose for a low blood sugar. Which of the following statements by the nurse represents the most appropriate response to this question?
    1. A)  “The ingestion of food allows the digestive tract to stimulate vagal activity and

      the release of incretins.”

    2. B)  “The combination of insulin and food will yield a higher blood sugar than

      intravenous glucose.”

    3. C)  “Both food and intravenous glucose will produce changes similarly in the

      gastrointestinal tract to increase blood sugar.”

    4. D)  “You are mistaken. The intravenous glucose yields a higher blood glucose

      through the release of incretins.”

Ans: A

Feedback:

Oral glucose is more effective than intravenous glucose because glucose or food in the digestive tract stimulates vagal activity and induces the release of gastrointestinal hormones called incretins. The combination of insulin and food does not yield a higher blood glucose than intravenous insulin. Food stimulates the vagal nerve activity, but intravenous glucose does not. A statement that indicates that the patient is mistaken will belittle the patient and should be rephrased.

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