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A 55-year-old woman with type 2 diabetes has recently been placed on glipizide. She asks the nurse when the best time would be to take this medication. What is the nurse's best response?
- A. Take this medication in the morning, 30 minutes before breakfast.
- B. Take this medication in the evening with a snack.
- C. This medication needs to be taken after the midday meal.
- D. It does not matter what time of day you take this medication.
Correct Answer: A
Rationale: Glipizide, a sulfonylurea, is taken 30 minutes before breakfast to align insulin secretion with postprandial glucose rise, mimicking normal physiology.
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A patient who has type 2 diabetes is scheduled for an oral endoscopy and has been NPO (nothing by mouth) since midnight. What is the best action by the nurse regarding the administration of her oral antidiabetic drugs?
- A. Administer half the original dose.
- B. Withhold all medications as ordered.
- C. Contact the prescriber for further orders.
- D. Give the medication with a sip of water.
Correct Answer: C
Rationale: NPO status increases hypoglycemia risk with oral antidiabetic drugs, so the prescriber must be contacted for adjusted orders. Giving or withholding without guidance is unsafe.
When monitoring a patient's response to oral antidiabetic drugs, the nurse knows that which laboratory result would indicate a therapeutic response?
- A. Random blood glucose level 180 mg/dL
- B. Blood glucose level of 50 mg/dL after meals
- C. Fasting blood glucose level of 92 mg/dL
- D. Evening blood glucose level below 80 mg/dL
Correct Answer: C
Rationale: A fasting blood glucose level of 80â??130 mg/dL, as per ADA guidelines, indicates a therapeutic response to oral antidiabetic drugs. Other options reflect hyperglycemia or hypoglycemia.
When teaching about hypoglycemia, the nurse will make sure that the patient is aware of the early signs of hypoglycemia, including which of these?
- A. Hypothermia and seizures
- B. Nausea and diarrhea
- C. Confusion and sweating
- D. Fruity, acetone odor to the breath
Correct Answer: C
Rationale: Early hypoglycemia signs include confusion and sweating due to central nervous system and sympathetic activation. Hypothermia and seizures are later symptoms, nausea/diarrhea are unrelated, and fruity breath indicates ketoacidosis.
The nurse is reviewing a patient's medication list and notes that sitagliptin (Januvia) is ordered. The nurse will question an additional order for which drug or drug class?
- A. Glitazone
- B. Insulin
- C. Metformin
- D. Sulfonylurea
Correct Answer: B
Rationale: Sitagliptin, a DPP-4 inhibitor, is not typically combined with insulin due to lack of established safety and efficacy. It can be used with metformin, sulfonylureas, or glitazones.
A patient has been diagnosed with metabolic syndrome and is started on the biguanide metformin. The nurse knows that the purpose of the metformin, in this situation, is which of these?
- A. To increase the pancreatic secretion of insulin
- B. To decrease insulin resistance
- C. To increase blood glucose levels
- D. To decrease the pancreatic secretion of insulin
Correct Answer: B
Rationale: Metformin reduces insulin resistance by decreasing hepatic glucose production and improving insulin sensitivity in tissues, beneficial for metabolic syndrome.