Nokea
A nurse is caring for a client diagnosed with type 2 diabetes. When teaching the client about this condition, the nurse would identify which of the following as a risk factor?
- A. Young age
- B. Regular exercise
- C. Obesity
- D. Polyuria
Correct Answer: C
Rationale: The nurse informs the client that obesity is a risk factor associated with type 2 diabetes. Young age and regular exercise are not risk factors for type 2 diabetes. Polyuria is a symptom of diabetes and not a risk factor leading to type 2 diabetes.
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After teaching an in-service presentation to a group of nurses about diabetes and insulin, the presenter determines that the presentation was successful when the group identifies which of the following as a rapid-acting insulin?
- A. Insulin aspart (NovoLog)
- B. Isophane insulin suspension (Novolin N)
- C. Insulin glargine (Lantus)
- D. Insulin detemir (Levemir)
- E. Insulin glulisine (Apidra)
Correct Answer: A,E
Rationale: Insulin aspart (NovoLog) and insulin glulisine (Apidra) are rapid-acting insulins. Isophane insulin suspension is an intermediate-acting insulin. Insulin glargine and detemir are long-acting insulins.
A nurse is caring for a client receiving insulin glargine (Lantus) 20 units at bedtime. Initiation of which of the following drugs may increase the client's insulin requirement?
- A. Methylprednisolone (Medrol)
- B. Metoprolol (Lopressor)
- C. Fenofibrate (Tricor)
- D. Estradiol (Estrace)
- E. Niacin (Niaspan)
Correct Answer: A,D,E
Rationale: Corticosteroids (methylprednisolone), estrogens (estradiol), and niacin (Niaspan) are among the drugs that can decrease the effect of insulin and require an increase in insulin dosage to control the client's diabetes. Beta blockers and fibrates increase the effect of insulin and thus may require a decrease in the dosage of insulin.
The nurse monitoring a client receiving insulin glulisine (Apidra) notices the client has become confused, diaphoretic, and nauseated. The nurse checks the client's blood glucose and it is 60 mg/dL. Which of the following would the nurse most likely give?
- A. Orange or other fruit juice
- B. Glucose tablets
- C. Insulin glargine (Lantus)
- D. Hard candy
- E. Insulin detemir (Levemir)
Correct Answer: A,B,D
Rationale: Methods of terminating a hypoglycemic reaction include the administration of one or more of the following: orange or other fruit juice, hard candy or honey, glucose tablets, glucagon, or glucose 10% or 50% IV.
A nurse is preparing to administer a drug that helps lower blood glucose by increasing the production of insulin by beta cells in the pancreas. Which of the following might this be?
- A. Glyburide (DiaBeta)
- B. Metformin (Glucophage)
- C. Pioglitazone (Actos)
- D. Glipizide (Glucotrol)
- E. Acarbose (Precose)
Correct Answer: A,D
Rationale: Sulfonylureas, like glyburide (DiaBeta) and glipizide (Glucotrol), help lower blood glucose by increasing the production of insulin by beta cells in the pancreas.
A nurse is caring for a client receiving insulin detemir 10 units at bedtime. Which of the following drugs, if started, would most likely require a decrease in the dosage of insulin?
- A. Sulfamethoxazole/trimethoprim (Septra)
- B. Metoprolol (Lopressor)
- C. Fenofibrate (Tricor)
- D. Diltiazem (Verapamil)
- E. Albuterol (Ventolin)
Correct Answer: A,B,C
Rationale: Sulfonamides (sulfamethoxazole/trimethoprim), beta-blocking drugs (metoprolol), and fibrates (fenofibrate), among others, can increase the effect of insulin and require a decrease in insulin dosage to control the client's diabetes. Diltiazem and albuterol decrease the effect of insulin, requiring an increase in the dosage.