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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.
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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 instructions for a patient with type 2 diabetes who also takes insulin injections as part of the therapy. The nurse asks the patient 'What should you do if your fasting blood glucose is 44 mg/dL?' Which response by the patient reflects a correct understanding of insulin therapy?
- A. I will call my doctor right away.
- B. I will give myself the regular insulin.
- C. I will take an oral form of glucose.
- D. I will rest until the symptoms pass.
Correct Answer: C
Rationale: A fasting blood glucose of 44 mg/dL indicates hypoglycemia, requiring immediate oral glucose intake (e.g., glucose tablets) to raise blood sugar. Insulin would worsen it, and delaying or calling the doctor is not optimal.
A patient will be taking U-500 insulin. The nurse is reviewing the use of this drug. Which of these statements are true? (Select all that apply.)
- A. U-500 insulin is 5 times stronger than U-100 insulin.
- B. U-500 insulin syringes must be used when giving U-500 insulin.
- C. U-500 syringes can deliver 500 units of insulin.
- D. Each line on a U-500 syringe measures 5 units of U-500 insulin.
- E. U-500 insulin delivers a smaller dose of insulin in a single injection.
Correct Answer: A,B,D
Rationale: U-500 insulin is five times more concentrated than U-100, requires specific U-500 syringes, and each line measures 5 units. It delivers larger doses in smaller volumes, not smaller doses.
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 teaching a patient who is starting metformin, which instruction by the nurse is correct?
- A. Take metformin if your blood glucose level is above 100 mg/dL.
- B. Take this 60 minutes after breakfast.
- C. Take the medication on an empty stomach 1 hour before meals.
- D. Take the medication with food to reduce gastrointestinal (GI) effects.
Correct Answer: D
Rationale: Metformin should be taken with food to minimize GI side effects like nausea and diarrhea. Timing with specific glucose levels or empty stomach is incorrect.