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A patient has just been diagnosed with type 2 diabetes. The physician has prescribed an oral antidiabetic agent that will inhibit the production of glucose by the liver and thereby aid in the control of blood glucose. What type of oral antidiabetic agent did the physician prescribe for this patient?
- A. A sulfonylurea
- B. A biguanide
- C. A thiazolidinedione
- D. An alpha glucosidase inhibitor
Correct Answer: B
Rationale: Sulfonylureas exert their primary action by directly stimulating the pancreas to secrete insulin and therefore require a functioning pancreas to be effective. Biguanides inhibit the production of glucose by the liver and are in used in type 2 diabetes to control blood glucose levels. Thiazolidinediones enhance insulin action at the receptor site without increasing insulin secretion from the beta cells of the pancreas. Alpha glucosidase inhibitors work by delaying the absorption of glucose in the intestinal system, resulting in a lower postprandial blood glucose level.
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A nurse is conducting a class on how to self-manage insulin regimens. A patient asks how long a vial of insulin can be stored at room temperature before it goes bad. What would be the nurses best answer?
- A. If you are going to use up the vial within 1 month it can be kept at room temperature.
- B. If a vial of insulin will be used up within 21 days, it may be kept at room temperature.
- C. If a vial of insulin will be used up within 2 weeks, it may be kept at room temperature.
- D. If a vial of insulin will be used up within 1 week, it may be kept at room temperature.
Correct Answer: A
Rationale: If a vial of insulin will be used up within 1 month, it may be kept at room temperature.
An occupational health nurse is screening a group of workers for diabetes. What statement should the nurse interpret as suggestive of diabetes?
- A. Ive always been a fan of sweet foods, but lately Im turned off by them.
- B. Lately, I drink and drink and cant seem to quench my thirst.
- C. No matter how much sleep I get, it seems to take me hours to wake up.
- D. When I went to the washroom the last few days, my urine smelled odd.
Correct Answer: B
Rationale: Classic clinical manifestations of diabetes include the three Ps: polyuria, polydipsia, and polyphagia. Lack of interest in sweet foods, fatigue, and foul-smelling urine are not suggestive of diabetes.
A nurse is caring for a patient newly diagnosed with type 1 diabetes. The nurse is educating the patient about self-administration of insulin in the home setting. The nurse should teach the patient to do which of the following?
- A. Avoid using the same injection site more than once in 2 to 3 weeks.
- B. Avoid mixing more than one type of insulin in a syringe.
- C. Cleanse the injection site thoroughly with alcohol prior to injecting.
- D. Inject at a 45 angle.
Correct Answer: A
Rationale: To prevent lipodystrophy, the patient should try not to use the same site more than once in 2 to 3 weeks. Mixing different types of insulin in a syringe is acceptable, within specific guidelines, and the needle is usually inserted at a 90 angle. Cleansing the injection site with alcohol is optional.
A nurse is teaching basic survival skills to a patient newly diagnosed with type 1 diabetes. What topic should the nurse address?
- A. Signs and symptoms of diabetic nephropathy
- B. Management of diabetic ketoacidosis
- C. Effects of surgery and pregnancy on blood sugar levels
- D. Recognition of hypoglycemia and hyperglycemia
Correct Answer: D
Rationale: It is imperative that newly diagnosed patients know the signs and symptoms and management of hypoand hyperglycemia. The other listed topics are valid points for education, but are not components of the patients immediate survival skills following a new diagnosis.
A patient with type 2 diabetes has been managing his blood glucose levels using diet and metformin (Glucophage). Following an ordered increase in the patients daily dose of metformin, the nurse should prioritize which of the following assessments?
- A. Monitoring the patients neutrophil levels
- B. Assessing the patient for signs of impaired liver function
- C. Monitoring the patients level of consciousness and behavior
- D. Reviewing the patients creatinine and BUN levels
Correct Answer: D
Rationale: Metformin has the potential to be nephrotoxic; consequently, the nurse should monitor the patients renal function. This drug does not typically affect patients neutrophils, liver function, or cognition.