Nokea
A patient is taking a sulfonylurea medication for new-onset type 2 diabetes mellitus. When reviewing potential adverse effects during patient teaching, the nurse will include information about which of these effects? (Select all that apply.)
- A. Hypoglycemia
- B. Nausea
- C. Diarrhea
- D. Weight gain
- E. Peripheral edema
Correct Answer: A,B,D
Rationale: Sulfonylureas can cause hypoglycemia due to increased insulin secretion, nausea as a GI side effect, and weight gain from insulin stimulation. Diarrhea and edema are not common.
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After starting treatment for type 2 diabetes mellitus 6 months earlier, a patient is in the office for a follow-up examination. The nurse will monitor which laboratory test to evaluate the patient's adherence to the antidiabetic therapy over the past few months?
- A. Hemoglobin levels
- B. Hemoglobin A1C level
- C. Fingerstick fasting blood glucose level
- D. Serum insulin levels
Correct Answer: B
Rationale: Hemoglobin A1C reflects average blood glucose over 2â??3 months, indicating adherence to antidiabetic therapy. Other tests provide less comprehensive data.
The nurse is teaching a review class to nurses about diabetes mellitus. Which statement by the nurse is correct?
- A. Patients with type 2 diabetes will never need insulin.
- B. Oral antidiabetic drugs are safe for use during pregnancy.
- C. Pediatric patients cannot take insulin.
- D. Insulin therapy is possible during pregnancy if managed carefully.
Correct Answer: D
Rationale: Insulin is the preferred therapy for diabetes in pregnancy due to safety concerns with oral antidiabetic drugs. Type 2 patients may need insulin, and pediatric patients can use insulin.
Which action is most appropriate regarding the nurse's administration of a rapid-acting insulin to a hospitalized patient?
- A. Give it within 15 minutes of mealtime.
- B. Give it after the meal has been completed.
- C. Administer it once daily at the time of the midday meal.
- D. Administer it with a snack before bedtime.
Correct Answer: A
Rationale: Rapid-acting insulin, like lispro, should be given within 15 minutes of a meal to match the postprandial glucose spike, mimicking natural insulin response.
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.
The nurse is teaching a group of patients about self-administration of insulin. What content is important to include?
- A. Patients need to use the injection site that is the most accessible.
- B. If two different insulins are ordered, they need to be given in separate injections.
- C. When mixing insulins, the cloudy (such as NPH) insulin is drawn up into the syringe first.
- D. When mixing insulins, the clear (such as regular) insulin is drawn up into the syringe first.
Correct Answer: D
Rationale: When mixing insulins, clear (regular) insulin is drawn up first to prevent contamination with cloudy (NPH) insulin. Rotation of injection sites is necessary, and compatible insulins can be mixed in one syringe.