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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.
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The nurse is preparing to administer insulin intravenously. Which statement about the administration of intravenous insulin is true?
- A. Insulin is never given intravenously.
- B. Only regular insulin can be administered intravenously.
- C. Insulin aspart or insulin lispro can be administered intravenously, but there must be a 50% dose reduction.
- D. Any form of insulin can be administered intravenously at the same dose as that is ordered for subcutaneous administration.
Correct Answer: B
Rationale: Only regular insulin is approved for IV administration, typically in emergencies like diabetic ketoacidosis, due to its predictable pharmacokinetics.
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.
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.
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.
A patient in the emergency department was showing signs of hypoglycemia and had a fingerstick glucose level of 38 mg/dL. The patient has just become unconscious. The nurse will anticipate which action to be next?
- A. Having the patient eat glucose tablets
- B. Having the patient consume fruit juice, a nondiet soft drink, or crackers
- C. Administering intravenous glucose (50% dextrose)
- D. Calling the lab to order a fasting blood glucose level
Correct Answer: C
Rationale: Unconscious patients with hypoglycemia require IV glucose (e.g., 50% dextrose) to rapidly restore blood sugar, as oral intake is not possible. Lab tests are not immediate priorities.