Nokea
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.
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When administering morning medications for a newly admitted patient, the nurse notes that the patient has an allergy to sulfa drugs. There is an order for the sulfonylurea glipizide (Glucotrol). Which action by the nurse is correct?
- A. Give the drug as ordered 30 minutes before breakfast.
- B. Hold the drug, and check the order with the prescriber.
- C. Give a reduced dose of the drug with breakfast.
- D. Give the drug, and monitor for adverse effects.
Correct Answer: B
Rationale: Sulfa drug allergies may cross-react with sulfonylureas like glipizide, so the nurse must verify the order with the prescriber to ensure safety.
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 teaching a group of patients about management of diabetes. Which statement about basal dosing is correct?
- A. Basal dosing delivers a constant dose of insulin.
- B. With basal dosing, you can eat what you want and then give yourself a dose of insulin.
- C. Glargine insulin is given as a bolus with meals.
- D. Basal-bolus dosing is the traditional method of managing blood glucose levels.
Correct Answer: A
Rationale: Basal dosing, such as with glargine, provides a steady insulin level to maintain baseline glucose control. Glargine is not a bolus insulin, and basal-bolus is a modern approach.
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.