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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.
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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.
The nurse is administering insulin lispro and will keep in mind that this insulin will start to have an effect within which time frame?
- A. 15 minutes
- B. 1 to 2 hours
- C. 80 minutes
- D. 3 to 5 hours
Correct Answer: A
Rationale: Insulin lispro, a rapid-acting insulin, has an onset of action within 15 minutes, making it effective shortly after administration. The other time frames refer to peak, half-life, or duration.
A 55-year-old woman with type 2 diabetes has recently been placed on glipizide. She asks the nurse when the best time would be to take this medication. What is the nurse's best response?
- A. Take this medication in the morning, 30 minutes before breakfast.
- B. Take this medication in the evening with a snack.
- C. This medication needs to be taken after the midday meal.
- D. It does not matter what time of day you take this medication.
Correct Answer: A
Rationale: Glipizide, a sulfonylurea, is taken 30 minutes before breakfast to align insulin secretion with postprandial glucose rise, mimicking normal physiology.
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.
The nurse is reviewing a patient's medication list and notes that sitagliptin (Januvia) is ordered. The nurse will question an additional order for which drug or drug class?
- A. Glitazone
- B. Insulin
- C. Metformin
- D. Sulfonylurea
Correct Answer: B
Rationale: Sitagliptin, a DPP-4 inhibitor, is not typically combined with insulin due to lack of established safety and efficacy. It can be used with metformin, sulfonylureas, or glitazones.