Nokea
After teaching an in-service presentation to a group of nurses about diabetes and insulin, the presenter determines that the presentation was successful when the group identifies which of the following as a rapid-acting insulin?
- A. Insulin aspart (NovoLog)
- B. Isophane insulin suspension (Novolin N)
- C. Insulin glargine (Lantus)
- D. Insulin detemir (Levemir)
- E. Insulin glulisine (Apidra)
Correct Answer: A,E
Rationale: Insulin aspart (NovoLog) and insulin glulisine (Apidra) are rapid-acting insulins. Isophane insulin suspension is an intermediate-acting insulin. Insulin glargine and detemir are long-acting insulins.
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A nurse is caring for a client with type 2 diabetes receiving a meglitinide. The nurse reviews the clients medical record based on the understanding that which condition would contraindicate the use of this drug?
- A. Diabetic ketoacidosis
- B. Kidney disease
- C. Severe heart failure
- D. Liver disease
Correct Answer: A
Rationale: Meglitinides are contraindicated in clients with diabetic ketoacidosis and severe endocrine disease. Thiazolidinediones are contraindicated in clients with severe heart failure and used with caution in clients with kidney disease, severe heart failure, and liver disease.
A nurse is caring for a client receiving insulin detemir 10 units at bedtime. Which of the following drugs, if started, would most likely require a decrease in the dosage of insulin?
- A. Sulfamethoxazole/trimethoprim (Septra)
- B. Metoprolol (Lopressor)
- C. Fenofibrate (Tricor)
- D. Diltiazem (Verapamil)
- E. Albuterol (Ventolin)
Correct Answer: A,B,C
Rationale: Sulfonamides (sulfamethoxazole/trimethoprim), beta-blocking drugs (metoprolol), and fibrates (fenofibrate), among others, can increase the effect of insulin and require a decrease in insulin dosage to control the client's diabetes. Diltiazem and albuterol decrease the effect of insulin, requiring an increase in the dosage.
After administering glimepiride, the nurse would assess the client for which of the following?
- A. Lactic acidosis
- B. Edema
- C. Hypoglycemia
- D. Heartburn
- E. Nausea
Correct Answer: C,D,E
Rationale: Adverse reactions associated with sulfonylureas, like glimepiride (Amaryl), include hypoglycemia, anorexia, nausea, vomiting, epigastric discomfort, weight gain, heartburn, and various vague neurologic symptoms, such as numbness and weakness of the extremities.
A nurse is preparing a presentation for a local community group about diabetes. Which of the following would the nurse include when describing type 1 diabetes?
- A. Insidious onset
- B. Occurs before age 20
- C. Insulin supplementation required for survival
- D. Formally known as non-insulin-dependent diabetes mellitus
- E. Obesity a risk factor
Correct Answer: B,C
Rationale: Type 1 diabetes is formerly known as insulin-dependent diabetes mellitus. It usually has a rapid onset and occurs before age 20. Those with type 1 diabetes produce insulin in insufficient amounts and therefore must have insulin supplementation to survive. Type 1 diabetes is an autoimmune disorder; therefore, obesity is not a risk factor.
A nurse is preparing to administer a drug that helps lower blood glucose by increasing the production of insulin by beta cells in the pancreas. Which of the following might this be?
- A. Glyburide (DiaBeta)
- B. Metformin (Glucophage)
- C. Pioglitazone (Actos)
- D. Glipizide (Glucotrol)
- E. Acarbose (Precose)
Correct Answer: A,D
Rationale: Sulfonylureas, like glyburide (DiaBeta) and glipizide (Glucotrol), help lower blood glucose by increasing the production of insulin by beta cells in the pancreas.