Nokea
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.
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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 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.
The nurse is teaching patients about self-injection of insulin. Which statement is true regarding injection sites?
- A. Avoid the abdomen because absorption there is irregular.
- B. Choose a different site at random for each injection.
- C. Give the injection in the same area each time.
- D. Rotate sites within the same location for about 1 week before rotating to a new location.
Correct Answer: D
Rationale: Rotating insulin injection sites within the same location (e.g., abdomen) for about 1 week ensures consistent absorption while preventing tissue damage. Random rotation or avoiding the abdomen is incorrect.
A patient with a history of chronic obstructive pulmonary disease (COPD) and type 2 diabetes has been treated for pneumonia for the past week. The patient has been receiving intravenous corticosteroids as well as antibiotics as part of his therapy. At this time, the pneumonia has resolved, but when monitoring the blood glucose levels, the nurse notices that the level is still elevated. What is the best explanation for this elevation?
- A. The antibiotics may cause an increase in glucose levels.
- B. The corticosteroids may cause an increase in glucose levels.
- C. The patient's type 2 diabetes has converted to type 1.
- D. The hypoxia caused by the COPD causes an increased need for insulin.
Correct Answer: B
Rationale: Corticosteroids increase blood glucose by inducing insulin resistance and stimulating gluconeogenesis. Antibiotics, COPD hypoxia, or type 1 conversion are not the primary causes.
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.