When blood glucose levels are difficult to control in type 2 diabetes some form of insulin may be added to the treatment regimen to control blood glucose and limit complication risks. Which of the following statements is accurate based on research?
- A. Premixed insulin analogues are better at lowering HbA1C and have less risk for hypoglycemia
- B. Premixed insulin analogues and the newer premixed insulins are associated with more weight gain than the oral antidiabetic agents
- C. Newer premixed insulins are better at lowering HbA1C and postprandial glucose levels than long-acting insulins
- D. Patients who are not controlled on oral agents and have postprandial hyperglycemia can have neutral protamine Hagedorn insulin added at bedtime
Correct Answer: D
Rationale: NPH at bedtime targets postprandial hyperglycemia in type 2 diabetes; premixed insulins vary in efficacy.
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The nurse, assisting with Phase I drug studies, is talking with a woman who asks, Why cant I participate in this study? What would be the nurses best response?
- A. Drugs pose a greater risk to women of reproductive age.
- B. Drugs are only tested on men because they are stronger.
- C. Women are more prone to adverse effects from medications.
- D. Drugs affect women differently than they affect women.
Correct Answer: A
Rationale: Phase I drug trials usually involve healthy male volunteers because chemicals may exert an unknown and harmful effect on ova in women which could result in fetal damage when the woman becomes pregnant. Drugs are tested on both men and women, but women must be fully informed of risks and sign a consent stating they understand the potential for birth defects. Women are not more prone to adverse effects of medications. Although some drugs may affect women differently than men, this is a rationale for why drugs need to be tested on women, not an explanation of why women are not included in a Phase I study.
Sally has been prescribed aspirin 320 mg per day for her atrial fibrillation. She also takes aspirin four or more times a day for arthritis pain. What are the symptoms of aspirin toxicity for which she would need to be evaluated?
- A. Tinnitus
- B. Diarrhea
- C. Hearing loss
- D. Photosensitivity
Correct Answer: A
Rationale: Tinnitus is an early sign of aspirin toxicity (salicylism); diarrhea or photosensitivity are less specific, and hearing loss is later.
A nurse is preparing to administer eye drops to a client. Which of the following actions should the nurse take? (Select all that apply.)
- A. Have the client lie on her side.
- B. Ask the client to look up at the nurse.
- C. Tell the client to blink when the drops enter her eye.
- D. Drop the medication into the center of the client's conjunctival sac.
Correct Answer: D
Rationale: Looking up exposes the conjunctival sac, where drops should be placed for effective administration and absorption.
It is reasonable to recommend supplementation with in the treatment of hyperlipidemia.
- A. Omega-3 fatty acids
- B. Probiotics
- C. Plant sterols
- D. Calcium
Correct Answer: C
Rationale: Plant sterols reduce LDL cholesterol by inhibiting intestinal cholesterol absorption.
The client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed?
- A. Echocardiography
- B. Electrocardiography
- C. Cervical radiography
- D. Pulmonary function studies
Correct Answer: D
Rationale: Bleomycin is an antineoplastic medication (Chemotherapeutic Agents) that can cause interstitial pneumonitis, which can progress to pulmonary fibrosis. Pulmonary function studies along with hematological, hepatic, and renal function tests need to be monitored. The nurse needs to monitor lung sounds for dyspnea and crackles, which indicate pulmonary toxicity. The medication needs to be discontinued immediately if pulmonary toxicity occurs. Options 1, 2, and 3 are unrelated to the specific use of this medication.
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