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When monitoring a patient's response to oral antidiabetic drugs, the nurse knows that which laboratory result would indicate a therapeutic response?
- A. Random blood glucose level 180 mg/dL
- B. Blood glucose level of 50 mg/dL after meals
- C. Fasting blood glucose level of 92 mg/dL
- D. Evening blood glucose level below 80 mg/dL
Correct Answer: C
Rationale: A fasting blood glucose level of 80â??130 mg/dL, as per ADA guidelines, indicates a therapeutic response to oral antidiabetic drugs. Other options reflect hyperglycemia or hypoglycemia.
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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.
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.
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.
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.
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.