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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.
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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.
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.
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.
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.
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.