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Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 44

Question 1 Type: MCMA The client has been diagnosed with diabetes mellitus type 1. He asks the nurse what this means. What is the best response by the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The e!ocrine "unction o" your pancreas is to secrete insulin and it is not working. 2. Without insulin you will de#elop ketoacidosis $%&A'. 3. The endocrine "unction o" your pancreas is to secrete insulin( but it isn)t working. 4. *our alpha cells should be able to secrete insulin( but cannot. 5. +t means your pancreas cannot secrete insulin. Corre t Ans!er: ,(-(. "ationa#e 1/ The endocrine( not the e!ocrine( "unction o" the pancreas is to secrete insulin. "ationa#e 2/ A conse0uence o" diabetes mellitus type 1 is that without insulin( se#ere metabolic disturbances( such as diabetic ketoacidosis $%&A' will result. "ationa#e 3/ The endocrine "unction o" the pancreas is to secrete insulin. "ationa#e 4/ +nsulin is secreted by the beta( not the alpha( cells o" the pancreas. "ationa#e 5/ 1ne "unction o" the pancreas is to secrete insulin. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2hysiological Adaptation )ursin&/*nte&rated Con epts: 3ursing 2rocess/ +mplementation (earnin& +ut ome: 4451 Question 2 Type: MCSA
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

The physician orders insulin lispro $Humalog'( 18 units "or the client. When will the nurse administer this medication? 1. Thirty minutes be"ore meals 2. 9i#e minutes be"ore a meal 3. When the meal trays arri#e on the "loor 4. 9i"teen minutes a"ter meals Corre t Ans!er: , "ationa#e 1/ The onset o" action "or insulin lispro $Humalog' is 18 to 1. minutes so it must be gi#en when the client is eating( not -8 minutes be"ore meals( to pre#ent hypoglycemia. "ationa#e 2/ The onset o" action "or insulin lispro $Humalog' is 18 to 1. minutes so it must be gi#en . to 18 minutes be"ore the client eats. "ationa#e 3/ The onset o" action "or insulin lispro $Humalog' is 18 to 1. minutes so it must be gi#en :ust be"ore the client eats( not when meal trays arri#e on the "loor( to pre#ent hypoglycemia. "ationa#e 4/ The onset o" action "or insulin lispro $Humalog' is 18 to 1. minutes so it must be gi#en when the client is eating( not 1. minutes a"ter meals( to pre#ent hypoglycemia. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2harmacological and 2arenteral Therapies )ursin&/*nte&rated Con epts: 3ursing 2rocess/ +mplementation (earnin& +ut ome: 445Question 3 Type: MCSA The physician writes orders "or the client with diabetes mellitus. Which order would the nurse #alidate with the physician? 1. ;antus insulin ,8< =+% 2. Administering regular insulin -8 minutes prior to meals 3. . units o" Humalog618 units 32H daily 4. Met"ormin $>lucophage' 1888 mg per day in di#ided doses
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

Corre t Ans!er: 1 "ationa#e 1/ ;antus insulin is usually prescribed in once5a5day dosing so an order "or =+% dosing should be #alidated with the physician. "ationa#e 2/ ?egular insulin is administered -8 minutes be"ore meals. "ationa#e 3/ Humalog and 32H insulin can be mi!ed. "ationa#e 4/ Met"ormin $>lucophage' is o"ten prescribed in di#ided doses o" 1888 mg per day. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy@ing C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2harmacological and 2arenteral Therapies )ursin&/*nte&rated Con epts: 3ursing 2rocess/ 2lanning (earnin& +ut ome: 445A Question 4 Type: MCSA A client with diabetes mellitus type 1 is "ound unresponsi#e in the clinical setting. Which nursing action is a priority? 1. Call a code. 2. Treat the client "or hypoglycemia. 3. Call the physician STAT. 4. Assess the clientBs #ital signs. Corre t Ans!er: , "ationa#e 1/ Assessment "or A=Cs should precede calling a codeC there is no in"ormation that the client is not breathing. "ationa#e 2/ When a client with diabetes mellitus type 1 is "ound unresponsi#e( the nurse should "ocus on and treat "or hypoglycemia( as this is more likely than hyperglycemia. "ationa#e 3/ .This is an emergency situation where the nurse must act be"ore calling the physician. "ationa#e 4/ Dital signs should be taken a"ter the client is treated "or hypoglycemia. $#o%a# "ationa#e:
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

Co&niti'e (e'e#: Analy@ing C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2harmacological and 2arenteral Therapies )ursin&/*nte&rated Con epts: 3ursing 2rocess/ +mplementation (earnin& +ut ome: 4454 Question 5 Type: MCSA The nurse makes a home #isit to a client with diabetes mellitus. %uring the #isit( the nurse notes that the clientBs -5 month supply o" insulin #ials that were deli#ered a week ago are not re"rigerated. What is the best action by the nurse at this time? 1. Ha#e the client place the insulin #ials in the re"rigerator. 2. Ha#e the client discard the #ials. 3. +nstruct the client to label each #ial with the date when opened. 4. Tell the client this is too much insulin to ha#e on hand. Corre t Ans!er: 1 "ationa#e 1/ Dials can be stored at room temperature up to one month. 9or longer storage( they should be re"rigerated. "ationa#e 2/ There is no need to discard the #ials. "ationa#e 3/ Writing the date o" opening on the #ial is good practice( but does not address the need to re"rigerate additional #ials. "ationa#e 4/ There is no indication that this is too much insulin to ha#e on hand. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: ?eduction o" ?isk 2otential )ursin&/*nte&rated Con epts: 3ursing 2rocess/ +mplementation (earnin& +ut ome: 445A Question , Type: MCSA The nurse has "inished teaching a client with diabetes mellitus how to administer insulin. The nurse e#aluates that learning has occurred when the client makes which statement?
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

1. + should only use a calibrated insulin syringe "or the in:ections. 2. + should check my blood sugar immediately prior to the administration. 3. + should use the abdominal area only "or insulin in:ections. 4. + should pro#ide direct pressure o#er the site "ollowing the in:ection. Corre t Ans!er: 1 "ationa#e 1/ To ensure the correct insulin dose( a calibrated insulin syringe must be used. "ationa#e 2/ There is no need to check blood glucose immediately prior to the in:ection. "ationa#e 3/ +nsulin in:ections should also be rotated to the arm and thigh( not :ust the abdominal area. "ationa#e 4/ There is no need to apply direct pressure o#er the site "ollowing an insulin in:ection. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2harmacological and 2arenteral Therapies )ursin&/*nte&rated Con epts: 3ursing 2rocess/ 7#aluation (earnin& +ut ome: 445A Question Type: MCSA A client with diabetes mellitus is taking oral agents( and is scheduled "or a diagnostic test that re0uires him to be 321 $nothing by mouth' and to ha#e contrast dye. What is the best plan by the nurse with regard to gi#ing the client his oral medications? 1. 3oti"y the diagnostic department and re0uest orders. 2. 3oti"y the physician and re0uest orders. 3. Administer the oral agents immediately a"ter the test. 4. Administer the oral agents with a sip o" water be"ore the test. Corre t Ans!er: , "ationa#e 1/ The radiologist in the diagnostic department might gi#e orders( but it would be best to check with the clientBs physician "irst. "ationa#e 2/ +t is best to noti"y the clientBs physician and re0uest orders.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

"ationa#e 3/ Some oral medications should not be gi#en "or up to , days a"ter recei#ing +D contrast. "ationa#e 4/ The client should not recei#e the medication during 321 $nothing by mouth' status unless directed by the physician. Some oral medications should not be gi#en "or , days be"ore recei#ing +D contrast. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy@ing C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: ?eduction o" ?isk 2otential )ursin&/*nte&rated Con epts: 3ursing 2rocess/ 2lanning (earnin& +ut ome: 445A Question . Type: MCSA The client has diabetes mellitus type ,. The nurse has taught the client about the illness and e#aluates that learning has occurred when the client makes which statement? 1. My beta cells :ust cannot produce enough insulin "or my cells. 2. My peripheral cells ha#e increased sensiti#ity to insulin. 3. My cells ha#e increased their receptors( but there is not enough insulin. 4. My cells cannot use the insulin my pancreas makes. Corre t Ans!er: 4 "ationa#e 1/ The beta cells continue to produce insulin with type , diabetes. "ationa#e 2/ 2eripheral cells ha#e a decreased( not an increased( sensiti#ity to insulin. "ationa#e 3/ There is a decrease( not an increase( in receptor sites with type , diabetes. "ationa#e 4/ With type , diabetes mellitus( the pancreas produces insulin( but the cells cannot use it. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy@ing C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2hysiological Adaptation )ursin&/*nte&rated Con epts: 3ursing 2rocess/ 7#aluation (earnin& +ut ome: 445. Question / Type: MCSA
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

The client has type 1 diabetes and recei#es insulin. He asks the nurse why he canBt :ust take pills instead. What is the best response by the nurse? 1. + know it is tough( but you will get used to the shots soon. 2. Ha#e you talked to your doctor about taking pills instead? 3. +nsulin canBt be in a pill because it is destroyed in stomach acid. 4. +nsulin must be in:ected because it needs to work 0uickly. Corre t Ans!er: "ationa#e 1/ Telling the client he will get used to the shots does not answer his 0uestion and is condescending. "ationa#e 2/ The nurse should answer the clientBs 0uestion( not re"er him back to the physician. "ationa#e 3/ +nsulin must be in:ected because it is destroyed in stomach acid i" taken orally. "ationa#e 4/ +nsulin must be in:ected because it is destroyed in stomach acid i" taken orallyC the onset o" action is not the issue here. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2harmacological and 2arenteral Therapies )ursin&/*nte&rated Con epts: 3ursing 2rocess/ +mplementation (earnin& +ut ome: 445Question 10 Type: MCSA The nurse teaches a class "or the public about diabetes mellitus. Which indi#idual does the nurse assess as being at highest risk "or de#eloping diabetes? 1. The -A5year5old client who smokes one pack o" cigarettes per day 2. The 4,5year5old client who is .8 pounds o#erweight 3. The .85year5old client who does not get any physical e!ercise 4. The .E5year5old client who drinks three glasses o" wine each e#ening Corre t Ans!er: , "ationa#e 1/ Smoking is a serious health concern( but is not a speci"ic risk "actor "or diabetes.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

"ationa#e 2/ 1besity increases the likelihood o" de#eloping diabetes mellitus due to o#erstimulation o" the endocrine system. "ationa#e 3/ 7!ercise is important( but a lack o" e!ercise is not as big o" a risk "actor as obesity. "ationa#e 4/ Consuming alcohol is associated with li#er disease( but is not as high a risk "actor "or diabetes as obesity. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: ?eduction o" ?isk 2otential )ursin&/*nte&rated Con epts: 3ursing 2rocess/ Assessment (earnin& +ut ome: 4.5A Question 11 Type: MCSA The client in:ects his insulin as prescribed( but then gets busy and "orgets to eat. What is the nurse)s most likely assessment "inding? 1. The client will be #ery thirsty. 2. The client will need to urinate. 3. The client will ha#e moist skin. 4. The client will complain o" nausea. Corre t Ans!er: "ationa#e 1/ Thirst is a sign o" hyperglycemiaC the client would e!perience hypoglycemia i" he did not eat. "ationa#e 2/ +ncreased urination is a sign o" hyperglycemiaC the client would e!perience hypoglycemia i" he did not eat. "ationa#e 3/ Moist skin is a sign o" hypoglycemia( which the client would e!perience i" he in:ected insulin and did not eat. "ationa#e 4/ 3ausea is a sign o" hyperglycemiaC the client would e!perience hypoglycemia i" he did not eat. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy@ing C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2hysiological Adaptation
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

)ursin&/*nte&rated Con epts: 3ursing 2rocess/ Assessment (earnin& +ut ome: 4454 Question 12 Type: MCMA The client recei#es met"ormin $>lucophage'. What will the best plan by the nurse include with regard to patient education with this drug? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. +t decreases sugar production in the li#er. 2. +t inhibits absorption o" carbohydrates. 3. +t stimulates the pancreas to produce more insulin. 4. +t reduces insulin resistance. 5. +t increases energy use. Corre t Ans!er: 1(4 "ationa#e 1/ Met"ormin $>lucophage' decreases sugar production $gluconeogenesis' in the li#er. "ationa#e 2/ Met"ormin $>lucophage' does not inhibit the absorption o" carbohydrates. "ationa#e 3/ Met"ormin $>lucophage' reduces insulin resistance. "ationa#e 4/ Met"ormin $>lucophage' reduces insulin resistance. "ationa#e 5/ Met"ormin $>lucophage' does not increase energy use. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2harmacological and 2arenteral Therapies )ursin&/*nte&rated Con epts: 3ursing 2rocess/ 2lanning (earnin& +ut ome: 445E Question 13 Type: MCSA

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

The client has diabetes type 1 and recei#es insulin "or glycemic control. The client tells the nurse that she likes to ha#e a glass o" wine with dinner. What will the best plan by the nurse "or client education include? 1. The alcohol could cause pancreatic disease and decrease insulin production. 2. The alcohol could predispose you to hypoglycemia. 3. The alcohol could cause serious li#er disease. 4. The alcohol could predispose you to hyperglycemia. Corre t Ans!er: , "ationa#e 1/ Alcohol can cause pancreatic disease( but the clientBs pancreas is not producing any insulin currently. "ationa#e 2/ Alcohol can potentiate hypoglycemic e""ects in the client. "ationa#e 3/ Alcohol can cause li#er disease( but the more immediate concern is hypoglycemia. "ationa#e 4/ Alcohol can potentiate hypoglycemic( not hyperglycemic( e""ects in the client. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy@ing C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: ?eduction o" ?isk 2otential )ursin&/*nte&rated Con epts: 3ursing 2rocess/ 2lanning (earnin& +ut ome: 445A Question 14 Type: MCSA The client has type 1 diabetes mellitus and recei#es insulin. Which laboratory test will the nurse assess? 1. 2otassium 2. Serum amylase 3. AST $aspartate aminotrans"erase' 4. Sodium Corre t Ans!er: 1 "ationa#e 1/ +nsulin causes potassium to mo#e into the cell and may cause hypokalemia. "ationa#e 2/ There is no need to monitor the serum amylase le#el.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

"ationa#e 3/ There is no need to monitor the AST $aspartate aminotrans"erase' le#el. "ationa#e 4/ There is no need to monitor the sodium le#el. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy@ing C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2hysiological Adaptation )ursin&/*nte&rated Con epts: 3ursing 2rocess/ +mplementation (earnin& +ut ome: 445F Question 15 Type: MCSA The physician orders intra#enous $+D' insulin "or the client with a blood sugar o" .E-. The nurse administers insulin lispro $Humalog' intra#enously $+D'. What does the best e#aluation by the nurse re#eal? 1. The nurse used the correct insulin. 2. The nurse should ha#e contacted the physician. 3. The nurse should ha#e used regular insulin $Humulin ?'. 4. The nurse could ha#e gi#en the insulin subcutaneously. Corre t Ans!er: "ationa#e 1/ The nurse did not use the correct insulin as it was not regular insulin. "ationa#e 2/ There was no need to contact the physicianC regular insulin is the only insulin that can be gi#en intra#enously $+D'. The physician should be contacted now. "ationa#e 3/ ?egular insulin is the only insulin that can be gi#en intra#enously $+D'. "ationa#e 4/ The nurse cannot gi#e the insulin subcutaneously when it is ordered to be gi#en intra#enously $+D'. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy@ing C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2harmacological and 2arenteral Therapies )ursin&/*nte&rated Con epts: 3ursing 2rocess/ 7#aluation (earnin& +ut ome: 445F Question 1, Type: MCSA
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

+nsulin is released when 1. blood glucose stays the same. 2. blood glucose increases. 3. blood glucose decreases. 4. glucagon increases. Corre t Ans!er: , "ationa#e 1/ +nsulin would not be released. "ationa#e 2/ +nsulin is released when blood glucose increases. "ationa#e 3/ >lucagon is released when glucose decreases. "ationa#e 4/ >lucagon increases when insulin is not needed. $#o%a# "ationa#e: Co&niti'e (e'e#: ?emembering C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2hysiological Adaptation )ursin&/*nte&rated Con epts: 3ursing 2rocess/ Assessment (earnin& +ut ome: 4451 Question 1Type: MCSA What is the primary "unction o" the islets o" ;angerhans in the pancreas? 1. Secretion o" en@ymes 2. Acting as e!ocrine 3. Secretion o" glucagon and insulin 4. Absorption o" insulin Corre t Ans!er: "ationa#e 1/ Secretion o" en@ymes relates to the e!ocrine "unction( which is to release en@ymes "or chemical digestion o" nutrients. "ationa#e 2/ 1ther cells o" the pancreas are responsible "or e!ocrine "unction.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

"ationa#e 3/ The cluster o" cells within the pancreas $islets o" ;angerhans' is responsible "or the endocrine "unction( which is to release insulin and glucagon. "ationa#e 4/ These are secretory cells( not absorpti#e cells. $#o%a# "ationa#e: Co&niti'e (e'e#: ?emembering C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2hysiological Adaptation )ursin&/*nte&rated Con epts: 3ursing 2rocess/ Assessment (earnin& +ut ome: 4451 Question 1. Type: MCSA Which sign or symptom is most typical o" an untreated client with type 1 diabetes? 1. +ncreased energy 2. Weight gain 3. 9atigue 4. %ecreased hunger Corre t Ans!er: "ationa#e 1/ Clients with type 1 %M do not e!perience increased energyC a typical sign6symptom is "atigue. "ationa#e 2/ Clients with type 1 %M typically e!perience weight loss as opposed to weight gain. "ationa#e 3/ 9atigue is a typical sign6symptom o" type 1 %M due to sustained hyperglycemia. "ationa#e 4/ Clients with type 1 %M typically e!perience polyphagiaGincreased hungerGas opposed to decreased hunger. $#o%a# "ationa#e: Co&niti'e (e'e#: ?emembering C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2hysiological Adaptation )ursin&/*nte&rated Con epts: 3ursing 2rocess/ Assessment (earnin& +ut ome: 445, Question 1/ Type: MCSA
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

The nurse understands that which o" the "ollowing drugs "alls under the classi"ication o" biguanides? 1. Met"ormin HC+ $>lucophage' 2. ?epaglinide $2randin' 3. Tolbutamide $1rinase' 4. Acarbose $2recose' Corre t Ans!er: 1 "ationa#e 1/ Met"ormin HC+ is the only drug that "alls within the classi"ication o" biguanides. "ationa#e 2/ ?epaglinide "alls within the classi"ication o" meglitinides. "ationa#e 3/ Tolbutamide "alls within the classi"ication o" sul"onylureas. "ationa#e 4/ Acarbose "alls within the classi"ication o" alpha5glucosidase inhibitors. $#o%a# "ationa#e: Co&niti'e (e'e#: ?emembering C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2harmacological and 2arenteral Therapies )ursin&/*nte&rated Con epts: 3ursing 2rocess/ +mplementation (earnin& +ut ome: 445E Question 20 Type: MCSA The mechanism o" action o" regular insulin is to 1. stimulate the pancreas to produce insulin. 2. promote entry o" glucose into the cells. 3. promote the entry o" glucose into the bloodstream. 4. stimulate the pancreas to secrete more insulin. Corre t Ans!er: , "ationa#e 1/ 1ral hypoglycemic drugs( such as glipi@ide( stimulate the pancreas to produce insulin. "ationa#e 2/ The action o" regular insulin is to promote entry o" glucose into the cells( thereby lowering glucose.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

"ationa#e 3/ +nsulin would not promote glucose into the bloodstream. "ationa#e 4/ 1ral hypoglycemic drugs( such as glipi@ide( stimulate the pancreas to secrete insulin. $#o%a# "ationa#e: Co&niti'e (e'e#: ?emembering C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2hysiological Adaptation )ursin&/*nte&rated Con epts: (earnin& +ut ome: 4451 Question 21 Type: MCMA The mother o" a 45year5old boy states( H+ can)t belie#e my son has type 1 diabetes. We eat well and + was so care"ul during the pregnancy. What could ha#e caused this?I How should the nurse respond? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. HThere must ha#e been something you were e!posed to during your pregnancy that caused it.I 2. HAre there others in your "amily that ha#e type 1 diabetes?I 3. HHe must ha#e been allowed to eat too much sugar.I 4. HWe are not certain what causes type 1 diabetes.I 5. H+t is thought to be a combination o" "actors.I Corre t Ans!er: ,(4(. "ationa#e 1/ There is no known "actor that would cause type 1 diabetes i" the mother was e!posed. "ationa#e 2/ There is a genetic "actor associated with type 1 diabetes. "ationa#e 3/ This is not a therapeutic statement and supports the urban myth that diabetes is caused by sugar ingestion. "ationa#e 4/ The speci"ic "actors that cause Type 1 diabetes are still undisco#ered. "ationa#e 5/ +t is thought that type 1 diabetes is caused by a number o" interrelated "actors. $#o%a# "ationa#e:
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

Co&niti'e (e'e#: Applying C#ient )eed: 2sychosocial +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: 3ursing 2rocess/ +mplementation (earnin& +ut ome: 44., Question 22 Type: MCMA A client( newly diagnosed with type 1 diabetes( says( H+ ha#e heard this is a bad disease. What complications could + ha#e?I How should the nurse respond? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. H2roblems with arteries can occur that may cause such problems as heart disease( stroke( kidney disease( or blindness.I 2. H;et)s not talk about that now( but rather "ocus on keeping you healthy.I 3. H*ou could ha#e ner#e problems that lead to numbness or tingling in your "eet or hands.I 4. H1ne o" the most serious complications is diabetic ketoacidosis.I 5. H*ou may e!perience inability to think and di""iculty with memory.I Corre t Ans!er: 1(-(4 "ationa#e 1/ Arterial damage can lead to the problems listed. "ationa#e 2/ The client is interested in this topic today and the topic should be addressed. "ationa#e 3/ 3europathy may occur( causing numbness( tingling( or loss o" sensation in the limbs. "ationa#e 4/ %&A is one o" the most serious complications o" type 1 diabetes. "ationa#e 5/ While these symptoms may occur related to CDA( they are not primary complications o" type 1 diabetes. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2hysiological Adaptation )ursin&/*nte&rated Con epts: 3ursing 2rocess/ +mplementation (earnin& +ut ome: 44.,
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

Question 23 Type: MCMA A client has been prescribed e!enatide $=yetta'. What medication education should the nurse pro#ide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. H%rink an A ounce glass o" water with this pill.I 2. H*ou should take this medication twice each day.I 3. H*ou may e!perience dryness o" the mouth while taking this drug.I 4. H*ou may de#elop diarrhea while taking this drug.I 5. HThis drug will help you secrete more insulin.I Corre t Ans!er: ,(4(. "ationa#e 1/ 7!enatide is an in:ectable drug. "ationa#e 2/ 7!enatide is o"ten in:ected twice daily. "ationa#e 3/ This is not an e!pected ad#erse reaction. "ationa#e 4/ %iarrhea is an e!pected ad#erse e""ect o" this drug. "ationa#e 5/ 1ne o" the actions o" this drug is to increase secretion o" insulin. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2harmacological and 2arenteral Therapies )ursin&/*nte&rated Con epts: 3ursing 2rocess/ +mplementation (earnin& +ut ome: 44.E Question 24 Type: MCMA A nurse has pro#ided education regarding type , diabetes to a newly diagnosed client. Which statements would the nurse interpret as indicating need "or additional education? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

Standard Text: Select all that apply. 1. HWell( at least the medications + will be on will help me lose weight.I 2. H+ can take an oral medication and will ne#er ha#e to in:ect mysel".I 3. H+ can increase my body)s ability to use the insulin + make by e!ercising regularly.I 4. H+ ha#e se#eral li"estyle changes to make.I 5. H+ don)t run the risk o" blindness and kidney disease like type 1 diabetics.I Corre t Ans!er: 1(,(. "ationa#e 1/ Some o" the medications used "or type , diabetes cause weight gain. "ationa#e 2/ As type , diabetes progresses( the cells that produce insulin may "ail( causing the need "or insulin. Some medications especially designed to treat type , diabetes are in:ected. "ationa#e 3/ The acti#ity o" insulin receptors can be increased by physical e!ercise. "ationa#e 4/ ;i"estyle changes can help the type , diabetic a#oid complications. "ationa#e 5/ +" type , diabetes is poorly managed these complications can occur. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy@ing C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2hysiological Adaptation )ursin&/*nte&rated Con epts: 3ursing 2rocess/ 7#aluation (earnin& +ut ome: 44.. Question 25 Type: MCMA A nurse is re#iewing the blood work o" a client who has recently begun treatment "or type , diabetes. Which results would indicate that the client is on target with therapy? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. H=A1C le#el is A.4J. 2. H=A1C le#el is E.-J.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.

3. 9asting blood glucose is 1-8 g6d;. 4. 9asting blood glucose is 188 g6d;. 5. 9asting blood glucose is EA g6d;. Corre t Ans!er: ,(4 "ationa#e 1/ This le#el is too high. "ationa#e 2/ Target le#el is E..J or less. "ationa#e 3/ This is too high. "ationa#e 4/ >oal is 118 g6d;. "ationa#e 5/ A 9=> o" EA g6d; is too low. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy@ing C#ient )eed: 2hysiological +ntegrity C#ient )eed Su%: 2hysiological Adaptation )ursin&/*nte&rated Con epts: 3ursing 2rocess/ 7#aluation (earnin& +ut ome: 44.A

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 467 Copyright ,814 by 2earson 7ducation( +nc.