Diabetes Pharmacology Study Notes – Antidiabetic Drugs, Insulin & Treatment

Chapter 48: Drugs for
Diabetes Mellitus


461. The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients
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who were just admitted. Which patient should the nurse assess first?
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a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30
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Novolin insulin.
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b. The patient with a pulse of 58 beats/minute who is about to receive digoxin [Lanoxin].
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c. The patient with a blood pressure of 136/92 mm Hg who complains of having a headache.
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d. The patient with an allergy to penicillin who is receiving an infusion of vancomycin [Vancocin].
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- CORRECT ANSWER-ANS: A
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The NPO patient with hypoglycemia who just received 70/30 Novolin insulin takes priority,
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because this patient needs to consume a good source of glucose immediately or perhaps the
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NPO status will be discontinued for this shift. The digoxin may be withheld for the patient with a
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pulse of 58 beats/minute, but this is not a priority action. The patient with a headache needs to
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be followed up, but because the blood pressure is 136/92 mm Hg, the headache is probably not
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caused by hypertension. The patient with an allergy to penicillin will not have a reaction to the
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vancomycin.
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462. A patient with type 1 diabetes recently became pregnant. The nurse plans a blood glucose
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testing schedule for her. What is the recommended monitoring schedule?
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a. Before each meal and before bed.
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b. In the morning for a fasting level and at 4:00 PM for the peak level.
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c. Six or seven times a day.
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d. Three times a day, along with urine glucose testing. - CORRECT ANSWER-ANS: C
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, A pregnant patient with type 1 diabetes must have frequent blood sugar monitoring (e.g., six or
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seven times a day) to manage both the patient and the fetus so that no teratogenic effects occur.
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Monitoring the blood sugar level before meals and at bedtime is not significant enough to
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provide the necessary glycemic control. Morning and 4:00 PM monitoring is not enough to
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provide glycemic control. Urine glucose testing is not sensitive enough to aid glycemic control,
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and monitoring three times a day is not enough.
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463. Which statement is correct about the contrast between acarbose and miglitol?
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a. Miglitol has not been associated with hepatic dysfunction.
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b. With miglitol, sucrose can be used to treat hypoglycemia.
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c. Miglitol is less effective in African Americans.
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d. Miglitol has no gastrointestinal side effects. - CORRECT ANSWER-ANS: A
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Unlike acarbose, miglitol has not been associated with hepatic dysfunction. Sucrose should not
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be used to treat hypoglycemia with miglitol. Miglitol is more effective in African-American
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patients. Miglitol has gastrointestinal side effects.
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464. A nurse is educating the staff nurses about ketoacidosis. To evaluate the group's
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understanding, the nurse asks, "Which sign or symptom would not be consistent with
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ketoacidosis?" The group gives which correct answer?
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a. Blood glucose level of 600 mg/dL
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b. Blood glucose level of 60 mg/dL
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c. Acidosis
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d. Ketones in the urine - CORRECT ANSWER-ANS: B
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A patient with diabetic ketoacidosis (DKA) has a high glucose level (at least 500 mg/dL or higher);
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therefore, a glucose level of 60 mg/dL would not be consistent with DKA. A blood glucose level of
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600 mg/dL, acidosis, and ketones in the urine are consistent with DKA.
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465. The nurse assesses a newly diagnosed patient for short-term complications of diabetes.
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What does this assessment include?
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a. Evaluation for hyperglycemia, hypoglycemia, and ketoacidosis.
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