Chapter 35: Drugs Used to Treat Diabetes Mellitus Clayton/Willihnganz: Basic Pharmacology for Nurses, 17th Edition

MULTIPLE CHOICE 1. A patient received the evening dose of Lispro subcutaneously at 16:30. What time will symptoms of hypoglycemia likely occur? a. 19:00 b. 18:30 c. 01:30 d. 06:00 ANS: B The most rapid-acting insulin, Lispro, peaks within 1 to 2 hours after administration. The peak time of insulin is when patients would most likely exhibit symptoms of hypoglycemia, particularly if they have inadequate dietary intake. The time of 19:00 would be past the peak of action and after signs of hypoglycemia would have appeared. The times of 01:30 and 06:00 are long after the peak of action and the time when signs of hypoglycemia would have appeared. DIF: Cognitive Level: Application REF: Page 551 | Page 552 OBJ: 2 | 3 | 4 TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: CONCEPT(S): Clinical Judgment; Glucose Regulation; Safety 2. It is 2:00 PM and a patient who has been NPO since 12:00 AM for a bronchoscopy is complaining of a headache and shakiness and is extremely irritable. Vital signs are within normal limits, and a one touch glucose reads 50 mg/dL. Which action is most important for the nurse to take? a. Have the patient eat a snack and drink milk. b. Administer glucagon subcutaneously. c. Call the bronchoscopy room to follow up with the delay. d. Obtain an A1c test. ANS: B Irritability, nervousness, headache, tremors, dizziness, apprehension, sweating, cold and clammy skin, and hunger are symptoms of hypoglycemia. The patient has not eaten since the prior day. A blood glucose of 50 mg/dL is true hypoglycemia and needs to be dealt with immediately. Glucagon is preferred over PO intake, given that an endoscopy is scheduled. Having the patient eat a snack and drink milk, calling the bronchoscopy room, and obtaining an A1c test are not appropriate responses. DIF: Cognitive Level: Analysis REF: Page 546 OBJ: 2 | 3 | 4 TOP: Nursing Process Step: Diagnosis MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: CONCEPT(S): Clinical Judgment; Glucose Regulation; Safety This study source was downloaded by from CourseH on :22:26 GMT -05:00 3. After a blood glucose reading, it is determined that the patient should receive 4 units of Lispro and 8 units of NPH. Which action will the nurse take to administer these medications? a. Draw up each insulin in separate syringes and administer two injections. b. Draw up the NPH first and then the Lispro using the same syringe. c. Administer the Li