NUR2474 Pharmacology Final Exam with Complete Solutions 1. a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin. *low/normal BGL and insulin will continue to drop glucose level. At risk for hypoglycemia. 2. d. Lispro (Humalog) *high blood sugar needs rapid acting insulin. 3. c. Six or seven times a day *pregnancy can effect glucose levels. Frequent monitoring re- quired. 1. The nurse working on a high-acuity med- ical-surgical unit is prioritizing care for four patients who were just admitted. Which pa- tient should the nurse assess first? a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin. b. The patient with a pulse of 58 beats per minute who is about to receive digoxin (Lanoxin) c. The patient with a blood pressure of 136/92 mm Hg who complains of having a headache d. The patient with an allergy to penicillin who is receiving an infusion of vancomycin (Vancocin) 2. A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL. Which formula - tion of insulin should the nurse prepare to administer? a. No insulin should be administered. b. NPH c. 70/30 mix d. Lispro (Humalog) 3. A patient with type 1 diabetes recently became pregnant. The nurse plans a blood glucose testing schedule for her. What is the recommended monitoring schedule? a. Before each meal and before bed b. In the morning for a fasting level and at 4 PM for the peak level NUR2474 Pharmacology Final Exam with Complete Solutions 4. a. "Unless you were fasting for longer than 8 hours, this does c. Six or seven times a day d. Three times a day, along with urine glu- cose testing 4. An adolescent patient recently attend - ed a health fair and had a serum glucose not necessarily mean you have test. The patient telephones the nurse and diabetes." *could be a normal level with - out fasting and does not mean diabetes unless it was high for a fasting blood glucose level. 5. c. Once daily at bedtime *goodnight glargine 6. d. The beta blocker can mask the symptoms of hypo - glycemia. *beta blockers block adrena - line which signals the liver to release glucose in the blood says, "My level was 125 mg/dL. Does that mean I have diabetes?" What is the nurse's most accurate response? a. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes." b. "At this level, you probably have dia - betes. You will need an oral glucose toler- ance test this week." c. "This level is conclusive evidence that you have diabetes." d. "This level is conclusive evidence that you do not have diabetes." 5. Insulin glargine is prescribed for a hos - pitalized patient who is diabetic. When will the nurse administer this drug? a. Approximately 15 to 30 minutes before each meal b. In the morning and at 4 PM c. Once daily at bedtime d. After meals and at bedtime 6. A patient with type 1 diabetes who takes insulin reports taking propranolol for hyper - tension. Why is the nurse concerned? a. The beta blocker can cause insulin resis- tance. b. Using the two agents together increases NUR2474 Pharmacology Final Exam with Complete Solutions when glucose is low to avoid hypoglycemia. 7. a. Miglitol has not been associ - ated with hepatic dysfunction. *key difference is that acar - bose has been associated with rare cases of hepatic dysfunc - tion 8. b. Flatulence e. Diarrhea *due to build up of gasses (flatulence) from to undigest - ed carbohydrates reaching the colon and causing an osmotic effect (diarrhea) 9. b. Neuropsychologic deficits in the fetus can occur if the con - dition is not treated. *Thyroid hormones are crucial for the normal development of the fetal brain and nervous system and must be treated in pregnancy. the risk of ketoacidosis. c. Propranolol increases insulin require - ments because of receptor blocking. d. The beta blocker can mask the symp - toms of hypoglycemia. 7. Which statement is correct about the contrast between a carbose and miglitol? a. Miglitol has not been associated with hepatic dysfunction. b. With miglitol, sucrose can be used to treat hypoglycemia. c. Miglitol is less effective in African Amer - icans. d. Miglitol has no gastrointestinal side ef - fects. 8. A nurse counsels a patient with diabetes who is starting therapy with an alpha - glu- cosidase inhibitor. The patient should be educated about the potential for which ad- verse reactions? (Select all that apply.) a. Hypoglycemia b. Flatulence c. Elevated iron levels in the blood d. Fluid retention e. Diarrhea 9. The nurse is caring for a pregnant patient recently diagnosed with hypothy - roidism. The patient tells the nurse she does not want to take medications while she is pregnant. What will the nurse explain to this patient? a. Hypothyroidism is a normal effect of pregnancy and usually is of no conse - NUR2474 Pharmacology Final Exam with Complete Solutions 10. 1
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. 12. 12. d."If I take calcium supple - ments, I may need to decrease my dose of Synthroid." *this statement is incorrect since calcium interferes with the absorption of Synthroid, it may need to be increased not decreased. c. Intravenous levothyroxine *IV allows for a more rapid cor- rection of thyroid hormone lev- els especially hypothyroidism with symptoms of myxede - ma coma or severe hypothy - roidism. This is considered a medical emergency.
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. 12. 12. d."If I take calcium supple - ments, I may need to decrease my dose of Synthroid." *this statement is incorrect since calcium interferes with the absorption of Synthroid, it may need to be increased not decreased. c. Intravenous levothyroxine *IV allows for a more rapid cor- rection of thyroid hormone lev- els especially hypothyroidism with symptoms of myxede - ma coma or severe hypothy - roidism. This is considered a medical emergency.
