NURS 676 Week 6 Exam questions with precise ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
detailed answers ||//\\||
benefits of transdermal estrogen - correct answer✔✔• total dose of estrogen is greatly
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
reduced (because the liver is bypassed). ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
• Less N/V
||//\\|| ||//\\||
• Blood levels of estrogen fluctuate less
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
• lower risk for DVT, pulmonary embolism, and stroke
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Type 1 diabetes diagnosis - correct answer✔✔-fasting plasma glucose >/= 126 mg/dL
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-random plasma glucose >/= 200mg/dL PLUS symptoms ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
- Oral glucose tolerance test (OGTT): 2-h plasma glucose >/= 200mg/dL
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-hemoglobin A1C 6.5 or higher ||//\\|| ||//\\|| ||//\\|| ||//\\||
which cells produce insulin - correct answer✔✔Beta cells of the islets of Langerhans in
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
pancreas
Type 1 diabetes management - correct answer✔✔1. diet
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
2. self-monitoring of blood glucose (SMBG)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
3. Physical activity
||//\\|| ||//\\||
4. Insulin replacement
||//\\|| ||//\\||
what is given to manage hypertension in diabetics - correct answer✔✔ACEIs or ARBs
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-reduces risk for diabetic nephropathy ||//\\|| ||//\\|| ||//\\|| ||//\\||
what is given to manage dyslipidemia in diabetics - correct answer✔✔Statins
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
,Type 1 diabetes complications - correct answer✔✔Diabetic Ketoacidosis (DKA)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
heart disease, renal failure, blindness, neuropathy, amputations, impotence, stroke
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Diabetic Ketoacidosis (DKA) pathophysiology - correct answer✔✔when insulin is not present
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
to move glucose into cells for energy, the body begins to metabolize fat; fatty acid
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
metabolism results in the formation of ketone bodies; ketone bodies are acidic and produce ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
metabolic acidosis, diuresis, and electrolyte loss ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Type 2 diabetes management - correct answer✔✔1. lifestyle changes PLUS metformin
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
2. add a second drug (thiazolidinedione, DPP-4 inhibitor, SGLT-2 inhibitor, or GLP-1 receptor
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
agonist
3. 3 drug combo
||//\\|| ||//\\|| ||//\\||
4. Insulin & GLP-1 receptor agonist
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Metformin - correct answer✔✔Biguanide ||//\\|| ||//\\|| ||//\\||
MOA:
1. inhibits glucose production in liver
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
2. reduces glucose absorption in the gut
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
3. sensitizes insulin receptors in target tissues--increases glucose uptake
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
NOT METABOLIZED ||//\\||
SE: GI, lactic acidosis
||//\\|| ||//\\|| ||//\\||
,-Type II, prevention, PCOS, Gestational
||//\\|| ||//\\|| ||//\\|| ||//\\||
Meglitinides (Glinides) - correct answer✔✔-stimulate pancreatic insulin release ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-shorter acting than sulfonylureas and are taken w/ each meal
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
repaglinide and nateglinide ||//\\|| ||//\\||
Thiazolidinediones (TZDs) - correct answer✔✔Glitazones ||//\\|| ||//\\|| ||//\\|| ||//\\||
MOA: ||//\\||
-decrease insulin resistance, increasing glucose uptake by muscle and fat ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-decrease glucose production by liver ||//\\|| ||//\\|| ||//\\|| ||//\\||
SE: hypoglycemia when there is excessive insulin, HF, bladder cancer, fractures in women,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
ovulation
Dipeptidyl Peptidase-4 (DPP-4) Inhibitors - correct answer✔✔Gliptins ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
- enhance actions of incretin hormones to stimulate glucose-dependent insulin and suppress
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
glucagon release by inhibiting DPP-4 ||//\\|| ||//\\|| ||//\\|| ||//\\||
-DPP-4 is an enzyme that inactivates incretin hormones
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
AE: hypoglycemia and pancreatitis
||//\\|| ||//\\|| ||//\\||
Incretin Hormones (GIP and GLP-1) - correct answer✔✔(1) stimulate glucose-dependent
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
release of insulin (2) suppress postprandial release of glucagon
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Glucagon - correct answer✔✔increases glucose production in the liver ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
, sodium-glucose cotransporter 2 (SGLT-2) inhibitor - correct answer✔✔"-gliflozin" ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
SGLT-2 accounts for 90% of glucose reabsorption in the kidney
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
blocks reabsorption of filtered glucose, increasing urinary excretion of glucose
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
AE: hypoglycemia, UTI, vulvovaginal infection, dehydration
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
glucagon-like peptide-1 (GLP-1) receptor agonist - correct answer✔✔incretin mimetics ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-slow gastric emptying ||//\\|| ||//\\||
-stimulate glucose-dependent release o insulin ||//\\|| ||//\\|| ||//\\|| ||//\\||
-inhibit postprandial release of glucagon ||//\\|| ||//\\|| ||//\\|| ||//\\||
-suppress appetite ||//\\||
AE: hypoglycemia, renal impairment, fetal harm, pancreatitis
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Sulfonylureas - correct answer✔✔glipizide, glyburide, glimepiride -stimulate release of insulin ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
from pancreatic islet
||//\\|| ||//\\|| ||//\\||
>> bind with/block ATP-sensitive potassium channels in cell membrane, which causes influx
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
of calcium, leading to insulin release
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
AE: hypoglycemia ||//\\||
C-peptide - correct answer✔✔Product of proinsulin cleavage ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
detailed answers ||//\\||
benefits of transdermal estrogen - correct answer✔✔• total dose of estrogen is greatly
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
reduced (because the liver is bypassed). ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
• Less N/V
||//\\|| ||//\\||
• Blood levels of estrogen fluctuate less
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
• lower risk for DVT, pulmonary embolism, and stroke
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Type 1 diabetes diagnosis - correct answer✔✔-fasting plasma glucose >/= 126 mg/dL
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-random plasma glucose >/= 200mg/dL PLUS symptoms ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
- Oral glucose tolerance test (OGTT): 2-h plasma glucose >/= 200mg/dL
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-hemoglobin A1C 6.5 or higher ||//\\|| ||//\\|| ||//\\|| ||//\\||
which cells produce insulin - correct answer✔✔Beta cells of the islets of Langerhans in
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
pancreas
Type 1 diabetes management - correct answer✔✔1. diet
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
2. self-monitoring of blood glucose (SMBG)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
3. Physical activity
||//\\|| ||//\\||
4. Insulin replacement
||//\\|| ||//\\||
what is given to manage hypertension in diabetics - correct answer✔✔ACEIs or ARBs
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-reduces risk for diabetic nephropathy ||//\\|| ||//\\|| ||//\\|| ||//\\||
what is given to manage dyslipidemia in diabetics - correct answer✔✔Statins
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
,Type 1 diabetes complications - correct answer✔✔Diabetic Ketoacidosis (DKA)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
heart disease, renal failure, blindness, neuropathy, amputations, impotence, stroke
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Diabetic Ketoacidosis (DKA) pathophysiology - correct answer✔✔when insulin is not present
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
to move glucose into cells for energy, the body begins to metabolize fat; fatty acid
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
metabolism results in the formation of ketone bodies; ketone bodies are acidic and produce ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
metabolic acidosis, diuresis, and electrolyte loss ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Type 2 diabetes management - correct answer✔✔1. lifestyle changes PLUS metformin
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
2. add a second drug (thiazolidinedione, DPP-4 inhibitor, SGLT-2 inhibitor, or GLP-1 receptor
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
agonist
3. 3 drug combo
||//\\|| ||//\\|| ||//\\||
4. Insulin & GLP-1 receptor agonist
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Metformin - correct answer✔✔Biguanide ||//\\|| ||//\\|| ||//\\||
MOA:
1. inhibits glucose production in liver
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
2. reduces glucose absorption in the gut
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
3. sensitizes insulin receptors in target tissues--increases glucose uptake
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
NOT METABOLIZED ||//\\||
SE: GI, lactic acidosis
||//\\|| ||//\\|| ||//\\||
,-Type II, prevention, PCOS, Gestational
||//\\|| ||//\\|| ||//\\|| ||//\\||
Meglitinides (Glinides) - correct answer✔✔-stimulate pancreatic insulin release ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-shorter acting than sulfonylureas and are taken w/ each meal
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
repaglinide and nateglinide ||//\\|| ||//\\||
Thiazolidinediones (TZDs) - correct answer✔✔Glitazones ||//\\|| ||//\\|| ||//\\|| ||//\\||
MOA: ||//\\||
-decrease insulin resistance, increasing glucose uptake by muscle and fat ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-decrease glucose production by liver ||//\\|| ||//\\|| ||//\\|| ||//\\||
SE: hypoglycemia when there is excessive insulin, HF, bladder cancer, fractures in women,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
ovulation
Dipeptidyl Peptidase-4 (DPP-4) Inhibitors - correct answer✔✔Gliptins ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
- enhance actions of incretin hormones to stimulate glucose-dependent insulin and suppress
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
glucagon release by inhibiting DPP-4 ||//\\|| ||//\\|| ||//\\|| ||//\\||
-DPP-4 is an enzyme that inactivates incretin hormones
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
AE: hypoglycemia and pancreatitis
||//\\|| ||//\\|| ||//\\||
Incretin Hormones (GIP and GLP-1) - correct answer✔✔(1) stimulate glucose-dependent
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
release of insulin (2) suppress postprandial release of glucagon
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Glucagon - correct answer✔✔increases glucose production in the liver ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
, sodium-glucose cotransporter 2 (SGLT-2) inhibitor - correct answer✔✔"-gliflozin" ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
SGLT-2 accounts for 90% of glucose reabsorption in the kidney
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
blocks reabsorption of filtered glucose, increasing urinary excretion of glucose
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
AE: hypoglycemia, UTI, vulvovaginal infection, dehydration
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
glucagon-like peptide-1 (GLP-1) receptor agonist - correct answer✔✔incretin mimetics ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-slow gastric emptying ||//\\|| ||//\\||
-stimulate glucose-dependent release o insulin ||//\\|| ||//\\|| ||//\\|| ||//\\||
-inhibit postprandial release of glucagon ||//\\|| ||//\\|| ||//\\|| ||//\\||
-suppress appetite ||//\\||
AE: hypoglycemia, renal impairment, fetal harm, pancreatitis
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Sulfonylureas - correct answer✔✔glipizide, glyburide, glimepiride -stimulate release of insulin ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
from pancreatic islet
||//\\|| ||//\\|| ||//\\||
>> bind with/block ATP-sensitive potassium channels in cell membrane, which causes influx
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
of calcium, leading to insulin release
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
AE: hypoglycemia ||//\\||
C-peptide - correct answer✔✔Product of proinsulin cleavage ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
