MEDICAL-SURGICAL NURSING TEST BANK
Medical-Surgical Nursing: Concepts and Practice
– Comprehensive Test Bank with Clinical
Scenarios, NCLEX-Style Questions, and
Rationales
lispro insulin (humulog) - Answer- rapid acting insulin
onset of lispro insulin (humolog) - Answer- under 15 minutes
peak of lispro insulin (humulog) - Answer- 30 min to 1.5 hours
when to administer lispro insulin (humulog) - Answer- 0-15 minutes prior to a meal
regular insulin (Humulin R, Novolin R) - Answer- short acting insulin
onset of regular insulin (humulin R, Novolin R) - Answer- 30 min to 60 minutes
peak of regular insulin (humulin R, Novolin R) - Answer- 2 to 3 hours
when to administer regular insulin (humulin R, Novolin R) - Answer- 30 minutes before a
meal
lente insulin (humulin L) - Answer- intermediate acting insulin
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, MEDICAL-SURGICAL NURSING TEST BANK
onset of lente insulin - Answer- 1 to 2 hours
when to administer lente insulin - Answer- does not need to be with a meal
peak of lente insulin - Answer- 4 to 12 hours
insulin glargine - Answer- long acting insulin
precautions with insulin glargine (lantus) - Answer- insulin glargine cannot be mixed with
other insulins!!, the action may be affected in an unpredictable manner.
onset of insulin glargine - Answer- 1-1.5 hours
peak of insulin glargine - Answer- has no peak...lasts 24 hr
storage for insulin - Answer- insulin vials should be stored in a refrigerator or they can be
kept at room temperature for up to 28 days. cartridges and pens should be stored at room
temperature and used within 28 days..
glucagon - Answer- a drug used to treat hypoglycemia. raises blood glucose levels
side effects of glucagon - Answer- n/v, hypotension, hypersensitivity, & hypokalemia
administration of glucagon - Answer- can be given SQ, IM, or IV. then as soon as the
patient is awake, give the patient some carbohydrate snack
mixing insulin - Answer- whenever mixing insulin, the short acting (regular/humilin R)
insulin is drawn up first in order to prevent contamination. short acting is clear insulin and
2|Page
, MEDICAL-SURGICAL NURSING TEST BANK
intermediate acting (humilin L/lente) is cloudy, so it is drawn up clear then cloudy. insulin
glargine cannot be mixed with any kind of insulin.
metformin - Answer- the most common oral hypoglycemic medication for pre diabetic
patients and non insulin dependent type 2 diabetes. is not used to treat type 1.
administration of metformin - Answer- taken each day. administer WITH food in order to
prevent GI upset. also take vitamin B12 and folic acid supplements
side effects of metformin - Answer- GI effects including anorexia, n/v, HA, abdominal
gas/pain, metallic taste, hypoglycemia,
LACTIC ACIDOSIS!! (unexplained muscle aches, fatigue, lethargy and hyperventilation)
*ok for pregnancy
precautions taking metformin - Answer- needs to be stopped 48 hours before any type of
radiographic test with iodinated contrast dye and can't be resumed until 48 hours after
because this can cause lactic acidosis or ARF. watch renal function when taking metformin.
when to d/c metformin - Answer- immediately if unexplained hypoxemia, dehydration, or
signs of lactic acidosis
what foods increase risk of hypoglycemia with oral anti diabetic drugs - Answer- celery,
coriander, dandelion root, garlic, ginseng
Diabetes mellitus - Answer- is a systemic, chronic, and progressive metabolic disease that
requires lifelong lifestyle modification. people with DM have the inability to metabolize
carbohydrates, proteins, and fats
Type 1 DM - Answer- can be genetic or autoimmune. involves the destruction of pancreatic
beta cells. has no or minimal insulin production.
aka Juvenile onset/ IDDM
3|Page
, MEDICAL-SURGICAL NURSING TEST BANK
Type 2 DM - Answer- can be genetic and environmental. either d/t desensitization (limited
response by beta cells) or insulin resistance (liver and peripheral tissues).
aka Adult onset/ NDDM
Type 1: age of onset, symptoms, insulin production, BMI, and insulin mgt - Answer- Age:
<30 but can occur at any age.
S/sx: abrupt onset, weight loss
Insulin production: None, no prevention.
BMI: usually non-obese
Insulin: dependent
Type 2: age of onset, symptoms, insulin production, BMI, and insulin mgt - Answer- Age:
peak at 50 yo
S/sx: slow onset, fatigue
Insulin production: low, normal, or high. Preventable.
BMI: 60-80% of type 2 pts are obese
Insulin: 20-30% require
diabetic ketoacidosis - Answer- a complication of diabetes.. is a lack of insulin and ketosis.
more common in Type 1
hyperglycemia-hyperosmolar state - Answer- a complication of diabetes... is an insulin
deficiency and profound dehydration
hypoglycemia - Answer- a complication of diabetes... is too little insulin, too little glucose
4|Page
Medical-Surgical Nursing: Concepts and Practice
– Comprehensive Test Bank with Clinical
Scenarios, NCLEX-Style Questions, and
Rationales
lispro insulin (humulog) - Answer- rapid acting insulin
onset of lispro insulin (humolog) - Answer- under 15 minutes
peak of lispro insulin (humulog) - Answer- 30 min to 1.5 hours
when to administer lispro insulin (humulog) - Answer- 0-15 minutes prior to a meal
regular insulin (Humulin R, Novolin R) - Answer- short acting insulin
onset of regular insulin (humulin R, Novolin R) - Answer- 30 min to 60 minutes
peak of regular insulin (humulin R, Novolin R) - Answer- 2 to 3 hours
when to administer regular insulin (humulin R, Novolin R) - Answer- 30 minutes before a
meal
lente insulin (humulin L) - Answer- intermediate acting insulin
1|Page
, MEDICAL-SURGICAL NURSING TEST BANK
onset of lente insulin - Answer- 1 to 2 hours
when to administer lente insulin - Answer- does not need to be with a meal
peak of lente insulin - Answer- 4 to 12 hours
insulin glargine - Answer- long acting insulin
precautions with insulin glargine (lantus) - Answer- insulin glargine cannot be mixed with
other insulins!!, the action may be affected in an unpredictable manner.
onset of insulin glargine - Answer- 1-1.5 hours
peak of insulin glargine - Answer- has no peak...lasts 24 hr
storage for insulin - Answer- insulin vials should be stored in a refrigerator or they can be
kept at room temperature for up to 28 days. cartridges and pens should be stored at room
temperature and used within 28 days..
glucagon - Answer- a drug used to treat hypoglycemia. raises blood glucose levels
side effects of glucagon - Answer- n/v, hypotension, hypersensitivity, & hypokalemia
administration of glucagon - Answer- can be given SQ, IM, or IV. then as soon as the
patient is awake, give the patient some carbohydrate snack
mixing insulin - Answer- whenever mixing insulin, the short acting (regular/humilin R)
insulin is drawn up first in order to prevent contamination. short acting is clear insulin and
2|Page
, MEDICAL-SURGICAL NURSING TEST BANK
intermediate acting (humilin L/lente) is cloudy, so it is drawn up clear then cloudy. insulin
glargine cannot be mixed with any kind of insulin.
metformin - Answer- the most common oral hypoglycemic medication for pre diabetic
patients and non insulin dependent type 2 diabetes. is not used to treat type 1.
administration of metformin - Answer- taken each day. administer WITH food in order to
prevent GI upset. also take vitamin B12 and folic acid supplements
side effects of metformin - Answer- GI effects including anorexia, n/v, HA, abdominal
gas/pain, metallic taste, hypoglycemia,
LACTIC ACIDOSIS!! (unexplained muscle aches, fatigue, lethargy and hyperventilation)
*ok for pregnancy
precautions taking metformin - Answer- needs to be stopped 48 hours before any type of
radiographic test with iodinated contrast dye and can't be resumed until 48 hours after
because this can cause lactic acidosis or ARF. watch renal function when taking metformin.
when to d/c metformin - Answer- immediately if unexplained hypoxemia, dehydration, or
signs of lactic acidosis
what foods increase risk of hypoglycemia with oral anti diabetic drugs - Answer- celery,
coriander, dandelion root, garlic, ginseng
Diabetes mellitus - Answer- is a systemic, chronic, and progressive metabolic disease that
requires lifelong lifestyle modification. people with DM have the inability to metabolize
carbohydrates, proteins, and fats
Type 1 DM - Answer- can be genetic or autoimmune. involves the destruction of pancreatic
beta cells. has no or minimal insulin production.
aka Juvenile onset/ IDDM
3|Page
, MEDICAL-SURGICAL NURSING TEST BANK
Type 2 DM - Answer- can be genetic and environmental. either d/t desensitization (limited
response by beta cells) or insulin resistance (liver and peripheral tissues).
aka Adult onset/ NDDM
Type 1: age of onset, symptoms, insulin production, BMI, and insulin mgt - Answer- Age:
<30 but can occur at any age.
S/sx: abrupt onset, weight loss
Insulin production: None, no prevention.
BMI: usually non-obese
Insulin: dependent
Type 2: age of onset, symptoms, insulin production, BMI, and insulin mgt - Answer- Age:
peak at 50 yo
S/sx: slow onset, fatigue
Insulin production: low, normal, or high. Preventable.
BMI: 60-80% of type 2 pts are obese
Insulin: 20-30% require
diabetic ketoacidosis - Answer- a complication of diabetes.. is a lack of insulin and ketosis.
more common in Type 1
hyperglycemia-hyperosmolar state - Answer- a complication of diabetes... is an insulin
deficiency and profound dehydration
hypoglycemia - Answer- a complication of diabetes... is too little insulin, too little glucose
4|Page
