Lewis's Medical Surgical
Nursing Questions And
Answers
A patient with diabetes is starting on intensive insulin therapy. Which type of
insulin will the
nurse discuss using for mealtime coverage?
a. Lispro (Humalog)
b. Glargine (Lantus)
c. Detemir (Levemir)
d. NPH (Humulin N) - ANS: A
Rapid- or short-acting insulin is used for mealtime coverage for patients
receiving intensive
insulin therapy. NPH, glargine, or detemir will be used as the basal insulin.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
Which information will the nurse include when teaching a patient who has type
2 diabetes
about glyburide?
a. Glyburide decreases glucagon secretion from the pancreas.
b. Glyburide stimulates insulin production and release from the pancreas.
c. Glyburide should be taken even if the morning blood glucose level is low.
,d. Glyburide should not be used for 48 hours after receiving IV contrast media. -
ANS: B
The sulfonylureas stimulate the production and release of insulin from the
pancreas. If the
glucose level is low, the patient should contact the health care provider before
taking
glyburide because hypoglycemia can occur with this class of medication.
Metformin should
be held for 48 hours after administration of IV contrast media, but this is not
necessary for
glyburide. Glyburide does not affect glucagon secretion.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
The nurse has been teaching a patient with type 2 diabetes about managing
blood glucose
levels and taking glipizide (Glucotrol). Which patient statement indicates a need
for additional
teaching?
a. "If I overeat at a meal, I will still take the usual dose of medication."
b. "Other medications besides the Glucotrol may affect my blood sugar."
c. "When I am ill, I may have to take insulin to control my blood sugar."
d. "My diabetes won't cause complications because I don't need insulin." - ANS:
D
The patient should understand that type 2 diabetes places the patient at risk for
many
complications and that good glucose control is as important when taking oral
agents as when
,using insulin. The other statements are accurate and indicate good
understanding of the use of
glipizide.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity
When a patient who takes metformin (Glucophage) to manage type 2 diabetes
develops an
allergic rash from an unknown cause, the health care provider prescribes
prednisone. What
should the nurse anticipate?
a. The patient may need a diet higher in calories while receiving prednisone.
b. The patient may develop acute hypoglycemia while taking the prednisone.
c. The patient may require administration of insulin while taking prednisone.
d. The patient may have rashes caused by metformin-prednisone interactions -
ANS: C
Glucose levels increase when patients are taking corticosteroids, and insulin
may be required
to control blood glucose. Hypoglycemia is not a side effect of prednisone.
Rashes are not an
adverse effect caused by taking metformin and prednisone simultaneously. The
patient may
have an increased appetite when taking prednisone but will not need a diet that
is higher in
calories.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
, A hospitalized patient who is diabetic received 38 U of NPH insulin at 7:00
AM. At 1:00 PM,
the patient has been away from the nursing unit for 2 hours, missing the lunch
delivery while
awaiting a chest x-ray. What is the best action by the nurse to prevent
hypoglycemia?
a. Plan to discontinue the evening dose of insulin.
b. Save the lunch tray for the patient's later return.
c. Request that if testing is further delayed, the patient will eat lunch first.
d. Send a glass of orange juice to the patient in the diagnostic testing area. -
ANS: C
Consistency for mealtimes assists with regulation of blood glucose, so the best
option is for
the patient to have lunch at the usual time. Waiting to eat until after the
procedure is likely to
cause hypoglycemia. Holding the insulin dose later will not prevent
hypoglycemia form the
peak of the NPH dose. A glass of juice will keep the patient from becoming
hypoglycemic but
will cause a rapid rise in blood glucose because of the rapid absorption of the
simple
carbohydrate in these items.
DIF: Cognitive Level: Analyze (analysis)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
Which action by the patient who is self-monitoring blood glucose indicates a
need for
additional teaching?
a. Washes the puncture site using warm water and soap.
Nursing Questions And
Answers
A patient with diabetes is starting on intensive insulin therapy. Which type of
insulin will the
nurse discuss using for mealtime coverage?
a. Lispro (Humalog)
b. Glargine (Lantus)
c. Detemir (Levemir)
d. NPH (Humulin N) - ANS: A
Rapid- or short-acting insulin is used for mealtime coverage for patients
receiving intensive
insulin therapy. NPH, glargine, or detemir will be used as the basal insulin.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
Which information will the nurse include when teaching a patient who has type
2 diabetes
about glyburide?
a. Glyburide decreases glucagon secretion from the pancreas.
b. Glyburide stimulates insulin production and release from the pancreas.
c. Glyburide should be taken even if the morning blood glucose level is low.
,d. Glyburide should not be used for 48 hours after receiving IV contrast media. -
ANS: B
The sulfonylureas stimulate the production and release of insulin from the
pancreas. If the
glucose level is low, the patient should contact the health care provider before
taking
glyburide because hypoglycemia can occur with this class of medication.
Metformin should
be held for 48 hours after administration of IV contrast media, but this is not
necessary for
glyburide. Glyburide does not affect glucagon secretion.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
The nurse has been teaching a patient with type 2 diabetes about managing
blood glucose
levels and taking glipizide (Glucotrol). Which patient statement indicates a need
for additional
teaching?
a. "If I overeat at a meal, I will still take the usual dose of medication."
b. "Other medications besides the Glucotrol may affect my blood sugar."
c. "When I am ill, I may have to take insulin to control my blood sugar."
d. "My diabetes won't cause complications because I don't need insulin." - ANS:
D
The patient should understand that type 2 diabetes places the patient at risk for
many
complications and that good glucose control is as important when taking oral
agents as when
,using insulin. The other statements are accurate and indicate good
understanding of the use of
glipizide.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity
When a patient who takes metformin (Glucophage) to manage type 2 diabetes
develops an
allergic rash from an unknown cause, the health care provider prescribes
prednisone. What
should the nurse anticipate?
a. The patient may need a diet higher in calories while receiving prednisone.
b. The patient may develop acute hypoglycemia while taking the prednisone.
c. The patient may require administration of insulin while taking prednisone.
d. The patient may have rashes caused by metformin-prednisone interactions -
ANS: C
Glucose levels increase when patients are taking corticosteroids, and insulin
may be required
to control blood glucose. Hypoglycemia is not a side effect of prednisone.
Rashes are not an
adverse effect caused by taking metformin and prednisone simultaneously. The
patient may
have an increased appetite when taking prednisone but will not need a diet that
is higher in
calories.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
, A hospitalized patient who is diabetic received 38 U of NPH insulin at 7:00
AM. At 1:00 PM,
the patient has been away from the nursing unit for 2 hours, missing the lunch
delivery while
awaiting a chest x-ray. What is the best action by the nurse to prevent
hypoglycemia?
a. Plan to discontinue the evening dose of insulin.
b. Save the lunch tray for the patient's later return.
c. Request that if testing is further delayed, the patient will eat lunch first.
d. Send a glass of orange juice to the patient in the diagnostic testing area. -
ANS: C
Consistency for mealtimes assists with regulation of blood glucose, so the best
option is for
the patient to have lunch at the usual time. Waiting to eat until after the
procedure is likely to
cause hypoglycemia. Holding the insulin dose later will not prevent
hypoglycemia form the
peak of the NPH dose. A glass of juice will keep the patient from becoming
hypoglycemic but
will cause a rapid rise in blood glucose because of the rapid absorption of the
simple
carbohydrate in these items.
DIF: Cognitive Level: Analyze (analysis)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
Which action by the patient who is self-monitoring blood glucose indicates a
need for
additional teaching?
a. Washes the puncture site using warm water and soap.
