Chapter 50: Antidiabetics McCuistion:
Pharmacology: A Patient-Centered
Nursing Process Approach, 11th Edition
A 45-year-old patient who is overweight has had a diagnosis of type 2 diabetes for 2 years.
The patient uses 20 units of long-acting insulin per day. The patient's fasting blood glucose
(FBG) is190 mg/dL. The patient asks the nurse about using an oral antidiabetic agent. The
nurse understands that oral antidiabetic agents
a. cannot be used if the patient is overweight.
b. cannot be used once a patient requires insulin.
c. may be used in patients with type 2 diabetes in combination with insulin.
d. may not be used since this patient's fasting blood glucose is too high. - ANS-ANS: C
Patients with type 2 diabetes often use long-acting insulin in combination with oral agents to
manage blood glucose.
\A patient develops type 2 diabetes mellitus. The nurse will explain that this type of diabetes
a. is often triggered by viral infections.
b. is not as common as type 1 diabetes.
c. is often related to heredity and obesity.
d. will not require insulin therapy. - ANS-ANS: C
Type 2 diabetes is often caused by obesity and hereditary factors. Viral infections triggering
an autoimmune response is associated with the development of type 1 diabetes Type 2
diabetes is the most common type of diabetes. Patients with type 2 diabetes may eventually
require treatment with insulin.
\A patient is ordered to receive insulin lispro at mealtimes. The nurse will instruct this patient
to ideally administer the medication at which time?
a. 10-15 min before eating
b. 15 min after eating
c. 30 min before eating
d. 10 min after eating - ANS-ANS: A
Lispro acts faster than regular insulin, and patients should be taught to give this medication
10- 15 minutes before eating.
\A patient reports that they are taking a rapid-acting insulin with meals, but can't remember
thename. Which of the following products is a rapid-acing insulin?
a. Regular insulin (Novolin R)
b. Insulin glargine (Lantus)
c. Insulin lispro (Humalog)
, d. Insulin degludec (Tresiba) - ANS-ANS: C
Insulin lispro (Humalog) is a rapid-acing insulin product. Regular insulin is considered a
short-acting insulin. Insulin glargine and insulin degludec are long-acting insulins.
\A patient was administered regular insulin 45 minutes ago, but has not yet received a
breakfast
tray. The patient is experiencing nervousness and tremors. What is the nurse's first action?
a. Administer glucagon.
b. Give the patient orange juice.
c. Notify the kitchen to deliver the tray.
d. Perform bedside glucose testing. - ANS-ANS: B
The patient is symptomatic and has hypoglycemia. The nurse should give orange juice.
Glucagon is given for patients unable to ingest carbohydrates. The kitchen should be
notified, and bedside glucose testing should be performed, but only after the patient is given
carbohydrates.
\A patient who has type 1 diabetes mellitus must take a glucocorticoid medication for
osteoarthritis. When teaching this patient, the nurse will explain that there may be a need to
a. decrease the glucocorticoid dose.
b. decrease the insulin dose.
c. increase the glucocorticoid dose.
d. increase the insulin dose. - ANS-ANS: D
Glucocorticoids can cause hyperglycemia, so the insulin dose may need to be increased.
Changing the glucocorticoid dose is usually not recommended. Decreasing the insulin dose
will only compound the hyperglycemic effects of the glucocorticoid.
\A patient who has type 2 diabetes mellitus asks the nurse about using a combination insulin
product such as Humalog 70/30. The nurse will tell the patient that use of this product
a. depends on individual insulin needs.
b. is useful for patients with severe insulin resistance.
c. means less rotation of injection sites.
d. requires refrigeration at all times. - ANS-ANS: A
Combination products are convenient because the patient does not have to mix insulin, but
the products depend on individual needs, since the doses are fixed. They are generally not
used for patients with severe insulin resistance that require large insulin doses. Patients
must continue to rotate injection sites. They do not require refrigeration after first use'
\A patient who has type 2 diabetes mellitus asks the nurse why the provider has changed
their oral antidiabetic agent from tolbutamide (Orinase) to glipizide (Glucotrol). The nurse will
explain that glipizide
a. has a longer duration of action.
b. has fewer gastrointestinal side effects.
c. may be taken on an as-needed basis.
d. does not cause hypoglycemia. - ANS-ANS: A
Pharmacology: A Patient-Centered
Nursing Process Approach, 11th Edition
A 45-year-old patient who is overweight has had a diagnosis of type 2 diabetes for 2 years.
The patient uses 20 units of long-acting insulin per day. The patient's fasting blood glucose
(FBG) is190 mg/dL. The patient asks the nurse about using an oral antidiabetic agent. The
nurse understands that oral antidiabetic agents
a. cannot be used if the patient is overweight.
b. cannot be used once a patient requires insulin.
c. may be used in patients with type 2 diabetes in combination with insulin.
d. may not be used since this patient's fasting blood glucose is too high. - ANS-ANS: C
Patients with type 2 diabetes often use long-acting insulin in combination with oral agents to
manage blood glucose.
\A patient develops type 2 diabetes mellitus. The nurse will explain that this type of diabetes
a. is often triggered by viral infections.
b. is not as common as type 1 diabetes.
c. is often related to heredity and obesity.
d. will not require insulin therapy. - ANS-ANS: C
Type 2 diabetes is often caused by obesity and hereditary factors. Viral infections triggering
an autoimmune response is associated with the development of type 1 diabetes Type 2
diabetes is the most common type of diabetes. Patients with type 2 diabetes may eventually
require treatment with insulin.
\A patient is ordered to receive insulin lispro at mealtimes. The nurse will instruct this patient
to ideally administer the medication at which time?
a. 10-15 min before eating
b. 15 min after eating
c. 30 min before eating
d. 10 min after eating - ANS-ANS: A
Lispro acts faster than regular insulin, and patients should be taught to give this medication
10- 15 minutes before eating.
\A patient reports that they are taking a rapid-acting insulin with meals, but can't remember
thename. Which of the following products is a rapid-acing insulin?
a. Regular insulin (Novolin R)
b. Insulin glargine (Lantus)
c. Insulin lispro (Humalog)
, d. Insulin degludec (Tresiba) - ANS-ANS: C
Insulin lispro (Humalog) is a rapid-acing insulin product. Regular insulin is considered a
short-acting insulin. Insulin glargine and insulin degludec are long-acting insulins.
\A patient was administered regular insulin 45 minutes ago, but has not yet received a
breakfast
tray. The patient is experiencing nervousness and tremors. What is the nurse's first action?
a. Administer glucagon.
b. Give the patient orange juice.
c. Notify the kitchen to deliver the tray.
d. Perform bedside glucose testing. - ANS-ANS: B
The patient is symptomatic and has hypoglycemia. The nurse should give orange juice.
Glucagon is given for patients unable to ingest carbohydrates. The kitchen should be
notified, and bedside glucose testing should be performed, but only after the patient is given
carbohydrates.
\A patient who has type 1 diabetes mellitus must take a glucocorticoid medication for
osteoarthritis. When teaching this patient, the nurse will explain that there may be a need to
a. decrease the glucocorticoid dose.
b. decrease the insulin dose.
c. increase the glucocorticoid dose.
d. increase the insulin dose. - ANS-ANS: D
Glucocorticoids can cause hyperglycemia, so the insulin dose may need to be increased.
Changing the glucocorticoid dose is usually not recommended. Decreasing the insulin dose
will only compound the hyperglycemic effects of the glucocorticoid.
\A patient who has type 2 diabetes mellitus asks the nurse about using a combination insulin
product such as Humalog 70/30. The nurse will tell the patient that use of this product
a. depends on individual insulin needs.
b. is useful for patients with severe insulin resistance.
c. means less rotation of injection sites.
d. requires refrigeration at all times. - ANS-ANS: A
Combination products are convenient because the patient does not have to mix insulin, but
the products depend on individual needs, since the doses are fixed. They are generally not
used for patients with severe insulin resistance that require large insulin doses. Patients
must continue to rotate injection sites. They do not require refrigeration after first use'
\A patient who has type 2 diabetes mellitus asks the nurse why the provider has changed
their oral antidiabetic agent from tolbutamide (Orinase) to glipizide (Glucotrol). The nurse will
explain that glipizide
a. has a longer duration of action.
b. has fewer gastrointestinal side effects.
c. may be taken on an as-needed basis.
d. does not cause hypoglycemia. - ANS-ANS: A
