NURS 5334 EXAM 3 QUESTIONS WITH
COMPLETE SOLUTIONS 2025
,What drugs are used to treat gestational diabetes? - ANSWERMetformin abd Insulin
What A1C value indicates diabetes mellitus? Pre-DM? - ANSWER6.5% or greater is
considered diabetes o 5.7-6.4%pre-diabetes
What fasting and random values indicate DM? - ANSWERFasting plasma glucose—126
or greater is diabetes. Random (casual) plasma glucose—anything greater than 200 is
diabetes
What are complications of insulin therapy? - ANSWERHypoglycemia
Can develop lipohypertrophy. Accumulation of subcutaneous fat that occurs when it is
injected too frequently at the same site. Allergic reactions
Characterized by red and intensely itchy welts, breathing becomes difficult
If severe allergy develops:
Desensitization procedure (small doses to larger doses). Hypokalemia
Promotes the uptake of potassium cells and insulin activates a membrane-bound
enzyme with sodium potassium and ATPase that pumps potassium into the cells and
sodium out
insulin drug interactions - ANSWERo Hypoglycemicagents
Can intensify the hypoglycemia included by insulin
Examples: sulfonylureas, glinides, alcohol o Usewithcautionwithhyperglycemicagents
Examples: thiazide and glucocorticoids and sympathomimetics
What effect do beta blockers have on insulin? - ANSWERdelay awareness of and
response to hypoglycemia by masking the signs that are associated with stimulation of
sympathetic nervous system
o Impairglycogenolysis
o Prevent the bodies counter-regulatory response
What are other therapeutic uses besides DM? - ANSWERHyperkalemia o Aids in
diagnosis of GH deficiency o Diabeticketoacidosis
Insulin dosage must be coordinated with what? - ANSWERCarbohydrate intake
What is B/P goal in diabetic? - ANSWERo To be controlled, within normal 120/80
What medication can be given to decrease risk of diabetic nephropathy? -
ANSWERACE inhibitor or ARB
, What role does exercise play in treatment of both type 1 and type 2 DM? -
ANSWERExercise increases cellular responsiveness to insulin and increases glucose
tolerance o 150 minute per week of moderate intensity exercise is recommended
What are the 4 steps in the 4-step approach? - ANSWERStep1—diagnosis
Lifestyle changes plus metformin o Step2
Lifestyle changes plus metformin and a second drug (sulfonylurea, TZD or a DPP4
inhibitor, a sodium glucose cotransporter or SGLT-2 inhibitor, a glucagon-like peptide 1,
or a GLP-1 receptor agonist or basal insulin
Second drug choice made considering efficacy, the hypoglycemia risk of the patient,
the patient tolerability, and weight-related considerations (some help weight loss, some
cause weight gain), cost
o Step3
Three drug combination
Metformin
Plus 2 other drugs from step 2
o Decidedbasedonadrugandpatientspecificconsiderations
o Step4
If 3 drug combination that includes basal insulin fails after 3-6 months, more
complex insulin regimen
Usually in combination with one or more non-insulin medications
When a patient is on insulin therapy what are the blood glucose goals before meals? At
bedtime? - ANSWERBeforemeals—70-130
o Bedtime—100-140
What is the A1C goal? When is goal below 7 not appropriate? - ANSWER7%or below o
Those with severe hypoglycemia risk, limited life expectancy ,advanced microvascular
or
macrovascular complications—not below 7
What are the short acting insulins? Intermediate? Long acting? -
ANSWERShortduration:Rapidacting
Insulin lispro [Humalog]
Insulin aspart [NovoLog]
Insulin glulisine [Apidra] o Shortduration:Sloweracting
Regular insulin [Humulin R, Novolin R] o Intermediateduration
Neutral protamine Hagedorn (NPH) insulin
Insulin detemir [Levemir] o Longduration
Insulin glargine
When are short duration insulins used? - ANSWERAdministered in association with
meals to control the post-prandial rise in blood glucose between meals and at night
When are intermediate insulins needed? - ANSWERAdminister 2-3 times daily to
provide glycemic control between meals and during the
COMPLETE SOLUTIONS 2025
,What drugs are used to treat gestational diabetes? - ANSWERMetformin abd Insulin
What A1C value indicates diabetes mellitus? Pre-DM? - ANSWER6.5% or greater is
considered diabetes o 5.7-6.4%pre-diabetes
What fasting and random values indicate DM? - ANSWERFasting plasma glucose—126
or greater is diabetes. Random (casual) plasma glucose—anything greater than 200 is
diabetes
What are complications of insulin therapy? - ANSWERHypoglycemia
Can develop lipohypertrophy. Accumulation of subcutaneous fat that occurs when it is
injected too frequently at the same site. Allergic reactions
Characterized by red and intensely itchy welts, breathing becomes difficult
If severe allergy develops:
Desensitization procedure (small doses to larger doses). Hypokalemia
Promotes the uptake of potassium cells and insulin activates a membrane-bound
enzyme with sodium potassium and ATPase that pumps potassium into the cells and
sodium out
insulin drug interactions - ANSWERo Hypoglycemicagents
Can intensify the hypoglycemia included by insulin
Examples: sulfonylureas, glinides, alcohol o Usewithcautionwithhyperglycemicagents
Examples: thiazide and glucocorticoids and sympathomimetics
What effect do beta blockers have on insulin? - ANSWERdelay awareness of and
response to hypoglycemia by masking the signs that are associated with stimulation of
sympathetic nervous system
o Impairglycogenolysis
o Prevent the bodies counter-regulatory response
What are other therapeutic uses besides DM? - ANSWERHyperkalemia o Aids in
diagnosis of GH deficiency o Diabeticketoacidosis
Insulin dosage must be coordinated with what? - ANSWERCarbohydrate intake
What is B/P goal in diabetic? - ANSWERo To be controlled, within normal 120/80
What medication can be given to decrease risk of diabetic nephropathy? -
ANSWERACE inhibitor or ARB
, What role does exercise play in treatment of both type 1 and type 2 DM? -
ANSWERExercise increases cellular responsiveness to insulin and increases glucose
tolerance o 150 minute per week of moderate intensity exercise is recommended
What are the 4 steps in the 4-step approach? - ANSWERStep1—diagnosis
Lifestyle changes plus metformin o Step2
Lifestyle changes plus metformin and a second drug (sulfonylurea, TZD or a DPP4
inhibitor, a sodium glucose cotransporter or SGLT-2 inhibitor, a glucagon-like peptide 1,
or a GLP-1 receptor agonist or basal insulin
Second drug choice made considering efficacy, the hypoglycemia risk of the patient,
the patient tolerability, and weight-related considerations (some help weight loss, some
cause weight gain), cost
o Step3
Three drug combination
Metformin
Plus 2 other drugs from step 2
o Decidedbasedonadrugandpatientspecificconsiderations
o Step4
If 3 drug combination that includes basal insulin fails after 3-6 months, more
complex insulin regimen
Usually in combination with one or more non-insulin medications
When a patient is on insulin therapy what are the blood glucose goals before meals? At
bedtime? - ANSWERBeforemeals—70-130
o Bedtime—100-140
What is the A1C goal? When is goal below 7 not appropriate? - ANSWER7%or below o
Those with severe hypoglycemia risk, limited life expectancy ,advanced microvascular
or
macrovascular complications—not below 7
What are the short acting insulins? Intermediate? Long acting? -
ANSWERShortduration:Rapidacting
Insulin lispro [Humalog]
Insulin aspart [NovoLog]
Insulin glulisine [Apidra] o Shortduration:Sloweracting
Regular insulin [Humulin R, Novolin R] o Intermediateduration
Neutral protamine Hagedorn (NPH) insulin
Insulin detemir [Levemir] o Longduration
Insulin glargine
When are short duration insulins used? - ANSWERAdministered in association with
meals to control the post-prandial rise in blood glucose between meals and at night
When are intermediate insulins needed? - ANSWERAdminister 2-3 times daily to
provide glycemic control between meals and during the
