The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients who were just admitted. Which patient should the nurse assess first?
A.
A patient with type 1 diabetes recently became pregnant. The nurse plans a blood glucose testing schedule for her. What is the recommended monitoring schedule?
C.
Which statement is correct about the contrast between acarbose and miglitol?
D.
A nurse is educating the staff nurses about ketoacidosis. To evaluate the group’s understanding, the nurse asks, “Which sign or symptom would not be consistent with ketoacidosis?” The group gives which correct answer?
D.
The nurse assesses a newly diagnosed patient for short-term complications of diabetes. What does this assessment include?
C.
A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The patient’s blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to administer?
C.
Regular insulin is indicated for sliding scale coverage
An elderly patient who has type 2 diabetes has a history of severe hypoglycemia. The patient’s spouse asks the nurse what the optimal A1c level is for the patient. Which is correct?
B.
For patients with a history of severe hypoglycemia and those with a limited life expectancy or advanced micro- and macrovascular complications, the target A1c level should be below 8.0. For most other patients with diabetes, the target is 7.0
An adolescent patient recently attended a health fair and had a serum glucose test. The patient telephones the nurse and says, “My level was 125 mg/dL. Does that mean I have diabetes?” What is the nurse’s most accurate response?
B.
A patient who has type 2 diabetes will begin taking glipizide [Glucotrol]. Which statement by the patient is concerning to the nurse?
B.
Glipizide is a sulfonylurea antidiabetic agent and can cause a disulfiram-like reaction when combined with alcohol.
What is the most reliable measure for assessing diabetes control over the preceding 3- month period?
A.
Insulin glargine is prescribed for a hospitalized patient who has diabetes. When will the nurse expect to administer this drug?
D.
A patient with hypothyroidism begins taking PO levothyroxine [Synthroid]. The nurse assesses the patient at the beginning of the shift and notes a heart rate of 62 beats/minute and a temperature of 97.2°F. The patient is lethargic and difficult to arouse. The nurse will contact the provider to request an order for which drug?
B.
A nurse is teaching a patient who will begin taking methimazole [Tapazole] for Graves disease about the medication. Which statement by the patient indicates understanding of the teaching?
A.
A patient is admitted to the hospital and will begin taking levothyroxine [Synthroid]. The nurse learns that the patient also takes warfarin [Coumadin]. The nurse will notify the provider to discuss the dose.
C.
Levothyroxine accelerates the degradation of vitamin K–dependent clotting factors, which enhances the effects of warfarin.
The nurse prepares a patient with Graves disease for radioactive iodine (131I) therapy. Which statement made by the patient best demonstrates understanding of 131I therapy?
A.
The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient tells the nurse she does not want to take medications while she is pregnant. What will the nurse explain to this patient?
A.
A patient has a free T4 level of 0.6 ng/dL and a free T3 level of 220 pg/dL. The patient asks the nurse what these laboratory values mean. How will the nurse respond?
C.
A free T4 level of less than 0.9 ng/dL and a free T3 level of less than 230 pg/dL are consistent with
hypothyroidism, but measurement of the thyroid-stimulating hormone (TSH) level is necessary to distinguish primary hypothyroidism from secondary hypothyroidism
An older adult patient is diagnosed with hypothyroidism. The initial free T4 level is 0.5 mg/dL, and the TSH level is 8 microunits/mL. The prescriber orders levothyroxine [Levothroid] 100 μg/day PO. What will the nurse do?
C.
In older adult patients, initial dosing of levothyroxine should start low and be increased gradually. A typical starting dose for an elderly patient is 25 to 50 mcg/day.
A patient in her twenties with Graves disease who takes methimazole [Tapazole] tells a nurse that she is trying to conceive and asks about disease management during pregnancy. What will the nurse tell her?
B.
A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine [Synthroid]. Which statement by the patient indicates a need for further teaching?
A.
A 1-year-old child with cretinism has been receiving 8 mcg/kg/day of levothyroxine [Synthroid]. The child comes to the clinic for a well-child checkup. The nurse will expect the provider to:
B.
In the treatment of cretinism, thyroid dosing decreases with age. For infants 6 to 12 months of age, the dose is 6 mcg/kg/day.
A patient arrives in the emergency department with a heart rate of 128 beats/minute and a temperature of 105°F. The patient’s skin feels hot and moist. The free T4 level is 4 ng/dL, the free T3 level is 685 pg/dL, and the TSH level is 0.1 microunits/mL. The nurse caring for this patient will expect to administer:
C.
Propylthiouracil is used for patients experiencing thyroid storm
Medication safe for managing diabetes during pregnancy are: Select all that apply.
a. Metformin
b. Insulin
c. Acarbose
d. Glyburide
a, b
Biguanides include:
B.
Sulfonylureas include: Select all that apply
a. Glipizide
b. Glyburide
c. Repaglinide
d. Pioglitazone
a, b
Meglitinides include:
B. (Glinides)
Thiazolidinediones (TZDs) include:
D. (Glitazones)
Alpha-Glucosidase Inhibitors (AGIs) include: Select all that apply
D.
Dipeptidyl Peptidase-4 (DPP-4) Inhibitors include: Select all that apply.
Drugs that raise blood glucose. Select all that apply.
a. norepinephrine
b. HCTZ
c. prednisone
d. albuterol
a, b, c
A patient with DM2 recently was diagnosed with heart failure and has had fluid retention. The patient has been taking Pioglitazone for several years. The nurse practitioner will recommend what course of action?
C.
Canagliflozin is given to patient with DM2 who recently was diagnosed with heart failure and has pitting edema 2+. The provider has ordered lasix. The nurse will take will take what action?
D.
Author
BodeS
ID
363782
Card Set
CH 48-49
Description
Drugs for Diabetes Mellitus
Drugs for Thyroid Disorders
