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A patient is prescribed metformin. Which is a side effect/adverse effect common to metformin?
C.Bitter or metallic taste
D.Polyuria and polydipsia
A patient received regular insulin at 7:30 am. At 9:30 am the patient feels slightly hungry and has a dull headache. The nurse should
A.test the patient's blood glucose level.
B.ensure that the patient has a meal.
C.provide the patient with 4 ounces of orange juice.
D.administer the next dose of insulin.
Which statement by a patient taking glipizide indicates that more teaching is indicated?
A."I will use a new needle every time I take the medication."
B."I will take the medication once a day in the morning."
C."I will eat my breakfast very soon after taking my Glucotrol."
D."This medication stimulates my pancreatic cells to make insulin."
The patient experiences the Somogyi effect. Which statement regarding the Somogyi effect does the nurse identify as being true?
A.This is a hyperglycemic condition.
B.The condition usually occurs immediately after dinner.
C.It is a response to excessive insulin.
D.Management usually requires increase of the bedtime insulin dose.
Which time frame would be most appropriate for administering sliding-scale lispro insulin?
A.Within 30 minutes of consuming breakfast
B.When the breakfast tray is served and ready to eat
C.Within 1 hour of obtaining blood glucose measurement
D.Within 15 minutes of obtaining blood glucose measurement
A nurse gives a patient NPH insulin at 8:00 am. At 2:00 pm the nurse finds the patient extremely lethargic but conscious. The patient is diaphoretic and slightly combative. The nurse should
A.call the health care provider.
B.ensure that the patient has a meal.
C.provide the patient with 4 ounces of orange juice.
D.administer the next dose of insulin.
When teaching the patient about the storage of insulin, which statement will the nurse include?
A.Keep the insulin in the freezer.
B.Warm the insulin in the microwave before administration.
C.Do not place insulin in sunlight or a warm environment.
D.Open insulin vials lose their strength after one year.
A patient with type 1 diabetes mellitus is ordered insulin therapy once daily to be administered at bedtime. What is the type of insulin the patient is most likely receiving?
Which is the ONLY antidiabetic drug (not insulin) approved for Type 1 AND 2 diabetes?
Which oral antidiabetic is contraindicated in Class III-IV heart failure?
Which of these is NOT a sign of hypoglycemia?
fruity sweet breath
Which of these is NOT a criteria for oral antidiabetic meds?
less than 40 units of insulin needed per day
fasting glucose < 200
normal renal function
normal cardiac function
Which is the longer lasting insulin listed below?
Which of these is a bulk forming laxative?
Which of these is a stimulant laxative?
Which of these is a stool softener/emollient?
Which of these osmotic laxatives is safe for clients with renal or cardiac disease?
Milk of Magnesia
polyethylene glycol (PEG)
Which of these electrolyte imbalances is common in diarrhea?
Ondansetron has been ordered for the patient undergoing cancer chemotherapy to control the severe nausea and vomiting. What side effects should the nurse observe for?
A.Headache, dizziness, and fatigue
B.Anorexia and hair loss
C.Abdominal cramping and irritability
D.Psychosis and middle ear disturbances
A patient is ordered a phenothiazine antiemetic for treatment of nausea and vomiting associated with chemotherapy. The drug will be most effective if administered
A.as requested by the patient.
B.1 hour after chemotherapy administration.
C.the night before treatment, the day of treatment, and for 24 hours after treatment.
D.the day of treatment.
A toddler ingests a small amount of household cleaning fluid. What is the safest advice for the nurse to provide the caregiver?
A.Give the child fluids and proceed to the emergency department.
B.Call the poison control center and follow directions.
C.Administer syrup of ipecac and monitor for vomiting.
D.Have the toddler eat bread to absorb the substance.
Which medications are most likely to be included in a common triple drug therapy program for peptic ulcer disease from H. pylori?
A.Metronidazole, omeprazole and clarithromycin
B.Amoxicillin, Tetracycline and metronidazole
C.Bismuth subsalicylate, tetracycline and amoxicillin
D.Ciprofloxacin and sucralfate
A patient with peptic ulcer disease is noted to have a positive breath test for H. pylori. The nurse would anticipate treating the patient with
A.antacids and narcotics.
B.pepsin inhibitors and antiemetics.
C.proton pump inhibitors and antibiotics.
D.emetic agents and tranquilizers.
An older adult patient reports taking aluminum hydroxide on a daily basis to relieve symptoms of gastroesophageal reflux disease (GERD). The nurse needs to evaluate for which condition?
When administering the histamine2 blocker ranitidine, the nurse will
A.monitor laboratory results because ranitidine decreases the effect of oral anticoagulants.
B.separate ranitidine and antacid dosage by at least 1 hour if possible.
C.teach the patient to avoid foods rich in vitamin B12.
D.expect a reduction in the patient's pain to occur after 5 days of therapy.
A patient with a gastric ulcer is ordered sucralfate. This medication works to
A.calm the patient to reduce acid production.
B.block the H2 receptors.
C.neutralize the gastric acids.
D.coat the gastric lining.
A patient who complains of gastric distress from aspirin will most likely benefit from the administration of which medication?
The patient tells the nurse that he has been treating his stomach pain with a lot of calcium carbonate. It is most important for the nurse to assess the patient for
The patient is ordered cimetidine. It is most important for the nurse to teach the patient about what dietary needs?
A.Avoid use of salt substitutes.
B.Eat foods rich in vitamin B12.
C.Eat a high-protein diet.
D.Avoid citrus foods.
Which are manifestations of hypocalcemia? (Select all that apply.)
A.Twitching of the mouth
a, b, d
Which foods would not be recommended for a patient who needs to eat a diet high in potassium?
B.Bananas and plums
C.Broccoli and peanut butter
D.Eggs and whole-grain breads
A patient sustains a significant blood loss secondary to a trauma. The nurse anticipates using which fluid to best replace the losses?
A patient is noted to have a serum potassium level of 5.6 mEq/L. The first action the nurse would anticipate would be to
A.provide IV hydration to dilute the potassium.
B.administer sodium polystyrene sulfonate (Kayexalate).
C.institute potassium restriction.
D.administer a potassium-wasting diuretic.
A nurse is caring for a patient who was admitted with multiple fractures and hypercalcemia. Which symptom would the nurse expect to find during an assessment of the patient with hypercalcemia?
What is probably the most undiagnosed electrolyte deficiency?
Iron toxicity is a serious cause of poisoning in children. It may be fatal because of an ulcerogenic effect, resulting in which of the following?
Which does the nurse identify as signs and symptoms of vitamin A toxicity? (Select all that apply.)
D.Vomiting and diarrhea
b, c, d
A patient is admitted to the emergency department after taking high doses of vitamin B and vitamin D. The nurse is more concerned about the vitamin D because
A.vitamin D is fat-soluble.
B.vitamin D is water-soluble.
C.vitamin D in high doses causes bleeding.
D.vitamin D in low doses results in scurvy.
A patient with pernicious anemia most likely has a deficiency of
A patient with type 2 diabetes asks about minerals that may be helpful in managing his illness. The nurse instructs him that which mineral may assist with the control of this illness?
A patient is taking iron supplementation. It is most important for the nurse to instruct the patient to
A.increase fluid intake to avoid urinary calculi.
B.increase fiber and fluid intake to avoid constipation.
C.increase deep breathing to avoid atelectasis.
D.use sunscreen to deal with photosensitivity.
A patient with type 1 diabetes mellitus has been ordered insulin aspart 10 units at 7:00 AM. What nursing intervention should the nurse perform after administering this medication?
Make sure the patient eats breakfast immediately.
Perform a fingerstick blood sugar test.
Flush the IV.
Have the patient void and dipstick the urine.
The patient newly diagnosed with type 2 diabetes mellitus has been ordered insulin glargine. What information is essential for the nurse to teach this patient?
"This medication has a duration of action of 24 h."
"This medication should be mixed with the regular insulin each morning."
"This medication is very expensive, but you will be receiving it only a short time."
"This medication is very short acting. You must be sure you eat after injecting it."
The nurse is teaching the patient how to administer insulin. What information is essential to include in the plan?
"Inject the insulin at a 30-degree angle between the fat and muscle."
"Do not mix any insulins in the same syringe."
"Avoid administering the insulin into your arm."
"For the most consistent absorption, inject the insulin into the abdomen."
The nurse administers NPH insulin at 8 AM. What intervention is essential for the nurse to perform?
Administer the insulin via IV pump.
Monitor fingerstick at 2 PM.
Make sure patient eats by 5 PM.
Assess the patient for hyperglycemia by 10 AM.
Which statement indicates to the nurse that the patient needs additional teaching on oral hypoglycemic agents?
"I will take the medication only when I need it."
"I will report symptoms of fatigue and loss of appetite."
"I will limit my alcohol consumption."
"I will monitor my blood sugar daily."
What information will the nurse teach the patient who has been prescribed an alpha glucosidase inhibitor?
"This medication will increase the sensitivity of insulin receptor sites."
"This medication cannot be used in combination with other antidiabetic agents."
"This medication will stimulate pancreatic insulin release."
"This medication will delay the absorption of carbohydrates from the intestines."
The patient with type 1 diabetes mellitus asks, "Why can't I take a sulfonylurea like my friend who has diabetes?" What is the nurse's best response?
"You are unable to store glucose, because you do not have insulin, and sulfonylurea helps with glucose storage."
"Sulfonylurea will lower your blood sugar too much, and you will be hypoglycemic."
"Sulfonylurea increases beta-cell stimulation to secrete insulin, and with your type of diabetes, the beta cells do not contain insulin. This medication will not work for you."
"You must be mistaken. If your friend has diabetes mellitus, she is taking insulin."
The nurse is teaching a patient who has been prescribed repaglinide. Which information should the nurse include in the teaching plan?
"This medication is compatible with all of your cardiac medications."
"This medication will not cause hypoglycemia."
"This medication has no side effects."
"You will need to be sure you eat as soon as you take this medication."
A nurse is providing teaching for a patient who has to administer a mixed insuling dose of 30 units regular insulin and 70 units NPH insulin. Which technique is most appropriate for the nurse to include in patient teaching?
Administer these insulins at least 10 min apart, so that you will know when they are working.
Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin.
Use the Z-track method for administration.
Draw the medication into two separate syringes but inject into the same spot.
Which is the most appropriate action for the nurse who is told that a patient typically takes his glipizide with food?
Inform the patient that the medication must be taken 15 min after a meal.
Immediately check the patient's blood glucose level.
Immediately call the health care provider.
Inform the patient that it is better to take the medication 30 min before a meal.
What is the nurse's best action when finding a patient with type 1 diabetes mellitus unresponsive, cold, and clammy?
Administer subcutaneous regular insulin immediately.
Start an insulin drip.
Draw blood glucose level and send to the laboratory.
A male patient 24 h post-op tells the nursing student that his nurse "gave him an extra shot of insulin and there must be some mistake." The nursing student verifies the patient received a sliding scale dose of insulin. What information should the nursing student provide to the patient?
"The effects of surgery result in a decrease in your metabolic rate; this increases secretion of glucagon and increases your glucose levels."
"Surgery often results in infection, and infection raises your glucose levels."
"You received extra insulin today because you have not been eating."
"Surgery can produce stress, which can produce stress; an additional small amount of insulin helps provide a constant glucose level."
The nurse is providing patient teaching for the drug miglitol for the patient with a diagnosis of type 2 diabetes. Which group of side effects should the nurse include in the patient teaching?
Dehydration, hypoglycemia, and thirst
Rash, gingivitis, and hypoglycemia
Flatulence, hypoglycemia, and diarrhea
Hypoglycemia, diaphoresis, and hypokalemia
A patient has been prescribed aluminum hydroxide and has received patient teaching. Which statement by the patient indicates an understanding of the instructions?
"I will drink 2 ounces of water after taking aluminum hydroxide."
"I will take aluminum hydroxide within 30 min of my other medications."
"I will take aluminum hydroxide at mealtime."
"I will take a laxative if I develop constipation."
What is a priority nursing intervention when administering ranitidine?
Administer just before meals.
Administer 1-2 h after meals.
Administer right after eating.
Administer during meals.
The health care provider prescribes lansoprazole (Prevacid) for a patient. Which assessment indicates to the nurse that the medication has had a therapeutic effect?
The patient has no gastric pain.
The patient has no diarrhea.
The patient has no esophageal pain.
The patient is able to eat.
The nurse is caring for a patient who is taking sucralfate for treatment of a duodenal ulcer. Which assessment requires immediate action by the nurse?
A sodium level 140 mEq/L
A calcium level 8.5 mg/dL
Absent bowel sounds, hard abdomen
Urinary output of 30 mL/h
What information should the nurse include in a teaching plan for the patient who is prescribed sucralfate?
"This medication will form a protective barrier over the gastric mucosa."
"This medication will enhance gastric absorption of meals."
"This medication will neutralize gastric acid."
"This medication will inhibit gastric acid."
The patient's health care provider prescribes rabeprazole to a patient. The nurse recognizes that this drug is effective for the patient because it belongs to which drug class?
Proton pump inhibitor
The health care provider has prescribed lansoprazole for the patient. Within 30 min of receiving the first dose of the medication, the patient experiences shortness of breath and develops a rash on his skin. What should the nurse identify as occuring?
Unexpected side effect of the medication
Allergic reaction to the medication
Toxic level of the medication
Typical side effect of the medication
The patient has been prescribed a treatment regimen that includes nizatidine. Which statement by the patient indicates a therapeutic outcome?
"I don't have any more stomach pain."
"My constipation has been relieved."
"I don't have such frequent headaches."
"My anxiety has been under control."
Which statement demonstrates to the nurse that the patient understands instructions regarding the use of histamine2-receptor antagonists?
"Smoking decreases the effects of the medication, so I should try a cessation program."
"I should take this medication 1 h after each meal to decrease gastric acidity."
"I should decrease bulk and fluids in my diet to prevent diarrhea."
"Since I am taking this medication, it is all right for me to eat spicy foods."
The nurse is caring for a patient who is experiencing gastric distress from the long-term use of aspirin for treatment of arthritis. Which intervention does the nurse anticipate that the provider may order?
Stop all aspirin therapy.
Instruct the patient to take the aspirin with milk.
Instruct the patient to take the aspirin on an empty stomach.
A patient is prescribed lorazepam and a glucocorticoid during chemotherapy treatments. What is the nurse's best action?
Administer the two medications at least 12 hours apart.
Only administer the lorazepam if the patient seems anxious.
Administer the medications and assess the patient for relief.
Call the health care provider and question the order.
Which statement by the patient indicates to the nurse that additional teaching is needed about antiemetic medication?
"I will not drive while I am taking these medications because they may cause drowsiness."
"I should take my prescribed antiemetic before receiving my chemotherapy dose and continue afterward."
"I will apply the scopolamine patches to rotating sites on my upper arms."
"I may take acetaminophen to treat the headache caused by ondansetron."
The nurse is administering loperamide to a patient with diarrhea. What assessment is essential for the nurse to perform?
Hourly blood pressure measurements
Intake and output every shift
Which outcome assessment is essential to monitor for in the patient taking diphenoxylate with atropine?
Decrease in urination
Increase in bowel sounds
Increase in number of bowel movements
Decrease in gastric motility
What should the nurse teach the patient about the reason for administering multiple medications for relief of nausea and vomiting?
Combination therapy decreases side effects due to lower doses of each drug.
Combination therapy blocks different vomiting pathways.
Combination therapy is more cost-effective.
Combination therapy decreases the risk of constipation.
In developing a plan of care for a patient receiving an antihistamine antiemetic agent, which is the priority nursing diagnosis?
Risk for injury related to side effects of medication
Fluid volume deficit related to nausea and vomiting
Alteration in comfort related to nausea and vomiting
Knowledge deficit regarding medication administration
What instruction is most important for the nurse to teach a patient who is taking an anticholinergic agent to treat nausea and vomiting?
"Check your heart rate and call the health care provider if it gets below 50 beats/min."
"Do not take more than two doses of this medication."
"Assess your stools for dark streaks."
"Brush your teeth and gargle to help with dryness in your mouth."
Which nursing intervention is a priority before administering magnesium hydroxide to a patient?
Assess renal function.
Obtain a history of constipation and causes.
Record baseline vital signs.
Advise the patient to take the medication with a glass of water.
Which assessment is most important for the patient who is taking stimulant laxatives?
Monitor heart rate and blood pressure every 4 hours.
Monitor signs and symptoms of fluid and electrolyte imbalance.
Monitor intake and output.
Monitor bowel elimination daily.
The patient is prescribed tetracycline as part of the treatment for acne. Which patient education information takes priority?
Take with milk.
Drink plenty of water.
Take at bedtime.
A patient is prescribed scopolamine. What information should the nurse include on the teaching plan for this patient?
Select all that apply.
"Do not take this medication if you are dizzy."
"Do not use laxatives while on this medication."
"Apply patch 4 hours before effect is desired."
"After 3 days, switch patch to alternate ear."
"Do not use this medication for longer than a day."
"Drowsiness is a concern while on this medication."
a, c, d, f
A patient is diagnosed with type 2 diabetes. The nurse is aware that which statement is true about this pt?
a. pt is most likely a teenager
b. pt is most likely a child younger than 10
c. heredity and obesity are major causative factors
d. viral infections contribute most to disease development
Antidiabetic drugs are designed to control signs and symptoms of DM. The nurse primarily expects a decrease in which?
a. blood glucose
b. fat metabolism
c. glycogen storage
d. protein metabolism
A pt is to receive insulin before breakfast, and the time of breakfast tray is variable. The nurse knows that which insulin should not be administered until the breakfast tray has arrived and the patient is ready to eat?
A pt is recieving a daily dose of NPH insulin at 7:30 am. The nurse expects the peak effect of this drug to occur at what time?
b. 10:30 am
c. 5 pm
A pt is prescribed glipizide. The nurse knows that which side effects and adverse effects may be expected? Select all that apply
c. increased alertness
d. increased weight gain
e. visual distrubance
b, e, f
A nurse is teaching a pt how to recognize symptoms of hypoglycemia. Which symptoms should be included in the teaching? Select all that apply
f. sweet breath odor
a, b, d
A patient is newly diagnoses with type 1 DM and requires daily insulin injections. What instructions should the nurse include in the teaching of insulin administration? Select all that apply
a. Teach family members how to administer glucagon by injection when the patient is having a hyperglycemic reaction
b. Instruct pt about the necessity for compliance with prescribed insulin therapy
c. Teach the pt that hypoglycemic reactions are more likely to occur at the onset of action time
d. Instruct pt in the care and handling of insulin container and syringe
A patient complains of constipation and requires a laxative. In providing teaching for this patient, the nurse reviews the common causes of constipation including?
a. motion sickness
b. poor dietary habits
c. food intolerance
d. bacteria (e. coli)
A pt with nausea is taking ondansetron. She asks the nurse how this drug works. The nurse is aware that this medication has which action?
a. enhances H1 receptor sites
b. blocks serotonin receptors in the CTZ
c. blocks dopamine receptors in the CTZ
d. stimulates anticholinergic receptor sites
A patient who has constipation is prescribed a bisacodyl suppository. Which explanation will the nurse use to explain the action of bisacodyl?
a. acts on smooth intestinal muscle to gently increase peristalsis
b. absorbs water into the intestines to increase bulk and peristalsis
c. Lowers surface tension and increases water accumulation in the intestines
d. Pulls salts into the colon and increases water in the feces to increase bulk
A patient is using scopolamine to prevent motion sickness. About which common side effect should the nurse teach the patient?
d. dry mouth
When metoclopramide is given for nausea, the nurse plans to caution the patient to avoid which substance?
d. carbonated beverages
The nurse is administering difenxoin with atropine to a pt. Which should be included in the patient teaching regarding this medication? Select all that apply
a. caution the patient to avoid laxative abuse
b. record the frequency of BM
c. caution the patient against taking sedatives concurrently
d. encourage the pat to increase fluids
e. instruct pt to avoid this drug if they have narrow angle glaucoma
f. teach the patient that the drug acts by drawing water into the intestine
a, b, c, d, e
A patient is diagnosed with peptic ulcer disease. The nurse realizes that which of these is a predisposing factor for this condition?
a. H. pylori
b. hyposecretion of pepsin
c. decreased hydrochloric acid
d. E. coli
A student nurse is preparing to administer sucralfate to a pt. Which statement by the nurse demonstrates understanding of sucralfate's mechanism of action?
a. sucralfate neutralizes gastric acidity
b. Gastric acid secretion is decreased by inhibiting histamine at histamine2 receptors in parietal cells
c. Gastric acid secretion is suppressed by inhibiting the hydrogen/potassium ATP enzyme
d. Sucralfate combines with protein to form a viscous substance that forms a protective covering over the ulcer
A patient is taking famotidine. What information should the nurse teach the patient about this drug? Select all that apply
a. drug should be administered for 4-8 weeks
b. Drug should be administered 30 mins before meals
c. Drug should be administered separately from iron by at least 1 hr
d. drug must always be administered with magnesium hydroxide
e. smoking should be avoided while taking this drug
f. foods high in vitamin B12 should be increased in the diet
a, c, e, f
When a patient complains of pain accompanying a peptic ulcer, why should the nurse give an antacid?
a. they decrease GI motility
b. Decreased gastric acid secretion
c. strengthen lower esophageal sphincter's action
d. Antacids neutralize HCl and reduce pepsin activity
A pt taking famotidine (to inhibit gastric secretions), should be aware of the side effects of:
e. blurred vision
a, b, f
The patient is taking esomeprazole for erosive gastroesophageal reflux disease. Which should the nurse include in pt teaching?
a. take med daily with breakfast
b. healing should occur in 1 week
c. the med decreases stomach acid secretion
d. A blood test to check kidney function should be done
Which oral antidiabetic drugs are contraindicated in Type one diabetes
Metformin and Sulfonylureas
What class of antidiabetic med causes flatulence, diarrhea and abd pain
What herbs increase insulin levels and have a direct hypoglycemic effect?
Garlic, bitter melon, aloe, or gymnema
What herb/supp lowers blood glucose levels?
What herbs/supps decrease the therapeutic effect of insulin , have a hyperglycemic effect
Rosemary or Stinging Nettle
What herb/supp may potentiate hypoglycemia when used with glipizide or metformin
What herb/supp may decrease insulin requirements
Which cells secrete glucagon and where are they located??
Alpha cells, islets of Langerhans in the pancreas
Onset of Lispro, Aspart, and Glulisine
Onset of regular insulin (short-acting)
30 mins Sq
Onset of NPH?
Onset of Glargine, detemir or lantus?
2 hours given SQ
Onset of regular insulin give IV?
PEAK of insulin given IV?
PEAK on lispro, aspart, glulisine?
PEAK of glargine, demir, or lantus?
PEAK of NPH?
PEAK of regular insulin given SQ?
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