When patients administer regular insulin (Humulin R U-500), they should be taught:
5 units of Humulin R U-500 is equal to 10 units on a U-100 insulin
... [Show More] syringe.
10 units of Humulin R U-500 is equal to 5 units on a U-100 insulin syringe.
10 units of Humulin R U-500 is equal to 10 units on a U-500 insulin syringe.
it should only be used in an insulin pump.
Question:
Patients taking thiazolidinedione (TZD) medications should be monitored for:
diarrhea and flatulence.
fluid retention and weight gain.
hypotension and dizziness.
weight loss and fatigue.
Question:
A patient diagnosed with Type 2 diabetes mellitus has an initial hemoglobin A1C of 7.2%. Assuming no contraindications, the American Diabetes Association's (ADA) initial recommendation for this patient includes:
acarbose (Precose).
metformin (Glucophage).
glipizide (Glucotrol).
liraglutide (Victoza).
Question:
Gynecomastia is NOT likely to be caused by:
clonazepam.
ketoconazole.
lavender oil.
marijuana.
Question:
Which of the following medications may cause gynecomastia?
amlodipine (Norvasc).
enalapril (Vasotec).
losartan (Cozaar).
verapamil (Calan).
Question:
Sodium-glucose co-transporter 2 (SGLT2) inhibitors reduce blood glucose by:
increasing insulin sensitivity at the cellular level.
increasing urinary glucose excretion.
potentiating insulin secretion from the pancreas.
suppressing glucagon secretion from the liver.
Question:
A patient who is started on a glucagon-like peptide (GLP-1), such as Victoza, should be informed that this class of medications may:
increase satiety.
cause hypoglycemia.
cause weight gain.
are inexpensive.
Question:
The most frequent side effect of metformin (Glucophage) is:
diarrhea.
hypoglycemia.
heartburn.
constipation.
Question:
Patients taking dipeptidyl-peptidase-4 (DDP-IV) inhibitors for the treatment of Type 2 diabetes do NOT routinely need to be monitored for:
pancreatitis.
severe joint pain.
skin exfoliation.
weight loss.
Question:
A patient who has Addison's disease has received a prescription for fludrocortisone. Fludrocortisone acts by:
suppressing immunity.
increasing inflammation.
regulating salt and water balance
preventing the breakdown of glucose.
Question:
A 63-year-old woman with Type 2 diabetes mellitus has been treated with metformin (Glucophage) for the past 3 months. Baseline estimated glomerular filtration rate was 63. Renal function on this patient should be checked:
every 6 months regardless of baseline estimated glomerular filtration rate.
every 6 months when estimated glomerular filtration rate is >60.
at least annually when estimated glomerular filtration rate is 60 or greater.
every 3 months when estimated glomerular filtration rate is less than 80.
Question:
Because of the mechanism of action, patients should be instructed to administer exenatide (Byetta):
daily at bedtime.
immediately following the largest meal of the day.
twice daily, within 1 hour prior to morning and evening meals.
at least 12 hours apart, regardless of meals.
Question:
A patient has type 2 diabetes and takes NPH insulin. If his blood glucose values are elevated before the evening meal, when should additional NPH insulin be given?
At breakfast
1 hour after breakfast
1 hour before lunch
With lunch
Question:
Which of the following is a rapid-acting insulin?
Aspart (NovoLog)
Glargine (Lantus)
NPH (Humulin N)
Regular (Humulin R)
Question:
Pioglitazone hydrochloride (Actos) is contraindicated in patients with:
Crohn's disease.
heart failure.
interstitial cystitis.
osteoporosis.
.
Question:
A patient who has Type 2 diabetes has a history of heart failure. He takes aspart (NovoLog) daily. Which drug class, in combination with Novolog, will significantly increase his risk of heart failure?
Atypical antipsychotics
Biguanides
Sulfonylureas
Thiazolidinediones
Question:
A 48-year-old patient is started on metformin (Glucophage) for Type 2 diabetes (T2DM). The maximum expected hemoglobin A1C reduction after initiation of this medication is:
0.5%.
1%.
2%.
3%.
Question:
Signs and symptoms of hypoglycemia may be blunted by:
beta-blockers.
calcium-channel blockers.
diuretics.
thyroid hormones.
Question:
Patients receiving atenolol (Tenormin) for symptomatic management of hyperthyroidism should be advised that:
this is a lifelong therapy.
it should be slowly tapered once euthyroid is obtained.
it must be taken at the same time as methimazole.
tremulousness and anxiety will require additional therapy.
Question:
A patient is receiving a fast-acting insulin to decrease post-prandial blood sugars. If the bedtime blood sugar is elevated, the patient should be advised to increase the fast-acting insulin dose at:
breakfast.
lunch.
dinner.
bedtime.
Question:
Prior to the administration of methimazole (Tapazole), the nurse practitioner should obtain a baseline:
electrocardiogram.
complete blood count.
iodine level.
electrolyte panel.
Question:
Sulfonylureas such as glyburide (Micronase) are extensively metabolized:
in the small intestine.
by the renal nephrons.
in the liver.
by beta cells in the pancreas.
Question:
Which of the following medication classes should be avoided in patients with Type 2 diabetes mellitus and a comorbidity of moderate to severe heart failure?
Biguanide
Thiazolidinediones
Glucagon-like peptide (GLP-1)
Sulfonylurea
Question:
Insulin detemir (Levemir):
has a longer duration of action than insulin glargine (Lantus).
may be used in insulin pumps.
may be administered once or twice daily.
is indicated as monotherapy for patients with Type 1 diabetes mellitus.
Question:
Patients receiving insulin detemir (Levemir) are at higher risk for developing:
hypocalcemia.
hypernatremia.
hypokalemia.
hypermagnesemia.
Question:
The medication that provides the greatest potential reduction in hemoglobin A1C levels is:
basal insulin.
dipeptidyl-peptidase-4 (DDP-4).
glucagon-like peptide (GLP-1).
Sodium-glucose co-transporter 2 (SGLT2) inhibitors.
Question:
Synthroid is a thyroid medication used to treat hypothyroidism. It contains a synthetic form of:
triiodothyronine (T3) and levothyroxine (T4).
triiodothyronine (T3).
levothyroxine (T4).
thyroid-stimulating hormone (TSH).
Question:
Alpha-glucosidase inhibitors such as acarbose (Precose) are contraindicated in patients with:
benign prostatic hypertrophy.
heart failure.
hepatic insufficiency.
inflammatory bowel disorders.
Question:
Patients who use insulin glargine (Lantus) should be advised:
to inspect for visible particles or color change before administration.
that hypoglycemia is not a concern with long-acting insulins.
to store unused, unopened vials or prefilled pens in the freezer.
that it is ok to mix with another insulin to avoid multiple sticks.
Question:
A patient who has Type 2 diabetes has consistently elevated blood sugars before lunch. When should a fast-acting insulin be added to this patient's regimen?
With breakfast
1 hour after breakfast
1 hour before lunch
With lunch
Question:
Insulins recommended for use in insulin pump delivery systems include:
Humulin R and glargine.
Novolin N and Humalog.
Apidra and Humalog.
Novolin 70/30 and Novolog.
Question:
Radioactive iodine treatment for the permanent treatment of hyperthyroidism is usually administered:
subcutaneously daily for 14 days.
intravenously over a period of weeks.
via laser treatments.
orally in a single dose.
.
Question:
In addition to hemoglobin A1C, patients receiving metformin (Glucophage) should be monitored for:
anemia, liver function and calcium levels.
liver function, microalbumin and vitamin K levels.
renal function, urine ketones and vitamin B12 levels.
renal function, liver function and vitamin B12 levels.
Question:
Which of the following patients would be at risk for lactic acidosis secondary to metformin (Glucophage) use?
A 50-year-old man with asthma
A 32-year-old pregnant woman
A 40-year-old woman with a 60% ejection fraction
A 65-year-old man who is a binge drinker
Question:
Which of the following side effects may be caused by methimazole (Tapazole)?
Osteoporosis
Anxiety
Hypothyroidism
Supraventricular tachycardia
Question:
Thiazolidinedione (TZD) medications:
delay absorption of carbohydrates.
increase insulin sensitivity.
suppress glucagon secretion.
potentiate insulin secretion.
Question:
Patients who are receiving radioiodine therapy for hyperthyroidism should be advised to:
avoid contact with young children for several days.
avoid becoming pregnant during treatment and for 12 months after treatment.
expect hair loss over the next 3 months.
monitor for laryngeal damage.
Question:
A patient is started on a sulfonylurea (i.e., glyburide). The nurse practitioner informs the patient that sulfonylureas are likely to:
cause weight loss.
reduce microvascular events.
delay gastric emptying.
reduce the risk of hypoglycemic events.
Question:
Radioiodine therapy is safe to administer to:
a 30-year-old-man who desires natural fatherhood.
a 32-year-old, 6-week postpartum woman who is breastfeeding.
a 38-year-old woman with severe orbitopathy.
a 28-year-old woman in her first trimester of pregnancy.
Question:
Undertreatment of hypothyroidism in pediatric patients may lead to:
accelerated bone maturation.
cretinism.
rickets.
tremors.
Question:
Methimazole for the treatment of Graves' disease is contraindicated in patients:
with atrial fibrillation.
who are younger than 12 years old.
who are pregnant.
with renal disease.
Question:
The onset of action of short-acting insulins is:
5 minutes.
15 minutes.
30 minutes.
90 minutes.
Question:
A 35-year-old woman with Type 2 diabetes mellitus has taken 1000 mg metformin twice daily for the past 3 months. Today's hemoglobin A1C has decreased to 7.8%. An appropriate action today is to:
add glimepiride (Amaryl) because this patient does not have health insurance and she is unable to afford a different medication.
continue the current dose of metformin for another 3 months before adding another agent.
discontinue her metformin and consider a once-daily insulin in the evening.
encourage lifestyle modifications (diet and exercise) for another 3 months before adding a second agent.
Question:
A patient with Graves' hyperthyroidism is started on thionamide therapy (methimazole [Tapazole]). The goal is to achieve a euthyroid state within:
24 hours.
72 hours.
7 days.
3 weeks.
Question:
Alpha-glucosidase inhibitors help to lower serum glucose by:
delaying the absorption of carbohydrates.
increasing insulin excretion.
suppressing glucagon secretion.
increasing insulin sensitivity.
Question:
An example of a medication that contains a combination of a sulfonylurea and biguanide is:
glipizide and metformin.
pioglitazone and metformin.
repaglinide and metformin.
sitagliptin and metformin.
Question:
The expected hemoglobin A1C reduction for patients who are started on a dipeptidyl peptidase-4 (DPP-4) inhibitor such as sitagliptin (Januvia) is:
0.6%.
1.0%.
1.5%.
2%.
Question:
Metformin (Glucophage) is a:
biguanide.
sulfonylurea.
DPP-4 inhibitor.
thiazolidinedione.
Question:
Which of the following medications is NOT a potential cause of gynecomastia?
cimetidine (Tagamet).
omeprazole (Prilosec).
pantoprazole (Protonix).
ranitidine (Zantac).
Question:
The generic name for Victoza is:
exenatide.
liraglutide.
nateglinide.
sitagliptin.
Question:
DPP IV inhibitors such as alogliptin (Nesina):
decrease hepatic glucose production.
decrease intestinal absorption of glucose and improve insulin sensitivity
suppress glucagon secretion and increase insulin secretion.
stimulate the release of insulin from functioning pancreatic beta cells.
Question:
The mechanism of action of methimazole (Tapazole) is to:
inactivate circulating T4 and T3.
block synthesis of thyroxine and triiodothyronine (T3).
increase the oxidation of iodine in the thyroid gland.
decrease the production of thyroid-stimulating hormone in the pituitary.
Question:
Victoza (liraglutide), a glucagon-like peptide-1 for the treatment of Type 2 diabetes, may potentially decrease the effectiveness of:
oral contraceptives.
selective serotonin reuptake inhibitors (SSRIs).
sulfonylureas.
vitamin K antagonists.
Question:
Which of the following is an intermediate-acting insulin?
Insulin glulisine (Apidra)
Insulin lispro (Humalog)
Insulin NPH (Humulin N)
Insulin glargine (Toujeo)
Question:
A 55-year-old obese woman with Type 2 diabetes mellitus has been receiving metformin and glimepiride daily at highest tolerated doses. Her most recent hemoglobin A1C is 9.0%. How should this be managed?
Pioglitazone (Actos) should be added to the regimen.
A rapid-acting insulin should be initiated at mealtime.
Add a long-acting insulin at bedtime, continue metformin, and discontinue the glimepiride.
Add a long-acting insulin at bedtime and continue the metformin and glimepiride.
Question:
Joe is a 50-year-old diabetic. He took Humulin R-100 6 hours ago, prior to lunch. He is now going to work out. With regard to hypoglycemia during exercise, Joe should:
not be concerned, because the duration of Humulin R-100 is only 4 hours.
check blood sugar. As long as it is >100 mg/dL, he should not be concerned.
have a fast-acting, 15-20 g carbohydrate snack available if needed.
avoid exercising until the Humulin R-100 has peaked at 8 hours.
Question:
Aspart (NovoLog) should be administered:
10 minutes prior to a meal.
30 minutes prior to a meal.
30 minutes after a meal.
just before sleep.
Question:
Levothyroxine use in the first trimester of pregnancy:
should be discontinued.
may require a decrease in dose.
may require an increase in dose.
will not require dosage adjustment.
Question:
A 32-year-old woman is diagnosed with hyperthyroidism. The nurse practitioner knows that initiating a beta-blocker:
will slowly increase serum triiodothyronine (T3) concentrations.
is not indicated unless the patient has symptomatic tachycardia.
decreases beta-adrenergic activity in the tissues, caused by hyperthyroidism.
stimulates the conversion of thyroxine (T4) to T3.
Question:
Trulicity (dulaglutide) a glucagon-like peptide-1, would be indicated for use in which of the following patients?
A 35-year-old with type 2 diabetes in ketoacidosis
A 35-year-old patient with type 2 diabetes and morbid obesity
An 11-year-old with type 1 diabetes
A 52-year-old with type 2 diabetes with severe renal impairment
Question:
Sulfonylureas such as glyburide (Diabeta) are expected to reduce the hemoglobin A1C in patients with Type 2 diabetes mellitus by:
0.5%.
1.5%.
2%.
3%.
Question:
Maximum plasma concentrations of glucagon, after intramuscular injection, are observed in approximately:
5 minutes.
15 minutes.
30 minutes.
45 minutes.
Question:
In addition to hypoglycemia, rapid-acting insulins may cause:
hyponatremia.
hypernatremia.
hypokalemia.
hyperkalemia.
Question:
The most common serious side effect associated with glimepiride (Amaryl) is:
asthenia.
diarrhea.
hypoglycemia.
metallic taste.
Question:
A patient is started on exenatide (Byetta) for Type 2 diabetes. Byetta should be discontinued if the patient exhibits:
persistent abdominal pain, radiating to the back.
fluid retention and weight gain.
hirsutism and gynecomastia.
hypotension and dizziness.
Question:
Glyburide (Diabeta) is a:
biguanide.
sulfonylurea.
meglitinide.
thiazolidinedione.
Question:
Many medications can enhance the hypoglycemic effect of sulfonylureas. Which medication class does NOT enhance the hypoglycemic effect of sulfonylureas?
Angiotensin-converting enzyme inhibitors
Beta-blockers
H2 receptor antagonists
Thiazide diuretics
Question:
The mechanism of action by which metformin (Glucophage) improves glucose tolerance is:
increased fasting insulin levels.
decreased intestinal absorption of glucose.
decreased peripheral glucose uptake and utilization.
increased insulin secretion.
Question:
Thiazolidinediones (TZDs) such as pioglitazone (Actos) reduce A1C by levels by:
0.7%.
1.5%.
2%.
3%.
Question:
Levothyroxine (Synthroid) is indicated in the treatment of:
hyperthyroidism.
hypothyroidism.
thyrotoxicosis.
weight reduction.
Question:
Lantus is:
insulin degludec with a 40-hour duration and no peak.
insulin detemir with a 24-hour duration and no peak.
insulin glargine with a 24-hour duration and no peak.
insulin lispro with a 12-hour duration and no peak.
Question:
Sulfonylurea agents such as glimepiride (Amaryl):
decrease hepatic glucose production.
decrease intestinal absorption of glucose and improves insulin sensitivity.
slow incretin metabolism, decrease glucagon secretion and increase insulin secretion.
stimulate the release of insulin from functioning pancreatic beta cells.
Question:
Insulin glargine (Lantus) is NOT indicated in the treatment of:
adults with Type 1 diabetes mellitus.
adults with Type 2 diabetes mellitus.
pediatric patients with Type 1 diabetes mellitus.
pediatric patients with Type 2 diabetes mellitus.
Question:
What are the benefits of initiating an alpha-glucosidase inhibitors such as acarbose (Precose) for a patient with Type 2 diabetes?
They have a low potential for hypoglycemia
They are rapidly absorbed
They reduce postprandial glucose values
They are given once weekly and do not cause weight gain
Question:
Exenatide (Byetta) is classified as:
dipeptidyl-peptidase-4 (DDP-4).
glargine insulin.
glucagon-like peptide (GLP-1).
Sodium-glucose co-transporter 2 (SGLT2) inhibitors
Question:
The onset of action of rapid-acting insulins is:
5 minutes.
15 minutes.
30 minutes.
45 minutes.
Question:
Sodium-glucose co-transporter 2 (SGLT2) inhibitors are oral antidiabetic agents and are known to cause:
anemia.
hypertension.
hypoglycemia.
weight loss.
Question:
The mechanism of action for glucagon-like peptide-1 (GLP-1) medications like Byetta, Victoza, Trulicity and others is:
delayed absorption of carbohydrates.
increased insulin sensitivity.
suppressed glucagon secretion.
potentiated insulin secretion.
Question:
Glucagon should be administered to the patient who has severe hypoglycemia secondary to:
the result of a prolonged fast.
adrenal insufficiency.
insulinoma.
intense exercise.
Question:
The combination of metformin (Glucophage) and glyburide (Diabeta) for the treatment of Type 2 diabetes is:
moderately efficacious with low risk of hypoglycemia.
moderately efficacious with high risk of hypoglycemia.
highly efficacious with moderate risk of hypoglycemia.
highly efficacious with low risk of hypoglycemia.
Question:
Which of the following is a short-acting insulin?
Aspart (NovoLog).
Glargine (Lantus)
NPH (Humulin N).
Regular (Humulin R).
Question:
Which statement about metformin (Glucophage) is correct?
It must be discontinued on the day that a patient has a tooth extraction.
This medication is approved for the treatment of ovarian hyperstimulation syndrome.
It is not recommended for use in the geriatric population.
It should be temporarily discontinued for radiologic studies with iodinated contrast.
Question:
Levothyroxine (Synthroid) is best administered:
with the first meal of the day.
anytime, as long as the dose is not skipped.
on an empty stomach, first thing in the morning.
on an empty stomach, prior to bed.
Question:
Patients should be advised to take glimepiride (Amaryl):
on an empty stomach, 1 hour before a meal.
in the morning with breakfast.
in the afternoon with a snack.
at bedtime with a snack.
Question:
Due to the mechanism of action of meglitinides used in the treatment of Type 2 diabetes, they should be administered:
at meal time.
at bedtime.
2 hours after a meal.
2 hours before the largest meal of the day.
Question:
Levothyroxine (Synthroid) would NOT be indicated for the treatment of:
primary (thyroidal) hypothyroidism.
secondary (pituitary) hypothyroidism.
subacute thyroiditis recovery.
tertiary (hypothalamic) hypothyroidism.
Question:
The most commonly reported side effect of the GLP-1 medication class is:
anemia.
abdominal pain.
nausea.
reflux.
Question:
Insulin promotes the absorption of glucose from the blood in many tissues/organs of the body. In which tissue/organ does this NOT occur?
Adipose tissue
Skeletal muscle
Brain
Liver
Question:
Regular insulin (Novolin R) should be administered:
10 minutes prior to a meal.
within 30 minutes of a meal.
30 minutes after a meal.
just before sleep. [Show Less]