1. What is the medication of choice for an initial acute attack of gout?
*A nonsteroidal anti-inflammatory drug (NSAID). Colchicine.
A corticosteroid.
... [Show More] Allopurinol (Zyloprim).
2. When teaching Marcy how to use her new insulin pump, you tell her that she needs to monitor her blood glucose level:
At least once a day.
Only occasionally because glycemic levels are maintained very steadily.
*At least 4 times a day.
On an as needed basis when she feels she needs to give herself an extra dose of insulin.
3. The process of aging results in:
An increase in liver weight and mass.
*A decreased absorption of fat-soluble vitamins. An increase in enzyme activity.
Constricted pancreatic ducts.
4. Eunice, age 32, has type 2 diabetes. She said she heard she should take an aspirin a day after she reaches menopause for its cardioprotective action. She does not have coronary ar
*“The American Diabetes Association recommends that you start on low-dose aspirin therapy now.”tery disease, but her father does. How do you respond?
5. Marie, age 50, has type 1 diabetes and checks her blood glucose level several times every day. Her blood glucose level ranges from 250 to 280 mg/dL in the morning and is usually about 140 at lunch, about 120 at dinner, and about 100 at bedtime. In the morning, she takes 30 units of neutral protamine Hagedorn (NPH) insulin and 4 units of regular insulin, and before dinner she takes 18 units of NPH insulin and 4 units of regular insulin. Although she has had her insulin dose adjusted several times in the past month, it has had no effect on her high morning blood glucose level. What is your next course of action?
Increase the evening NPH insulin dose by 2 more units.
*Have her check her blood glucose level between 2 am and 4 am for the next several days. Increase the morning regular insulin dose by 2 units.
Order a fasting blood sugar test.
6. Which class of antihypertensive agents may be problematic for clients with diabetes? Angiotensin-converting enzyme (ACE) inhibitors.
Calcium channel blockers.
*Beta blockers.
Alpha blockers.
ACE inhibitors are the first choice for clients with diabetes who have hypertension because they slow the progression of diabetic nephropathy.
Calcium channel blockers provide pressure reduction without adverse effects on lipids and glucose control.
Beta blockers may be problematic in clients with diabetes because they block what is often the first sign of hypoglycemia—tachycardia. Many clients with diabetes have compelling indications (such as coronary artery disease) for the use of beta blockers. In these clients, the need for a beta blocker outweighs any risk that might occur. Decreasing the possibility of low blood sugar by selecting appropriate agents and adjusting dosages may be necessary. If a client with diabetes is on a beta blocker, it is important to explain that instead of tachycardia, he or she will notice other signs of hypoglycemia (such as sweating) that are not affected by beta blockers.
Alpha blockers provide smooth control and an improved lipid profile.
7. Jenny, age 46, has hypertension that has been controlled with hydrochlorothiazide 50 mg every day for the past 3 years. She is 5 ft 8 in tall and weighs 220 lb. Her fasting blood sugar (FBS) is 300 mg/dL, serum cholesterol level is 250 mg/dL, serum potassium level is 3.4 mEq, and she has 4+ glucosuria. Your next course of action would be to:
Discontinue her hydrochlorothiazide. Order a glucose tolerance test (GTT).
*Repeat her FBS and do a glycated hemoglobin (HbA1c). Start insulin therapy. [Show Less]