A nurse is caring for an adolescent client who has a long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to treat this client?

Insulin glargine

Regular insulin

Insulin detemir

NPH insulin

Answer and Explanation

The Correct Answer is B

Choice A reason: Insulin glargine is not the type of insulin to use for diabetic ketoacidosis, as it is a long-acting insulin that has a duration of 24 hours and no peak effect. It is used to provide basal insulin coverage and prevent hyperglycemia.

Choice B reason: Regular insulin is the type of insulin to use for diabetic ketoacidosis, as it is a short-acting insulin that has an onset of 30 to 60 minutes and a peak of 2 to 4 hours. It is used to lower the blood glucose level rapidly and correct the acidosis.

Choice C reason: Insulin detemir is also not the type of insulin to use for diabetic ketoacidosis, as it is a long-acting insulin that has a duration of 12 to 24 hours and no peak effect. It is also used to provide basal insulin coverage and prevent hyperglycemia.

Choice D reason: NPH insulin is also not the type of insulin to use for diabetic ketoacidosis, as it is an intermediate-acting insulin that has an onset of 2 to 4 hours and a peak of 4 to 12 hours. It is used to provide intermediate insulin coverage and prevent hyperglycemia.

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Correct Answer is B

Explanation

Choice A reason: Antibiotics are not likely to interact with corticosteroids, unless they are aminoglycosides, which can increase the risk of hypokalemia. However, most antibiotics do not affect the metabolism or efficacy of corticosteroids.

Choice B reason: Nonsteroidal anti-inflammatory drugs (NSAIDs) can interact with corticosteroids, as they both have anti-inflammatory and immunosuppressive effects. This can increase the risk of gastrointestinal bleeding, ulceration, and perforation. Therefore, the nurse should monitor the patient for signs of bleeding and advise the patient to avoid taking NSAIDs with corticosteroids.

Choice C reason: Opioid analgesics are not likely to interact with corticosteroids, unless they are codeine, which can decrease the clearance of corticosteroids. However, most opioid analgesics do not affect the metabolism or efficacy of corticosteroids.

Choice D reason: Antidepressants are not likely to interact with corticosteroids, unless they are monoamine oxidase inhibitors (MAOIs), which can increase the risk of hypertension and hypertensive crisis. However, most antidepressants do not affect the metabolism or efficacy of corticosteroids.

A. Hemoglobin A1C level B. Serum insulin level C. Fingerstick fasting blood glucose level D. Hemoglobin level

Correct Answer is A

Explanation

Choice A reason: This is correct because hemoglobin A1C level reflects the average blood glucose level over the past 2 to 3 months. It is a reliable indicator of the patient's glycemic control and adherence to the antidiabetic therapy. The goal for most patients with type 2 diabetes is to keep the hemoglobin A1C level below 7%.

Choice B reason: This is incorrect because serum insulin level is not a good measure of the patient's adherence to the antidiabetic therapy, as it may vary depending on the type, dose, and timing of the insulin or oral antidiabetic agents. Serum insulin level may also be affected by other factors, such as stress, infection, or exercise.

Choice C reason: This is incorrect because fingerstick fasting blood glucose level only reflects the blood glucose level at a single point in time. It does not provide information about the patient's long-term glycemic control or adherence to the antidiabetic therapy. Fingerstick fasting blood glucose level may also be influenced by the patient's diet, activity, or medication intake before the test.

Choice D reason: This is incorrect because hemoglobin level is not related to the patient's adherence to the antidiabetic therapy, as it measures the amount of oxygen-carrying protein in the red blood cells. Hemoglobin level may be affected by conditions such as anemia, dehydration, or blood loss.

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Naxlex Comprehensive Predictor Exams

A patient will be starting therapy with a corticosteroid. The nurse reviews the prescriber's orders and notes that an interaction may occur if the corticosteroid is taken with which of these drug classes?

Correct Answer is B

Explanation

After starting treatment for type 2 diabetes mellitus 6 months earlier, a patient is in the office for a follow-up examination. The nurse will monitor which laboratory test to evaluate the patient's adherence to the antidiabetic therapy over the past few months?

Correct Answer is A

Explanation

A woman visits a health center requesting oral contraceptives. Which laboratory test is most important for the nurse to assess before the patient begins oral contraceptive therapy?

The nurse is planning an educational program on sildenafil to a group of older male clients. Which of the following information should the nurse include in the educational program?

A gardener needs a decongestant because of seasonal allergy problems and asks the nurse whether he should take an oral form or a nasal spray. Which of these is a benefit of orally administered decongestants?

A 73-year-old male patient is in the clinic for a yearly physical and is asking for a prescription for sildenafil. He has listed on his health history that he is taking a nitrate for angina. The nurse is aware that which problem may occur if sildenafil is taken with a nitrate?

A nurse is caring for a client who has nephrotic syndrome and is receiving high-dose corticosteroid therapy. For which of the following electrolyte imbalances should the nurse monitor?

A nurse is teaching a client who has type 1 diabetes about insulin administration. Which of the following statements by the client indicates an understanding of the teaching?

A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client who has diabetes mellitus. When mixing the two types of insulin, which of the following actions should the nurse take first?