NURS 5334 EXAM 3 QUESTIONS AND VERIFIED
ANSWERS 2025
WhatZdrugsZareZusedZtoZtreatZgestationalZdiabetes?Z-ZcorrectZanswer-MetforminZabdZInsulin
WhatZA1CZvalueZindicatesZdiabetesZmellitus?ZPre-DM?Z-ZcorrectZanswer-
6.5%ZorZgreaterZisZconsideredZdiabetesZoZ5.7-6.4%pre-diabetes
WhatZfastingZandZrandomZvaluesZindicateZDM?Z-ZcorrectZanswer-FastingZplasmaZglucose—
126ZorZgreaterZisZdiabetes.ZRandomZ(casual)ZplasmaZglucose—anythingZgreaterZthanZ200ZisZdiabetes
WhatZareZcomplicationsZofZinsulinZtherapy?Z-ZcorrectZanswer-Hypoglycemia
CanZdevelopZlipohypertrophy.ZAccumulationZofZsubcutaneousZfatZthatZoccursZwhenZitZisZinjectedZtooZfrequ
entlyZatZtheZsameZsite.ZAllergicZreactions
Z CharacterizedZbyZredZandZintenselyZitchyZwelts,ZbreathingZbecomesZdifficult
Z IfZsevereZallergyZdevelops:
Z DesensitizationZprocedureZ(smallZdosesZtoZlargerZdoses).ZHypokalemia
ZPromotesZtheZuptakeZofZpotassiumZcellsZandZinsulinZactivatesZaZmembrane-
boundZenzymeZwithZsodiumZpotassiumZandZATPaseZthatZpumpsZpotassiumZintoZtheZcellsZandZsodiumZout
insulinZdrugZinteractionsZ-ZcorrectZanswer-oZHypoglycemicagents
Z CanZintensifyZtheZhypoglycemiaZincludedZbyZinsulin
Z Examples:Zsulfonylureas,Zglinides,ZalcoholZoZUsewithcautionwithhyperglycemicagents
Z Examples:ZthiazideZandZglucocorticoidsZandZsympathomimetics
WhatZeffectZdoZbetaZblockersZhaveZonZinsulin?Z-ZcorrectZanswer-
delayZawarenessZofZandZresponseZtoZhypoglycemiaZbyZmaskingZtheZsignsZthatZareZassociatedZwithZstimulati
onZofZsympatheticZnervousZsystem
oZImpairglycogenolysis
oZPreventZtheZbodiesZcounter-regulatoryZresponse
,WhatZareZotherZtherapeuticZusesZbesidesZDM?Z-ZcorrectZanswer-
HyperkalemiaZoZAidsZinZdiagnosisZofZGHZdeficiencyZoZDiabeticketoacidosis
InsulinZdosageZmustZbeZcoordinatedZwithZwhat?Z-ZcorrectZanswer-CarbohydrateZintake
WhatZisZB/PZgoalZinZdiabetic?Z-ZcorrectZanswer-oZToZbeZcontrolled,ZwithinZnormalZ120/80
WhatZmedicationZcanZbeZgivenZtoZdecreaseZriskZofZdiabeticZnephropathy?Z-ZcorrectZanswer-
ACEZinhibitorZorZARB
WhatZroleZdoesZexerciseZplayZinZtreatmentZofZbothZtypeZ1ZandZtypeZ2ZDM?Z-ZcorrectZanswer-
ExerciseZincreasesZcellularZresponsivenessZtoZinsulinZandZincreasesZglucoseZtoleranceZoZ150ZminuteZperZwe
ekZofZmoderateZintensityZexerciseZisZrecommended
WhatZareZtheZ4ZstepsZinZtheZ4-stepZapproach?Z-ZcorrectZanswer-Step1—diagnosis
Z LifestyleZchangesZplusZmetforminZoZStep2
ZLifestyleZchangesZplusZmetforminZandZaZsecondZdrugZ(sulfonylurea,ZTZDZorZaZDPP4Zinhibitor,ZaZsodiumZ
glucoseZcotransporterZorZSGLT-2Zinhibitor,ZaZglucagon-likeZpeptideZ1,ZorZaZGLP-
1ZreceptorZagonistZorZbasalZinsulin
ZSecondZdrugZchoiceZmadeZconsideringZefficacy,ZtheZhypoglycemiaZriskZofZtheZpatient,ZtheZpatientZtolerabil
ity,ZandZweight-relatedZconsiderationsZ(someZhelpZweightZloss,ZsomeZcauseZweightZgain),Zcost
oZStep3
Z ThreeZdrugZcombination
Z Metformin
Z PlusZ2ZotherZdrugsZfromZstepZ2
oZDecidedbasedonadrugandpatientspecificconsiderations
oZStep4
Z IfZ3ZdrugZcombinationZthatZincludesZbasalZinsulinZfailsZafterZ3-6Zmonths,Zmore
complexZinsulinZregimen
Z UsuallyZinZcombinationZwithZoneZorZmoreZnon-insulinZmedications
WhenZaZpatientZisZonZinsulinZtherapyZwhatZareZtheZbloodZglucoseZgoalsZbeforeZmeals?ZAtZbedtime?Z-
ZcorrectZanswer-Beforemeals—70-130
,oZBedtime—100-140
WhatZisZtheZA1CZgoal?ZWhenZisZgoalZbelowZ7ZnotZappropriate?Z-ZcorrectZanswer-
7%orZbelowZoZThoseZwithZsevereZhypoglycemiaZrisk,ZlimitedZlifeZexpectancyZ,advancedZmicrovascularZor
macrovascularZcomplications—notZbelowZ7
WhatZareZtheZshortZactingZinsulins?ZIntermediate?ZLongZacting?Z-ZcorrectZanswer-
Shortduration:Rapidacting
Z InsulinZlisproZ[Humalog]
Z InsulinZaspartZ[NovoLog]
Z InsulinZglulisineZ[Apidra]ZoZShortduration:Sloweracting
Z RegularZinsulinZ[HumulinZR,ZNovolinZR]ZoZIntermediateduration
Z NeutralZprotamineZHagedornZ(NPH)Zinsulin
Z InsulinZdetemirZ[Levemir]ZoZLongduration
Z InsulinZglargine
WhenZareZshortZdurationZinsulinsZused?Z-ZcorrectZanswer-
AdministeredZinZassociationZwithZmealsZtoZcontrolZtheZpost-
prandialZriseZinZbloodZglucoseZbetweenZmealsZandZatZnight
WhenZareZintermediateZinsulinsZneeded?Z-ZcorrectZanswer-AdministerZ2-
3ZtimesZdailyZtoZprovideZglycemicZcontrolZbetweenZmealsZandZduringZthe
night
HowZlongZisZdurationZofZglargine?ZLevemir?ZDegludec?Z-ZcorrectZanswer-Glargine—
upZtoZ24ZhoursZoZLevemir
Z LowZdoseZ(0.2Zunits/kg)—12Zhours
Z HighZdosesZ(0.4Zunits/kg)—20-24Zhours
oZDegludec—upZtoZ42Zhours
WhatZareZroutesZofZadministration?ZWhichZcanZbeZinhaled?Z-ZcorrectZanswer-
SQZinjectionZIVZinfusion.ZInhalation—Afrezza,ZmealZtimeZinsulin
, TypicalZinsulinZdosingZforZtypeZ1?ZTypeZ2?Z-ZcorrectZanswer-
TotalZdosesZmayZrangeZfromZ0.1Zunit/kgZbodyZweightZtoZmoreZthanZ2.5Zunits/kgZType1
Z InitialZdosesZtypicallyZrangeZfromZ0.5-0.6Zunits/kgZperZdayZType2
Z InitialZdosesZrangeZfromZ0.2-0.6Zunits/kgZperZday
Z DosageZincreasedZorZdecreasedZaccordingZtoZcarbZintake,Zactivity
WhatZareZtheZ3ZdosingZschedules?Z-ZcorrectZanswer-
oZTwiceZdailyZdosingZoZIntensiveZbasal/bolusZstrategyZoZContinuedZsubcutaneousZinsulin
HowZdoesZmetforminZwork?Z-ZcorrectZanswer-
oZInhibitsZglucoseZproductionZinZtheZliveroZReducesZglucoseZabsorptionZinZtheZgutoZSensitizesZinsulinZrece
ptorsZinZtargetZtissuesZ(fatZandZskeletalZmuscle)ZthusZincrease
glucoseZuptakeZandZresponseZtoZwhateverZinsulinZisZavailable
MetforminZWhatZareZsideZeffects?ZBBZwarning?Z-ZcorrectZanswer-oZGIZeffects—diarrhea
oZLacticZacidosis
HowZdoesZalcoholZeffect?Z-ZcorrectZanswer-InhibitsZtheZbreakdownZofZlacticZacid
WhatZareZtheZtherapeuticZusesZotherZthanZDM?Z-ZcorrectZanswer-oZGestationalZdiabetes
oZPCOS
SulfonylureasZ-ZcorrectZanswer-oZFirstZgeneration
Z ChlorpropamideZ[Diabinese]
Z TolazamideZ[Tolinase]
Z TolbutamineZ[Orinase]
oZSecondZGeneration:
Z GlyburideZ[Diabeta,ZGlynase,ZMicronase]ZwithZmetforminZ[Glucovance]
Z GlypizideZ(Glucotrol,ZGlucotrolZXL);ZwithZmetforminZ[metaglip])
ANSWERS 2025
WhatZdrugsZareZusedZtoZtreatZgestationalZdiabetes?Z-ZcorrectZanswer-MetforminZabdZInsulin
WhatZA1CZvalueZindicatesZdiabetesZmellitus?ZPre-DM?Z-ZcorrectZanswer-
6.5%ZorZgreaterZisZconsideredZdiabetesZoZ5.7-6.4%pre-diabetes
WhatZfastingZandZrandomZvaluesZindicateZDM?Z-ZcorrectZanswer-FastingZplasmaZglucose—
126ZorZgreaterZisZdiabetes.ZRandomZ(casual)ZplasmaZglucose—anythingZgreaterZthanZ200ZisZdiabetes
WhatZareZcomplicationsZofZinsulinZtherapy?Z-ZcorrectZanswer-Hypoglycemia
CanZdevelopZlipohypertrophy.ZAccumulationZofZsubcutaneousZfatZthatZoccursZwhenZitZisZinjectedZtooZfrequ
entlyZatZtheZsameZsite.ZAllergicZreactions
Z CharacterizedZbyZredZandZintenselyZitchyZwelts,ZbreathingZbecomesZdifficult
Z IfZsevereZallergyZdevelops:
Z DesensitizationZprocedureZ(smallZdosesZtoZlargerZdoses).ZHypokalemia
ZPromotesZtheZuptakeZofZpotassiumZcellsZandZinsulinZactivatesZaZmembrane-
boundZenzymeZwithZsodiumZpotassiumZandZATPaseZthatZpumpsZpotassiumZintoZtheZcellsZandZsodiumZout
insulinZdrugZinteractionsZ-ZcorrectZanswer-oZHypoglycemicagents
Z CanZintensifyZtheZhypoglycemiaZincludedZbyZinsulin
Z Examples:Zsulfonylureas,Zglinides,ZalcoholZoZUsewithcautionwithhyperglycemicagents
Z Examples:ZthiazideZandZglucocorticoidsZandZsympathomimetics
WhatZeffectZdoZbetaZblockersZhaveZonZinsulin?Z-ZcorrectZanswer-
delayZawarenessZofZandZresponseZtoZhypoglycemiaZbyZmaskingZtheZsignsZthatZareZassociatedZwithZstimulati
onZofZsympatheticZnervousZsystem
oZImpairglycogenolysis
oZPreventZtheZbodiesZcounter-regulatoryZresponse
,WhatZareZotherZtherapeuticZusesZbesidesZDM?Z-ZcorrectZanswer-
HyperkalemiaZoZAidsZinZdiagnosisZofZGHZdeficiencyZoZDiabeticketoacidosis
InsulinZdosageZmustZbeZcoordinatedZwithZwhat?Z-ZcorrectZanswer-CarbohydrateZintake
WhatZisZB/PZgoalZinZdiabetic?Z-ZcorrectZanswer-oZToZbeZcontrolled,ZwithinZnormalZ120/80
WhatZmedicationZcanZbeZgivenZtoZdecreaseZriskZofZdiabeticZnephropathy?Z-ZcorrectZanswer-
ACEZinhibitorZorZARB
WhatZroleZdoesZexerciseZplayZinZtreatmentZofZbothZtypeZ1ZandZtypeZ2ZDM?Z-ZcorrectZanswer-
ExerciseZincreasesZcellularZresponsivenessZtoZinsulinZandZincreasesZglucoseZtoleranceZoZ150ZminuteZperZwe
ekZofZmoderateZintensityZexerciseZisZrecommended
WhatZareZtheZ4ZstepsZinZtheZ4-stepZapproach?Z-ZcorrectZanswer-Step1—diagnosis
Z LifestyleZchangesZplusZmetforminZoZStep2
ZLifestyleZchangesZplusZmetforminZandZaZsecondZdrugZ(sulfonylurea,ZTZDZorZaZDPP4Zinhibitor,ZaZsodiumZ
glucoseZcotransporterZorZSGLT-2Zinhibitor,ZaZglucagon-likeZpeptideZ1,ZorZaZGLP-
1ZreceptorZagonistZorZbasalZinsulin
ZSecondZdrugZchoiceZmadeZconsideringZefficacy,ZtheZhypoglycemiaZriskZofZtheZpatient,ZtheZpatientZtolerabil
ity,ZandZweight-relatedZconsiderationsZ(someZhelpZweightZloss,ZsomeZcauseZweightZgain),Zcost
oZStep3
Z ThreeZdrugZcombination
Z Metformin
Z PlusZ2ZotherZdrugsZfromZstepZ2
oZDecidedbasedonadrugandpatientspecificconsiderations
oZStep4
Z IfZ3ZdrugZcombinationZthatZincludesZbasalZinsulinZfailsZafterZ3-6Zmonths,Zmore
complexZinsulinZregimen
Z UsuallyZinZcombinationZwithZoneZorZmoreZnon-insulinZmedications
WhenZaZpatientZisZonZinsulinZtherapyZwhatZareZtheZbloodZglucoseZgoalsZbeforeZmeals?ZAtZbedtime?Z-
ZcorrectZanswer-Beforemeals—70-130
,oZBedtime—100-140
WhatZisZtheZA1CZgoal?ZWhenZisZgoalZbelowZ7ZnotZappropriate?Z-ZcorrectZanswer-
7%orZbelowZoZThoseZwithZsevereZhypoglycemiaZrisk,ZlimitedZlifeZexpectancyZ,advancedZmicrovascularZor
macrovascularZcomplications—notZbelowZ7
WhatZareZtheZshortZactingZinsulins?ZIntermediate?ZLongZacting?Z-ZcorrectZanswer-
Shortduration:Rapidacting
Z InsulinZlisproZ[Humalog]
Z InsulinZaspartZ[NovoLog]
Z InsulinZglulisineZ[Apidra]ZoZShortduration:Sloweracting
Z RegularZinsulinZ[HumulinZR,ZNovolinZR]ZoZIntermediateduration
Z NeutralZprotamineZHagedornZ(NPH)Zinsulin
Z InsulinZdetemirZ[Levemir]ZoZLongduration
Z InsulinZglargine
WhenZareZshortZdurationZinsulinsZused?Z-ZcorrectZanswer-
AdministeredZinZassociationZwithZmealsZtoZcontrolZtheZpost-
prandialZriseZinZbloodZglucoseZbetweenZmealsZandZatZnight
WhenZareZintermediateZinsulinsZneeded?Z-ZcorrectZanswer-AdministerZ2-
3ZtimesZdailyZtoZprovideZglycemicZcontrolZbetweenZmealsZandZduringZthe
night
HowZlongZisZdurationZofZglargine?ZLevemir?ZDegludec?Z-ZcorrectZanswer-Glargine—
upZtoZ24ZhoursZoZLevemir
Z LowZdoseZ(0.2Zunits/kg)—12Zhours
Z HighZdosesZ(0.4Zunits/kg)—20-24Zhours
oZDegludec—upZtoZ42Zhours
WhatZareZroutesZofZadministration?ZWhichZcanZbeZinhaled?Z-ZcorrectZanswer-
SQZinjectionZIVZinfusion.ZInhalation—Afrezza,ZmealZtimeZinsulin
, TypicalZinsulinZdosingZforZtypeZ1?ZTypeZ2?Z-ZcorrectZanswer-
TotalZdosesZmayZrangeZfromZ0.1Zunit/kgZbodyZweightZtoZmoreZthanZ2.5Zunits/kgZType1
Z InitialZdosesZtypicallyZrangeZfromZ0.5-0.6Zunits/kgZperZdayZType2
Z InitialZdosesZrangeZfromZ0.2-0.6Zunits/kgZperZday
Z DosageZincreasedZorZdecreasedZaccordingZtoZcarbZintake,Zactivity
WhatZareZtheZ3ZdosingZschedules?Z-ZcorrectZanswer-
oZTwiceZdailyZdosingZoZIntensiveZbasal/bolusZstrategyZoZContinuedZsubcutaneousZinsulin
HowZdoesZmetforminZwork?Z-ZcorrectZanswer-
oZInhibitsZglucoseZproductionZinZtheZliveroZReducesZglucoseZabsorptionZinZtheZgutoZSensitizesZinsulinZrece
ptorsZinZtargetZtissuesZ(fatZandZskeletalZmuscle)ZthusZincrease
glucoseZuptakeZandZresponseZtoZwhateverZinsulinZisZavailable
MetforminZWhatZareZsideZeffects?ZBBZwarning?Z-ZcorrectZanswer-oZGIZeffects—diarrhea
oZLacticZacidosis
HowZdoesZalcoholZeffect?Z-ZcorrectZanswer-InhibitsZtheZbreakdownZofZlacticZacid
WhatZareZtheZtherapeuticZusesZotherZthanZDM?Z-ZcorrectZanswer-oZGestationalZdiabetes
oZPCOS
SulfonylureasZ-ZcorrectZanswer-oZFirstZgeneration
Z ChlorpropamideZ[Diabinese]
Z TolazamideZ[Tolinase]
Z TolbutamineZ[Orinase]
oZSecondZGeneration:
Z GlyburideZ[Diabeta,ZGlynase,ZMicronase]ZwithZmetforminZ[Glucovance]
Z GlypizideZ(Glucotrol,ZGlucotrolZXL);ZwithZmetforminZ[metaglip])