NR 566 MIDTERM TEST BANK Question 1.
Both men & women experience bone loss with aging. The bones most likely to demonstrate significant loss are:
1. Cortical bones
2. Femoral neck bones
3. Cervical vertebrae
4. Pelvic bones
Question 2. Bisphosphonates treat or prevent osteoporosis by:
1. Inhibiting osteoclastic activity
2. Fostering bone resorption
3. Enhancing calcium uptake in the bone
4. Strengthening the osteoclastic proton pump
Question 3. Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to long-term use of which of the following drugs?
1. Selective estrogen receptor modulators
2. Aspirin
3. Glucocorticoids
4. Calcium supplements
Question 4. Patients with cystic fibrosis are often prescribed enzyme replacement for pancreatic secretions. Each replacement drug has lipase, protease, & amylase components, but the drug is prescribed in units of:
1. Lipase
2. Protease
3. Amylase
4. Pancreatin Question 5. Brands of pancreatic enzyme replacement drugs are:
1. Bioequivalent
2. About the same in cost per unit of lipase across brands
3. Able to be interchanged between generic & brand-name products to reduce cost
4. None of the above
Question 6. When given subcutaneously, how long until neutral protamine Hagedorninsulin begins to take effect (onset of action) after administration?
1. 15 to 30 minutes
2. 60 to 90 minutes
3. 3 to 4 hours
4. 6 to 8 hours
Question 7. Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs & symptoms of hypoglycemia include:
1. “Fruity” breath odor & rapid respiration
2. Diarrhea, abdominal pain, weight loss, & hypertension
3. Dizziness, confusion, diaphoresis, & tachycardia
4. Easy bruising, palpitations, cardiac dysrhythmias, & coma
Question 8. Nonselective beta blockers & alcohol create serious drug interactions with insulin because they:
1. Increase blood glucose levels
2. Produce unexplained diaphoresis
3. Interfere with the ability of the body to metabolize glucose
4. Mask the signs & symptoms of altered glucose levels
Question 9. Lispro is an insulin analogue produced by recombinant DNA technology. Which of the following statements about this
form of insulin is NOT true? 1. Optimal time of prepr&ial injection is 15 minutes.
2. Duration of action is increased when the dose is increased.
3. It is compatible with neutral protamine Hagedorn insulin.
4. It has no pronounced peak.
Question 10. The decision may be made to switch from twice daily neutral protamine Hagedorn (NPH) insulin to insulin glargine to improve glycemia control throughout the day. If this is done:
1. The initial dose of glargine is reduced by 20% to avoid hypoglycemia.
2. The initial dose of glargine is 2 to 10 units per day.
3. Patients who have been on high doses of NPH will need tests for insulin antibodies.
4. Obese patients may require more than 100 units per day.
Question 11. When blood glucose levels are difficult to control in type 2 diabetes some form of insulin may be added to the treatment regimen to control blood glucose & limit complication risks. Which of the following statements is accurate based on research?
1. Premixed insulin analogues are better at lowering HbA1C & have less risk for hypoglycemia.
2. Premixed insulin analogues & the newer premixed insulins are associated with more weight gain than the oral antidiabetic agents.
3. Newer premixed insulins are better at lowering HbA1C & postpr&ial glucose levels than long-acting insulins.
4. Patients who are not controlled on oral agents & have postprial hyperglycemia can have neutral protamine Hagedorn insulin added at bedtime.
Question 12. Metformin is a primary choice of drug to treat hyperglycemia in type 2 diabetes because it:
1. Substitutes for insulin usually secreted by the pancreas
2. Decreases glycogenolysis by the liver
3. Increases the release of insulin from beta cells
4. Decreases peripheral glucose utilization
Question 13. Prior to prescribing metformin, the provider should:
1. Draw a serum creatinine to assess renal function
2. Try the patient on insulin 3. Tell the patient to increase iodine intake
4. Have the patient stop taking any sulfonylurea to avoid dangerous drug interactions
Question 14. The action of “gliptins” is different from other antidiabetic agents because they:
1. Have a low risk for hypoglycemia
2. Are not associated with weight gain
3. Close ATP-dependent potassium channels in the beta cell
4. Act on the incretin system to indirectly increase insulin production
Question 15. Sitagliptin has been approved for :
1. Monotherapy in once-daily doses
2. Combination therapy with metformin
3. Both 1 & 2
4. Neither 1 nor 2
Question 16. GLP-1 agonists:
1. Directly bind to a receptor in the pancreatic beta cell
2. Have been approved for monotherapy
3. Speed gastric emptying to decrease appetite
4. Can be given orally once daily
Question 17. Avoid concurrent administration of exenatide with which of the following drugs?
1. Digoxin
2. Warfarin
3. Lovastatin
4. All of the above
Question 18.
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