NURS 5334 EXAM 3 WITH
QUESTIONS AND VERIFIED
ANSWERS 2024-2025
What medications are used to manage gestational diabetes? - ANSWER Metformin
with insulin
Which A1C value suggests diabetes mellitus? Pre-DM? - ANSWER 6.5% or more
is termed diabetes, or 5.7-6.4% pre-diabetes.
What are the fasting and random levels that suggest DM? - ANSWER: Diabetes is
defined as fasting plasma glucose levels of 126 or higher. Random (casual) plasma
glucose—anything greater than 200 indicates diabetes.
What are the complications of insulin therapy? - Answer: Hypoglycemia.
Can cause lipohypertrophy. Subcutaneous fat accumulates when it is injected too
regularly at the same place. Allergic ANSWERs.
Breathing gets difficult when you have red and very itching welts.
If severe allergies develop:
Desensitization technique (from little to large dosages). Hypokalemia
Insulin activates a membrane-bound enzyme containing sodium, potassium, and
ATPase, which pumps potassium into the cells and sodium out.
Examples include sulfonylureas, glinides, and alcohol. Use with caution with
hyperglycemic drugs.
Examples include thiazide, glucocorticoids, and sympathomimetics.
How do beta blockers affect insulin levels? It ANSWER postpones awareness and
reaction to hypoglycemia by concealing the signals associated with stimulation of
the sympathetic nervous system.
o Impair glycogenolysis.
o Prevent the body's counterregulatory ANSWER.
Aside from DM, what additional therapeutic uses exist? - ANSWER: Hyperkalemia
aids in the diagnosis of GH insufficiency and diabetic ketoacidosis.
What should insulin dosage be coordinated with? - ANSWER: carbohydrate intake
What is the B/P objective in diabetics? - ANSWER: To be managed, within normal
120/80.
What medications can be given to reduce the risk of diabetic nephropathy? -
Answer: ACE inhibitor or ARB.
What function does exercise have in the treatment of both type 1 and type 2
diabetes? - ANSWER Exercise enhances cellular reactivity to insulin and raises
glucose tolerance. 150 minutes of moderate-intensity exercise per week is advised.
What are the four steps in the 4-step method? - ANSWER Step 1 — diagnosis
Lifestyle changes plus metformin or Step 2
,Lifestyle adjustments plus metformin and a second medicine (sulfonylurea, TZD or
a DPP4 inhibitor, a sodium-glucose cotransporter or SGLT-2 inhibitor, a
glucagon-like peptide 1, or a GLP-1 receptor agonist or basal insulin)
The second drug decision was determined considering efficacy, the patient's
hypoglycemia risk, patient acceptability, weight-related considerations (some help
weight loss, some induce weight gain), and cost.
o Step 3.
Three drug combination.
Metformin
Plus two additional medications from phase two.
o Decided based on drug and patient specific considerations.
o Step 4.
If a three-drug combination with basal insulin fails after 3-6 months,
complicated insulin regimen.
Usually in conjunction with one or more non-insulin medicines.
What are the blood glucose objectives for an insulin-treated patient before meals?
At bedtime? - ANSWER Before meals: 70-130
o Bedtime—100–140
What is the A1C goal? When is a goal of less than 7 inappropriate? - ANSWER 7%
or below o Those with significant hypoglycemia risk, short life expectancy,
advanced microvascular or
macrovascular complications—not less than 7.
, What are the short-acting insulins? Intermediate? Long-acting? - ANSWER Short
Duration: Rapid acting
Insulin Lispro [Humalog]
Insulin Aspart [NovoLog]
Insulin Glulisine [Apidra] o Shortduration: Sloweracting
Regular insulin [Humulin R, Novolin R] has intermediate duration.
Neutral protamine Hagedorn (NPH) insulin.
Insulin detemir [Levemir] of long duration
Insulin Glargine
When are short-duration insulins used? - ANSWER Administered in conjunction
with meals to control the postprandial rise in blood glucose between meals and at
night.
When are intermediate insulins needed? - ANSWER Administer 2-3 times daily to
maintain glycemic control between meals and during the
night
What is the duration of glargine? Levemir? Degludec? - ANSWER Glargine—up
to 24 hours of Levemir.
Low dose (0.2 units/kg) — 12 hours
High doses (0.4 units/kg): 20-24 hours.
o Degludec: up to 42 hours.
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