Exam (elaborations)
CMSRN 3 QUESTIONS AND ANSWERS
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Exam of 7 pages for the course CMSRN at CMSRN (CMSRN 3)
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CMSRN 3Antidiuretic hormone (ADH) is synthesized in the:
A. Hypothalamus
B. Pituitary gland
C. Pineal gland
D. Thalamus - answerA. Hypothalamus
Antidiuretic hormone is an example of a neuroendocrine hormone; it has components of
both the endocrine and the nervous system. It is synthesized in the hypothalamus and
travels along axons that terminate adjacent to capillaries in the posterior pituitary.
The physician has ordered chlorpropamide (Diabinese) to treat a patient with central
diabetes insipidus. The nurse is aware:
A. Contraindications include heart disease and renal insufficiency
B. Usual dosing in diabetes insipidus is 100 mg daily
C. This medication is an oral hypoglycemic
D. This medication suppresses the release of vasopressin - answerC. This medication
is an oral hypoglycemic
Chlorpropamide is an oral hypoglycemic (first generation sulfonylurea). It lowers blood
glucose levels by enhancing pancreatic beta-cell insulin secretion (primary use). It also
potentiates the action (not suppresses the release) of small or residual amounts of
circulating vasopressin (ADH), making it useful in treating diabetes insipidus
(hyposecretion of ADH). Usual dosing in diabetes insipidus is 125-500 mg daily.
Contraindications include liver disease (not heart disease) and renal insufficiency.
In patients with diabetes mellitus who have normal renal function, protein intake should
be:
A. 30%-35% of daily caloric intake
B. 20%-25% of daily caloric intake
C. 15%-20% of daily caloric intake
D. 5%-10% of daily caloric intake - answerC. 15%-20% of daily caloric intake
In patients with diabetes mellitus, who have normal renal function, there is little
evidence to suggest that usual protein intake (15-20% of daily caloric intake) should be
modified. With evidence of neuropathy, it may be necessary to restrict protein to the
adult.
You are caring for a patient with Type 2 diabetes mellitus who has been prescribed
glipizide (Glucotrol), an oral antidiabetic agent, for trouble controlling blood glucose
, levels through diet and exercise alone. Which medication instruction should you provide
to the patient?
A. "After you start taking glipizide, you won't need to check your blood glucose levels
anymore."
B. "Take glipizide after meals to prevent heartburn."
C. "Glipizide may cause a low serum sodium level, so be sure to have your sodium level
checked monthly."
D. "Be sure to take glipizide 30 minutes before meals." - answerD. "Be sure to take
glipizide 30 minutes before meals."
The patient should be instructed to take glipizide twice a day, 30 minutes before a meal
because food decreases its absorption.
All of the following statements related to carbohydrate intake in the diabetic patient are
true except:
A. Low-carbohydrate diets which restrict total carbohydrates to less than 130/g day are
recommended in the management of diabetes mellitus
B. Scientific evidence does not support the restriction of sucrose
C. Daily carbohydrate intake depends on blood glucose and lipid goals
D. Fiber intake should be 25-35 g/day - answerA. Low-carbohydrate diets which restrict
total carbohydrates to less than 130/g day are recommended in the management of
diabetes mellitus
Diets which severely limit carbohydrates are not recommended in the management of
diabetes mellitus. Percentage of calories varies and depends on individual eating
habits, blood glucose, and lipid goals.
Carbohydrates from fruits, vegetables, whole grains, legumes, and low-fat dairy
products are encouraged. Fiber intake should be 25-35 g/day. Scientific evidence does
not support the restriction of sucrose, but it should be eaten within the context of a
healthy diet in concordance with glucose and lipid levels.
Which of the following type 2 Diabetes medications is to be taken with the very first bite
of each meal?
A. Sitagliptin (Januvia)
B. Acarbose (Precose)
C. Dapagliflozin (Farxiga)
D. Chlorpropamide (Diabinese) - answerB. Acarbose (Precose)
Acarbose and Miglitol are alpha-glucosidase inhibitors. They improve glycemic control
in adults with diabetes. They can cause bloating and flatulence and are contraindicated
in patients with inflammatory bowel disease, colonic irritation, partial intestinal
obstruction or in any gastrointestinal conditions that may deteriorate as a result of
increased intestinal gas formation. They must be taken with the first bite of each meal,
three times daily.
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