Exam (elaborations)
NURS 5334 EXAM 3 QUESTIONS AND VERIFIED ANSWERS 2025
NURS 5334 EXAM 3 QUESTIONS AND VERIFIED ANSWERS 2025
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NURS 5334 EXAM 3 QUESTIONS AND VERIFIED
ANSWERS 2025
WhatQdrugsQareQusedQtoQtreatQgestationalQdiabetes?Q-QcorrectQanswer-MetforminQabdQInsulin
WhatQA1CQvalueQindicatesQdiabetesQmellitus?QPre-DM?Q-QcorrectQanswer-
6.5%QorQgreaterQisQconsideredQdiabetesQoQ5.7-6.4%pre-diabetes
WhatQfastingQandQrandomQvaluesQindicateQDM?Q-QcorrectQanswer-FastingQplasmaQglucose—
126QorQgreaterQisQdiabetes.QRandomQ(casual)QplasmaQglucose—anythingQgreaterQthanQ200QisQdiabetes
WhatQareQcomplicationsQofQinsulinQtherapy?Q-QcorrectQanswer-Hypoglycemia
CanQdevelopQlipohypertrophy.QAccumulationQofQsubcutaneousQfatQthatQoccursQwhenQitQisQinjectedQtooQfreq
uentlyQatQtheQsameQsite.QAllergicQreactions
CharacterizedQbyQredQandQintenselyQitchyQwelts,QbreathingQbecomesQdifficult
Q
IfQsevereQallergyQdevelops:
Q
DesensitizationQprocedureQ(smallQdosesQtoQlargerQdoses).QHypokalemia
Q
QPromotesQtheQuptakeQofQpotassiumQcellsQandQinsulinQactivatesQaQmembrane-
boundQenzymeQwithQsodiumQpotassiumQandQATPaseQthatQpumpsQpotassiumQintoQtheQcellsQandQsodiumQout
insulinQdrugQinteractionsQ-QcorrectQanswer-oQHypoglycemicagents
CanQintensifyQtheQhypoglycemiaQincludedQbyQinsulin
Q
Examples:Qsulfonylureas,Qglinides,QalcoholQoQUsewithcautionwithhyperglycemicagents
Q
Examples:QthiazideQandQglucocorticoidsQandQsympathomimetics
Q
WhatQeffectQdoQbetaQblockersQhaveQonQinsulin?Q-QcorrectQanswer-
delayQawarenessQofQandQresponseQtoQhypoglycemiaQbyQmaskingQtheQsignsQthatQareQassociatedQwithQstimul
ationQofQsympatheticQnervousQsystem
oQImpairglycogenolysis
oQPreventQtheQbodiesQcounter-regulatoryQresponse
,WhatQareQotherQtherapeuticQusesQbesidesQDM?Q-QcorrectQanswer-
HyperkalemiaQoQAidsQinQdiagnosisQofQGHQdeficiencyQoQDiabeticketoacidosis
InsulinQdosageQmustQbeQcoordinatedQwithQwhat?Q-QcorrectQanswer-CarbohydrateQintake
WhatQisQB/PQgoalQinQdiabetic?Q-QcorrectQanswer-oQToQbeQcontrolled,QwithinQnormalQ120/80
WhatQmedicationQcanQbeQgivenQtoQdecreaseQriskQofQdiabeticQnephropathy?Q-QcorrectQanswer-
ACEQinhibitorQorQARB
WhatQroleQdoesQexerciseQplayQinQtreatmentQofQbothQtypeQ1QandQtypeQ2QDM?Q-QcorrectQanswer-
ExerciseQincreasesQcellularQresponsivenessQtoQinsulinQandQincreasesQglucoseQtoleranceQoQ150QminuteQperQ
weekQofQmoderateQintensityQexerciseQisQrecommended
WhatQareQtheQ4QstepsQinQtheQ4-stepQapproach?Q-QcorrectQanswer-Step1—diagnosis
LifestyleQchangesQplusQmetforminQoQStep2
Q
QLifestyleQchangesQplusQmetforminQandQaQsecondQdrugQ(sulfonylurea,QTZDQorQaQDPP4Qinhibitor,QaQsodiu
mQglucoseQcotransporterQorQSGLT-2Qinhibitor,QaQglucagon-likeQpeptideQ1,QorQaQGLP-
1QreceptorQagonistQorQbasalQinsulin
QSecondQdrugQchoiceQmadeQconsideringQefficacy,QtheQhypoglycemiaQriskQofQtheQpatient,QtheQpatientQtolera
bility,QandQweight-relatedQconsiderationsQ(someQhelpQweightQloss,QsomeQcauseQweightQgain),Qcost
oQStep3
ThreeQdrugQcombination
Q
Metformin
Q
PlusQ2QotherQdrugsQfromQstepQ2
Q
oQDecidedbasedonadrugandpatientspecificconsiderations
oQStep4
IfQ3QdrugQcombinationQthatQincludesQbasalQinsulinQfailsQafterQ3-6Qmonths,Qmore
Q
complexQinsulinQregimen
UsuallyQinQcombinationQwithQoneQorQmoreQnon-insulinQmedications
Q
WhenQaQpatientQisQonQinsulinQtherapyQwhatQareQtheQbloodQglucoseQgoalsQbeforeQmeals?QAtQbedtime?Q-
QcorrectQanswer-Beforemeals—70-130
,oQBedtime—100-140
WhatQisQtheQA1CQgoal?QWhenQisQgoalQbelowQ7QnotQappropriate?Q-QcorrectQanswer-
7%orQbelowQoQThoseQwithQsevereQhypoglycemiaQrisk,QlimitedQlifeQexpectancyQ,advancedQmicrovascularQo
r
macrovascularQcomplications—notQbelowQ7
WhatQareQtheQshortQactingQinsulins?QIntermediate?QLongQacting?Q-QcorrectQanswer-
Shortduration:Rapidacting
InsulinQlisproQ[Humalog]
Q
InsulinQaspartQ[NovoLog]
Q
InsulinQglulisineQ[Apidra]QoQShortduration:Sloweracting
Q
RegularQinsulinQ[HumulinQR,QNovolinQR]QoQIntermediateduration
Q
NeutralQprotamineQHagedornQ(NPH)Qinsulin
Q
InsulinQdetemirQ[Levemir]QoQLongduration
Q
InsulinQglargine
Q
WhenQareQshortQdurationQinsulinsQused?Q-QcorrectQanswer-
AdministeredQinQassociationQwithQmealsQtoQcontrolQtheQpost-
prandialQriseQinQbloodQglucoseQbetweenQmealsQandQatQnight
WhenQareQintermediateQinsulinsQneeded?Q-QcorrectQanswer-AdministerQ2-
3QtimesQdailyQtoQprovideQglycemicQcontrolQbetweenQmealsQandQduringQthe
night
HowQlongQisQdurationQofQglargine?QLevemir?QDegludec?Q-QcorrectQanswer-Glargine—
upQtoQ24QhoursQoQLevemir
LowQdoseQ(0.2Qunits/kg)—12Qhours
Q
HighQdosesQ(0.4Qunits/kg)—20-24Qhours
Q
oQDegludec—upQtoQ42Qhours
WhatQareQroutesQofQadministration?QWhichQcanQbeQinhaled?Q-QcorrectQanswer-
SQQinjectionQIVQinfusion.QInhalation—Afrezza,QmealQtimeQinsulin
, TypicalQinsulinQdosingQforQtypeQ1?QTypeQ2?Q-QcorrectQanswer-
TotalQdosesQmayQrangeQfromQ0.1Qunit/kgQbodyQweightQtoQmoreQthanQ2.5Qunits/kgQType1
InitialQdosesQtypicallyQrangeQfromQ0.5-0.6Qunits/kgQperQdayQType2
Q
InitialQdosesQrangeQfromQ0.2-0.6Qunits/kgQperQday
Q
DosageQincreasedQorQdecreasedQaccordingQtoQcarbQintake,Qactivity
Q
WhatQareQtheQ3QdosingQschedules?Q-QcorrectQanswer-
oQTwiceQdailyQdosingQoQIntensiveQbasal/bolusQstrategyQoQContinuedQsubcutaneousQinsulin
HowQdoesQmetforminQwork?Q-QcorrectQanswer-
oQInhibitsQglucoseQproductionQinQtheQliveroQReducesQglucoseQabsorptionQinQtheQgutoQSensitizesQinsulinQre
ceptorsQinQtargetQtissuesQ(fatQandQskeletalQmuscle)QthusQincrease
glucoseQuptakeQandQresponseQtoQwhateverQinsulinQisQavailable
MetforminQWhatQareQsideQeffects?QBBQwarning?Q-QcorrectQanswer-oQGIQeffects—diarrhea
oQLacticQacidosis
HowQdoesQalcoholQeffect?Q-QcorrectQanswer-InhibitsQtheQbreakdownQofQlacticQacid
WhatQareQtheQtherapeuticQusesQotherQthanQDM?Q-QcorrectQanswer-oQGestationalQdiabetes
oQPCOS
SulfonylureasQ-QcorrectQanswer-oQFirstQgeneration
ChlorpropamideQ[Diabinese]
Q
TolazamideQ[Tolinase]
Q
TolbutamineQ[Orinase]
Q
oQSecondQGeneration:
GlyburideQ[Diabeta,QGlynase,QMicronase]QwithQmetforminQ[Glucovance]
Q
GlypizideQ(Glucotrol,QGlucotrolQXL);QwithQmetforminQ[metaglip])
Q