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STUVIA 2024/2025Chapter 47: Antidiabetics
A 45-year-old patient who is overweight has had a diagnosis of type 2 diabetes for 2 years. The
patient uses 20 units of long-acting insulin per day. The patient's fasting blood glucose (FBG) is 190
mg/dL. The patient asks the nurse about using an oral antidiabetic agent. The nurse understands that
oral antidiabetic agents:
a. cannot be used if the patient is overweight.
b. cannot be used once a patient requires insulin.
c. may be used in patients with type 2 diabetes in combination with insulin.
d. may not be used since this patient's fasting blood glucose is too high. - ✔✔ANS: C
Patients with type 2 diabetes often use long-acting insulin in combination with oral agents to manage
blood glucose.
A patient develops type 2 diabetes mellitus. The nurse will explain that this type of diabetes:
a. is generally triggered by medications.
b. is not as common as type 1 diabetes.
c. is often related to heredity and obesity.
d. will not require insulin therapy. - ✔✔ANS: C
Type 2 diabetes is often caused by obesity and hereditary factors. Secondary diabetes is triggered by
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medications. Type 2 diabetes is the most common type of diabetes. Patients with type 2 diabetes may
eventually require treatment with insulin.
A patient is ordered to receive insulin lispro at mealtimes. The nurse will instruct this patient to
administer the medication at which time?
a. 10-15 min before eating
b. 15 min after eating
c. 30 min before eating
d. 10 min after eating - ✔✔ANS: A
Lispro acts faster than regular insulin, and patients should be taught to give this medication 10-15
minutes before eating.
A patient reports that they are taking a rapid-acting insulin with meals, but can't remember the name.
Which of the following products is a rapid-acing insulin?
a. Regular insulin (Novolin R)
b. Insulin glargine (Lantus)
c. Insulin lispro (Humalog)
d. Insulin degludec (Tresiba) - ✔✔ANS: C
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Insulin lispro (Humalog) is a rapid-acing insulin product. Regular insulin is considered a short-acting
insulin. Insulin glargine and insulin degludec are long-acting insulins.
A patient was administered regular insulin 30 minutes ago, but has not received a breakfast tray. The
patient is experiencing nervousness and tremors. What is the nurse's first action?
a. Administer glucagon.
b. Give the patient orange juice.
c. Notify the kitchen to deliver the tray.
d. Perform bedside glucose testing. - ✔✔ANS: B
The patient is symptomatic and has hypoglycemia. The nurse should give orange juice. Glucagon is
given for patients unable to ingest carbohydrates. The kitchen should be notified, and bedside
glucose testing should be performed, but only after the patient is given carbohydrates.
A patient who has type 1 diabetes mellitus asks the nurse about using a combination insulin product
such as Humalog 70/30. The nurse will tell the patient that use of this product:
a. depends on individual insulin needs.
b. is useful for patients with severe insulin resistance.
c. means less rotation of injection sites.
d. requires refrigeration at all times. - ✔✔ANS: A
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Combination products are convenient because the patient does not have to mix insulin, but the
products depend on individual needs, since the doses are fixed. They are generally not used for
patients with severe insulin resistance that require large insulin doses. Patients must continue to
rotate injection sites. They do not require refrigeration after first use.
A patient who has type 1 diabetes mellitus must take a glucocorticoid medication for osteoarthritis.
When teaching this patient, the nurse will explain that there may be a need to:
a. decrease the glucocorticoid dose.
b. decrease the insulin dose.
c. increase the glucocorticoid dose.
d. increase the insulin dose. - ✔✔ANS: D
Glucocorticoids can cause hyperglycemia, so the insulin dose may need to be increased. Changing
the glucocorticoid dose is usually not recommended. Decreasing the insulin dose will only compound
the hyperglycemic effects.
A patient who has type 2 diabetes mellitus asks the nurse why the provider has changed the oral
antidiabetic agent from tolbutamide (Orinase) to glipizide (Glucotrol). The nurse will explain that
glipizide
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