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LEHNE’S PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE NURSES AND PHYSICIAN ASSISTANTS 2ND EDITION ROSENTHAL TEST BANK EXAM WITH ACTUAL QUESTIONSAND COMPLETE 100%CORRECT ANSWERS WITH VERIFIED AND WELL EXPLAINED RATIONALES ALREADY GRADED A+ BY EXPERTS |LATEST VERSION 2024 WITH GUARANTEED SUCCESS AFTER...
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LEHNE’S PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE
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LEHNE’S
PHARMACOTHERAPEUTICS FOR
ADVANCED PRACTICE NURSES
AND PHYSICIAN ASSISTANTS 2ND
EDITION ROSENTHAL TEST
BANK EXAM WITH ACTUAL
QUESTIONSAND COMPLETE
100%CORRECT ANSWERS WITH
VERIFIED AND WELL EXPLAINED
RATIONALES ALREADY GRADED
A+ BY EXPERTS |LATEST
VERSION 2024 WITH
GUARANTEED SUCCESS AFTER
DOWNLOAD ALREADY
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EXAMS
3. A patient with type 1 diabetes recently became pregnant. What blood glucose testing schedule
will the provider recommended during the pregnancy?
a. Before each meal and before bed
b. In the morning for a fasting level and at 4:00 PM for the peak level
c. Six or seven times a day
d. Three times a day, along with urine glucose testing ANS: C
A pregnant patient with type 1 diabetes must have frequent blood sugar monitoring (e.g., six or
seven times a day) to manage the patient's glucose levels & to ensure that no harm occurs to the
fetus. Monitoring the blood sugar level before meals & at bedtime is not significant enough to
provide the necessary glycemic control. Morning and 4:00 PM monitoring is not enough to
provide glycemic control. Urine glucose testing is not sensitive enough to aid glycemic control,
& monitoring three times a day is not enough.
4. An adolescent had a serum glucose test at a health fair. The parent calls the clinic and says,
"The level was 125 mg/dL. Does that mean my child has diabetes?" What is the provider's most
accurate response?
a. "Unless your child were fasting for longer than 8 hours, this does not necessarily indicate
diabetes."
b. "At this level, there is a possibility of diabetes. We'll schedule your child for an oral glucose
tolerance test this week."
c. "This level is conclusive evidence that your child has diabetes."
d. "This level is conclusive evidence that your child do not have diabetes." ANS: A
If a person has not fasted for 8 hours, a blood sugar level of 125 mg/dL would be considered
normal, because it is less than 200 mg/dL for a random sampling. Also, a person must have
positive outcomes on two separate days to be diagnosed with diabetes. This patient does not need
to have an oral glucose tolerance test, because the 125 mg/dL reading is so far below 200 mg/dL,
which would require further work-up. No conclusive evidence indicates that this patient has
diabetes, because the random sample value is so low, and the patient has not had two separate
tests on different days. However, this also is not conclusive evidence that the patient does not
have diabetes.
5. What method will the provider consider the most reliable measure for assessing a patient's
diabetes control over the preceding 3-month period?
a. Self-monitoring blood glucose (SMBG) graph report
, b. Random blood glucose level
c. Fasting blood glucose level
d. Glycosylated hemoglobin level (A1c) ANS: D
The glycosylated hemoglobin level tells much about what the plasma glucose concentration has
been, on average, over the previous 2 to 3 months. The SMBG graph report is done by the patient
and indicates each blood sugar level the patient has on a daily basis. It is not as reliable as the
glycosylated hemoglobin level, because the equipment used might not be accurate and the testing
may not reflect actual measurements 100% of the time. Random blood sugar levels are not as
accurate as the glycosylated hemoglobin level for the same reason that the SMBG is not. One
fasting blood glucose level indicates the patient's blood sugar level for that one time when it was
obtained but is not reflective of a 3-month period.
6. Insulin glargine is prescribed by the provider for a hospitalized patient with type 1 diabetes.
When will the provider order this medication to be administered?
a. Approximately 15 to 30 minutes before each meal
b. In the morning and at 4:00 PM
c. Once daily at bedtime
d. After meals and at bedtime ANS: C
Glargine insulin is indicated for once-daily subcutaneous administration to treat adults and
children with type 1 diabetes and adults with type 2 diabetes. According to the package labeling,
the once-daily injection should be given at bedtime. Glargine insulin should not be given more
than once a day, although some patients require bid dosing to achieve a full 24 hours of basal
coverage.
7. A patient with type 1 diabetes reports taking propranolol for hypertension. What concern does
this information present for the provider?
a. The β blocker can cause insulin resistance.
b. Using propranolol with insulin increases the risk of diabetic ketoacidosis (DKA).
c. Propranolol increases insulin requirements because of receptor blocking.
d. The β blocker can mask the symptoms of hypoglycemia. ANS: D
β blockers can delay awareness of and response to hypoglycemia by masking signs associated
with stimulation of the sympathetic nervous system (e.g., tachycardia, palpitations) that
hypoglycemia normally causes. Furthermore, β blockade impairs glycogenolysis, which is one
means by which the body can counteract a fall in blood glucose; β blockers, therefore, can
worsen insulin-induced hypoglycemia. Propranolol does not cause insulin resistance. The
incidence of DKA is not increased by concurrent use of propranolol and insulin. Insulin
requirements are not increased because of receptor blocking by propranolol.
8. An older adult patient with type 2 diabetes has a history of severe hypoglycemia. The patient's
partner asks the provider what A1c level they should strive to achieve. What guideline will the
prescriber provide?
a. Between 6.5 and 7.0
b. Below 7.0
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