Glucagon may fail to raise blood glucose in a client whose liver glycogen has been depleted by starvation or heavy alcohol use.
Missing Word
glycogen
Glycogen is the stored form of glucose in the liver. Glucagon works by breaking it down, so when stores are empty, intravenous dextrose is needed instead.
Category: Glucagon
Question 2
Sitagliptin blocks the enzyme that inactivates incretins, gut hormones that increase insulin release after a meal.
Missing Word
incretins
Incretins such as GLP-1 are released by the intestine when food arrives. DPP-4 inhibitors keep them active longer, which boosts glucose-dependent insulin release and lowers glucagon.
Category: Oral Antidiabetic Drugs
Question 3
Pramlintide is a synthetic form of amylin, a hormone released by the pancreas along with insulin that slows gastric emptying and lowers glucagon after meals.
Missing Word
amylin
Amylin is co-secreted with insulin by the pancreatic beta cells. People with type 1 diabetes lack it, and pramlintide replaces its effects at mealtimes.
Category: Non-Insulin Injectables
Question 4
During intravenous insulin therapy for diabetic ketoacidosis, the nurse monitors closely for hypokalemia, because insulin moves potassium from the blood into the cells.
Missing Word
hypokalemia
Insulin activates the sodium-potassium pump and shifts potassium into cells, so serum potassium can fall quickly as diabetic ketoacidosis is treated. A low level can cause muscle weakness and dangerous dysrhythmias, so potassium is monitored and replaced as ordered.
Category: Oral Antidiabetic Drugs
Question 5
The injectable drug that activates both GIP and GLP-1 receptors to treat type 2 diabetes is tirzepatide.
Missing Word
tirzepatide
Tirzepatide is a dual incretin receptor agonist. Like GLP-1 receptor agonists, it causes nausea and other GI effects and carries the same thyroid C-cell tumor warning.
Category: Non-Insulin Injectables
Question 6
Pramlintide is contraindicated in gastroparesis because it further slows the movement of food out of the stomach.
Missing Word
gastroparesis
Gastroparesis is delayed stomach emptying, often a complication of diabetic nerve damage. A drug that slows emptying would worsen nausea and make glucose control unpredictable.
Category: Non-Insulin Injectables
Question 7
The thiazolidinedione pioglitazone should not be used in a client with active bladder cancer.
Missing Word
pioglitazone
Pioglitazone has been associated with an increased risk of bladder cancer, so clients report blood in the urine, urgency or painful urination. It also carries a boxed warning about heart failure.
Category: Oral Antidiabetic Drugs
Question 8
Sulfonylureas and meglitinides are called secretagogues because they make the pancreas release more insulin.
Missing Word
secretagogues
A secretagogue is a substance that causes another substance to be secreted. Because these drugs raise insulin release regardless of food intake, hypoglycemia is their main risk.
Category: Oral Antidiabetic Drugs
Question 9
The first subcutaneous insulin dose is given before an insulin infusion is stopped, because intravenous insulin acts so briefly that stopping it without overlap causes rebound hyperglycemia.
Missing Word
hyperglycemia
Hyperglycemia is a high blood glucose level. Intravenous regular insulin wears off quickly, so the infusion continues for a time after the first subcutaneous dose, letting the injected insulin start working before the drip ends.
Category: Insulin Types
Question 10
An insulin's onset is the time it takes after injection to begin lowering blood glucose.
Missing Word
onset
Onset, peak and duration describe an insulin's action profile. Knowing the onset tells the client when food must be available after the dose.
Category: Insulin Types
Question 11
Prefilled insulin pens must never be shared between clients, even when the needle is changed, because blood can flow back into the cartridge.
Missing Word
pens
Insulin pens hold many doses in one cartridge. Backflow of blood can contaminate it, so sharing a pen can spread bloodborne infections.
Category: Injection Teaching
Question 12
Diazoxide opens potassium channels in the pancreas to block insulin release and is used to treat hypoglycemia caused by excess insulin.
Missing Word
Diazoxide
Diazoxide counteracts insulin overproduction, as from an insulin-secreting tumor. It can cause fluid retention and raise uric acid.
Category: Glucagon
Question 13
NPH insulin is human insulin combined with protamine, a protein that slows its absorption and lengthens its action.
Missing Word
protamine
Protamine binds insulin into crystals that dissolve slowly under the skin, giving NPH its intermediate action and suspension form.
Category: Insulin Types
Question 14
A fruity odor on the breath of a client in diabetic ketoacidosis comes from acetone, one of the ketone bodies.
Missing Word
acetone
Acetone is a volatile ketone exhaled in the breath. Its fruity smell, with deep rapid breathing and high glucose, signals ketoacidosis that needs insulin and fluids.
Category: Hypoglycemia and Sick Days
Question 15
The meglitinide repaglinide is contraindicated with gemfibrozil, because that fibrate raises its blood level enough to cause severe hypoglycemia.
Missing Word
repaglinide
Repaglinide is a short-acting insulin secretagogue taken before meals. Gemfibrozil blocks the liver enzyme that breaks it down and sharply increases repaglinide exposure, so the combination is not used.
Category: Oral Antidiabetic Drugs