PHARM module 5 A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The patient’s blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to administer? a. NPH b. No insulin should be administered. c. Lispro [Humalog] d. 70/30 mix A patient with Cushing’s syndrome has undergone surgery and radiation treatment. The nurse will expect to teach the patient about which medication? a. Ketoconazole [Nizoral] b. Fludrocortisone acetate [Florinef] c. Dexamethasone d. Cosyntropin A patient is admitted with nausea, vomiting, diarrhea, and abdominal pain. The patient appears emaciated and complains of feeling weak. The nurse notes a heart rate of 98 beats/min and a blood pressure of 88/54 mm Hg. The nurse reviews the chart and notes an increased serum potassium level and a decreased serum sodium level. The nurse expects the provider to order which medication initially? a. Dexamethasone b. Fludrocortisone [Florinef] c. Hydrocortisone d. Cosyntropin [Cortrosyn] What is the most reliable measure for assessing diabetes control over the preceding 3-month period? a. Patient’s report b. Glycosylated hemoglobin level c. Self-monitoring blood glucose (SMBG) graph report d. Fasting blood glucose level A patient with arthritis is admitted to the hospital. The patient’s serum glucose level is 350 gm/dL, and the blood pressure is 182/98 mm Hg. The nurse notes that the patient’s face appears rounded and puffy. The patient complains of feeling weak. What will the nurse do? a. Request an order for ketoconazole [Nizoral]. b. Suspect that this patient has Addison’s disease. c. Ask which drugs the patient takes for arthritis. d. Contact the provider to discuss whether the patient has a pituitary carcinoma. A patient who has chronic adrenal insufficiency is admitted to the hospital for an open cholecystectomy. The nurse obtaining the admission history learns that the patient takes hydrocortisone 25 mg PO daily in the morning. The patient’s surgery is scheduled for the next morning. The nurse will expect an order to: a. administer hydrocortisone 50 mg PO in the morning. b. withhold the morning dose of hydrocortisone and give it after surgery. c. administer the usual morning dose of hydrocortisone 25 mg PO. PHARM module 5 d. administer hydrocortisone 50 mg IV before surgery. Which statement is accurate about the long-term complications of diabetes? a. Optimal control of both types of diabetes reduces the risk of eye, kidney, and nerve damage. b. Long-term complications are almost always the result of hypoglycemia and ketoacidosis. Optimal control of type 1 diabetes produces excessive episodes of life-threatening c. hypoglycemia. The complication rates for patients with optimally controlled type 2 diabetes are the same as d. for those whose disease is not optimally controlled. A patient who has been taking 25 mg of hydrocortisone each morning for several months reports feeling fatigued late in the day each day. What will the nurse tell the patient to discuss with the provider? a. Assessing serum electrolytes to check for toxicity b. Splitting the daily dose into a morning and an afternoon dose c. Increasing the dose to 50 mg daily d. Adding a mineralocorticoid to the drug regimen