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Chapter 53: Diabetes Mellitus Agents Test Bank



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Chapter 53: Diabetes Mellitus Agents

Test Bank

MULTIPLE CHOICE

1. A 40-year-old patient is in the clinic for a routine physical examination. The patient has a body mass index (BMI) of 26. The patient is active and walks a dog daily. A lipid profile reveals low-density lipoprotein (LDL) of 100 mg/dL, high-density lipoprotein (HDL) of 30 mg/dL, and triglycerides of 250 mg/dL. The primary care nurse practitioner (NP) should:

a.

order a fasting plasma glucose level.

b.

consider prescribing metformin (Glucophage).

c.

suggest dietary changes and increased exercise.

d.

obtain serum insulin and hemoglobin A1c levels.

2. A patient is newly diagnosed with type 2 diabetes mellitus. The primary care NP reviews this patient’s laboratory tests and notes normal renal function, increased triglycerides, and deceased HDL levels. The NP should prescribe:

a.

nateglinide (Starlix).

b.

glyburide (Micronase).

c.

colesevelam (Welchol).

d.

metformin (Glucophage).

3. A patient who has insulin-dependent type 2 diabetes reports having difficulty keeping blood glucose within normal limits and has had multiple episodes of both hypoglycemia and hyperglycemia. As adjunct therapy to manage this problem, the primary care NP should prescribe:

a.

pramlintide (Symlin).

b.

repaglinide (Prandin).

c.

glyburide (Micronase).

d.

metformin (Glucophage).

4. A patient with type 2 diabetes mellitus takes metformin (Glucophage) 1000 mg twice daily and glyburide (Micronase) 12 mg daily. At an annual physical examination, the BMI is 29 and hemoglobin A1c is 7.3%. The NP should:

a.

begin insulin therapy.

b.

change to therapy with colesevelam (Welchol).

c.

add a third oral antidiabetic agent to this patient’s drug regimen.

d.

enroll the patient in a weight loss program to achieve better glycemic control.

5. A 30-year-old white woman has a BMI of 26 and weighs 150 lb. At an annual physical examination, the patient’s fasting plasma glucose is 130 mg/dL. The patient walks 1 mile three or four times weekly. She has had two children who weighed 7 lb and 8 lb at birth. Her personal and family histories are noncontributory. The primary care NP should:

a.

order metformin (Glucophage).

b.

order a lipid profile, complete blood count, and liver function tests (LFTs).

c.

order an oral glucose tolerance test.

d.

set a weight loss goal of 10 to 15 lb.

6. A patient who is newly diagnosed with type 2 diabetes mellitus has not responded to changes in diet or exercise. The patient is mildly obese and has a fasting blood glucose of 130 mg/dL. The patient has normal renal function tests. The primary care NP plans to prescribe a combination product. Which of the following is indicated for this patient?

a.

Metformin/glyburide (Glucovance)

b.

Insulin and metformin (Glucophage)

c.

Saxagliptin/metformin (Kombiglyze)

d.

Metformin/pioglitazone (ACTOplus met)

7. A patient who has type 2 diabetes mellitus takes metformin (Glucophage). The patient tells the primary care NP that he will have surgery in a few weeks. The NP should recommend:

a.

taking the metformin dose as usual the morning of surgery.

b.

using insulin during the perioperative and postoperative periods.

c.

that the patient stop taking metformin several days before surgery.

d.

adding a sulfonylurea medication until recovery from surgery is complete.

8. A patient who has diabetes is taking metformin 1000 mg daily. At a clinic visit, the patient reports having abdominal pain and nausea. The primary care NP notes a heart rate of 92 beats per minute. The NP should:

a.

obtain LFTs.

b.

decrease the dose of metformin.

c.

change metformin to glyburide.

d.

order electrolytes, ketones, and serum glucose.

9. A 12-year-old patient who is obese develops type 2 diabetes mellitus. The primary care NP should order:

a.

nateglinide (Starlix).

b.

glyburide (Micronase).

c.

colesevelam (Welchol).

d.

metformin (Glucophage).

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