Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
The nurse is explaining to a patient why oral antihyperglycemic agents are not effective in Type 1 diabetes. What is the reason?
A. People with Type 1 diabetes have little or none of their own insulin that can be released.
People with Type 1 diabetes have little or no insulin that can be released. This is because their pancreatic β-cells, which produce insulin, are destroyed by an autoimmune process. Without insulin, glucose cannot be taken up into cells to be used for energy. Oral antihyperglycemic agents work by increasing the release of insulin or increasing the body’s sensitivity to insulin, so they are not effective in Type 1 diabetes where there is an absolute insulin deficiency.
B. People with Type 1 diabetes would need so much of an oral antihyperglycemic agent that it would cost too much.
The cost of oral antihyperglycemic agents is not the primary reason they are not used in Type 1 diabetes. The main issue is the lack of insulin production, which these medications cannot address.
C. People with Type 1 diabetes have resistance to their endogenous insulin.
People with Type 1 diabetes do not typically have resistance to their endogenous insulin. Insulin resistance is more commonly associated with Type 2 diabetes.
D. People with Type 1 diabetes would have more episodes of hypoglycemia with oral antihyperglycemic agents.
While hypoglycemia can occur with the use of some antihyperglycemic agents, this is not the primary reason these medications are not used in Type 1 diabetes. The main issue is the absolute deficiency of insulin.
This question is an excerpt from Nurse Dive's nursing test bank - Ati Med Surg Nurs 200 Proctored Exam Roxoborouh Memorial College. Take the full exam now
Full Explanation
Choice A rationale
People with Type 1 diabetes have little or no insulin that can be released. This is because their pancreatic β-cells, which produce insulin, are destroyed by an autoimmune process. Without insulin, glucose cannot be taken up into cells to be used for energy. Oral antihyperglycemic agents work by increasing the release of insulin or increasing the body’s sensitivity to insulin, so they are not effective in Type 1 diabetes where there is an absolute insulin deficiency.
Choice B rationale
The cost of oral antihyperglycemic agents is not the primary reason they are not used in Type 1 diabetes. The main issue is the lack of insulin production, which these medications cannot address.
Choice C rationale
People with Type 1 diabetes do not typically have resistance to their endogenous insulin. Insulin resistance is more commonly associated with Type 2 diabetes.
Choice D rationale
While hypoglycemia can occur with the use of some antihyperglycemic agents, this is not the primary reason these medications are not used in Type 1 diabetes. The main issue is the absolute deficiency of insulin.
Similar Questions
A patient has returned to the unit following a peripheral artery angiogram with a stent insertion.
Four hours post-procedure, the nurse can no longer palpate the dorsalis pedis pulse and the foot is cold and dusky. What should be the nurse’s immediate action?
A. Reposition the limb and reassess.
While repositioning the limb and reassessing might be a part of the overall evaluation, it should not be the immediate action. The symptoms described are indicative of a serious issue that requires immediate medical attention.
B. Apply a warm blanket.
Applying a warm blanket will not address the underlying issue. The symptoms described suggest a problem with circulation that needs immediate medical attention.
C. Notify the healthcare provider.
Notifying the healthcare provider is the correct immediate action. The symptoms described suggest that the patient may be experiencing a complication such as occlusion of the stent. This is a medical emergency that requires immediate intervention.
D. Elevate the extremity on a pillow.
Elevating the extremity on a pillow is not the immediate action to take. While elevation can help with conditions like edema, it does not address the serious symptoms the patient is experiencing.
Full Explanation
Choice A rationale
While repositioning the limb and reassessing might be a part of the overall evaluation, it should not be the immediate action. The symptoms described are indicative of a serious issue that requires immediate medical attention.
Choice B rationale
Applying a warm blanket will not address the underlying issue. The symptoms described suggest a problem with circulation that needs immediate medical attention.
Choice C rationale
Notifying the healthcare provider is the correct immediate action. The symptoms described suggest that the patient may be experiencing a complication such as occlusion of the stent. This is a medical emergency that requires immediate intervention.
Choice D rationale
Elevating the extremity on a pillow is not the immediate action to take. While elevation can help with conditions like edema, it does not address the serious symptoms the patient is experiencing.
A patient is recovering from an episode of diabetic ketoacidosis and reports feeling “anxious, shaky, and sweaty.”. What should be the nurse’s initial action?
A. Obtain a full set of vital signs.
While obtaining a full set of vital signs is an important part of assessing a patient’s condition, it should not be the initial action in this case. The symptoms described by the patient suggest hypoglycemia, which requires immediate confirmation and treatment.
B. Administer 1 mg glucagon subcutaneously.
Administering 1 mg glucagon subcutaneously is not the initial action. Glucagon is used to treat severe hypoglycemia when the patient is unable to take glucose orally. However, the patient’s blood glucose level should be checked first.
C. Administer 25 mL of 50% dextrose.
Administering 25 mL of 50% dextrose is not the initial action. This treatment is used for severe hypoglycemia, but the patient’s blood glucose level should be checked first to confirm hypoglycemia.
D. Obtain a blood glucose reading.
Obtaining a blood glucose reading is the correct initial action. The symptoms described by the patient suggest hypoglycemia. Checking the blood glucose level will confirm whether the patient is hypoglycemic and needs treatment.
Full Explanation
Choice A rationale
While obtaining a full set of vital signs is an important part of assessing a patient’s condition, it should not be the initial action in this case. The symptoms described by the patient suggest hypoglycemia, which requires immediate confirmation and treatment.
Choice B rationale
Administering 1 mg glucagon subcutaneously is not the initial action. Glucagon is used to treat severe hypoglycemia when the patient is unable to take glucose orally. However, the patient’s blood glucose level should be checked first.
Choice C rationale
Administering 25 mL of 50% dextrose is not the initial action. This treatment is used for severe hypoglycemia, but the patient’s blood glucose level should be checked first to confirm hypoglycemia.
Choice D rationale
Obtaining a blood glucose reading is the correct initial action. The symptoms described by the patient suggest hypoglycemia. Checking the blood glucose level will confirm whether the patient is hypoglycemic and needs treatment.
The nurse is teaching a patient to wash their hands after using the bathroom as an attempt to break the chain of infection.
Between which two links in the chain of infection does this action intervene?
A. Infectious agent and reservoir.
The infectious agent is the pathogen that causes the disease, and the reservoir is where the infectious agent lives and multiplies. Hand washing does not directly intervene between these two links.
B. Mode of transmission and portal of entry.
The mode of transmission is how the infectious agent travels to other people and places, and the portal of entry is the route by which an infectious agent enters a new host. Hand washing does not directly intervene between these two links.
C. Susceptible host and infectious agent.
The susceptible host is a person who is vulnerable to the disease, and the infectious agent is the pathogen that causes the disease. Hand washing does not directly intervene between these two links.
D. Portal of exit and mode of transmission.
The portal of exit is the route by which an infectious agent escapes or leaves the reservoir, and the mode of transmission is how the infectious agent travels to other people and places. Hand washing directly intervenes between these two links by removing the infectious agent from the hands (portal of exit) and preventing its transmission to other people or surfaces.
Full Explanation
Choice A rationale
The infectious agent is the pathogen that causes the disease, and the reservoir is where the infectious agent lives and multiplies. Hand washing does not directly intervene between these two links.
Choice B rationale
The mode of transmission is how the infectious agent travels to other people and places, and the portal of entry is the route by which an infectious agent enters a new host. Hand washing does not directly intervene between these two links.
Choice C rationale
The susceptible host is a person who is vulnerable to the disease, and the infectious agent is the pathogen that causes the disease. Hand washing does not directly intervene between these two links.
Choice D rationale
The portal of exit is the route by which an infectious agent escapes or leaves the reservoir, and the mode of transmission is how the infectious agent travels to other people and places. Hand washing directly intervenes between these two links by removing the infectious agent from the hands (portal of exit) and preventing its transmission to other people or surfaces.