NR 566 / NR566 Advanced Pharmacology Care of the Family Midterm Review Quiz bank AND Solutions

1. Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms of hypoglycemia include: A. “Fruity” breath odor and rapid respiration B. Diarrhea, abdominal pain, weight loss, and hypertension C. Dizziness, confusion, diaphoresis, and tachycardia D. Easy bruising, palpitations, cardiac dysrhythmias, and coma 2. Nonselective beta blockers and alcohol create serious drug interactions with insulin because they: A. Increase blood glucose levels B. Produce unexplained diaphoresis C. Interfere with the ability of the body to metabolize glucose D. Mask the signs and symptoms of altered glucose levels 3. Lispro is an insulin analogue produced by recombinant DNA technology. Which of the following statements about this form of insulin is NOT true? A. Optimal time of preprandial injection is 15 minutes. B. Duration of action is increased when the dose is increased. C. It is compatible with neutral protamine Hagedorn insulin. D. It has no pronounced peak. 4. The decision may be made to switch from twice daily neutral protamine Hagedorn (NPH) insulin to insulin glargine to improve glycemia control throughout the day. If this is done: A. The initial dose of glargine is reduced by 20% to avoid hypoglycemia. B. The initial dose of glargine is 2 to 10 units per day. C. Patients who have been on high doses of NPH will need tests for insulin antibodies. D. Obese patients may require more than 100 units per day. 5. When blood glucose levels are difficult to control in type 2 diabetes some form of insulin may be added to the treatment regimen to control blood glucose and limit complication risks. Which of the following statements is accurate based on research? A. Premixed insulin analogues are better at lowering HbA1C and have less risk for hypoglycemia. B. Premixed insulin analogues and the newer premixed insulins are associated with more weight gain than the oral antidiabetic agents. C. Newer premixed insulins are better at lowering HbA1C and postprandial glucose levels than long-acting insulins. D. Patients who are not controlled on oral agents and have postprandial hyperglycemia can have neutral protamine Hagedorn insulin added at bedtime. 6. Metformin is a primary choice of drug to treat hyperglycemia in type 2 diabetes because it: A. Substitutes for insulin usually secreted by the pancreas B. Decreases glycogenolysis by the liver C. Increases the release of insulin from beta cells D. Decreases peripheral glucose utilization 7. Prior to prescribing metformin, the provider should: A. Draw a serum creatinine to assess renal function B. Try the patient on insulin C. Tell the patient to increase iodine intake D. Have the patient stop taking any sulfonylurea to avoid dangerous drug interactions 8. The action of “gliptins” is different from other antidiabetic agents because they: A. Have a low risk for hypoglycemia B. Are not associated with weight gain C. Close ATP-dependent potassium channels in the beta cell D. Act on the incretin system to indirectly increase insulin production 9. Sitagliptin has been approved for: A. Monotherapy in once-daily doses B. Combination therapy with metformin C. Both 1 and 2 D. Neither 1 nor 2