**Nclex Question 1** The nurse is teaching a patient that was newly prescribed Metformin. Which of the following should the nurse include in the teaching? (Select all that apply)

• This medication decreases the amount of glucose released from the liver.
• You may experience diarrhea and nausea while taking this medication.
• You are at risk for hypoglycemia, so do not skip your meals.
• You should take this medication with food to minimize symptoms.
• This medication must be stopped when having a dye study or surgical procedure.

**Nclex Question 2** A nurse is teaching a client who has been prescribed glipizide. Which statement by the client indicates the need for further teaching?

• I will take this medication 30 minutes before a meal
• If i feel shaky or dizzy ill eat some honey or drink juice
• This medication is safe to take with alcohol
• I will monitor for signs of low blood sugar

Hint

**Nclex Question 3** A client taking pioglitazone develops 5 lbs of weight gain and increasing dyspnea. Which action should the nurse take first?

• Instruct client to restrict fluid intake
• Notify provider immediately
• Administer diuretic
• Teach client to elevate their legs

NPH is intermediate-acting insulin.

What is the onset for intermediate acting insulin?

• 15 to 30 minutes
• 1-2 hours
• 0.5-1 hours
• 4-6 hours

At which time should the nurse closely monitor the client for signs of hypoglycemia?

• At the time of insulin administration
• Immediately after a meal
• 12 hours after insulin administration
• During the peak action of insulin

Fill in the blanks. SGLT2 inhibitors block the reabsorption of (_____) and excrete it in the urine, which may increase the risk of (_____) as bacteria feed on sugar.

• insulin
• glucose
• hypoglycemia
• UTI

A nurse administers metformin to a client with type 2 diabetes. Which lab value should the nurse monitor more closely?

• Liver enzymes
• White blood cell count
• Serum lactate
• Sodium levels

Peak time for regular insulin is 30 min to 1 hour.

Which action by the client using NPH insulin warrants follow up?

• Rotating injection sites
• Eating a bedtime snack
• Drawing up insulin glargine and NPH in the same syringe
• Rolling the vial gently before use

A nurse is reviewing a prescription for sitagliptin. Which potential adverse effect is the priority to report?

• Headache
• Runny nose
• Upper abdominal pain radiating to the back
• Mild rash on forearms

What should the nurse include in teaching a client starting pramlintide?

• Take your oral meds with pramlintide to improve absorption
• Mix pramlintide with insulin for convenience
• Use separate injection site from your insulin
• Take this medication after meals for the best results

Complete the word (1 letter) Shortness of breath and fruity breath odor are the most concerning symptoms for a client taking '_mpagliflozin'.

• E

Keep insulin pens at room temperature for up to 14 days after opening.

A nurse is administering exenatide to a client. When is the best time to give this medication?

• With meals
• Immediately after meals
• Up to 60 min before meals
• Bed time

A nurse is caring for a client taking bromocriptine. Which condition in the client history should prompt the nurse to question this order?

• Hypotension
• Type 2 diabetes
• History of MI
• Fatigue

Hint

Which adverse effect is most concerning for a client taking metformin? Select O for: fatigue and hyperventilation Select X for: metallic taste and nausea

What are the facts about TZD drugs? (Select all that apply)

• Pioglitazone is a drug in the TZD class.
• Glimepiride is a drug in the TZD class.
• Can increase insulin sensitivity
• Can cause hypoglycemia
• Can cause fluid retention

Which medications should not be taken alcohol due to disulfiram-like reactions or increased hypoglycemia? (select 2)

• Glipizide
• Repaglinide
• Metformin
• Bromocriptine
• Acrabose

A nurse is caring for a client receiving pramlintide. Which instructions should be included? (select 3)

• Take your oral meds 1 hour after pramlintide
• This medication can cause severe hypoglycemia when used with insulin
• Mix this medication with insulin for better effects
• Use a separate syringe and rotate sites
• Report nausea and vomiting if persistent