N4 TEST Oral Diabetes Medications

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1.
Which of the following does not contribute to the development of hyperglycemia in clients with type 2 diabetes?
a. Insulin resistance
b. Impaired insulin secretion
c. Decreased hepatic glucose production
d. Increased production of glucose in the liver

2.
When should pharmacologic therapy be initiated in clients with type 2 diabetes?
a. Three months before medical nutrition therapy and exercise are initiated.
b. When medical nutrition therapy and exercise alone do not lower blood glucose levels within three months.
c. When the client does not want to try medical nutrition therapy and exercise.
d. As soon as type 2 diabetes is diagnosed.

3.
Which of the following classes of diabetes medications target the organ where insulin is produced?
a. Sulfonylureas and alpha-glucosidase inhibitors
b. Biguanides and thiazolidinediones
c. Meglitinides and alpha-glucosidase inhibitors
d. Sulfonylureas and meglitinides

4.
A client who does not respond to 4 mg once/day of glimepiride should:
a. Be considered for another drug or combination therapy.
b. Discontinue taking all medications.
c. Have their dose increased to 16 mg once/day.
d. Have their dose decreased to 2 mg once/day.

5.
Side effects of metformin include all of the following except:
a. Nausea
b. Weight gain
c. Metallic taste
d. Gastrointestinal discomfort

6.
Which of the following statements regarding meglitinides is false?
a. Side effects include upper respiratory infection, nausea, diarrhea, headache, and flu-like symptoms.
b. They produce the same general effects as sulfonylureas.
c. They should be taken 1 hour after meals in order to have the greatest effect on postprandial glucose.
d. They are associated with a lower risk of hypoglycemia than sulfonylureas.

7.
Thiazolidinediones are safe to use in clients with:
a. Normal serum transaminase levels.
b. Serum transaminase levels >2.5 times the upper limit of normal.
c. Congestive heart failure.
d. Congestive heart failure and New York Heart Association Class IV functional status.

8.
Which of the following statements regarding alpha-glucosidase inhibitors is false?
a. Acarbose should not be used in clients with liver cirrhosis.
b. Dosing should start with the maximum recommended dose and gradually decrease over a period of 2 to 4 weeks.
c. Side effects go away once medication is discontinued.
d. They should be taken with food.

9.
Which of the following statements regarding the initiation of pharmacologic therapy is true?
a. A medication should be chosen based solely on its ability to lower hemoglobin A1C levels.
b. A medication should be chosen based solely on its ability to lower fasting plasma glucose levels.
c. Clients should decide which medications they feel are most convenient for them.
d. A number of factors, such as client and drug characteristics, should be considered when choosing a medication.

10.
Which of the following combinations is not available in a single agent?
a. Biguanide + sulfonylurea
b. Acarbose + metformin
c. Biguanide + thiazolidinedione
d. Rosiglitazone + metformin