ATI Skills Module 3.0- Diabetes Mellitus Management

A nurse is caring for a client who has type 1 diabetes mellitus and is in need of a long-acting insulin preparation. The nurse anticipates receiving a prescription for which of the following insulin? A. Insulin glargine B. Insulin aspart C. Insulin glulisine D. Insulin lispro

A. Insulin glargine Rationale: Long-acting insulin, such as insulin glargine, is intended to provide basal glucose control. The dosage is typically once daily at the same time each day.

A nurse is reviewing the results of the routine laboratory tests performed as part of a client's annual physical examination. Which of the following values indicates a fasting blood glucose measurement that is outside the expected reference range? A. 78 mg/dL B. 118 mg/dL C. 85 mg/dL D. 104 mg/dL

B. 118 mg/dL Rationale: This results exceeds the expected reference range for a fasting blood glucose measurement, which is generally between 74-106 mg/dL

A nurse is caring for a client who has type 1 diabetes mellitus and reports feeling anxious and having palpitations. the glucometer reads 50mg/dL. Which of the following actions should the nurse take? A. Give client 1tsp honey B. Give 4oz apple juice C. Give 4oz skim milk D. give one or two tablets of glucose

B. Give 4oz apple juice Rationale: After confirming hypoglycemia, the nurse should give the client 15 to 20 g of rapid-acting, concentrated carbohydrate source, such as 4 to 6 oz of fruit juice, 8 oz of skim milk, 1 tbsp of honey, or commercially prepared glucose tablets per package instructions.

A nurse is teaching a client who has type 1 diabetes mellitus about the peak time of neutral protamine Hagedorn (NPH) insulin. Which of the following statements by the client indicates an understanding of the teaching? A. "NPH insulin peaks in 1 to 5 hours" B. "NPH insulin is peakless" C. "NPH insulin peaks in 6 to 14 hours" D. "NHP insulin peaks in 12 to 24 hours"

C. "NPH insulin peaks in 6 to 14 hours" Rationale: NPH insulin has an onset of 60-120 min, peaks in 6-14 hr, and has a duration of 16-24 hr.

A nurse is teaching a client who was recently diagnosed with type 1 diabetes mellitus how to check blood glucose levels. Which of the following instructions should the nurse include in the teaching? A. "Blood can be smeared from the fingertip onto the test strip" B. "Use a syringe and needle to collect and transfer blood to test strip." C. "To collect a sample for testing, hold the test strip next to the blood on the fingertip" D. "Use a capillary tube to collect and transfer the blood from the fingertip"

C. "To collect a sample for testing, hold the test strip next to the blood on the fingertip" Rationale: This allows the blood to flow over the reagent pad until the amount of blood on the strip is adequate. A sample that is too small can result in falsely low readings.

A nurse is reviewing self-administration of insulin using a pre-filled pen with a client who started using the pen the previous week. The client asks what can be done to help reduce injection pain. Which of the following instructions should the nurse give the client? A. agitate the syringe slightly before injection B. store the pens with the needle pointing upward C. insert the needle slowly. D. Keep the pen at room temperature for a few minutes.

D. Keep the pen at room temperature for a few minutes. Rationale: Injecting room-temperature insulin is less painful than injecting cold insulin.

A nurse is teaching a client who has a new diagnosis of type 2 diabetes mellitus about metformin. The nurse should explain that this type of medication works by which of the following mechanism? A. Increasing insulin secretion by the pancreas B. Delaying carbohydrate digestion C. Increasing the cellular response to insulin D. Reducing hepatic glucose production

D. Reducing hepatic glucose production Rationale: Biguanides reduce hepatic glucose production while increasing insulin action on muscle glucose uptake.

A nurse is teaching a client who has type 1 diabetes mellitus about the use of an insulin pump. Which of the following information should the nurse include in the teaching? A. The pump should remain in place while bathing B. insulin is injected intermittently based on the client's blood glucose level C. the pump using intermediate-acting insulin D. The risk for developing DKA can be increased with the use of an insulin pump

D. The risk for developing DKA can be increased with the use of an insulin pump Rationale: Malfunction of the pump from low battery power, occlusion of tubing or needles, or lack of insulin in the pump increases the risk of DKA, particularly if the client is not aware of it.