ch. 38

A diabetic patient has been admitted to the ICU with diabetic ketoacidosis. The family asks the nurse what the signs of ketoacidosis are. What would be the nurse's best response? (Mark all that apply.) A) Fruity breath B) Hypoglycemia C) Dehydration D) Edema E) Slow, deep respirations

a

A patient with type 2 diabetes is taking an oral hypoglycemic. What effect is possible from the administration of chromium in this patient? A) It may lower blood glucose level. B) It may increase blood glucose level. C) It may potentate DKA. D) It may cause HHNC.

a

After making an initial assessment of your patients you review their medications. What medication order should you question for a diabetic patient who takes insulin to control their diabetes? A) Propranolol (Inderal) 10 mg PO t.i.d. B) Furosemide (Lasix) 60 mg/d PO C) Cefaclor (Ceclor) 250 mg PO q 8 h D) Metoclopramide (Reglan) 20 mg PO

a

What hormone, secreted with insulin, increases satiety and suppresses glucagon secretion? A) Amylin B) Amylase C) Aldosterone D) Anti-diuretic hormone

a

You are the nurse educator at the diabetes clinic. When talking to a class of adolescent diabetics you tell them that the most recognized signs of diabetes are what? A) Hyperglycemia and glycosuria B) Hypoglycemia and glucagon levels C) Carbohydrate use and insulin levels D) Protein intake and hyperglycemia

a

A diabetic patient has just received an insulin pump. What would be important to include in patient teaching? A) Watch for signs and symptoms of infection B) Check blood glucose frequently C) Change tubing frequently D) Have pump calibrated weekly

b

An insulin dependent diabetic is having trouble with hypoglycemia late in the morning. During the health history the nurse becomes aware of the most likely cause. What would cause the late morning hypoglycemia? A) The patient likes to nap when he comes home from work before his evening meal. B) The patient jogs two miles in the morning before he goes to work. C) The patient likes to have an early lunch with his girlfriend. D) The patient eats oatmeal early in the morning before his morning.

b

Oral anti-diabetic agents can be used in various combinations for what purpose? A) Maximum effects B) Additive effects C) Minimalistic effects D) Synergistic effects

b

The nurse is instructing a patient on mixing insulin. When mixing NPH insulin with lente insulins what is the time frame for injecting your medication? A) 5 minutes B) 10 minutes C) 15 minutes D) 20 minutes

b

The pathophysiology class is studying diabetes. A student asks the instructor what is considered a sign of a hypoglycemic reaction. The instructor's response would be what? A) Dry, flaky skin B) Diaphoresis C) Flushing of the face D) Fruity breath

b

When learning about type 1 diabetes what would the student nurses learn is a distinguishing characteristic of this disease? A) Blood glucose level can be controlled with diet. B) Exogenous insulin is required for life. C) Oral agents can control the disease process. D) It always starts in childhood.

b

You are presenting an educational event at a local senior citizen's club about diabetes. What would you tell the attendees at the event about diabetes? A) It always starts in childhood B) It is a complicated disorder that alters the metabolism of glucose C) It can cause bruising of the tissue all the way to the bone D) It sometimes causes widespread changes in the blood vessels

b

A diabetic patient is taking regular and NPH insulin to manage his diabetes. What is the best evaluation tool to measure the overall patient response to the insulin therapy? A) Blood pressure B) Bilirubin level C) Glycosylated hemoglobin (HbAlc) levels D) Fasting blood glucose levels

c

A patient comes to the diabetic educator and asks about changing his insulin. The patient explains that his occupation takes him on long international flights and he does not want to administer insulin on the plane. What insulin would the diabetic educator recommend? A) Lispro (Humalog) B) Glulisine (Apidra) C) Ultralente (Humulin U Ultralenta) D) Aspart (Novolog)

c

A patient is brought to the Emergency Department (ED) with severe hypoglycemia. What drug would the nurse prepare to administer intravenously? A) Diazole (Hyperstat) B) Glyburide (DiaBeta) C) Glucagon (GlucaGen) D) Insulin (Humulin R)

c

A patient with type 2 diabetes presents at the clinic for a routine follow-up appointment. The patient asks the nurse if they can take the herbal supplement glucosamine for their osteoarthritis. What is the correct response by the nurse? A) "It will increase blood glucose levels." B) "It will decrease blood glucose levels." C) "Long-term effects on humans are unknown." D) "It is safe for type 2 diabetes, but unsafe for type 1."

c

A student asks the nursing instructor what insulin has the quickest therapeutic effect once administered. What would be the best response? A) PZI (Humulin U) B) NPH (Humulin N) C) Regular (Humulin R) D) Ultralente (Humulin U Ultralente)

c

As a diabetic educator you are teaching a newly diagnosed diabetic about aspects of the disease process. What would you tell the patient about the body's control of glucose? A) The body uses what you take in B) Storage of glucose is very limited C) It is related to fat and protein metabolism D) Balancing energy conservation with energy consumption is very difficult

c

As the first line treatment a patient with type 2 diabetes has diet and exercise. When these fail, what may be added as monotherapy or in combination with metformin to control their disease process? A) Repaglinide B) A sitagliptin C) Thiazolidinediones D) An incretin agent

c

You are conducting a class for newly diagnosed adult diabetic patients. What would you know the patients need extensive education about? A) Nutritional understanding B) Preservation of intact skin C) The disease D) Self-care

c

A patient is admitted to the Emergency Department in diabetic ketoacidosis (DKA) with a blood glucose level of 33 mmol/L. The physician orders an initial dose of 25 U insulin IV. Which type of insulin will be administered? A) NPH insulin B) Humulin L insulin C) Humulin N insulin D) Regular insulin

d

As the nurse caring for a young child is diagnosed with type 1 diabetes (IDDM), you know that they become at high risk for what and you include assessment and management of this in their care plan? A) Disturbed sleep pattern B) Anxiety C) Self-care deficit D) Delayed growth and development

d

Diabetic retinopathy is a disorder diabetics develop as a result of a thickening of the basement membrane. What is this caused by? A) Inability of cell replication in the eye B) Increase of aqueous humor in the eye C) Decrease of nerve innervations throughout the eye D) Inability of oxygen to diffuse across vessel membrane to tissues in the eye

d

In what condition is human insulin not recommended for diabetic patients? A) Gestational diabetes B) Type 2 diabetes controlled on oral antidiabetic agents with systemic infection C) Type 1 diabetes of many years D) Type 2 diabetes controlled by diet

d