Diabetes Chapter 46

Which instruction about insulin administration should a nurse give to a client? A. "Always follow the same order when drawing the different insulins into the syringe." B. "Store unopened vials of insulin in the freezer at temperatures well below freezing." C. "Discard the intermediate-acting insulin if it appears cloudy." D. "Shake the vials before withdrawing the insulin."

A

When administering insulin to a client with type 1 diabetes, which of the following would be most important for the nurse to keep in mind? A. Accuracy of the dosage B. Area for insulin injection C. Technique for injecting D. Duration of the insulin

A

A client has been recently diagnosed with type 2 diabetes, and reports continued weight loss despite increased hunger and food consumption. This condition is called: A. polydipsia. B. polyphagia. C. anorexia. D. polyuria.

B

A client tells the nurse that she has been working hard for the past 3 months to control her type 2 diabetes with diet and exercise. To determine the effectiveness of the client's efforts, the nurse should check: A. serum fructosamine level. B. glycosylated hemoglobin level. C. urine glucose level. D. fasting blood glucose level.

B

A client with diabetes mellitus is receiving an oral antidiabetic agent. When caring for this client, the nurse should observe for signs of: A. blurred vision B. hypoglycemia C. polyuria D. polydipsia

B

A client with type 1 diabetes mellitus is being taught about self-injection of insulin. Which fact about site rotation should the nurse include in the teaching? A. Avoid the abdomen because absorption there is irregular. B. Use all available injection sites within one area. C. Choose a different site at random for each injection. D. Rotate sites from area to area every other day.

B

A client with type 2 diabetes asks the nurse why he can't have a pancreatic transplant. Which of the following would the nurse include as a possible reason? A. Need for exocrine enzymatic drainage B. Underlying problem of insulin resistance C. Increased risk for urologic complications D. Need for lifelong immunosuppressive therapy

B

A nurse explains to a client that she will administer his first insulin dose in his abdomen. How does absorption at the abdominal site compare with absorption at other sites? A. Insulin is absorbed unpredictably at all injection sites. B. Insulin is absorbed more rapidly at abdominal injection sites than at other sites. C. Insulin is absorbed more slowly at abdominal injection sites than at other sites. D. Insulin is absorbed rapidly regardless of the injection site.

B

A nurse is caring for a client with an abnormally low blood glucose concentration. What glucose level should the nurse observe when assessing laboratory results? A. 95 mg/dL (5.27 mmol/L) B. Less than 70 mg/dL (3.7 mmol/L) C. Between 70 and 75 mg/dL (3.9 to 4.16 mmol/L) D. Between 75 and 90 mg/dL (4.16 to 5.00 mmol/L)

B

A nurse is caring for a diabetic patient with a diagnosis of nephropathy. What would the nurse expect the urinalysis report to indicate? A. Red blood cells B. Albumin C. White blood cells D. Bacteria

B

A nurse is preparing a client with type 1 diabetes for discharge. The client can care for himself; however, he's had a problem with unstable blood glucose levels in the past. Based on the client's history, he should be referred to which health care worker? A. Psychiatrist B. Dietitian C. Social worker D. Home health nurse

B

A client is admitted with diabetic ketoacidosis (DKA). Which order from the physician should the nurse implement first? A. Infuse 0.9% normal saline solution 1 L/hr for 2 hours. B. Start an infusion of regular insulin at 50 U/hr. C. Administer regular insulin 30 U IV push. D. Administer sodium bicarbonate 50 mEq IV push.

A

A 60-year-old client comes to the ED reporting weakness, vision problems, increased thirst, increased urination, and frequent infections that do not seem to heal easily. The physician suspects that the client has diabetes. Which classic symptom should the nurse watch for to confirm the diagnosis of diabetes? A. Numbness B. Dizziness C. Fatigue D. Increased hunger

D

A patient with diabetic ketoacidosis (DKA) has had a large volume of fluid infused for rehydration. What potential complication from rehydration should the nurse monitor for? A. Hyperkalemia B. Hyperglycemia C. Hyponatremia D. Hypokalemia

D

A health care provider prescribes short-acting insulin for a patient, instructing the patient to take the insulin 20 to 30 minutes before a meal. The nurse explains to the patient that Humulin-R taken at 6:30 AM will reach peak effectiveness by: A. 2:30 PM. B. 12:30 PM. C. 10:30 AM. D. 8:30 AM.

2

A client is taking glyburide (DiaBeta), 1.25 mg P.O. daily, to treat type 2 diabetes. Which statement indicates the need for further client teaching about managing this disease? A. "I skip lunch when I don't feel hungry." B. "I avoid exposure to the sun as much as possible." C. "I always carry hard candy to eat in case my blood sugar level drops." D. "I always wear my medical identification bracelet."

A

A client with a history of type 1 diabetes is demonstrating fast, deep, labored breathing and has fruity odored breath. What could be the cause of the client's current serious condition? A. ketoacidosis B. hepatic disorder C. All options are correct. D. hyperosmolar hyperglycemic nonketotic syndrome

A

A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and symptoms? A. Coma, anxiety, confusion, headache, and cool, moist skin B. Kussmaul respirations, dry skin, hypotension, and bradycardia C. Polyuria, polydipsia, polyphagia, and weight loss D. Polyuria, polydipsia, hypotension, and hypernatremia

A

A nurse expects to find which signs and symptoms in a client experiencing hypoglycemia? A. Nervousness, diaphoresis, and confusion B. Polyuria, headache, and fatigue C. Polydipsia, pallor, and irritability D. Polyphagia and flushed, dry skin

A

During a class on exercise for clients with diabetes mellitus, a client asks the nurse educator how often to exercise. To meet the goals of planned exercise, the nurse educator should advise the client to exercise: A. at least three times per week. B. at least once per week. C. at least five times per week. D. every day.

A

The client with diabetes asks the nurse why shoes and socks are removed at each office visit. The nurse gives which assessment finding as the explanation for the inspection of feet? A. Sensory neuropathy B. Retinopathy C. Nephropathy D. Autonomic neuropathy

A

The nurse is administering lispro insulin. Based on the onset of action, how long before breakfast should the nurse administer the injection? A. 10 to 15 minutes B. 30 to 40 minutes C. 1 to 2 hours D. 3 hours

A

Which intervention is essential when performing dressing changes on a client with a diabetic foot ulcer? A. Using sterile technique during the dressing change B. Applying a heating pad C. Cleaning the wound with a povidone-iodine solution D. Debriding the wound three times per day

A

Which statement is correct regarding glargine insulin? A. It cannot be mixed with any other type of insulin. B. It is absorbed rapidly. C. Its peak action occurs in 2 to 3 hours. D. It is given twice daily.

A

The nurse is explaining glycosylated hemoglobin testing to a diabetic client. Which of the following provides the best reason for this order? A. Provides best information on the body's ability to maintain normal blood functioning B. Reflects the amount of glucose stored in hemoglobin over past several months.

B

Which type of insulin acts most quickly? A. Regular B. Lispro C. Glargine D. NPH

B quick like lisp

Which of the following factors would a nurse identify as a most likely cause of diabetic ketoacidosis (DKA) in a client with diabetes? A. The client has eaten and has not taken or received insulin. B. The client has been exercising more than usual. C. The client continues medication therapy despite adequate food intake. D. The client has not consumed sufficient calories.

C

A 16-year-old client newly diagnosed with type 1 diabetes has a very low body weight despite eating regular meals. The client is upset because friends frequently state, "You look anorexic." Which statement by the nurse would be the best response to help this client understand the cause of weight loss due to this condition? A. "I will refer you to a dietician who can help you with your weight." B. "You may be having undiagnosed infections, causing you to lose extra weight." C. "Your body is using protein and fat for energy instead of glucose." D. "Don't worry about what your friends think; the carbohydrates you eat are being quickly digested, increasing your metabolism."

C

Which statement is true regarding gestational diabetes? A. It occurs in most pregnancies. B. There is a low risk for perinatal complications. C. A glucose challenge test should be performed between 24 and 28 weeks. D. Onset usually occurs in the first trimester.

C

A client is admitted to the health care center with abdominal pain, nausea, and vomiting. The medical reports indicate a history of type 1 diabetes. The nurse suspects the client's symptoms to be those of diabetic ketoacidosis (DKA). Which action will help the nurse confirm the diagnosis? A. Assess the client's ability to take a deep breath B. Assess the client's ability to move all extremities C. Assess the client's breath odor D. Assess for excessive sweating

C

A client who was diagnosed with type 1 diabetes 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blood glucose level? A. Slow, shallow respirations B. Arm and leg trembling C. Rapid, thready pulse D. Cool, moist skin

C

A client with diabetes mellitus has a blood glucose level of 40 mg/dL. Which rapidly absorbed carbohydrate would be most effective? A. three to five LifeSavers candies B. 4 oz of skim milk C. 1/2 cup fruit juice or regular soft drink D. 1/2 tbsp honey or syrup

C

A client with type 1 diabetes is experiencing polyphagia. The nurse knows to assess for which additional clinical manifestation(s) associated with this classic symptom? A. Dehydration B. Altered mental state C. Muscle wasting and tissue loss D. Weight gain

C

A nurse is assigned to care for a postoperative client with diabetes mellitus. During the assessment interview, the client reports that he's impotent and says he's concerned about the effect on his marriage. In planning this client's care, the most appropriate intervention would be to: A. encourage the client to ask questions about personal sexuality. B. provide time for privacy. C. suggest referral to a sex counselor or other appropriate professional. D. provide support for the spouse or significant other.

C

A patient has been newly diagnosed with type 2 diabetes, and the nurse is assisting with the development of a meal plan. What step should be taken into consideration prior to making the meal plan? A. Making sure that the patient is aware that quantity of foods will be limited B. Ensuring that the patient understands that some favorite foods may not be allowed on the meal plan and substitutes will need to be found C. Reviewing the patient's diet history to identify eating habits and lifestyle and cultural eating patterns D. Determining whether the patient is on insulin or taking oral antidiabetic medication

C

An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting: A. 18 to 20 g of a simple carbohydrate. B. 2 to 5 g of a simple carbohydrate. C. 10 to 15 g of a simple carbohydrate. D. 25 to 30 g of a simple carbohydrate.

C

The nurse is reviewing the initial laboratory test results of a client diagnosed with DKA. Which of the following would the nurse expect to find? A. PaCO2 of 40 mm Hg B. Blood glucose level of 250 mg/dL C. Blood pH of 6.9 D. Serum bicarbonate of 19 mEq/L

C

What is the only insulin that can be given intravenously? A. Lantus B. NPH C. Regular D. Ultralente

C

Which combination of adverse effects should a nurse monitor for when administering IV insulin to a client with diabetic ketoacidosis? A. Hypocalcemia and hyperkalemia B. Hyperkalemia and hyperglycemia C. Hypokalemia and hypoglycemia D. Hypernatremia and hypercalcemia

C

A client with a history of type 1 diabetes is demonstrating fast, deep, labored breathing and has fruity odored breath. What could be the cause of the client's current serious condition? A. hepatic disorder B. hyperosmolar hyperglycemic nonketotic syndrome C. All options are correct. D. ketoacidosis

D

A nurse is caring for a client with type 1 diabetes who exhibits confusion, light-headedness, and aberrant behavior. The client is conscious. The nurse should first administer: A. I.V. bolus of dextrose 50%. B. I.M. or subcutaneous glucagon. C. 10 units of fast-acting insulin. D. 15 to 20 g of a fast-acting carbohydrate such as orange juice.

D

NPH is an example of which type of insulin? A. Short-acting B. Rapid-acting C. Long-acting D. Intermediate-acting

D

Which is a characteristic of type 2 diabetes? A. ketosis-prone when insulin absent B. presence of islet antibodies C. little or no insulin D. insulin resistance

D