Diabetes Practice Questions

The nurse prioritizes which nursing diagnosis in the plan of care for the patient with type 2 DM? A. Risk for infection B. Risk for falls C. Risk for impaired gas exchange D. Risk for injury: hyperkalemia

Answer: A Rationale: Infection is a great risk due to poor peripheral perfusion and diabetic peripheral neuropathy which decreases sensation which may lead to undetected injury and infection.

The client diagnosed with type 1 diabetes is receiving Humalog, a rapid-acting insulin, by sliding scale. The order reads blood glucose level: <150, zero (0) units; 151 to 200, three(3) units; 201 to 250, six (6) units; >251, contact health-care provider. The unlicensed assistive personnel (UAP) reports to the nurse the client's glucometer reading is 189. How much insulin should the nurse administer to the client?

3 units The client's result is 189, which is between 151 and 200, so the nurse should administer three (3) units of Humalog insulin subcutaneously.

The diabetic educator is teaching a class on diabetes type 1 and is discussing sick-day rules. Which interventions should the diabetes educator include in the discussion? Select all that apply. A. Take diabetic medication even if unable to eat the client's normal diabetic diet. B. If unable to eat, drink liquids equal to the client's normal caloric intake. C. It is not necessary to notify the health-care provider (HCP) if ketones are in the urine. D. Test blood glucose levels and test urine ketones once a day and keep a record. E. Call the health-care provider if glucose levels are higher than 180 mg/dL.

A, B & E The most important issue to teach clients is to take insulin even if they are unable to eat. Glucose levels are increased with illness and stress. The client should drink liquids such as regular cola or orange juice, or eat regular gelatin, which provide enough glucose to prevent hypoglycemia when receiving insulin. Ketones indicate a breakdown of fat and must be reported to the HCP because they can lead to metabolic acidosis. Blood glucose levels and ketones must be checked every three (3) to four (4) hours, not daily. The HCP should be notified if the blood glucose level is this high. Regular insulin may need to be prescribed to keep the blood glucose level within acceptable range.

The client is admitted to the ICU diagnosed with DKA. Which interventions should the nurse implement? Select all that apply. A. Maintain adequate ventilation. B. Assess fluid volume status. C. Administer intravenous potassium. D. Check for urinary ketones. E. Monitor intake and output.

A,B,C,D,E The nurse should always address the airway when a client is seriously ill. The client must be assessed for fluid volume deficit and then for fluid volume excess after fluid replacement is started. The electrolyte imbalance of primary con- cern is depletion of potassium. Ketones are excreted in the urine; levels are documented from negative to large amount. Ketones should be monitored frequently. The nurse must ensure the client's fluid intake and output are equal.

The client diagnosed with type 1 diabetes is found lying unconscious on the floor of the bathroom. Which intervention should the nurse implement first? A. Administer 50% dextrose (IVP). B. Notify the health-care provider. C. Move the client to the ICU. D. Check the serum glucose level.

A. Administer 50% dextrose (IVP). The nurse should assume the client is hypoglycemic and administer IVP dextrose, which will rouse the client immediately. If the collapse is the result of hyperglycemia, this additional dextrose will not further injure the client. B- The health-care provider may or may not need to be notified, but this is not the first intervention. C- The client should be left in the client's room, and 50% dextrose should be administered first. D- The serum glucose level requires a venipuncture, which will take too long. A blood glucometer reading may be obtained, but the nurse should first treat the client, not the ma- chine. The glucometer only reads "low" after a certain point, and a serum level is needed to confirm exact glucose level.

The home health nurse is completing the admission assessment for a 76-year-old client diagnosed with type 2 diabetes controlled with 70/30 insulin. Which intervention should be included in the plan of care? A. Assess the client's ability to read small print. B. Monitor the client's serum prothrombin time (PT) level. C. Teach the client how to perform a hemoglobin A1c test daily. D. Instruct the client to check the feet weekly.

A. Assess the client's ability to read small print. Age-related visual changes and diabetic retinopathy could cause the client to have difficulty in reading and drawing up insulin dosage accurately.

The nurse administered 28 units of Humulin N, an intermediate-acting insulin, to a client diagnosed with type 1 diabetes at 1600. Which intervention should the nurse implement? A. Ensure the client eats the bedtime snack. B. Determine how much food the client ate at lunch. C. Perform a glucometer reading at 0700. D. Offer the client protein after administering insulin.

A. Ensure the client eats a bedtime snack. Humulin N peaks in six (6) to eight(8) hours, making the client at risk for hypoglycemia around midnight, which is why the client should receive a bedtime snack. This snack will prevent nighttime hypoglycemia.

The elderly client is admitted to the intensive care department diagnosed with severe HHNS. Which collaborative intervention should the nurse include in the plan of care? A. Infuse 0.9% normal saline intravenously. B. Administer intermediate-acting insulin. C. Perform blood glucometer checks daily. D. Monitor arterial blood gas (ABG) results.

A. Infuse 0.9% normal saline intravenously. The initial fluid replacement is 0.9% nor- mal saline (an isotonic solution) intrave- nously, followed by 0.45% saline. The rate depends on the client's fluid volume status and physical health, especially of the heart. B is wrong because Regular insulin, not intermediate, is the insulin of choice because of its quick onset and peak in two (2) to four (4) hours. C is wrong because Blood glucometer checks are done every one (1) hour or more often in clients with HHNS who are receiving regular insulin drips. D is wrong because Arterial blood gases are not affected in HHNS because there is no breakdown of fat resulting in ketones leading to metabolic acidosis.

The nurse is developing a care plan for the client diagnosed with type 1 diabetes. The nurse identifies the problem "high risk for hyperglycemia related to noncompliance with the medication regimen." Which statement is an appropriate short-term goal for the client? A. The client will have a blood glucose level between 90 and 140 mg/dL. B. The client will demonstrate appropriate insulin injection technique. C. The nurse will monitor the client's blood glucose levels four (4) times a day. D. The client will maintain normal kidney function with 30-mL/hr urine output.

A. The client will have a blood glucose level between 90 and 140 mg/dL. The short-term goal must address the response part of the nursing diagnosis, which is "high risk for hyperglycemia," and this blood glucose level is within acceptable ranges for a client who is noncompliant. B is an appropriate goal for a knowledge- deficit nursing diagnosis. Noncompliance is not always the result of knowledge deficit. C - The nurse is implementing an intervention, and the question asks for a goal which addresses the problem of "high risk for hyperglycemia." D- The question asks for a short-term goal and this is an example of a long-term goal.

The nurse correlates which laboratory value with the diagnosis of DM? A. Fasting blood glucose greater than 140 mg/dL B. Hemoglobin A1c, 5.8% C. Random blood glucose, 150 mg/dL D. OGTT, 155 mg/dL

Answer: A Rationale: A fasting blood glucose greater than 140 mg/dL indicates DM. The other values are indicative of pre-diabetes.

A nurse is reviewing orders for patients newly diagnosed with type 2 DM. What initial medication orders should be anticipated? A. Metformin PO twice a day B. Nutritional insulin subcutaneously prior to meals C. Basal insulin subcutaneously before bed D. Correctional insulin subcutaneously after meals

Answer: A Rationale: Metformin is a drug used to maintain glucose levels in type 2 DM. Insulin may be used later if glucose control cannot be maintained overtime. B, C,and D are orders for a patient with type 1 DM.

The charge nurse is reviewing orders for a newly admitted patient with type 1 DM. It is a priority for the charge nurse to follow up with the provider about which order? A. NovoLog insulin subcutaneous at bedtime B. NovoLog insulin subcutaneous 15 minutes prior to meals C. Basal insulin subcutaneous at bedtime D. Correctional and nutritional insulin administered immediately after the meal

Answer: A Rationale: NovoLog is a fast acting insulin reserved for correctional or prandial insulin—administration at bedtime without adequate nutritional intake may result in hypoglycemia.

What is the most likely cause of the Somogyi effect? A. Basal insulin injections before bed without a small snack B. Naturally occurring release of hormones during the night C. Increased consumption of complex carbohydrates throughout the day D. Glucagon administration before breakfast

Answer: A Rationale: The increased blood glucose levels of the dawn phenomenon result from the naturally occurring release of hormones such as glucagon, cortisol, and growth hormone in the early morning. Because the body does not have sufficient insulin to control this glucose surge, blood glucose levels rise. This is most likely reflected in higher fasting blood glucose levels in the morning. The Somogyi effect results in increased blood glucose levels due to an excessive insulin dosage at night. This can occur in a patient who injects basal insulin before bed without also having a small bedtime snack. In that circumstance, blood glucose levels drop and the body responds in the same way as in the dawn phenomenon, releasing growth hormone, cortisol, and catecholamines in an effort to increase blood glucose by releasing glucose stores from the liver.

he nurse recognizes which of the following statements as correct in relation to the pathophysiology of type 2DM? (Select all that apply.) A. It is due to a relative lack of insulin. B. It is due to insulin resistance. C. It is due to an absolute lack of insulin. D. It remains stable over time. E. It is due to an autoimmune process that destroysthe beta cells of the pancreas.

Answer: A and B Rationale: Type 2 is a relative lack of insulin or due to insulin resistance. Type 1 is an absolute lack of insulin due to an autoimmune process that destroys the beta cells of the pancreas. Neither are stable over time.

The nurse monitors for which clinical manifestations in the patient newly diagnosed with type 1 DM?(Select all that apply.) A. Polyuria B. Fatigue C. Weight loss D. Polyphagia E. Decreased appetite

Answer: A, B, C, and D Rationale: Fatigue, polyuria, weight loss, and polyphagia are all clinical manifestations. Glucose is typically totally reabsorbed in the renal tubules. Hyperglycemia results in glucose excretion in the urine, which creates an osmotic effect that effectively reduces water reabsorption into the renal tubules, leading to excessive volume loss through the kidneys. Hyperglycemia also causes hyperosmolarity in the blood, which causes a shift of fluid from the intracellular space to the vascular space. The loss of intracellular water combined with the volume loss through the kidneys creates excessive thirst in the patient, or polydipsia. The lack of insulin necessary to move glucose into the cells leads to the breakdown of proteins and fat as a source of energy. This starvation of the cells leads to polyphagia, increased appetite. Despite an increased appetite leading to consumption of large amounts of food, the continual breakdown of fats and proteins leads to weight loss and fatigue.

The nurse recognizes that blood glucose monitoring before meals and at bedtime is done to achieve which outcome? (Select all that apply.) A. Maintain glycemic control. B. Prevent complications of long-term hyperglycemia. C. Facilitate insulin administration that mimics the healthy pancreas. D. Provide frequent practice with the finger stick technique. E. Prevent acute complications of type 1 diabetes.

Answer: A, B, and C Rationale: Blood glucose monitoring before meals and at bedtime facilitates insulin administration that mimics the healthy pancreas which helps maintain glycemic control and prevents complications of long-term hyperglycemia. The goal is not frequent practice. Acute complications can occur independent of glucose monitoring such as infection or stress which increase glucose needs.

The nurse correlates which laboratory values as a diagnostic for DKA? (Select all that apply.) A. Serum bicarbonate of 18 mEq/L B. Negative anion gap C. Serum glucose of 350 mg/dL D. Positive anion gap E. Arterial pH of 7.36

Answer: A, C, and D Rationale: Diagnosis of DKA includes: Blood glucose level greater than 250 mg/dL, Ketonuria (ketones in urine), Arterial pH of less than or equal to 7.3, Serum bicarbonate levels of less than or equal to 18 mEq/L, positive anion gap

The nurse is screening patients for the risk of developing type 2 DM. The nurse should consider which patients at risk? (Select all that apply.) A. Women with a history of gestational diabetes B. Women with a history of multiple births C. Men with a history of pancreatic cancer D. Men who are overweight or obese E. Men and women with cardiovascular disease

Answer: A, D, and E Rationale: Multiple births or a history of pancreatic cancer do not increase the risk of type 2 DM. Pancreatic cancer may result in surgically induced type 1 DM.

The nurse documents glucose in the urine as which finding? A. Polyuria B. Glucosuria C. Hyperglycemia D. Hyperosmolarity

Answer: B Rationale: Glucosuria is glucose in the urine. Polyuria is excessive urine output. Hyperglycemia is high serum glucose and hyperosmolarity is increased body fluid osmolality or concentration.

The nurse is providing care for a patient newly diagnosed with type 1 diabetes. Which lifestyle modifications need to be included into the plan of care? A. Limit exercise, carbohydrate counting, self monitoring of blood glucose B. Distribute carbohydrate intake throughout the day, control weight, limit alcohol C. Carbohydrate counting, self-monitoring of blood glucose, physician visits as needed D. Limit protein intake, distribute carbohydrate intake throughout the day, regular physician visits

Answer: B Rationale: Recommendations for the control of type 2 DM include aerobic training and resistance training, controlling weight which is associated with insulin resistance, distributing carbohydrates throughout the day in small meals and snacks, self-blood glucose monitoring, limiting alcohol as it contains carbohydrates, and regular physician visits.

The nurse understands that type 1 DM is caused by which of the following conditions? (Select all that apply.) A. Gestational diabetes B. A history of mumps or rubella C. Family history of autoimmune disorders D. Autoimmune destruction of the beta cells of the pancreas E. Obesity

Answer: B and D Rationale: Type I DM is caused by an autoimmune process in which the insulin-producing beta cells of the pancreas are destroyed. Triggers are not fully understood, but a history of mumps or rubella are sometimes implicated.

Which are considered clinical manifestations of type 2 diabetes? (Select all that apply.) A. Decreased appetite B. Poor wound healing C. Fatigue D. Hyperactivity E. Visual disturbances

Answer: B, C, and E Rationale: Decreased appetite and hyperactivity are not associated with type 2 DM. Poor wound healing is due to decreased peripheral circulation. Visual disturbances are due to microvascular effects ofDM and fatigue is due to the breakdown of fats and proteins for energy needs.

The nurse should intervene immediately if a patient has which blood glucose level? A. 200 mg/dL B. 152 mg/dL C. 80 mg/dL D. 40 mg/dL

Answer: D Rationale: As the brain can only use glucose for its metabolic functions, a glucose of 40 requires immediate treatment to avoid potential irreversible CNS dysfunction.

What is measured by the HbgA1c test? A. Amount of glucagon stored in the liver B. Specific insulin levels in blood plasma C. Levels of hemoglobin after physical activity D. Average blood glucose concentration over time

Answer: D Rationale: HbgA1c is the average blood glucose concentration over time.

The nurse at a freestanding health-care clinicis caring for a 56-year-old male client who is homeless and is a type 2 diabetic controlled with insulin. Which action is an example of client advocacy? A. Ask the client if he has somewhere he can go and live. B. Arrange for someone to give him insulin at a local homeless shelter. C. Notify Adult Protective Services about the client's situation. D. Ask the HCP to take the client off insulin because he is homeless.

B. Arrange for someone to give him insulin at a local homeless shelter. Client advocacy focuses support on the client's autonomy. Even if the nurse dis- agrees with his living on the street, it is the client's right. Arranging for someone to give him his insulin provides for his needs and allows his choices.

The client with type 2 diabetes controlled with biguanide oral diabetic medication is scheduled for a computed tomography (CT) scan with contrast of the abdomen to evaluate pancreatic function. Which intervention should the nurse implement? A. Provide a high-fat diet 24 hours prior to test. B. Hold the biguanide medication for 48 hours prior to test. C. Obtain an informed consent form for the test. D. Administer pancreatic enzymes prior to the test.

B. Hold the biguanide medication for 48 hours prior to test. Biguanide medication must be held for a test with contrast medium because it in- creases the risk of lactic acidosis, which leads to renal problems.

The UAP on the medical floor tells the nurse the client diagnosed with DKA wants something else to eat for lunch. Which intervention should the nurse implement? A. Instruct the UAP to get the client additional food. B. Notify the dietitian about the client's request. C. Request the HCP increase the client's caloric intake. D. Tell the UAP the client cannot have anything else.

B. Notify the dietitian about the client's request. The client will not be compliant with the diet if he or she is still hungry. Therefore, the nurse should request the dietitian talk to the client to try to adjust the meals so the client will adhere to the diet. The client is on a special diet and should not have any additional food. The nurse does not need to notify the HCP for an increase in caloric intake. The appropriate referral is to the dietitian.The client is on a special diet. The nurse needs to help the client maintain compliance with the medical treatment and should refer the client to the dietitian.

Which electrolyte replacement should the nurse anticipate being ordered by the health-care provider in the client diagnosed with diabetic ketoacidosis (DKA) who has just been admitted to the ICU? A. Glucose. B. Potassium. C. Calcium. D. Sodium.

B. Potassium. The client in DKA loses potassium from increased urinary output, acidosis, catabolic state, and vomiting. Replacement is essential for preventing cardiac dysrhythmias secondary to hypokalemia. Glucose is elevated in DKA; therefore, the HCP would not be replacing glucose. Calcium is not affected in the client with DKA. The prescribed IV for DKA—0.9% normal saline—has sodium, but it is not specifically ordered for sodium replacement. This is an isotonic solution.

Which assessment data indicate the client diagnosed with diabetic ketoacidosis is responding to the medical treatment? A. The client has tented skin turgor and dry mucous membranes. B. The client is alert and oriented to date, time, and place. C. The client's ABG results are pH 7.29, Paco2 44, HCO3 15. D. The client's serum potassium level is 3.3 mEq/L.

B. The client is alert and oriented to date, time, and place. The client's level of consciousness can be altered because of dehydration and acidosis. If the client's sensorium is intact, the client is getting better and responding to the medical treatment. A indicates that the client is dehydrated, which does not indicate the client is getting better. B's ABGs indicate metabolic acidosis; therefore, the client is not responding to treatment. D's potassium level is low and indicates hypokalemia, which shows the client is not responding to medical treatment.

An 18-year-old female client, 5′4′′ tall, weighing 113 kg, comes to the clinic for a nonhealing wound on her lower leg, which she has had for two (2) weeks. Which disease process should the nurse suspect the client has developed? A. Type 1 diabetes. B. Type 2 diabetes. C. Gestational diabetes. D. Acanthosis nigricans.

B. Type 2 Diabetes Type 2 diabetes is a disorder usually occurring around the age of 40, but it is now being detected in children and young adults as a result of obesity and sedentary lifestyles. Nonhealing wounds are a hallmark sign of type 2 diabetes. This client weighs 248.6 pounds and is short.

a patient is receiving a daily dose of NPH insulin at 7:30 AM. the nurse expects the peak effect of this drug to occur at what time? a. 8:15 am b. 10:30 am c. 5:00 pm d. 11:00 pm

C

The emergency department nurse is caring for a client diagnosed with HHNS who has a blood glucose of 680 mg/dL. Which question should the nurse ask the client to determine the cause of this acute complication? A. "When is the last time you took your insulin?" B. "When did you have your last meal?" C. "Have you had some type of infection lately?" D. "How long have you had diabetes?"

C. "Have you had some type of infection lately?" The most common precipitating factor is infection. The manifestations may be slow to appear, with onset ranging from 24 hours to two (2) weeks. A client with type 2 diabetes usually is pre- scribed oral hypoglycemic medications, not insulin. B- The client could not eat enough food to cause a 680-mg/dL blood glucose level; therefore, this question does not need to be asked. D -This does not help determine the cause of this client's HHNS.

In a diabetic patient, numbness, tingling, and pain in the hands and feet are all symptoms of which complication? A. Autonomic neuropathy B. Hyperosmolar hyperglycemic syndrome C. Diabetic peripheral neuropathy D. Diabetic ketoacidosis

C. Diabetic peripheral neuropathy

The client diagnosed with type 2 diabetesis admitted to the intensive care unit (ICU) with hyperosmolar hyperglycemic nonketotic syndrome (HHNS) coma. Which assessment data should the nurse expect the client to exhibit? A. Kussmaul's respirations. B. Diarrhea and epigastric pain. C. Dry mucous membranes. D. Ketone breath odor.

C. Dry mucous membranes. Dry mucous membranes are a result of the hyperglycemia and occur with both HHNS and DKA. Kussmaul's respirations occur with diabetic ketoacidosis (DKA) as a result of the breakdown of fat, resulting in ketones. Diarrhea and epigastric pain are not associated with HHNS. Ketone breath odor occurs with DKA as a result of the breakdown of fat, resulting in ketones.

The client received 10 units of Humulin R,a fast-acting insulin, at 0700. At 1030 the unlicensed assistive personnel (UAP) tells the nurse the client has a headache and is really acting "funny." Which intervention should the nurse implement first? A. Instruct the UAP to obtain the blood glucose level. B. Have the client drink eight (8) ounces of orange juice. C. Go to the client's room and assess the client for hypoglycemia. D. Prepare to administer one (1) ampule 50% dextrose intravenously.

C. Go to the client's room and assess the client for hypoglycemia. Regular insulin peaks in two (2) to four (4) hours. Therefore, the nurse should think about the possibility the client is having a hypoglycemic reaction and should assess the client. The nurse should not delegate nursing tasks to a UAP if the client is unstable.

The nurse is discussing ways to prevent diabetic ketoacidosis with the client diagnosed with type 1 diabetes. Which instruction is most important to discuss with the client? A. Refer the client to the American Diabetes Association. B. Do not take any over-the-counter (OTC) medications. C. Take the prescribed insulin even when unable to eat because of illness. D. Explain the need to get the annual flu and pneumonia vaccines.

C. Take the prescribed insulin even when unable to eat because of illness. Illness increases blood glucose levels; therefore, the client must take insulin and consume high-carbohydrate foods such as regular Jell-O, regular popsicles, and orange juice. The American Diabetes Association is an excellent referral, but the nurse should discuss specific ways to prevent DKA. The client should be careful with OTC medications, but this intervention does not help prevent the development of DKA. Vaccines are important to help prevent illness, but regardless of whether the client gets these vaccines, the client can still develop diabetic ketoacidosis.

The nurse is assessing the feet of a client with long-term type 2 diabetes. Which assessment data warrant immediate intervention by the nurse? A. The client has crumbling toenails. B. The client has athlete's foot. C. The client has a necrotic big toe. D. The client has thickened toenails.

C. The client has a necrotic big toe A necrotic big toe indicates "dead" tissue. The client does not feel pain, does not realize the injury, and does not seek treat- ment. Increased blood glucose levels de- crease the oxygen supply needed to heal the wound and increase the risk for devel- oping an infection.

The charge nurse is making client assignments in the intensive care unit. Which client should be assigned to the most experienced nurse? A. The client with type 2 diabetes who has a blood glucose level of 348 mg/dL. B. The client diagnosed with type 1 diabetes who is experiencing hypoglycemia. C. The client with DKA who has multifocal premature ventricular contractions. D. The client with HHNS who has a plasma osmolarity of 290 mOsm/L.

C. The client with DKA who has multifocal premature ventricular contractions. Multifocal PVCs, which are secondary to hypokalemia and can occur in clients with DKA, are a potentially life-threatening emergency. This client needs an experienced nurse. A -This blood glucose level is elevated, but not life threatening, in the client diagnosed with type 2 diabetes. Therefore, a less experienced nurse could care for this client. B- Hypoglycemia is an acute complication of type 1 diabetes, but it can be managed by frequent monitoring, so a less experienced nurse could care for this client. D- A plasma osmolarity of 280 to 300 mOsm/L is within normal limits; therefore, a less experienced nurse could care for this client.

The client diagnosed with type 1 diabetes has a glycosylated hemoglobin (A1c) of 8.1%. Which interpretation should the nurse make based on this result? A. This result is below normal levels. B. This result is within acceptable levels. C. This result is above recommended levels. D. This result is dangerously high

C. The result is above recommended levels. This result parallels a serum blood glucose level of approximately 180 to 200 mg/dL. An A1c is a blood test reflecting average blood glucose levels over a period of three (3) months; clients with elevated blood glucose levels are at risk for develop ing long-term complications.

The client diagnosed with HHNS was admitted yesterday with a blood glucose level of 780 mg/ dL. The client's blood glucose level is now 300 mg/dL. Which intervention should the nurse implement? A. Increase the regular insulin IV drip. B. Check the client's urine for ketones. C. Provide the client with a therapeutic diabetic meal. D. Notify the HCP to obtain an order to decrease insulin.

D. Notify the HCP to obtain an order to decrease insulin. When the glucose level is decreased to around 300 mg/dL, the regular insulin infusion therapy is decreased. Subcutaneous insulin will be administered per sliding scale. A is not correct because the regular intravenous insulin is continued because ketosis is not present, as with DKA. B is not correct because the client diagnosed with type 2 diabetes does not excrete ketones in HHNS because there is enough insulin to prevent fat break- down but not enough to lower blood glucose. C is not correct because the client may or may not feel like eating, but it is not the appropriate intervention when the blood glucose level is reduced to 300 mg/dL.

The nurse is discussing the importance of exercising with a client diagnosed with type 2 diabetes whose diabetes is well controlled with diet and exercise. Which information should the nurse include in the teaching about diabetes? A. Eat a simple carbohydrate snack before exercising. B. Carry peanut butter crackers when exercising. C. Encourage the client to walk 20 minutes three (3) times a week. D. Perform warm-up and cool-down exercises.

D. Perform warm-up and cool-down exercises All clients who exercise should perform warm-up and cool-down exercises to help prevent muscle strain and injury.

Which arterial blood gas results should the nurse expect in the client diagnosed with diabetic ketoacidosis? A. pH 7.34, Pao2 99, Paco2 48, HCO3 24. B. pH 7.38, Pao2 95, Paco2 40, HCO3 22. C. pH 7.46, Pao2 85, Paco2 30, HCO3 26. D. pH 7.30, Pao2 90, Paco2 30, HCO3 18.

D. pH 7.30, Pao2 90, Paco2 30, HCO3 18. This ABG indicates metabolic acidosis, which is expected in a client diagnosed with diabetic ketoacidosis.

Anti diabetic drugs are designed to control signs and symptoms of diabetes mellitus. the nurse primarily expects a decrease in which?a. blood glucose b. fat metabolism c. glycogen storage d. protein mobilization

a

a nurse is teaching a patient how to recognize symptoms of hypoglycemia. which symptoms should be included in the teaching? (select all that apply) a. headache b. nervousness c. bradycardia d. sweating e. thirst f. sweet breath odor

a, b, d

a patient is to receive insulin before breakfast, and the time of breakfast tray delivery is variable. the nurse knows that which insulin should not be administered until the breakfast tray has arrived and the patient is ready to eat? a. NPH b. Lispro c. glargine d. regular

b

A patient is newly diagnosed with Type 1 diabetes mellitus and requires daily insulin injections. which instructions should the nurse include in the teaching of insulin administration? (select all that apply) a. teach family members how to administer glucagon by injection when the patient has a hyperglycemic reaction b. instruct the patient about the necessity for compliance with prescribed insulin therapy c. teach the patient that hypoglycemic reactions are more likely to occur at the onset of action time d. instruct the patient in the care and handling of the insulin container and syringe

b & d

A patient is prescribed Glipizide. the nurse knows that which side effects and adverse effects may be expected? (select all that apply) a. tachypnea b. tachycardia c. increased alertness d. increased weight gain e. visual disturbances f. hunger

b, e, & f

A patient is diagnosed with type 2 diabetes mellitus. the nurse is aware that which statement is true about this patient? a. the patient is most likely a teenager b. the patient is most likely a child younger than 10 years c. heredity and obesity are major causative factors d. viral infections contribute most to disease development

c