Evolve - Management of Diabetes

The nurse is evaluating the teaching session on nutrition for the newly diagnosed diabetic patient. Which statement indicates an understanding of the teaching?

"When my blood sugar is less than 70 mg/dL, I will take 15 grams of a fast-acting carbohydrate, such as orange juice, and recheck in 15 minutes."

A patient with type 2 diabetes who takes metformin daily to manage blood sugar is scheduled for an intravenous pyelogram (IVP). Which question by the nurse is most important to ask the patient when preparing for the procedure?

"When was the last time you took your metformin?"

A patient with diabetes who takes long-acting and mealtime insulin calls the ambulatory center with complaints of an upper respiratory infection. The patient has a decreased appetite, fever, and cough. Which instructions should the nurse give the patient?

"Any illness can cause a hormone response that can result in hyperglycemia." "If you are sick, you should check your blood sugar every four hours, even if you are not eating regularly."

The nurse is teaching a patient with diabetes about proper dietary recommendations. The nurse determines that the patient understands the teaching when he or she makes which statement?

"I should have no more than 60 grams of carbohydrates in each meal."`

The nurse is caring for a patient in an outpatient diabetes clinic. Which statement by the patient indicates an understanding of the teaching?

"I will be sure to measure my finger stick blood glucose level four times a day, and more frequently when I am ill."

After a teaching session with the registered nurse, the newly diagnosed patient with type 1 diabetes mellitus is correct when he or she makes which statement? Multiple choice question

"I will need to be medicated with insulin for the rest of my life."

Which statement by a patient indicates an insufficient understanding of the prescribed medication metformin?

"I will take this medication when my blood sugar is greater than 200 mg/dL."

The nurse provides education to a patient with type 1 diabetes. Which statement made by the patient indicates a need for further instruction?

"I'll check my blood sugar level after every meal."

The nurse provides dietary instructions to a patient with type 1 diabetes mellitus. Which statement made by the patient indicates a need for further teaching? Multiple choice question

"If I go over my calories, I can just increase my insulin."

Which statement by the patient with diabetes mellitus indicates that further education regarding exercise is required?

"It is especially important that I exercise if my blood sugar is above 250 mg/dL and my urine is positive for ketones."

After discussing prevention of type 1 diabetes complications with the nurse, the patient is correct when making which statement?

"It is important that I take my blood pressure medication to help prevent kidney damage."

A patient prescribed metformin complains of an "upset stomach" after ingestion of the medication. The nurse asks a student nurse what suggestion he or she would make. What is the most appropriate suggestion by the student? Multiple choice question

"Take metformin with food to decrease gastrointestinal (GI) side effects."

The nurse has taught a patient who was admitted with diabetes, cellulitis, and osteomyelitis about the principles of foot care. The nurse determines that additional teaching is necessary when the patient makes which statement?

"Taking a hot bath every day will help with my circulation."

A nurse is caring for a patient on an inpatient unit with type I diabetes mellitus. The primary health care provider has ordered regular insulin to be administered. The nurse is preparing the medication for subcutaneous injection. The patient asks the nurse why the abdomen is the chosen site to inject the insulin. Which response by the nurse demonstrates an understanding of the choice of injection site?

"The abdomen is the preferred site for injection because the insulin will be absorbed faster there than at other sites."

The patient states, "I want my partner to be able to make medical decisions in the event that I cannot." How should the nurse respond? Multiple choice question

"You need to have a written durable power of attorney for health care."

A patient is prescribed lispro therapy. Related to meal times, the nurse should instruct the patient to administer the insulin when?

15 minutes after a meal

The patient with diabetes should consume fiber as part of a healthy diet. The current recommendation for persons with diabetes is Multiple choice question

25 to 30 g/day

A nurse is caring for a patient with diabetes mellitus who is in an inpatient unit. The primary health care provider has ordered regular insulin. The nurse is preparing the medication for subcutaneous injection. What is the most effective site for subcutaneous injection of insulin?

Abdomen

The nurse is teaching an insulin-dependent diabetic patient about the effects of exercise on blood glucose level. The American Diabetic Association (ADA) recommends moderate activity that expends 200-350 kcal/hr. When collaborating with the patient to develop a self-management plan, what examples of moderate activity does the nurse offer? . Multiple selection question

Bowling Dancing Walking briskly

A patient with type 2 diabetes has a urinary tract infection (UTI). The unlicensed assistive personnel (UAP) reported to the nurse that the patient's blood glucose is 642 mg/dL and the patient is hard to arouse. When the nurse assesses the urine, there are no ketones present. What collaborative care should the nurse expect for this patient?

Cardiac monitoring to detect potassium changes

A patient hospitalized with diabetes mellitus has become shaky, anxious, and diaphoretic. Which action should the nurse implement first? Multiple choice question

Check the blood glucose level.

A patient diagnosed with type 1 diabetes has had elevated blood sugar readings each morning for the past four days. Which intervention by the nurse should be performed initially?

Check the patient's blood sugar at 3 AM

The nurse is assisting a patient with newly diagnosed type 2 diabetes to learn dietary planning as part of the initial management of diabetes. The nurse would encourage the patient to limit intake of which foods to help reduce the percent of fat in the diet?

Cheese

The nurse is discussing a healthy eating plan for a patient with diabetes. What should the nurse include in the teaching about diabetes and diet?

Consume carbohydrates with alcohol.

A patient with type 2 diabetes mellitus (DM) is prescribed an oral hyperglycemic agent. The nurse provides the patient with a list of food items with a high glycemic index (GI). What should the nurse include on the list?

Cornflake cereal with regular milk and white bread sandwich with potato stuffing

The newly diagnosed patient with type 2 diabetes has been prescribed metformin. What should the nurse tell the patient to best explain how this medication works?

Decreases rate of hepatic glucose production; augments glucose uptake by tissues, especially muscles

To demonstrate an understanding of Somogyi effect, the nurse correctly identifies which defining characteristics?

Documented morning hyperglycemia May be avoided by consuming a bedtime snack Treatment is a lower dose of insulin in the evening Documented hypoglycemia between 2:00 AM and 4:00 AM

After admitting a patient with diabetic ketoacidosis (DKA) to the emergency department, which nursing intervention is a priority ?

Establish an intravenous (IV) access

A nurse caring for a patient with type 1 diabetes encourages the patient to exercise regularly as part of diabetes management. What precautions should the patient take when exercising?

Exercise after meals. Have a warm-up and cool-down period.. Carry glucose tablets or hard candies when exercising.

To determine how well a patient's diabetes mellitus has been controlled over the past two to three months, what assessment parameter should the nurse review?

Glycosylated hemoglobin

The nurse has been teaching a patient newly diagnosed with diabetes mellitus to test his or her own blood glucose level. During evaluation of his or her technique, the nurse determines that the teaching has been adequate when the patient performs which task? Multiple choice question

Hangs the arm in the dependent position for one minute before puncturing

A nurse is providing discharge teaching to a patient with a new diagnosis of type I diabetes mellitus who will need to give self-injections of insulin at home. What statement by the patient indicates to the nurse that the discharge teaching was effective? Multiple choice question

I need to rotate sites of injection to allow for better absorption of the insulin."

The nurse provides education to a patient with newly diagnosed type 1 diabetes mellitus. Which statement made by the patient indicates a need for further instruction?

If I skip breakfast, I can hold my insulin until noon."

The patient has a prescription for repaglandin. The nurse instructs the patient to take the medication at which time?

Immediately before meals

A patient with type 2 diabetes mellitus (DM) receives a prescription for metformin. The nurse identifies that which statement is characteristic of this medication?

It decreases hepatic glucose production.

One of the unlicensed assistive personnel (UAP) reports to the nurse that a patient with diabetes is slow to respond, pale, and diaphoretic. What is the nurse's priority intervention? Multiple choice question

Obtain a bedside glucose reading.

The nurse is monitoring a family caregiver who is learning to inject pramlintide prescribed for glucose control. The nurse should intervene when noting which caregiver action?

Preparing the injection site on the back of the arm with an alcohol wipe

A patient with type 1 diabetes mellitus reports feeling shaky and lightheaded. The patient's skin is pale and sweaty. The nurse should take what immediate action?

Providing the patient with a glucose tablet

The nurse is educating a diabetic patient about the use of premixed insulin neutral protamine hagedorn /regular 70/30. What should the nurse inform the patient about using this insulin?

Rotate the injection within one anatomic site for a week.

After administering glucagon to an unconscious patient, the nurse should place the patient in which position? Multiple choice question Supine Side-lying High-Fowler's Semi-Fowler's

Side-lying

A patient with type 2 diabetes takes oral hypoglycemics and is admitted to the hospital with a urinary tract infection (UTI). The patient asks why insulin injections have been prescribed. What explanation should the nurse provide?

The infection increases the glucose level, resulting in a need for more insulin.

The nurse is assessing a diabetic patient with complaints of night sweats, hyperglycemia, and headache on awakening. What should the nurse's assessment include? Multiple selection question

The variability in mealtime or insulin administration Measurement of bedtime and morning fasting blood glucose levels on several occasions Measurement of blood glucose levels between 2:00 and 4:00 AM on several occasions

The nurse is caring for a patient diagnosed with diabetes mellitus (DM) who has developed insulin resistance. Which class of glucose-lowering agents can reduce insulin resistance? Multiple choice question

Thiazolidinediones

Which class of drugs used to treat diabetes mellitus (DM) may be referred to as "insulin sensitizers"?

Thiazolidinediones

The nurse is evaluating the outcome of patient teaching regarding aspart insulin. The patient demonstrates an appropriate understanding when stating: Multiple choice question

"This insulin is used to treat the elevated sugar that occurs after meal intake."

The nurse is reviewing diabetic self-care management with a patient newly diagnosed with diabetes. The patient is in need of further education when stating to the nurse: Multiple choice question

"To toughen my skin so I do not get pressure sores, I should rub my feet down with rubbing alcohol after my bath."

A patient calls the health care provider's office at 8:00 AM and states, "I just experienced an episode of low blood sugar, which responded to oral glucose tablets." To help identify the cause of the low blood sugar, an appropriate question the nurse should ask is: Multiple choice question

"Were you more active than usual yesterday?"

The nurse is providing education to a patient that is diagnosed with diabetes mellitus (DM). What instructions are appropriate for the nurse to include in the teaching? Multiple selection question

"You should decrease your dietary sugar intake." "I will teach you how to self-administer your insulin." "You should monitor your blood sugar as prescribed."

The nurse observes a return demonstration by a patient who is learning how to mix regular insulin and NPH insulin in the same syringe. Which action by the patient indicates the need for further teaching?

Withdrawing the NPH insulin first