EVOLVE QUIZ ON DIABETES
A client newly diagnosed with type 1 diabetes receives information about insulin. The client states, "I hate shots. Why can't I take the insulin in pill form?" What is the nurse's best response? 1 "Your diabetic condition is too serious for oral insulin." 2 "Insulin is poorly absorbed and its action is erratic when taken by mouth." 3 "Insulin by mouth causes a high incidence of allergic and adverse reactions." 4 "Once your diabetes is controlled, your physician might consider oral insulin."
2 "Insulin is poorly absorbed and its action is erratic when taken by mouth."
The nurse provides education about signs and symptoms of hypoglycemia to a client with newly diagnosed type 1 diabetes. The nurse concludes that the teaching was effective when the client states, "I will drink orange juice and eat a slice of bread when I feel: 1 Nervous and weak." 2 Flushed and short of breath." 3 Thirsty and have a headache." 4 Nauseated and have abdominal cramps."
1 Nervous and weak."
A nurse is caring for a client recently diagnosed with type 1 diabetes. For what signs and symptoms of an insulin reaction should the nurse assess this client? (Select all that apply.) 1 Headache 2 Diaphoresis 3 Nervousness 4 Excessive thirst 5 Kussmaul respirations
1 Headache 2 Diaphoresis 3 Nervousness
A client with type 2 diabetes, who is taking an oral hypoglycemic agent, is to have a serum glucose test early in the morning. The client asks the nurse, "What do I have to do to prepare for this test?" Which statement by the nurse reflects accurate information? 1 "Eat your usual breakfast." 2 "Have clear liquids for breakfast." 3 "Take your medication before the test." 4 "Do not ingest anything before the test."
4 "Do not ingest anything before the test."
The nurse is caring for a client with a diagnosis of diabetic ketoacidosis. Which arterial blood gas results are associated with this diagnosis? 1 pH: 7.28; Pco2: 28; HCO3: 18 2 pH: 7.30; Pco2: 54; HCO3: 28 3 pH: 7.50; Pco2: 49; HCO3: 32 4 pH: 7.52; Pco2: 26; HCO3: 20
1 pH: 7.28; Pco2: 28; HCO3: 18
A nurse is caring for a client with a diagnosis of type 1 diabetes who has developed diabetic coma. Which element excessively accumulates in the blood to precipitate the signs and symptoms associated with this condition? 1 Sodium bicarbonate, causing alkalosis 2 Ketones as a result of rapid fat breakdown, causing acidosis 3 Nitrogen from protein catabolism, causing ammonia intoxication 4 Glucose from rapid carbohydrate metabolism, causing drowsiness
2 Ketones as a result of rapid fat breakdown, causing acidosis
A client with type 1 diabetes consistently has high glucose levels on awakening in the morning. What should the nurse instruct the client to do to differentiate between the Somogyi effect and the dawn phenomenon? 1 Eat a snack before going to bed. 2 Measure the blood glucose level between 2 AM and 4 AM. 3 Administer the prescribed bedtime insulin immediately before going to bed. 4 Identify whether symptoms experienced in the morning are associated with either hyperglycemia or hypoglycemia.
2 Measure the blood glucose level between 2 AM and 4 AM.
Which is the best advice the nurse can give regarding foot care to a client diagnosed with diabetes? 1 Remove corns on the feet 2 Wear shoes that are larger than the feet 3 Examine the feet weekly for potential sores 4 Wear synthetic fiber socks when exercising
4 Wear synthetic fiber socks when exercising
A nurse mixes a short-acting and an intermediate-acting insulin in the same syringe to administer to a client with diabetes. List the actions in the order the nurse should perform them. Incorrect 1. Don a pair of clean gloves. 2. Put air into the short-acting insulin vial. 3. Withdraw the prescribed amount of short-acting insulin. 4. Put air into the intermediate-acting insulin vial. 5. Withdraw the prescribed amount of intermediate-acting insulin.
4. Put air into the intermediate-acting insulin vial. 2. Put air into the short-acting insulin vial. 3. Withdraw the prescribed amount of short-acting insulin. 5. Withdraw the prescribed amount of intermediate-acting insulin. 1. Don a pair of clean gloves.
A client with diabetes asks the nurse whether the new forearm stick glucose monitor gives the same results as a fingerstick. What is the nurse's best response to this question? 1 "There is no difference between readings." 2 "These types of monitors are meant for children." 3 "Readings are on a different scale for each monitor." 4 "Faster readings can be obtained from a fingerstick."
1 "There is no difference between readings."
A health care provider prescribes 36 units of NPH insulin (Novolin N) and 12 units of regular insulin (Novolin R). The nurse plans to administer these drugs in one syringe. Identify the steps in this procedure in priority order. (Start with the number of the picture that represents the first step and end with the number by the picture that represents the last step.) (IMAGE QUESTION)!! 1 1, 3, 2, 4 2 1, 3, 4, 2 3 1, 2, 3, 4 4 1, 4, 2, 3
1 1, 3, 2, 4
A client with type 1 diabetes self-administers NPH insulin (Novolin N) every morning at 8:00 AM. The nurse concludes that the client understands the action of this insulin when the client says, "I should be alert for signs of hypoglycemia between: 1 12 PM and 8 PM." 2 10 AM and 1 PM." 3 10 PM and midnight." 4 8:30 AM and 9:30 AM."
1 12 PM and 8 PM."
A nurse is caring for a client who has a 20-year history of type 2 diabetes. The nurse should assess for what physiological changes that are associated with a long history of diabetes? 1 Blurry, spotty, or hazy vision 2 Arthritic changes in the hands 3 Hyperactive knee and ankle jerk reflexes 4 Dependent pallor of the feet and lower legs
1 Blurry, spotty, or hazy vision
A client is admitted to the hospital with diabetic ketoacidosis. The nurse concludes that the client's elevated ketone level is caused by incomplete oxidation of which nutrient? 1 Fats 2 Protein 3 Potassium 4 Carbohydrates
1 Fats
A client with diabetes states, "I cannot eat big meals; I prefer to snack throughout the day." What information should the nurse include in a response to this client's statement? 1 Regulated food intake is basic to control. 2 Salt and sugar restriction is the main concern. 3 Small, frequent meals are better for digestion. 4 Large meals can contribute to a weight problem.
1 Regulated food intake is basic to control.
The nurse is counseling a client with type 1 diabetes about the client's favorite foods that are lowest in carbohydrates (CHO). The nurse determines that this concept is understood when the client chooses eight ounces of: 1 Skim milk 2 Apple juice 3 Nonfat yogurt 4 Fresh orange juice
1 Skim milk
Several hours after administering insulin, the nurse is assessing a client for an adverse response to the insulin. Which client responses are indicative of a hypoglycemic reaction? (Select all that apply.) 1 Confusion 2 Tremors 3 Anorexia 4 Glycosuria 5 Diaphoresis
1 Confusion 2 Tremors 5 Diaphoresis
A nurse is caring for a client who has had type 1 diabetes for 25 years. The client states, "I have been really bad for the last 15 years. I have not paid attention to my diet and have done little to control my diabetes." What signs of common complications of diabetes might the nurse expect to identify when assessing this client? (Select all that apply.) 1 Leg ulcers 2 Loss of visual acuity 3 Thick, yellow toenails 4 Increased growth of body hair 5 Decreased sensation in the feet
1 Leg ulcers 2 Loss of visual acuity 3 Thick, yellow toenails 5 Decreased sensation in the feet
A client is learning alternate site testing (AST) for glucose monitoring. Which client statement indicates to the nurse that additional teaching is necessary? 1 "I need to rub my forearm vigorously until warm before testing at this site." 2 "The fingertip is preferred for glucose monitoring if hyperglycemia is suspected." 3 "Alternate site testing is unsafe if I am experiencing a rapid change in glucose levels." 4 "I have to make sure that my current glucose monitor can be used at an alternative site."
2 "The fingertip is preferred for glucose monitoring if hyperglycemia is suspected."
A client with diabetes mellitus complains of difficulty seeing. The nurse concludes that the causative factor is: 1 Lack of glucose in the retina 2 Neovascularization of the retina 3 Inadequate glucose supply to rods and cones 4 Destructive effect of ketones on retinal metabolism
2 Neovascularization of the retina
A nurse is caring for a postoperative client who has diabetes. Which is the most common cause of diabetic ketoacidosis that the nurse needs to consider when caring for this client? 1 Emotional stress 2 Presence of infection 3 Increased insulin dose 4 Inadequate food intake
2 Presence of infection
The nurse is providing teaching to a client who recently has been diagnosed with type 1 diabetes. The nurse reinforces the importance of monitoring for ketoacidosis. What are the signs and symptoms of ketoacidosis? (Select all that apply.) 1 Decreased urinary output 2 Excessive thirst 3 Hyperactivity 4 Fruity-scented breath 5 Confusion
2 Excessive thirst 4 Fruity-scented breath 5 Confusion
The nurse is caring for a client with type 1 diabetes. For which signs or symptoms of insulin reaction should the nurse particularly be observant? (Select all that apply.) 1 Lethargy 2 Headache 3 Diaphoresis 4 Excessive thirst 5 Deep respirations
2 Headache 3 Diaphoresis 4 Excessive thirst
A client with type 1 diabetes self-administers Novolin N insulin every morning at 8 AM. The nurse evaluates that the client understands the action of the insulin when the client says, "I should be alert for signs of hypoglycemia between: 1 9 am and 10 am." 2 10 am and 11 am." 3 2 pm and 8 pm." 4 8 pm and 12 noon."
3 2 pm and 8 pm."
Four hours after surgery the blood glucose level of a client who has type 1 diabetes is elevated. The nurse can expect to: 1 Administer an oral hypoglycemic 2 Institute urine glucose monitoring 3 Give supplemental doses of regular insulin 4 Decrease the rate of the intravenous infusion
3 Give supplemental doses of regular insulin
A client has a glycosylated hemoglobin measurement of 6%. What should the nurse conclude about this client when planning a teaching plan based on the results of this laboratory test? 1 Is experiencing a rebound hyperglycemia 2 Needs the insulin changed to a different type 3 Has followed the treatment plan as prescribed 4 Requires further teaching regarding nutritional guidelines
3 Has followed the treatment plan as prescribed
A client newly diagnosed as having type 1 diabetes is taught to exercise on a regular basis primarily because exercise has been shown to: 1 Decrease insulin sensitivity 2 Stimulate glucagon production 3 Improve the cellular uptake of glucose 4 Reduce metabolic requirements for glucose
3 Improve the cellular uptake of glucose
Which insulin should the nurse prepare for the emergency treatment of ketoacidosis? 1 Glargine (Lantus) 2 NPH insulin (Novolin N) 3 Insulin aspart (NovoLog) 4 Insulin detemir (Levemir)
3 Insulin aspart (NovoLog)
A nurse is caring for a client with type 1 diabetes, and the health care provider prescribes one tube of glucose gel. What is the primary reason for the administration of glucose gel to this client? 1 Diabetic acidosis 2 Hyperinsulin secretion 3 Insulin-induced hypoglycemia 4 Idiosyncratic reactions to insulin
3 Insulin-induced hypoglycemia
The nurse is teaching a diabetic client about the advantages of using an insulin pump. What information should the nurse include? (Select all that apply.) 1 It prevents ketoacidosis 2 It helps cause weight loss 3 It can improve A1c levels 4 An insulin pump costs less than subcutaneous injections 5 Clients can exercise without eating more carbohydrates
3 It can improve A1c levels 5 Clients can exercise without eating more carbohydrates
A client is taught how to recognize indications of a hypoglycemic reaction. Which signs and symptoms identified by the client indicate to the nurse that the teaching was effective? (Select all that apply.) 1 Fatigue 2 Nausea 3 Weakness 4 Nervousness 5 Increased thirst 6 Increased perspiration
3 Weakness 4 Nervousness 6 Increased perspiration
A client with diabetes is being taught to self-administer a subcutaneous injection of insulin. Identify the preferred site for the self-administration of this drug. 1. A 2. B 3. C 4. D
3. C
A client with type 2 diabetes is taking one oral hypoglycemic tablet daily. The client asks whether an extra pill should be taken before exercise. The best response by the nurse is: 1 "You will need to decrease your exercise." 2 "An extra pill will help your body use glucose correctly." 3 "When taking medicine, your diet will not be affected by exercise." 4 "No, but you should observe for signs of hypoglycemia while exercising."
4 "No, but you should observe for signs of hypoglycemia while exercising."
A urine specimen is needed to test for the presence of ketones in a client who is diabetic. What should the nurse do when collecting this specimen from a urinary retention catheter? 1 Disconnect the catheter and drain the urine into a clean container. 2 Clean the drainage valve and remove the urine from the catheter bag. 3 Wipe the catheter with alcohol and drain the urine into a sterile test tube. 4 Clamp the catheter, cleanse the port, and use a sterile syringe to remove urine.
4 Clamp the catheter, cleanse the port, and use a sterile syringe to remove urine.
A nurse teaches a client with type 2 diabetes how to provide self-care to prevent infections of the feet. The nurse evaluates that the teaching was effective when the client says, "I should: 1 Massage my feet and legs with oil or lotion." 2 Apply heat intermittently to my feet and legs." 3 Eat foods high in protein and carbohydrate kilocalories." 4 Control my blood glucose with diet, exercise, and medication."
4 Control my blood glucose with diet, exercise, and medication."
A nurse administers a tube of glucose gel to a client who is hypoglycemic. What should the nurse consider about this reversal of hypoglycemia? 1 It liberates glucose from hepatic stores of glycogen. 2 Insulin action is blocked as it competes for tissue sites. 3 Glycogen is supplied to the brain as well as other vital organs. 4 It provides a glucose substitute for rapid replacement of deficits.
4 It provides a glucose substitute for rapid replacement of deficits.
A client with type 2 diabetes develops gout, and allopurinol (Zyloprim) is prescribed. The client is also taking metformin (Glucophage) and an over-the-counter nonsteroidal anti-inflammatory drug (NSAID). When teaching about the administration of allopurinol, what should the nurse instruct the client to do? 1 Decrease the daily dose of NSAIDs. 2 Limit fluid intake to one quart a day. 3 Take the medication on an empty stomach. 4 Monitor blood glucose levels more frequently.
4 Monitor blood glucose levels more frequently.
A client tells the nurse during the admission history that an oral hypoglycemic agent is taken daily. For which condition does the nurse conclude that an oral hypoglycemic agent may be prescribed by the health care provider? 1 Ketosis 2 Obesity 3 Type 1 diabetes 4 Reduced insulin production
4 Reduced insulin production
A nurse is caring for a client with type 1 diabetes who developed ketoacidosis. Which laboratory value supports the presence of diabetic ketoacidosis? 1 Increased serum lipids 2 Decreased hematocrit level 3 Increased serum calcium levels 4 Decreased blood urea nitrogen level
1 Increased serum lipids
A nurse is caring for several clients with type 1 diabetes, and they each have a prescription for a specific type of insulin. Which insulin does the nurse conclude has the fastest onset of action? 1 Insulin lispro (Humalog) 2 Insulin glargine (Lantus) 3 NPH insulin (Novolin N) 4 Regular insulin (Novolin R)
1 Insulin lispro (Humalog)
The nurse provides a list of appropriate food choices to a client with newly diagnosed diabetes. The client reviews the list and says, "I do not like and refuse to eat asparagus, broccoli, and mushrooms." In response, the nurse teaches the client about the food exchange list. The nurse evaluates that the teaching is understood when the client states, "Instead of asparagus, broccoli, and mushrooms, I can eat: 1 String beans, beets, or carrots." 2 Corn, lima beans, or dried peas." 3 Baked beans, potatoes, or parsnips." 4 Corn muffins, corn chips, or pretzels."
1 String beans, beets, or carrots."
A nurse is assessing a client with diabetic ketoacidosis. Which clinical manifestations should the nurse expect? (Select all that apply.) 1 Dry skin 2 Abdominal pain 3 Kussmaul respirations 4 Absence of ketones in the urine 5 Blood glucose level of less than 100 mg/dL
1 Dry skin 2 Abdominal pain 3 Kussmaul respirations
A nurse is formulating a teaching plan for a client recently diagnosed with type 2 diabetes. What interventions should the nurse include that will decrease the risk of complications? (Select all that apply.) 1 Examining the feet daily 2 Wearing well-fitting shoes 3 Performing regular exercise 4 Powdering the feet after showering 5 Visiting the health care provider weekly 6 Testing bathwater with the toes before bathing
1 Examining the feet daily 2 Wearing well-fitting shoes 3 Performing regular exercise
A client who has acromegaly and insulin-dependent diabetes undergoes a hypophysectomy. The nurse identifies that further teaching about the hypophysectomy is necessary when the client states, "I know I will: 1 Be sterile for the rest of my life." 2 Require larger doses of insulin than I did preoperatively." 3 Have to take cortisone or a similar drug for the rest of my life." 4 Have to take thyroxine or a similar medication for the rest of my life."
2 Require larger doses of insulin than I did preoperatively."
While a nurse is teaching a client with diabetes about food choices, the client states, "I do not like broccoli." The nurse suggests that a food that can be substituted for the broccoli is: 1 Peas 2 Corn 3 Green beans 4 Mashed potato
3 Green beans
A nurse is caring for a client admitted to the hospital for diabetic ketoacidosis. Which clinical findings related to this event should the nurse document in the client's clinical record? (Select all that apply.) 1 Sweating 2 Retinopathy 3 Acetone breath 4 Increased arterial bicarbonate level 5 Decreased arterial carbon dioxide level
3 Acetone breath 5 Decreased arterial carbon dioxide level
A client with untreated type 1 diabetes mellitus may lapse into a coma because of acidosis. An increase in which component in the blood is a direct cause of this type of acidosis? 1 Ketones 2 Glucose 3 Lactic acid 4 Glutamic acid
1 Ketones
A nurse is preparing to administer insulin to a client with diabetes. In which order should the nurse perform the actions associated with insulin administration? 1. Wash hands with soap and water 2. Wipe the top of the insulin vial with an alcohol swab 3. Instill air into the vial of insulin equal to the desired dose 4. Rotate the vial of insulin between the palms of the hands 5. Withdraw the correct amount of insulin from the inverted vial
1. Wash hands with soap and water Incorrect 4. Rotate the vial of insulin between the palms of the hands Correct 2. Wipe the top of the insulin vial with an alcohol swab Incorrect 3. Instill air into the vial of insulin equal to the desired dose Incorrect 5. Withdraw the correct amount of insulin from the inverted vial
client newly diagnosed with type 2 diabetes is receiving glyburide (Micronase) and asks the nurse how this drug works. The nurse explains that glyburide: 1 Stimulates the pancreas to produce insulin 2 Accelerates the liver's release of stored glycogen 3 Increases glucose transport across the cell membrane 4 Lowers blood glucose in the absence of pancreatic function
1 Stimulates the pancreas to produce insulin
A nurse concludes that a client has a hypoglycemic reaction to insulin. Which clinical findings support this conclusion? (Select all that apply.) 1 Irritability 2 Glycosuria 3 Dry, hot skin 4 Heart palpitations 5 Fruity odor of breath
1 Irritability 4 Heart palpitations
A client has a hypoglycemic reaction to insulin. Which client responses should the nurse document as clinical manifestations of hypoglycemia? (Select all that apply.) 1 Pallor 2 Tremors 3 Glycosuria 4 Acetonuria 5 Diaphoresis
1 Pallor 2 Tremors 5 Diaphoresis
A nurse is caring for a client newly diagnosed with type 1 diabetes. When the health care provider tries to regulate this client's insulin regimen, the client experiences episodes of hypoglycemia and hyperglycemia, and 15 g of a simple sugar is prescribed. What is the reason this is administered when a client experiences hypoglycemia? 1 Inhibits glycogenesis 2 Stimulates release of insulin 3 Increases blood glucose levels 4 Provides more storage of glucose
3 Increases blood glucose levels
A nurse is assessing a client experiencing a diabetic coma. What unique response associated with diabetic coma that is not exhibited with hyperglycemic hyperosmolar nonketotic syndrome (HHNS) should the nurse identify when assessing this client? 1 Fluid loss 2 Glycosuria 3 Kussmaul respirations 4 Increased blood glucose level
3 Kussmaul respirations
When obtaining the history of a client recently diagnosed with type 1 diabetes, the nurse expects to identify the presence of: 1 Edema 2 Anorexia 3 Weight loss 4 Hypoglycemic episodes
3 Weight loss
A nurse identifies that the client is experiencing a hypoglycemic reaction. Which nursing intervention should the nurse implement to relieve the symptoms associated with this reaction? 1 Giving 4 oz of fruit juice 2 Administering 5% dextrose solution intravenously (IV) 3 Withholding a subsequent dose of insulin 4 Providing a snack of cheese and dry crackers
1 Giving 4 oz of fruit juice
A client with diabetes asks how exercise will affect insulin and dietary needs. The nurse should respond, "Exercise: 1 Increases the need for carbohydrates and decreases the need for insulin." 2 Increases the need for insulin and increases the need for carbohydrates." 3 Decreases the need for insulin and decreases the need for carbohydrates." 4 Decreases the need for carbohydrates but does not affect the need for insulin."
1 Increases the need for carbohydrates and decreases the need for insulin."
A client is admitted to the hospital with a diagnosis of diabetic ketoacidosis. What is the initial intervention that the nurse should expect the health care provider to prescribe for this client? 1 Intravenous (IV) fluids 2 Potassium 3 NPH insulin (Novolin N) 4 Sodium polystyrene sulfonate (Kayexalate)
1 Intravenous (IV) fluids
A client who is 60 pounds more than the ideal body weight is admitted to the hospital with a diagnosis of type 1 diabetes. Which concept should the nurse include in teaching about diabetes when discussing strategies to lose weight? 1 Obesity leads to insulin resistance 2 Surplus fat causes excretion of insulin 3 Fat cells absorb insulin and prevent its circulation to other cells 4 Lipids accumulate in the pancreas and interfere with insulin production
1 Obesity leads to insulin resistance
A nurse is caring for a client who is receiving total parenteral nutrition. Which responses indicate that the client is experiencing hyperglycemia? (Select all that apply.) 1 Polyuria 2 Polydipsia 3 Paralytic ileus 4 Serum glucose of 105 mg/dL 5 Respiratory rate of 16 breaths per minute
1 Polyuria 2 Polydipsia
The nurse provides education related to manifestations of hyperglycemia to a client with type 1 diabetes. Which signs and symptoms identified by the client indicate that the teaching was effective? (Select all that apply.) 1 Thirst 2 Headache 3 Nervousness 4 Fruity breath odor 5 Excessive urination
1 Thirst 4 Fruity breath odor 5 Excessive urination
A client who has type 1 diabetes is admitted to the hospital for major surgery. Before surgery the client's insulin requirements are elevated but well controlled. Postoperatively, the nurse anticipates that the client's insulin requirements will: 1 Decrease 2 Fluctuate 3 Increase sharply 4 Remain elevated
4 Remain elevated
A nurse working in the diabetes clinic is evaluating a client's success with managing the medical regimen. Which is the best indication that a client with type 1 diabetes is successfully managing the disease? 1 Reduction in excess body weight 2 Stabilization of the serum glucose 3 Demonstrated knowledge of the disease 4 Adherence to the prescription for insulin
2 Stabilization of the serum glucose
A nurse evaluates that a client with diabetes understands the teaching about the treatment of hypoglycemia when the client says, "If I become hypoglycemic I initially should eat: 1 Fruit juice and a lollipop. 2 Sugar and a slice of bread. 3 Chocolate candy and a banana. 4 Peanut butter crackers and a glass of milk
2 Sugar and a slice of bread.
An obese client must self-administer insulin at home. The nurse should teach the client to use what technique? 1 Pinch the tissue and inject at a 45-degree angle 2 Pinch the tissue and inject at a 60-degree angle 3 Spread the tissue and inject at a 45-degree angle 4 Spread the tissue and inject at a 90-degree angle
4 Spread the tissue and inject at a 90-degree angle
Which clinical indicator should the nurse identify as expected for a client with type 2 diabetes? 1 Ketones in the blood but not in the urine. 2 Glucose in the urine but not hyperglycemia. 3 Urine negative for ketones and hyperglycemia. 4 Blood and urine positive for both glucose and ketones
3 Urine negative for ketones and hyperglycemia.
A nurse is collecting information about a client who has type 1 diabetes and is being admitted because of diabetic ketoacidotic coma. Which factors can predispose a client to this condition? (Select all that apply.) 1 Taking too much insulin 2 Getting too much exercise 3 Excessive emotional stress 4 Running a fever with the flu 5 Eating fewer calories than prescribed
3 Excessive emotional stress 4 Running a fever with the flu
A client who was diagnosed recently with type 1 diabetes states, "I feel bad. I don't think I even want to go home. My spouse doesn't care about my diabetes." What is the most appropriate nursing response? 1 "What can I do to make you feel better?" 2 "It seems that you don't get along with your spouse." 3 "It's probably temporary. Your spouse needs more time to adjust." 4 "You are unhappy. Have you tried to talk with your spouse?"
4 "You are unhappy. Have you tried to talk with your spouse?"
A nurse is planning to teach facts about hyperglycemia to a client with the diagnosis of diabetes. What information should the nurse include in the discussion about what causes diabetic acidosis? 1 Breakdown of fat stores for energy 2 Ingestion of too many highly acidic foods 3 Excessive secretion of endogenous insulin 4 Increased amounts of cholesterol in the extracellular compartment
1 Breakdown of fat stores for energy
The nurse develops a teaching plan for a client with diabetes who has been diagnosed with lower extremity arterial disease (LEAD). The nurse includes measures to increase arterial blood flow to the extremities, including: 1 Exercises that promote muscular activity 2 Meticulous care of minor skin breakdown 3 Elevation of the legs above the level of the heart 4 Soaking the feet in hot water each day
1 Exercises that promote muscular activity
A client with type 1 diabetes is transported via ambulance to the emergency department of the hospital. The client has dry, hot, flushed skin and a fruity odor to the breath and is having Kussmaul respirations. Which complication does the nurse suspect that the client is experiencing? 1 Ketoacidosis 2 Somogyi phenomenon 3 Hypoglycemic reaction 4 Hyperosmolar nonketotic coma
1 Ketoacidosis
A nurse is assessing a client with a diagnosis of diabetes insipidus. For which signs indicative of diabetes insipidus should the nurse assess the client? (Select all that apply.) 1 Excessive thirst 2 Increased blood glucose 3 Dry mucous membranes 4 Increased blood pressure 5 Decreased serum osmolarity 6 Decreased urine specific gravity
1 Excessive thirst 3 Dry mucous membranes 6 Decreased urine specific gravity
A client is diagnosed with diabetic ketoacidosis. Which insulin should the nurse expect the health care provider to prescribe? 1 Insulin lispro (Humalog) 2 Insulin glargine (Lantus) 3 NPH insulin (Novolin N) 4 Regular insulin (Novolin R)
4 Regular insulin (Novolin R)
A client with history of multiple chronic illnesses comes to the emergency department (ED) complaining of a small progressive weight loss over the last month and feeling lethargic and thirsty all the time. The client's fasting blood glucose is 180 mg/dL and vital signs are blood pressure (BP) 118/78 mm Hg, oral temperature 99.6º F, pulse 72 beats per minute and regular, and respirations 22 breaths per minute and irregular. The nurse reviews the assessment findings and the client's medical record. What condition does the nurse conclude the client is experiencing? (IMAGE QUESTION)!! 1 Hypervolemia 2 Hyperglycemia 3 Infectious process 4 Respiratory distress
2 Hyperglycemia
A nurse is assessing a client and suspects diabetic ketoacidosis (DKA). What clinical findings support this conclusion? 1 Nervousness and tachycardia 2 Erythema toxicum rash and pruritus 3 Diaphoresis and altered mental state 4 Deep respirations and fruity odor to the breath
4 Deep respirations and fruity odor to the breath
A client with type 1 diabetes comes to the clinic because of concerns regarding erratic control of blood glucose with the prescribed insulin therapy. The client has been experiencing a sudden fall in the blood glucose level, followed by a sudden episode of hyperglycemia. Which complication of insulin therapy should the nurse conclude that the client is experiencing? 1 Somogyi effect 2 Dawn phenomenon 3 Diabetic ketoacidosis 4 Hyperosmolar nonketotic syndrome
1 Somogyi effect
A client newly diagnosed with type 2 diabetes is receiving glyburide (Micronase) and asks the nurse how this drug works. The nurse explains that glyburide: 1 Stimulates the pancreas to produce insulin 2 Accelerates the liver's release of stored glycogen 3 Increases glucose transport across the cell membrane 4 Lowers blood glucose in the absence of pancreatic function
1 Stimulates the pancreas to produce insulin
A client with diabetes is given instructions about foot care. The nurse determines that the instructions are understood when the client states, "I will: 1 Cut my toenails before bathing." 2 Soak my feet daily for one hour." 3 Examine my feet using a mirror at least once a week." 4 Break in my new shoes over the course of several weeks.
4 Break in my new shoes over the course of several weeks.
A nurse is caring for a newly admitted client with a diagnosis of Cushing syndrome. Why should the nurse monitor this client for clinical indicators of diabetes mellitus? 1 Cortical hormones stimulate rapid weight loss. 2 Tissue catabolism results in a negative nitrogen balance. 3 Glucocorticoids accelerate the process of gluco-neogenesis. 4 Excessive adrenocorticotropic hormone (ACTH) secretion damages pancreatic tissue.
3 Glucocorticoids accelerate the process of gluco-neogenesis.
The nurse concludes that a client with type 1 diabetes is experiencing hypoglycemia. Which responses support this conclusion? (Select all that apply.) 1 Vomiting 2 Headache 3 Tachycardia 4 Cool clammy skin 5 Increased respirations
2 Headache 3 Tachycardia 4 Cool clammy skin
A nurse is assessing a client with a diagnosis of hypoglycemia. What clinical manifestations support this diagnosis? (Select all that apply.) 1 Thirst 2 Palpitations 3 Diaphoresis 4 Slurred speech 5 Hyperventilation
2 Palpitations 3 Diaphoresis 4 Slurred speech
A client with type 2 diabetes is admitted for elective surgery. The health care provider prescribes regular insulin even though oral antidiabetics were adequate before the client's hospitalization. The nurse concludes that regular insulin is needed because the: 1 Client will need a higher serum glucose level while on bed rest 2 Possibility of acidosis is greater when a client is on oral hypoglycemics 3 Dosage can be adjusted to changing needs during recovery from surgery 4 Stress of surgery may precipitate uncontrollable periods of hypoglycaemia
3 Dosage can be adjusted to changing needs during recovery from surgery
A nurse is caring for an alert client who has diabetes and is receiving an 1800-calorie American Diabetic Association diet. The client's blood glucose level is 60 mg/dL. The health care provider's protocol calls for treatment of hypoglycemia with 15 g of a simple carbohydrate. The nurse should: 1 Provide 12 ounces of non-diet soda 2 Give 25 mL dextrose 50% by slow intravenous (IV) push 3 Have the client drink 8 ounces of fruit juice 4 Ask the client to ingest one tube of glucose gel
4 Ask the client to ingest one tube of glucose gel
