Exam 2- EAQ ?
which eye problem is the leading cause of blindness in clients with diabetes? a-cataracts b-glaucoma c-retinopathy d-astigmatism
c
a client who is 60 pounds more than the ideal body weight is admitted to the hospital with a diagnosis of T1DM. which concept would the nurse include in teaching about diabetes when discussing strategies to lose weight? a-obesity leads to insulin resistance b-surplus fat causes excretion of insulin c-fat cells absorb insulin and prevent its circulation to other cells d-lipids accumulate in the pancreas and interfere with insulin production
a
an adolescent with a history of type 1 diabetes is admitted in ketoacidosis. Which cause would the nurse suspect precipitating this episode? a-infection b-increased exercise c-recent weight loss d-overdose of insulin
a
the nurse is interviewing a client admitted for uncontrolled diabetes. The client had been binging on alcohol for the past 2 weeks. The client states. "I am worried about how I am going to pay my bills for my family while i am hospitalized." which statement by the nurse is therapeutic? a-you are worried about paying your bills b- don't worry; your bills will get paid eventually c- when was the last time you were admitted for hyperglycemia d-you really shouldn't be drinking alcohol because of your diagnosis of diabetes
a
which fasting plasma glucose level would indicate a client has prediabetes? a-70 mg/dL b-100 mg/dL c-130 mg/dL d-160 mg/dL
b
the nurse is assessing a client with diabetic ketoacidosis. which clinical manifestations would the nurse expect? SATA a-dry skin b-abdominal pain c-kussmaul respirations d-absence of ketones in the urine e- blood glucose level of less than 72 mg/dL (3.3 mmol/L)
a, b, c
the nurse suspects that a client has diabetes mellitus. Which statement made by the client helped the nurse reach this conclusion? SATA a-i am 65 years old b- i quite often feel thirsty c- i eat food every 2 hours d- i have excessive sweating e- i sometimes experience shortness of breath
a, b, c
the nurse is caring for the newborn of a mother with diabetes. For which signs of hypoglycemia would the nurse assess the newborn? SATA a-pallor b-irritability c-hypotenua d-ineffective suckling e-excessive birth weight
a, b, c, d
the nurse is formulating a teaching plan for a client recently diagnosed with T2DM. Which interventions would the nurse include to decrease the risk of complications? SATA a-examine the feet daily b-wear well fitting shoes c-perform regular exercise d-powder the feet after showering e-visit the HCP weekly f-test bathwater with the toes before bathing
a, b, c
which statement by a client with T2DM indicates to the nurse that additional dietary teaching is needed? a-i can eat as much dietetic food as i want b-i can have lettuce whenever I want it c- I know that half of my diet should be carbs d- i need to reduce the amounts of saturated fats in my diet
a
which statement would a nurse make about older adults and type 2 diabetes? a-older adults seldom develop ketoacidosis b-older adults secrete no endogenous insulin c-older adults have a lower risk of complications d-older adults develop a sudden onset of symtoms
a
a client with T1DM has an above the knee amputation because of severe lower extremity arterial disease. 2 days after surgery, which intervention is appropriate when preparing the client to eat dinner? a-checking the client's serum glucose level b- assisting the client out of bed into a chair c-placing the client int he high fowlers position d-ensuring the client's residual limb is elevated
a
a mother asks the neonatal nurse why her infant must be monitored so closely for hypoglycemia when her type 1 diabetes was in excellent control during the entire pregnancy. What is the best response? a-a healthy newborn's glucose level drop after birth, so we're being especially cautious with your baby because of your diabetes b-a newborn's pancreas produces an increased amount of insulin during the first day of birth, so were checking whether hypoglycemia has occurred c- babies of mothers with diabetes do not have large stores of glucose at birth, so its difficult for them to maintain the blood glucose level within an acceptable range d-babies of mothers with diabetes have a higher than average insulin level because of the excess glucose received from the mother during pregnancy, so the glucose level may drop.
d
for a pregnant client with T1DM, which action is most likely to reduce the risk of disease-related complications? a-monitor and control blood glucose levels b- limit pregnancy weight gain to an average of 25 pounds c- plan an elective cesarean section delivery d-attend all prenatal office visits
a
the nurse is teaching a client newly diagnosed with type 1 diabetes about self-care. Which is the PRIMARY long-term goal? a-maintaining normoglycemia b-complying with the diabetic diet c- adhering to an exercise program d-developing a nonstressful lifestyle
a
which factor contributes to a client's slow rate of healing? SATA a-diabetes b-cataract c-smoking d-dematitis e-alcohol abuse
a, c, e
Which manifestation would the nurse include when teaching a client about ketoacidosis? a-confusion b-hyperactivity c-excessive thirst d-fruity-scented breath e-decreased urinary output
a-confusion c-excessive thirst d-fruity-scented breath
which molecule excessively accumulates in the blood to precipitate the signs and symptoms associated with a diabetic coma? a-sodium bicarbonate, causing alkalosis b-ketones as a result of rapid fat breakdown, causing acidosis c-nitrogen from a protein catabolism, causing ammonia intoxication d-glucose from rapid carbohydrate metabolism, causing drowsiness
b
which unique response is associated with DKA that is not exhibited with HHKNS? a-fluid loss b- glycosuria c-kussmaul respirations d-increased blood glucose level
c
while obtaining a client's healthy history, which factor would the nurse identify as predisposing the client to T2DM? a-having diabetes insipidus b-eating low cholesterol foods c-being 20 pounds (9kg) overweight d-drinking a daily alcoholic beverage
c
a child with T2DM is scheduled for abdominal surgery. which factors are most important for the nurse to consider during post-operstive period? SATA a-infection will likely occur at the surgical site b-ketoacidosis frequently occurs later in the post-operative period c-the blood glucose level will increase bc of the stress of surgery d-urine test results are the most useful gauge of diabetic control after surgery e-diabetic control is usually maintained with insulin after surgery
c, e
which assessment finding would the nurse associate with a client with diabetic keoacidosis? select all that apply a-diaphoresis b-retinopathy c-acetone breath d-increased arterial bicarbonate level e-decreased arterial carbon dioxide level
c, e
which factors can predispose a client with type 1 diabetes to a diabetic ketoacidotic coma? a-taking too much insulin b-getting too much exercise c-excessive emotional stress d-running a fever with the flu e-eating fewer calories than prescribed
c-excessive emotional stress d-running a fever with the flu
a 15 year old adolescent is found to have type 1 diabetes. Which would the nurse include when teaching the adolescent about type 1 diabetes? a-it does not always require insulin b-it involves early vascular changes c-it occurs more often in obese adolescents d-it had a more rapid onset than does type 2
d
which laboratory results support the nurse's suspicion that a client diagnosed with T1DM is experiencing ketoacidosis? a-BG of 40/100, blood ph of 7.37 b-BG of 130/100, blood ph of 7.35 c-BG of 650/100, blood ph of 7.42 d-BG of 300/1--, blood ph of 7.20
d
which laboratory test would the nurse expect to be prescribed that will reveal the effectiveness of a diabetic regimen for a child with type 1 diabetes? a-sereum glucose b-glucose tolerance c-fasting blood sugar d-glycosylated hemoglobin
d
which finding would lead the nurser to recheck the blood glucose levels of a diabetic client before administering a mealtime insulin dose? SATA a-confusion b-drowsiness c-diaphoresis d-nervousness e-HR of 110 bpm
all of the above
a 15 year old adolescent with T1DM arrives at the diabetic outpatient clinic with a parent. the adolescent sits back in the chair with arms folded, frowns, and displays a withdrawn attitude. The adolescent and parent argue in front of the nurse. Which approach would be taken by the nurse? a-encouraging the adolescent to take more interest in and responsibility for treatment b-speaking separately with each of them, encouraging them to recognizing and vent their anger c-trying to persuade the 2 of them to work out their differences together before returning to the clinic d-asking the parent to stay in the waiting room while the adolescent meets with the clinic's staff members
b
which common cause of diabetic ketoacidosis would the nurse consider when caring for a postoperative client with diabetes? a-emotional stress b- presence of infection c-increased insulin dose d-inadequate food intake
b
a 14 year old adolescent with diabetes has been self administering insulin twice a day. this morning, the parents found their child lethargic and confused. lab testing reveals a hemoglobin a1c of 10% and a BG level of 200mg/dL. which occurrence would the nurse suspect as the cause of the client's condition? a-hypoglycemia b-somogyi effect c-uncontrolled blood glucose level d-noncompliance with the prescribed insulin regimen
c
an increase in which blood component is responsible for the acidosis related to untreated diabetes mellitus? a-ketones b-glucose c-lactic acid d-glutamic acid
a
a client's breath has a sweet, fruity odor. Which condition is affecting the client? a-gum disease b-uremic acidosis c-diabetic acidosis d-infection inside a cast
c
when obtaining the history of a client recently diagnosed with type 1 diabetes, which symptom would the nurse expect to see? a-edema b-anorexia c-weight loss d-hypoglycemic episodes
c
which laboratory value supports the presence of diabetic ketoacidosis in a client with type 1 diabetes? a-decreased sereum glucose levels b-decreased serum calcium levels c-increased blood urea nitrogen levels d-increased sereum bicarbonate levels
c
a client with T1DM has dry, hot, flushed skin; a fruity odor to the breath; and it having kussmual respirations. Which complication does the nurse suspect that the client is experiencing? a-ketoacidosis b-somogyi phenomenon c-hypoglycemic reaction d- hyperosmolar nonketotic coma
a
which cause of tremors, pallor, and diaphoresis, would be suspected in a client with type 1 diabetes? a-overeating b- viral infection c-aerobic exercise d-missed insulin dose
a
an obese client with T2DM asks about the intake of alcohol or special "dietetic" food in the diet. which instruction would be included in the teaching plan? a-alcohol can be consumed, with its calories counted in the diet b- unlimited amounts of sugar substitutes can be used as desired c- alcohol should not be used in cooking because it adds too many calories d- special "dietetic" foods are needed because many regular foods cannot be used
a
which laboratory values support the presence of diabetic keotacidosis? a-increased serum lipids b-decreaed hematocrit level c- increased serum calcium levels d-decreased blood uria nitrogen levels
a
the nurse is monitoring the newborn of a diabetic mother for tremors, periods of apnea, cyanosis, and poor suckling ability. With which complication are these manifestations associated? a-hypoglycemeia b-hypercalcemia c-central nervous system edema d-congenital depression of the islets of langerhans
a
which intervention would the nurse prioritize when planning a teaching program for a child who was recently diagnosed with T1DM a-exploring the child's feelings about diabetes b-explaining how to calculate carbohydrate intake c-ensuring that the child learns to monitor BG d- helping the child practice administering insulin injections
a
the nurse plans to teach a 9 year old boy with a learning disability about his diabetes, the parent intervenes and states, "that won't be necessary. with his learning issues, i recognize that he can't care for himself." which is the best response by the nurse? a-then i will teach you what he needs to have done b-he seems bright enough to me. i think he can learn this c-including your son now will help him take on more of his own care in the future d-this material is not difficult. even a slow child can learn how to care for himself
c
which cellular process associated with T1DM results in increased client fatigue? a-increased metabolism at the cellular level b-increased glucose absorption from the intestine c-decreased production of insulin by the pancreas d-decreased glucose secretion into the renal tubules
c
the nurse is assessing a client admitted with diabetic ketoacidosis. which statement made by the client indicates a need for further education on sick day management? a-i will stop taking my insulin when i am ill bc i am not eating b-i will check my urine for ketones when my blood sugar is over 250 c- i will alternate drinking gatorade and water throughout the day while ill d- i will continue all my insulin including my glargine when i a, sick
a
the nurse is in the process of discharging a 9 year old boy with recently diagnosed T1DM. Which parental statement would indicate potential issue in future family dynamics? a-we know that our child is special, so we'll go easy on the discipline b-well have to encourage our son to do as much for himself c-our whole family, including our child, is in for a lot of ups and downs over the years d- we hope our son can still be in the boy scouts and play baseball
a
which education would the nurse provide the parents of a child with type 1 diabetes who ask why they should test the child's urine for ketones during periods of stress or illness, even though blood glucose testing is being done 4x a day? a-urine should be tested for ketones during illness and when blood glucose level is increased b-blood glucose testing before meals and at bedtime may be stopped once the child is stabilized on insulin c-urine testing remains the most accurate way to check for a high glucose level if double-voided specimens are used d- the short term glucose level is more accurately reflected in a urine specimen than in a blood specimen, especially in children
a
which is the priority concern of a 10 year old child who was recently diagnosed with type 2 diabetes? a-how much school might be missed b-whether the diabetes can be controlled c-how a parent will react to the diagnosis d-whether having diabetes means future sterility
a
which physiological changes would the nurse expect to find in a client with a 20-year history of type 2 diabetes? a-blurry, spotty, hazy vision b-arthritic changes in the hands c-hyperactive knee and ankle jerk reflexes d-dependent pallor of the feet and lower legs
a
which newborn would the nurse anticipate will experience hypoglycemia? SATA a-preterm infant b-infant with down syndromw c-small for gestational age infant d- large for gestational age infant e-appropriate for gestational age infant
a, c, d
which clinical finding supports the diagnosis of diabetic ketoacidosis (DKA)? a-nervousness and tachycardia b-erythema toxicum rash and pruritus c-diaphoresis and altered mental state d-deep respirations and fruity odor to the breath
d
which type of eye disorder will the nurse expect to read in the EMR of a client who has increased BP, severe myopia, and high BG levels? a-uveitis b-glaucoma c-corneal abrasions d-keratoconjunctivitis sicca
b
which intervention would the nurse complete first for the client found to have glucose in the urine? a-administering the oral fluids b-planning to teach the client about diabetes c-giving hypoglycemic meds d-reporting the finding to the primary health care provider
d
a client with type 1 diabetes for 25 years states, "i have been really bad for the past 15 years. I have not paid attention to my diet and have done very little to control my diabetes." Which common complications of diabetes might the nurse expect to identify when assessing this client? select all that apply a-leg ulcers b-loss of visual acuity c-thick, yellow toenails d-increased growth of body hair e-decreased sensation in the feet
a, b, c, e
a client's fasting plasma glucose levels are being evaluated. The nurse identifies that the client is considered to be diabetic if the ranges are within which range? a-40-60 b-80-99 c-100-125 d-126-140
d
which complication associated with type 1 diabetes should the nurse include in the teaching plan for the parent of a newly diagnosed child? a-obesity b-ketoacidosis c-resistance to treatment d-hypersensitivity to other medications
b
the primary health care provider prescribes daily fasting blood glucose levels for a client with diabetes mellitus. Which is the goal of fasting glucose levels for a client with diabetes mellitus? a-40-65 mg/dL (2.2-3.6 mmol/L) of blood b-70-105 mg/dl (3.9-5.8 mmol/L) of blood c-110-145 mg/dL (6.1-8 mmol/L) of blood d-150-175 mg/dL (8.3-9.7 mmol/L) of blood
b
which action would foster acceptance of the diabetic regimen by an adolescent with T1DM who is brought to the emergency department in ketoacidosis and admits to not adhering to the diabetic regimen? a-determine what the adolescent has been taught about diabetes b-encourage the adolescent to express feelings about having diabetes c-explain to the parents that it is their responsibility to demonstrate their acceptance d-provide the family with printed materials about the consequences of ineffectively controlled diabetes
b
which statement made by a diabetic client shows that dietary teaching by the nurse was effective? a-my diet should be rigidly controlled to avoid emergencies b-my diet can be planned around a wide variety of commonly used foods c-my diet is based on nutritional requirements that are the same for all people d-my diet must not include eating any combination dishes/processed foods
b
which child would the nurse recommend screening for T2DM during a local health screening, SATA a-a child who recently turned 10, has not yet entered puberty, and has no other risk factors b-7 year old boy, BMI in the 80th percentile, no other risk factors c-african american child, BMI in the 87th percentile, family history of diabetes d-9 year old hispanic child, BMI in the 90th percentile, no other risk factors e-white child, BMI in the 96th percentile, signs of insulin resistance
a, c, e
the regulation of type 1 diabetes in an 8 year old child is attained with a combination of therapeutic modalities in addition to the admin of insulin. Which modalities would the nurse include in the teaching plan? SATA a-dietary control b-regular exercise c-urine testing for glucose d-blood glucose monitoring e-use of oral hypoglycemic agents
a, b, d
a client is taught how to recognize signs of hypoglycemic reaction. Which symptoms identified by the client indicate to the nurse that the teaching was effective? select all that apply a-fatigue b-nausea c-weakness d-nervousness e-increased thirst f-increased perspiration
a, c, d, f
a client with diabetes mellitus complains of difficulty seeing. which factor would the nurse suspect as being the cause? a-lack of glucose in the retina b-the growth of a new retina blood vessels of "neurovascularization" c-inadequate glucose supply to rods and cones d-destructive effort and ketones on retinal metabolism
b
which responses would the nurse expect a client experiencing hypoglycemia to exhibit? SATA a- nausea b-palpitations c-tachycardia d-nervousness e-warm, dry skin f- increased respirations
b, c, d
the nurse is teaching a young adolescent with T2DM about nutritional needs. Which statement demonstrates that the adolescent understands what was taught a- i can have low-fat, low-cal candy bars b-regular soft drinks are better than diet ones c-its okay for me to eat one slice of pizza at a party d-my fasting blood sugar should be no higher than 150
c
which fluid shift will the nurse take into consideration when assessing a client with type 1 diabetes who is experiencing a fluid imbalance? a-intravascular to intestinal as a result of glycosuria b- extracellular to interstitial as a result of hypoproteinemia c-intracellular to intravascular as a result of hyperosmolarity d- intracellular to intravascular as a result of increased hydrostatic pressure
c
which initial response would the nurse make to a 67 year old male with T2DM who sadly confides in the nurse that he has been unable to have an erection for several years? a-at your age, sex isnt that important b-that is a natural occurrence at your age c-you sound upset about not being able to have an erection d- maybe its time for you to speak to your HCP about this
c
the nurse teaches a client with type 2 diabetes how to provide self-care to prevent infections of the feet. Which statement made by the client shows that teaching was effective? a-i should massage my feet and legs with oil and lotion b-i should apply heat intermittently to my feet and legs c-i should eat foods high in protein and carbohydrate kilocalories d-i should control my blood sugar with diet, exercise, and medication
d
when teaching a client with diabetes about monitoring for episodes of hypoglycemia, which symptom would the nurse including in the teaching plan? a-thirst b-nausea c-anorexia d-sweating
d
which is an appropriate teaching goal for a client who is newly diagnosed as having T2DM? a-to perform foot care weekly b-to administer insulin as prescribed c-to test urine for both sugar and acetone d-to identify symptoms of hypo/hyperglycemia
d
when determining the main difference between T1DM & T2DM, the nurse recognizes which clinical presentation about type 1? a-onset of the disease is slow b-excessive weight is a contributing factor c- complications are not present at the time of diagnosis d- treatment involves diet, exercise, and oral meds
c
which result would the nurse expect to find when assessing the laboratory values of a client with T2DM a- ketones in the blood but not in the urine b- glucose in the urine but not in the blood c-urine and blood positive for glucose and ketones d-urine negative for ketones and positive glucose in the blood
d
a student with type 1 diabetes asks the nurse which primary hormone causes the blood glucose level to rise. Which hormone would the nurse report? a-insulin b-glucagon c-epinephrine d-adrenocorticotropic hormone (ACTH)
b
the nurse teaching a prenatal class is asked why infants of diabetic mothers are larger than those born to women who do not have diabetes. On which information about pregnancy and diabetes would the nurse base the response? a-taking exogenous insulin stimulates fetal growth b-consuming more calories covers the insulin secreted by the fetus c-extra circulating glucose causes the fetus to acquire fatty deposits d-fetal weight gain increases from an excessive response of the pancreatic enzymes
c
