H356 Exam 4 Diabetes & Kahoot
Lantus insulin 250u in 250mL of 0.9% saline at 6 mL/hr. How many units/hr should you infuse? 60 units 0.6 units 6 units 0 units
0 units
The nurse is educating a group of children and their parents about risk factors for developing type 2 diabetes mellitus (DM). A parent asks the nurse to identify the most common age range for diagnosis. Which answer by the nurse is the most accurate? 10 to 19 years 16 to 18 years Birth to 2 years 3 to 9 years
10 to 19 years Children are at the greatest risk for diagnosis of type 2 diabetes mellitus between the ages of 10 to 19 years. The other age ranges are not the most accurate for the development of type 2 diabetes mellitus.
When should Glucotrol be administered? 30 min before meals 30 min after meals when a meal has been skipped only in an emergency, like DKA
30 min before meals
The nurse is caring for several clients diagnosed with diabetes mellitus. Which client would not require a sliding-scale insulin dose? A client who missed a meal A client who is under severe stress A client who receives parenteral nutrition A client who receives corticosteroids
A client who missed a meal The client who missed a meal will not require a sliding-scale insulin dose. Administering insulin to this client could cause hypoglycemia. The other clients would need a sliding-scale insulin dose, as parenteral nutrition, stress, and corticosteroids are all risk factors for hyperglycemia.
A nurse is presenting information to a group of clients about nutrition habits that prevent type 2 diabetes mellitus. Which of the following should the nurse include in the information? (Select all that apply.) A. Eat less meat and processed foods. B. Decrease intake of saturated fats. C. Increase daily fiber intake. D. Limit saturated fat intake to 15% of daily caloric intake. E. Include omega-3 fatty acids in the diet.
A. CORRECT: Healthy nutrition should include decreasing the consumption of meats and processed foods, which can prevent diabetes and hyperlipidemia. B. CORRECT: Healthy nutrition should include lowering LDL by decreasing intake of saturated fats, which can prevent diabetes and hyperlipidemia. C. CORRECT: Healthy nutrition should include increasing dietary fiber to control weight gain and decrease the risk of diabetes and hyperlipidemia. D. INCORRECT: The recommendation for saturated fat intake is no more than 7% of total daily caloric intake. E. CORRECT: Healthy nutrition should include omega-3 fatty acids for secondary prevention of diabetes and heart disease.
A nurse is teaching foot care to a client who has diabetes mellitus. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. Remove calluses using over-the-counter remedies. B. Apply lotion between toes. C. Perform nail care after bathing. D. Trim toenails straight across. E. Wear closed-toe shoes.
A. INCORRECT: A podiatrist should remove calluses or corns. Commercial over-the-counter remedies may increase the risk for tissue injury and an infection. B. INCORRECT: Applying lotion between the toes increases moisture for growth of micro-organisms, which can lead to infection. C. CORRECT: Perform nail care after bathing, when toenails are soft and easier to trim. D. CORRECT: Trim toenails straight across to prevent injury to soft tissue of the toes. E. CORRECT: Wear closed-toe shoes to prevent injury to soft tissue of the toes and feet.
A nurse is caring for a client who has blood glucose of 52 mg/dL. The client is lethargic but arousable. Which of the following actions should the nurse perform first? A. Recheck blood glucose in 15 min. B. Provide a carbohydrate and protein food. C. Provide 4 oz grape juice. D. Report findings to the provider.
A. INCORRECT: Blood glucose is rechecked in 15 min after a rapidly absorbed carbohydrate is ingested, but is not the priority nursing action. B. INCORRECT: A carbohydrate and protein food is given to the client if the next meal is more than 1 hr away after the blood glucose returns to a normal range. This is not the priority nursing action. C. CORRECT: The client's acute need for a rapidly absorbed carbohydrate, such as grape juice, takes priority when treating the blood glucose of 52 mg/dL. D. INCORRECT: Reporting the findings to the provider is not the priority action.
A nurse is preparing to administer a morning dose of aspart insulin (NovoLog) to a client who has type 1 diabetes mellitus. Which of the following is an appropriate action by the nurse? A. Check the client's blood glucose immediately after breakfast. B. Administer the insulin when breakfast arrives. C. Hold breakfast for 1 hr after insulin administration. D. Clarify the prescription because insulin should not be administered at this time.
A. INCORRECT: Blood glucose should be checked prior to insulin administration to prevent an episode of hypoglycemia. B. CORRECT: Administer aspart insulin when breakfast arrives to avoid a hypoglycemic episode. Aspart insulin is rapid-acting, and should be administered 5 to 10 min before breakfast. C. INCORRECT: Aspart insulin is rapid-acting and is administered 5 to 10 min before breakfast. Breakfast should be available at the time of the injection. D. INCORRECT: Aspart insulin is administered at breakfast time and may be prescribed for administration 2 to 3 times a day.
A nurse is preparing to administer the morning doses of glargine (Lantus) insulin and regular (Humulin R) insulin to a client who has a blood glucose of 278 mg/dL. Which of the following is an appropriate nursing action? A. Draw up the regular insulin and then the glargine insulin in the same syringe. B. Draw up the glargine insulin then the regular insulin in the same syringe. C. Draw up and administer regular and glargine insulin in separate syringes. D. Administer the regular insulin, wait 1 hr, and then administer the glargine insulin.
A. INCORRECT: These insulins are not compatible. They should not be drawn up in the same syringe. B. INCORRECT: These insulins are not compatible. They should not be drawn up in the same syringe. C. CORRECT: Administer each insulin as a separate injection. These insulins are not compatible and should not be drawn up in the same syringe. D. INCORRECT: These insulins should be administered at the same time. Regular insulin is short‑acting and should lower the blood glucose level in a short period of time. Glargine insulin is long‑acting and administered once a day
A nurse is providing discharge teaching to a client who experienced DKA. which of the following should the nurse include in teaching? (select all that apply) A. drink 3 L of fluids daily B. monitor blood glucose every 4hr when ill C. Admin insulin as prescribed when ill D. Notify the provider when blood glucose is 200 mg/dL E. Report ketones in the urine after 24 hr of illness
A. drink 3 L of fluids daily B. monitor blood glucose every 4hr when ill C. admin insulin as prescribed when ill E. report ketones in urine after 24 hr of illness Drinking 3L of fluids daily may prevent dehydration if client develops DKA. Blood glucose tends to increase during illness so monitor often. Illness often causes blood glucose to increase. admin regular doses of insulin. The provider should be notified if there are ketones in urine after 24 hr of illness notify the provider when blood glucose is greater than 240 mg/dL, not 200 mg/dL
A nurse is reviewing the health record of a client who has hyperglycemic-hyperosmolar state (HHS). Which of the following data confirms this diagnosis? (select all that apply) A. Evidence of recent MI B. BUN 35 mg/dL C. Takes a calcium channel blocker D. age 77 years old E. no insulin production
A. evidence of recent MI B. BUN 35 mg/dL C. takes a calcium channel blocker D. age 77 The client who has type 2 diabetes mellitus and had a MI is at risk for developing HHS. This is due to increased hormone production during illness or stress, which can stimulate the liver to produce glucose and decrease the effects of insulin The client who has type 2 diabetes mellitus may be at risk for developing HHS when the BUN is 35 mg/dL b/c it is an indication of decreased kidney function and inability of the kidney to filter high levels of blood glucose into the urine A calcium channel blocker is one of several meds that increase risk The older adult client is at risk for developing type 2 diabetes and may be unaware of associated symptoms, increasing risk for HHS
The nurse is caring for a child who is diagnosed with type 2 diabetes mellitus (DM). Which assessment finding specifically supports the diagnosis of type 2 DM vs type 1 DM? Polyuria Acanthosis nigricans Ketosis Blurred vision
Acanthosis nigricans Acanthosis nigricans, hyperpigmentation and thickening of the skin, is a clinical manifestation that occurs only in type 2 DM. Blurred vision, polyuria, and ketosis are more likely to occur in clients who have type 1 DM.
Place each nursing implementation in the correct column for each condition. Diabetic ketoacidosis (DK) or Hypoglycemia Administer an insulin infusion If blood glucose is less than 70 mg/dL, give glucose rapidly Reintroduce oral feedings when child is alert Teach parents signs and symptoms of condition and how to treat Administer subcutaneous insulin injections For the unconscious child, administer glucagon by injection Administer IV fluid boluses
Administer an insulin infusion- DK If blood glucose is less than 70 mg/dL, give glucose rapidly- hypoglycemia Reintroduce oral feedings when child is alert- DK Teach parents signs and symptoms of condition and how to treat- hypoglycemia Administer subcutaneous insulin injections- DK For the unconscious child, administer glucagon by injection- hypoglycemia Administer IV fluid boluses- DK
The school nurse is assessing a 10-year-old student diagnosed with type 1 diabetes mellitus. The student complains of symptoms of hypoglycemia, which is confirmed by a glucose level check. What should the nurse do for her until her mother comes for her? Administer glucose tablets Encourage vigorous physical activity Administer glucagon Administer an IV infusion of dextrose
Administer glucose tablets In a hospital setting, you might administer an intravenous (IV) infusion of dextrose. However, treatment in a clinic or school setting for a conscious child would involve administering glucose immediately from a low-fat carbohydrate snack or drink, sugar gel, glucose tablets, or glucose paste. Only if the child is unconscious would you administer glucagon. Vigorous physical activity is not appropriate for a child with hypoglycemia.
The nurse is planning care for a school-age client diagnosed with type 2 diabetes mellitus (DM). Which task will the nurse plan at the first annual visit for this child? Assess dietary needs Administer influenza vaccine Administer a psychosocial assessment Establish baseline hemoglobin A1C
Administer influenza vaccine During the first annual check-up for a child diagnosed with type 2 DM, the nurse would plan to administer an influenza vaccine per the plan of care. The nurse would draw labs to establish hemoglobin A1C and administer a psychosocial assessment during the initial visit after diagnosis. Assessing dietary needs would occur at the first quarterly visit after diagnosis.
Which substance, if mixed with an oral hypoglycemic agent, can cause profound hypoglycemia for adolescents diagnosed with diabetes mellitus? Glucose supplements Marijuana Alcohol Sports drink
Alcohol Profound hypoglycemia can occur when oral hypoglycemic agents are mixed with alcohol consumption. Adolescent clients should be educated not to consume alcohol in conjunction with this pharmacologic therapy for diabetes mellitus. Marijuana, glucose supplements, and sports drinks are not known to cause this reaction when mixed with oral hypoglycemic agents.
A nurse is doing discharge teaching with a client who has been newly diagnosed with diabetes mellitus type 2. Which statement from the client indicates the need for additional teaching? I need to be alert for infections. It is important to test my blood sugar at least four times a day. As long as I'm in my house I can walk barefoot. I need to stay hydrated during the day.
As long as I'm in my house I can walk barefoot Clients with diabetes should always wear shoes in order to protect their feet from injury. The client should be alert for infection or injuries; stay well hydrated; and test the blood sugar four times a day.
Greer Bell is a 59-year-old man who was admitted to the hospital with reports of chest pain, dyspnea, polyuria, polydipsia, and polyphagia. His glycosylated hemoglobin (A1C) is 9%. While the nurse is taking Mr. Bell's admission history, he mentions that his feet feel numb. Which would be the priority assessment for Mr. Bell? Inspecting the eyes for cataracts Assessing the feet for injury Palpating the liver for enlargement Assessing the location of both kidneys
Assessing the feet for injury Mr. Bell has an elevated A1C and symptoms consistent with diabetes mellitus. In addition, he is reporting symptoms of peripheral neuropathy. These put him at risk of developing foot ulcers. Liver disease is not an expected complication of diabetes mellitus. Although nephropathy and such retinopathy as cataractsare complications of diabetes mellitus, the client is currently not reporting symptoms suggestive of these conditions.
A nurse is reviewing laboratory reports of a client who has hyperglycemic-hyperosmolar state (HHS). Which of the following is an expected finding? A. Serum pH 7.2 B. Serum osmolarity 350 mOsm/L C. Serum potassium 3.8 mg/dL D. Serum creatinine 0.8 mg/dL
B. Serum Osmolarity 350 mOsm/L a client who has HHS would have a serum osmolarity greater than 320 mOsm/L pH of 7.2 is an indication of DKA. Potassium 3.8 is within expected reference range. A client who has HHS would have decreased potassium due to diuresis. Creatinine 0.8 is within range. A client who has HHS would have a level greater than 1.5 mg/dL
A nurse is assessing a client who has DKA and ketones in the urine. Which of the following are expected findings? (select all that apply) A. Weight gain B. fruity odor of breath C. Abdominal pain D. Kussmaul Respirations E. Metabolic acidosis
B. fruity odor of breath C. abdominal pain D. Kussmaul Respirations E. metabolic acidosis fruity odor of breath is a manifestation of elevated ketone levels. Abdominal pain is a GI manifestation of increased ketones and acidosis. Kussmaul respirations are an attempt to excrete carbon dioxide and acid when in metabolic acidosis. Metabolic acidosis is caused from glucose, protein, and fat breakdown, which produces ketones
What diagnostic tool is used to assess urinary retention? Urinalysis Specific Gravity Cystoscope Bladder scan
Bladder scan
A young client is admitted for lethargy and weight loss. Which clinical manifestation would the nurse suspect for a potential diagnosis of type 1 diabetes mellitus? (Select all that apply.) Blurred vision Weight gain Fever Polyuria Glucosuria
Blurred vision Polyuria Glucosuria Manifestations of type 1 diabetes mellitus are caused by the lack of insulin to transport glucose into the cells for energy. The resulting hyperglycemia leads to polyuria, glucosuria, and blurred vision. Polyuria occurs because water is drawn into the general circulation, increasing renal blood flow. Once the blood glucose exceeds the renal threshold, which is 180 mg/dl, glucose will spill into the urine. Blurred vision is caused by swelling of the lenses of the eyes in response to increased fluid volume. Clients with type 1 diabetes mellitus usually lose weight as proteins and fats are metabolized for energy and water is lost in the urine. In addition, clients with type 1 diabetes are frequently unable to develop a fever when cellular fuel stores are depleted because of a lack of insulin.
A nurse is preparing to administer IV fluids to a client who has DKA. Which of the following is an appropriate nursing action? A. admin an IV infusion of regular insulin at 0.3 U/kg/hr B. admin an IV infusion of .45% sodium chloride C. rapidly admin an IV infusion of 0.9% sodium chloride D. add glucose to the IV infusion when serum glucose is 350 mg/dL
C. rapidly admin an IV infusion of 0.9% sodium chloride The nurse should rapidly admin an IV infusion of 0.9% sodium chloride, an isotonic fluid, as prescribed to maintain blood perfusion to vital organs admin 0.1 unit/kg/hr, not 0.3. administration of 0.45% follows the isotonic fluid. Add glucose when levels are at 250 mg/dL, not 350
What type of renal stones are the most common, occurring in 60% of renal cases? Petosky stones Cystine stones Sodium stones Calculi stones
Calculi stones Lewis had the answer in class for this as cystine stones, but the book says cystine is the least common.
Gladys Lewis is a 48-year-old woman with a history of hypertension who is admitted to the hospital with an infected, poorly healing wound on her right ankle. She reports that she has been experiencing fatigue, blurred vision, polyuria, and polydipsia for the past month. Ms. Lewis has a body mass index (BMI) of 32 and a blood glucose level of 225 mg/dl, and her urine is negative for ketones. What does the nurse suspect may be happening to Ms. Lewis? Client is having a hypoglycemic reaction Client is experiencing diabetes insipidus Client is experiencing hyperglycemia Client has type 1 diabetes mellitus
Client is experiencing hyperglycemia Ms. Lewis's risk factors of hypertension and obesity, as well as her symptoms of fatigue, blurred vision, polyuria, and polydipsia, are consistent with hyperglycemia and probably type 2 diabetes. New-onset type 1 diabetes is typically seen in young children and adolescents and associated with ketonemia. Ms. Lewis's blood glucose is elevated, so she is not hypoglycemic. Diabetes insipidus is a condition that occurs when there is an insufficient amount of antidiuretic hormone and is not associated with hyperglycemia.
The nurse is caring for a pediatric client who is experiencing diabetic ketoacidosis (DKA). Which assessment finding indicates the need for the nurse to monitor this client for cardiac arrhythmias? Decreased potassium level Elevated blood glucose level Decreased albumin level Decreased urine output
Decreased potassium level A decreased potassium level (hypokalemia) can cause cardiac arrhythmias. Elevated blood glucose level, decreased albumin level, and decreased urine output do not cause cardiac arrhythmias.
Eight-year-old Holly Keaton has recently been diagnosed with type 1 diabetes mellitus. Her mother says she has missed some insulin doses recently. Holly has flushed ears and cheeks, and has been complaining of nausea and abdominal pain. Which condition is most urgent to rule out? Type 2 diabetes mellitus Diabetic ketoacidosis Acanthosis nigricans Hypoglycemia
Diabetic ketoacidosis Children with new onset type 1 diabetes mellitus (DM) are at greatest risk for developing diabetic ketoacidosis (DKA). DKA can be caused by missing insulin doses, incorrect administration of insulin, illness, trauma, or surgery. Some of the clinical manifestations of DKA are abdominal pain, nausea and vomiting, and flushed ears and cheeks. Type 2 DM is not a complication of type 1 DM; it has different causes and symptoms. Acanthosis nigricans (hyperpigmentation and thickening of the skin) is a symptom of type 2 DM.
The nurse is caring for a child diagnosed with type 1 diabetes mellitus (DM). The nurse educates the child and parents that insulin dosing is based on which item? Diet Urine output Weight Age
Diet Insulin dose is not based on weight, age, or urine output. Insulin dose is based on diet, specifically carbohydrate intake.
Diabetes mellitus is the leading cause of which complication? Encephalopathy End-stage renal disease Heart failure Coronary artery disease
End-stage renal disease Diabetes mellitus damages the microvascular circulation and is the leading cause of end-stage renal disease. Although diabetes mellitus is associated with coronary artery disease and heart failure, it is not the leading cause of these conditions. Diabetes mellitus is not associated with encephalopathy.
The nurse is taking a health history from a client who has diabetes mellitus. Which symptom reported by the client may indicate the development of complications? (Select all that apply.) Frequent voiding of urine Quick wound healing Vision changes Numbness in the feet Dizziness
Frequent voiding of urine Vision changes Numbness in the feet Dizziness Vision changes, dizziness, numbness in the feet, and frequent voiding of urine may indicate that the client has developed complications of diabetes mellitus (DM). Clients with diabetes frequently experience prolonged wound healing; therefore, a report of quick wound healing would not indicate that the client has developed a complication of DM.
Which of the following statements is correct? Gestational diabetes (GD) is triggered by a viral infection. GD occurs primarily in the 1st trimester. GD occurs primarily in women over 40. GD increases the risk of type II diabetes later in life.
GD increases the risk of type II diabetes later in life.
The school nurse is caring for a child who is experiencing hypoglycemia. The child is unconscious. What treatment options are most appropriate for this child? (Select all that apply.) Glucagon Low-fat carbohydrate snack Insulin injection Glucose tablets Sugar gel or paste
Glucagon Sugar gel or paste A low-fat carbohydrate snack is not appropriate for an unconscious child experiencing hypoglycemia. An insulin injection is given to treat hyperglycemia, not hypoglycemia. Glucose tablets are not appropriate for an unconscious child experiencing hypoglycemia. Glucagon is an appropriate treatment option for an unconscious child experiencing hypoglycemia in a school setting. Sugar gel or paste onto the gums is an appropriate treatment option for an unconscious child experiencing hypoglycemia in a school setting.
Which finding confirms a diagnosis of diabetes mellitus in children? Weight and height greater than 95th percentile for age HbA1C that is greater than or equal to 6.5% Blood pressure of 130/90 mmHg Fasting glucose less than or equal to 126 mg/dL
HbA1C that is greater than or equal to 6.5% An HbA1C that is greater than or equal to 6.5% is a diagnostic finding that confirms the diagnosis of diabetes mellitus in children. A fasting plasma glucose of 126 gm/dL or higher confirms the presence of diabetes. Weight, height, and blood pressure are not findings that support the diagnosis of diabetes mellitus in children.
The nurse is caring for a child who is diagnosed with type 2 diabetes mellitus (DM). The parents want to know how this happened to their child. Which items in this child's history will the nurse share with the parents as risk factors for developing this type of DM? (Select all that apply.) Active lifestyle High-fat diet Race Obesity Family history of DM
High-fat diet Race Obesity Family history of DM Obesity, a high-fat diet, a family history of DM, and race are risk factors for developing type 2 DM. An active lifestyle is not a risk factor for developing type 2 DM.
The nurse is caring for a child with type 1 diabetes mellitus (DM) who is experiencing hypoglycemia. In reviewing the child's history, what item most likely caused the hypoglycemia? Inaccurate insulin dose Lack of growth Too many calories Decreased exercise
Inaccurate insulin dose An inaccurate insulin dose, specifically a dose that is too large, can cause hypoglycemia. Too few calories, not too many calories, often cause hypoglycemia. Increased exercise without proper nutrition often causes hypoglycemia. Rapid growth spurts, not a lack of growth, often causes hypoglycemia.
Which is a pathophysiological feature of type 2 diabetes mellitus? (Select all that apply.) Complete insulin deficiency Inadequate insulin production Insulin resistance Ketone production Complete destruction of beta cells
Inadequate insulin production Insulin resistance Type 2 diabetes mellitus is associated with a reduction in insulin production by pancreatic beta cells along with cellular resistance to insulin. Although the pancreas produces some insulin, enough to keep the body from breaking down fats into ketones, there is not enough to keep the client's blood glucose level within normal limits. Type 1 diabetes results from an autoimmune process that destroys all pancreatic beta cells, resulting in a complete insulin deficiency. Clients with type 1 diabetes mellitus will start to break down free fatty acids and produce ketones if they do not receive insulin injections.
Which is a preventive measure to decrease the risk of developing type 2 diabetes mellitus during childhood? Gaining weight Increasing activity Receiving age appropriate immunizations Increasing high fat foods
Increasing activity A preventive measure to decrease the risk of developing type 2 diabetes mellitus during childhood is increasing activity. Other preventive measures include maintaining an appropriate BMI and decreasing high calorie foods. A high-fat diet is a risk factor for developing type 2 diabetes mellitus during childhood. While it is important to receive age-appropriate immunizations, this does not decrease the risk of developing type 2 diabetes mellitus.
A client is diagnosed with type 2 diabetes mellitus. Which information about type 2 diabetes mellitus should the nurse include when providing client education? Metabolism of dietary carbohydrates is enhanced. The onset of hyperglycemia is rapid. The liver suppresses the release of glucose. Insulin resistance occurs in peripheral tissues.
Insulin resistance occurs in peripheral tissues. Type 2 diabetes mellitus occurs as a result of impaired insulin resistance in peripheral tissues, so this information needs to be included in client education. The liver does not suppress glucose release in type 2 diabetes mellitus; the liver produces more glucose than normal with type 2 diabetes mellitus. The onset of hyperglycemia is not rapid in type 2 diabetes mellitus; hyperglycemia increases gradually and usually exists long before the diagnosis of type 2 diabetes mellitus. The metabolism of dietary carbohydrates is not enhanced in type 2 diabetes mellitus; dietary carbohydrates are poorly metabolized in type 2 diabetes mellitus.
The nurse is assisting a client with type 2 diabetes mellitus to plan to meet nutritional needs. Which general rules should the nurse include in the plan? (Select all that apply.) Intake of 20% protein and 10% fat Intake of 20% fat Intake of 10% protein 15 grams of carbohydrate for every 1 unit of regular insulin Intake of 45dash65% of carbohydrates
Intake of 20% protein and 10% fat 15 grams of carbohydrate for every 1 unit of regular insulin Intake of 45dash65% of carbohydrates The recommendations are 45dash65% carbohydrates, 20% protein, 10% fat, and 15 grams of carbohydrate for every 1 unit of regular insulin.
A client has questions about surgery to replace the need to take insulin several times a day. Which is a surgical intervention that can be considered for clients with diabetes mellitus? (Select all that apply.) Islet cell transplantation Removing the spleen Replacing a part of the liver Replacing pancreatic cells Replacing the pancreas
Islet cell transplantation Replacing pancreatic cells Replacing the pancreas Islet cell transplantation, replacing the pancreas, and replacing pancreatic cells are surgical interventions for clients with diabetes. Removing the spleen or transplanting the liver will not correct insulin production.
Which is a specific recommendation for exercise for a client with diabetes mellitus? (Select all that apply.) Keep the exercise brief and moderate Exercise no more than 60 minutes a week Exercise at least 150 minutes per week Stay hydrated during exercise Keep sessions short, as prolonged sessions cause hypoglycemia
Keep the exercise brief and moderate Exercise at least 150 minutes per week Stay hydrated during exercise Keep sessions short, as prolonged sessions cause hypoglycemia The recommendation is to exercise at least 150 minutes per week; to keep the exercise brief and moderate; and to stay hydrated during exercise to prevent hypoglycemia or hyperglycemia. Prolonged exercise can cause hypoglycemia.
A client with diabetes mellitus is being taught to monitor the blood glucose level. Which factor that affects accurate glucose monitoring should the nurse include in the instruction? (Select all that apply.) Low hematocrit level High hematocrit level WBC (white blood cell) count Overdose medications Creatinine level
Low hematocrit level High hematocrit level Overdose medications Factors that affect accurate glucose monitoring include medication overdoses, a low hematocrit level, and a high hematocrit level. The WBC count and creatinine levels do not affect accurate glucose monitoring.
Ten-year-old Jeffrey Brooks is diagnosed with type 2 diabetes mellitus. Which nursing intervention is not appropriate for you to complete during outpatient visits? Check HbA1C levels to determine average blood glucose over the past 3 months Emphasize the importance of annual evaluations to monitor for potential complications Assess height, weight, and BMI, and plot on appropriate growth curve for age and gender Monitor glucose and administer insulin injections daily
Monitor glucose and administer insulin injections daily Clients must learn to monitor glucose and administer insulin daily. If the client is unable to perform these tasks, the parents must do it for him. This is not an intervention that will be performed on a daily basis by the nurse in an outpatient clinic. For outpatient visits, you will assess height, weight, and body mass index (BMI), and plot on appropriate growth curve for age and gender; check HbA1C levels to determine average blood glucose over the past 3 months; and emphasize the importance of annual evaluations to monitor for potential complications.
Which therapy is involved in the treatment of a client with diabetes? (Select all that apply.) Daily weight checking Nutrition Medication Fluid restriction Exercise
Nutrition Medication Exercise Clients with diabetes are treated with exercise, nutrition, and medication. Fluid restriction and daily weight checking are not part of the treatment plan for clients with diabetes.
Which medication prescribed for urinary urgency and frequency? Furosemide Bumetanide Oxybutynin Bethanechol
Oxybutynin
The nurse is caring for a 70-year-old client admitted for possible type 2 diabetes mellitus. When obtaining the client's history, which conditions are potential indicators of diabetes mellitus in this older client? (Select all that apply.) Periodontal disease Hypertension Glaucoma Gastroparesis Impotence
Periodontal disease Glaucoma Gastroparesis Impotence Periodontal disease, gastroparesis, impotence, and glaucoma are potential indicators of diabetes mellitus in older clients. Orthostatic hypotension, not hypertension, is a condition that is a potential indicator of diabetes mellitus in older clients.
Which risk factor is associated with type 2 diabetes mellitus? (Select all that apply.) Physical inactivity Weight loss Blood pressure greater than or equals 130/85 mmHg HDL cholesterol greater than or equals 35 mg/dl Triglyceride level greater than or equals 250 mg/dl
Physical inactivity Blood pressure greater than or equals 130/85 mmHg Triglyceride level greater than or equals 250 mg/dl Metabolic syndrome is a constellation of risk factors that put the client at risk of type 2 diabetes mellitus and coronary artery disease. These risk factors include abdominal obesity, hypertension, triglyceridemia, low HDL cholesterol, and physical inactivity. Weight loss and normal HDL cholesterol levels do not put the client at risk of type 2 diabetes mellitus.
A client with diabetes mellitus is admitted to the medical unit for chronic complications. The nurse ensures that the client's room is free of clutter and has a night light, and checks the water temperature before bathing the client. Which potential problem do these interventions address when caring for this client? Risk of infection Risk of injury Acute pain Ineffective coping
Risk of injury These interventions address the potential problem of risk of injury. They do not address the potential problems of acute pain, ineffective coping, and risk of infection.
Which intervention is appropriate for a child, diagnosed with type 1 diabetes mellitus, who requires routine insulin administration? Administer by IM injection Provide glucose tablets of hyperglycemia Rotate injection sites Recommend a diet high in carbohydrates
Rotate injection sites An appropriate nursing intervention for a client diagnosed with type 1 diabetes mellitus, who requires routine insulin administration, is to rotate the injection sites. Insulin is administered by the subcutaneous route, not the intramuscular route. Glucose tablets are provided to treat hypoglycemia, not hyperglycemia. A high- carbohydrate diet is not appropriate for a client with type 1 diabetes mellitus
Which is a priority teaching point for the nurse to provide to a client with new-onset diabetes mellitus? There may be vascular changes in the upper extremities. Foot complications will arise when blood glucose levels are either too high or too low. Sense of touch and perception of pain may be absent. Complications may be caused by neuropathy.
Sense of touch and perception of pain may be absent. The priority is for the client to be aware that their feet and legs may have an altered perception of touch and pain, which can lead to injuries to the feet that are not noticed. There may be vascular changes to the lower though not the upper extremities; and neuropathy is common in poorly regulated clients with diabetes.
The nurse is planning care for a client with diabetes mellitus and addressing the potential problem of risk of infection. Which intervention will best assist in addressing this risk? Promoting smoking cessation. Instructing the client to have an oral examination yearly. Teaching the client to use lukewarm water and soap for foot and skin care. Monitoring sensation in extremities daily.
Teaching the client to use lukewarm water and soap for foot and skin care. Teaching the client good skin care by using lukewarm water and soap is an intervention that will address the potential problem of risk of infection. Instructing the client to have an oral examination yearly, promoting smoking cessation, and monitoring sensation in the extremities do not address the potential problem of risk of infection. The client should have an oral examination every 4 to 6 months.
The nurse is reviewing fasting serum blood glucose levels on several children on a pediatric medicaldashsurgical unit. For which child does the nurse expect to provide information about treatment options for type 1 diabetes mellitus (DM)? The child with a fasting blood glucose of 100 mg/dL The child with a fasting blood glucose of 120 mg/dL The child with a fasting blood glucose of 140 mg/dL The child with a fasting blood glucose of 80 mg/dL
The child with a fasting blood glucose of 140 mg/dL Fasting blood glucose levels of 80 mg/dL, 100 mg/dL, and 120 mg/dL are considered normal. A fasting blood glucose greater than or equal to 126 mg/dL would contribute to a diagnosis of type 1 DM. A child with a fasting blood glucose of 140 mg/dL meets this criterion.
The nurse is teaching a family about diabetic ketoacidosis (DKA). Which statement by the family indicates understanding of the symptoms that occur with DKA? Two separate glucose readings of greater than 400 mg/dL Four separate glucose readings greater than 200 mg/dL A single glucose reading of 400 mg/dL Three separate glucose readings greater than 200 mg/dL
Two separate glucose readings of greater than 400 mg/dL A single blood glucose reading does not indicate ketoacidosis. Two separate blood glucose readings of greater than 400 mg/dL would be an indicator of ketoacidosis. Three or four separate glucose readings greater than 200 mg/dL indicate the need for better management of blood glucose levels, but are not indicative of DKA.
Which 80 year old Asian male is most at risk for osteoporosis? Having a BMI >40% Smoking one pack a day for 50 years Only drinking skim milk for his entire life Using corticosteroids due to a chronic lung disorder.
Using corticosteroids due to a chronic lung disorder.
Which are risk factors for the development of type 1 diabetes mellitus in children? (Select all that apply.) Female gender High-fat diet Overweight Viral infection Genetic predisposition
Viral infection Genetic predisposition The risk factors associated with the development of type 1 diabetes mellitus in children include a genetic predisposition and viral infections. Being overweight, consuming a high-fat diet, and being female are risk factors for type 2 diabetes mellitus in children.
A post-menopausal patient is concerned about osteoporosis. Which patient teaching is a true statement? Weight-bearing exercise is helpful to prevent osteoporosis. Hormone replacement therapy should be initiated ASAP. You should first determine if you are at risk for osteoporosis. Post-menopause decline is too rapid for preventative meausres.
Weight-bearing exercise is helpful to prevent osteoporosis.
A teenager has Type I DM. What will help decrease his need for insulin? sleep exercise stress low carb diet
exercise
The nurse is caring for a child who is hospitalized for the treatment of diabetic ketoacidosis (DKA). The child's parents ask why their child is receiving potassium. What is the best answer for the nurse to provide to this child's parents? "Potassium is administered to treat hypokalemia." "Potassium is administered to treat cerebral edema." "Potassium is administered to treat acidosis." "Potassium is administered to decrease blood glucose levels."
"Potassium is administered to treat hypokalemia." Insulin, not potassium, is administered to decrease blood glucose levels. Potassium is not given to treat acidosis. Sodium bicarbonate would be administered to treat acidosis. Mannitol, not potassium, is administered to treat cerebral edema. Potassium is administered to treat hypokalemia.
Walter Wariner, an 82-year-old man, reports frequent bouts of nausea and indigestion. He tells the nurse that he has been experiencing numbness and tingling in his feet. Which is the best response by the nurse? "These may be symptoms of diabetes mellitus. You should have your blood sugar checked." "These are normal signs of aging. There is no need to worry." "These may be signs of renal failure. You should have your kidneys checked." "These may be signs of hypertension. You should have your blood pressure checked."
"These may be symptoms of diabetes mellitus. You should have your blood sugar checked." Frequent bouts of nausea and indigestion may be a symptom of gastroparesis. Numbness and tingling in the feet may indicate neuropathy. Both of these conditions are complications of diabetes mellitus. Therefore, Mr. Wariner should have his blood sugar checked to see whether it is elevated. Hypertension and renal failure typically do not result in the symptoms reported by Mr. Wariner. In addition, these symptoms are not a result of the normal aging process, so they should not be ignored.
The nurse is teaching a child with diabetes and her family about sick day guidelines. Which statement by the family indicates appropriate understanding of the material presented? "We will test for ketones when the blood glucose level is 200 mg/dL." "We will test for ketones when the blood glucose level is 220 mg/dL." "We will test for ketones when the blood glucose level is 160 mg/dL." "We will test for ketones when the blood glucose level is 180 mg/dL."
"We will test for ketones when the blood glucose level is 220 mg/dL." Blood glucose levels of 160 mg/dL, 180 mg/dL, and 200 mg/dL are elevated, but they would not require testing for ketones. Once the blood glucose level exceeds 200 mg/dL, the child and family should test the urine for ketones.
The nurse is educating a client newly diagnosed with type 1 diabetes mellitus. Which information should the nurse include in client education about the regular monitoring of glucose levels? Self-monitoring of blood glucose should occur three or four times a day. Urine testing is used only until glucose goals are achieved. Urine testing will assist in measuring hypoglycemia. Self-monitoring of blood glucose is painless and noninvasive.
Self-monitoring of blood glucose should occur three or four times a day. Self-monitoring of blood glucose should occur three or four times a day with type 1 diabetes mellitus. Urine testing will not detect or measure hypoglycemia, but it will show ketones if the client is severely hyperglycemic or during illness or pregnancy; it is not used only until glucose goals are achieved. Self-monitoring of blood glucose requires a client to prick the finger to obtain blood, so this test is not painless or noninvasive.
