PN med surge exam 4
Which breakfast menu is most appropriate for a patient with diabetes?
One slice whole-grain toast with peanut butter, skim milk, orange juice
Which organ secretes insulin and glucagon for blood glucose homeostasis?
Pancreas
The nurse is caring for a client with an episode of hypoglycemia. Which of the following requires correction by the charge nurse?
Providing the client with 30 g of carbohydrates
The nurse is checking a random blood glucose (RBG) in a client with suspected diabetes mellitus. Which finding is indicative of diabetes?
RBG of 200 mg/dL
Place in order the steps the nurse should take for a client with clinical manifestations of hypoglycemia.
Re-check glucose in 15 minutes Notify the health-care provider Confirm hypoglycemia with glucose meter Administer 15 g of fast-acting carbohydrate
An obese adult patient is admitted to the hospital for shoulder repair. The nurse notes that the patient gets up four times during the night to urinate. Which action by the nurse is most important at this time?
Request an order for a fasting blood glucose test.
The nurse is reviewing orders and notes an order of varying doses of short-acting insulin based on blood glucose readings. This is known as what?
Sliding-scale insulin
Which meal plan is best for the patient with reactive hypoglycemia?
Small, frequent meals
The nurse is administering lispro insulin to a client. When should the nurse administer the medication?
When the client is eating
A nursing home resident with a long history of diabetes requests a heating pad for cold, numb feet. What is the best response by the nurse?
"A heating pad can cause burns, but I can bring you some extra socks."
A client asks the nurse what caused their hyperosmolar hyperglycemic state (HHS). Which response by the nurse is best?
"HHS results from untreated diabetes."
A client with diabetes is talking to the nurse about nutrition. Which statement made by the client requires correction by the nurse?
"I eat more carbohydrates and cover it with more insulin."
The nurse knows a patient with type 1 diabetes needs more education when the patient makes which of the following statements?
"I must take insulin pills for the rest of my life."
The nurse is teaching a client about foot care. Which statement made by the client indicates the need for further education?
"I need to look at my feet once a week to see if I have sores."
The nurse is providing teaching for a client with type 2 diabetes. Which statement indicates an understanding by the client?
"I should check my blood sugar 3 times daily like the doctor said."
Which statements by the patient with a new diagnosis of diabetes show understanding of instruction related to leading a healthy life and preventing complications? Select all that apply.
"I should have a yearly eye examination." "I must check my feet daily." "I should aim to keep my premeal blood glucose readings under 130 mg/dL."
The nurse is teaching a client about oral hypoglycemic agents. Which statement made by the client indicates an understanding of the teaching?
"I should take my medicine before meals."
The nurse is teaching a client with diabetes about renal failure. Which statement made by the client indicates a need for further teaching?
"I will never have to receive dialysis."
The nurse is teaching a client about self-administration of insulin. Which statement made by the client indicates an understanding of the teaching?
"I will rotate insulin injection sites every week."
The nurse is teaching a client about fast-acting sources of sugar. Which of the following should the nurse include in the teaching? Select all that apply.
4 oz orange juice Miniature box of raisins
For which of the following blood glucose results would the nurse administer a "fast sugar"?
48
The nurse administers neutral protamine Hagedorn (NPH) insulin to a diabetic client. When should the nurse anticipate a hypoglycemic reaction to occur?
6-12 hours
The nurse may find the following results of blood glucose testing during the peak action of insulin. Which of these results indicates a risk?
60 mg/dL
The nurse is teaching a diabetic client about prevention of complications involving the eyes. Which of the following statements made by the client indicates an understanding of the teaching?
"If I take my insulin like I am supposed to, it can reduce the risk of eye problems"
A patient who is preparing for surgery asks the nurse why the health care provider discontinued oral hypoglycemic agent orders and initiated sliding-scale insulin. Which response by the nurse is best?
"It helps us maintain better control of your blood glucose during surgery. You will most likely be back on your pills before you go home."
A client is discussing an insulin pump with the nurse. Which statement made by the client requires correction by the nurse?
"The catheter is placed in subcutaneous tissue and stays for 2 weeks."
Diabetes is diagnosed when the fasting blood glucose is greater than _____ mg/dL. Fill in the blank.
126
The nurse is calculating a client's estimated blood glucose with a HbA1c of 9.4. What is the client's estimated blood glucose? Round to the nearest whole number. Enter the numeral only.
223
The nurse is caring for a group of clients. Which client is at highest risk for developing type 2 diabetes?
A Hispanic client who is obese and does not exercise
The nurse is caring for a group of clients. Which client is at highest risk for developing diabetic ketoacidosis (DKA)?
A client with type 1 diabetes who has the flu
Which of the following lowers blood glucose and makes glucose available to cells for energy?
Insulin
The nurse is caring for a client with hypoglycemia. Which clinical manifestations can the nurse expect to find? Select all that apply.
Irritability Confusion Tremor
A client presents to the hospital in diabetic ketoacidosis (DKA). Which clinical manifestations can the nurse expect to document?
Kussmaul respirations
Which of the following orders would the nurse question in a client with type I diabetes?
Acarbose
The nurse is caring for a client with hyperosmolar hyperglycemic state (HHS). Which of the following interventions should the nurse implement?
Administer 0.9% normal saline as ordered
A client with type 2 diabetes has a blood glucose level of 260 mg/dL. There is an order for insulin on a sliding scale. Which action should the nurse take?
Administer the insulin as ordered
The nurse is caring for a client who experienced the Somogyi effect. Which of the following interventions should the nurse implement?
Monitor the blood glucose level between 02:00 and 04:00 a.m.
The nurse is preparing a presentation about exercise for a group of diabetics. Which information should the nurse include in the presentation?
Avoid exercise if ketones are present in blood or urine
The nurse is teaching a diabetic client about foot care. Which of the following should the nurse include in the teaching? Select all that apply.
Never go barefoot Cut toenails to natural shape of nail Schedule an exam with a podiatrist annually
The nurse is administering an oral glucose tolerance test (OGTT). Which result indicates diabetes after 2 hours?
Blood glucose level of 220 mg/dL
Which of the following foods should the nurse avoid giving a client in order to treat hypoglycemia?
Chocolate
The nurse is caring for a client with symptoms of hyperglycemia. Which of the following interventions should the nurse implement first?
Confirm hyperglycemia with a glucose meter
The nurse is caring for a client who is receiving metformin. Which intervention should the nurse implement?
Notify the health-care provider (HCP) of symptoms of lactic acidosis
The nurse notes a fasting blood glucose (FBG) result of 160 mg/dL. Which condition does the nurse suspect?
Diabetes mellitus
The nurse reviews lab results for a client and notes ketones in the urine. Which condition does the nurse suspect based on these results?
Diabetic ketoacidosis
A client with type 2 diabetes asks the nurse what long-term complications can occur. The nurse will include which of the following complications in the response? Select all that apply.
Diabetic retinopathy Nephropathy Neuropathy Foot problems
The nurse is caring for a client suspected of having diabetes mellitus. Which clinical manifestation is the nurse likely to find?
Dusky lower extremities with weak peripheral pulses
A client with type 2 diabetes is undergoing surgery and is prescribed insulin while in the hospital. The client states that they do not take insulin and refuse the insulin. Which action by the nurse is best?
Explain why the insulin is being given at this time
The nurse is caring for a client with diabetes. Which of the following should the nurse report to the health-care provider?
Fever of 101.6°
The nurse is caring for a client with neuropathy. Which medication should the nurse plan to administer?
Gabapentin
The nurse is caring for a client who develops hypoglycemia. The client has dysphagia. Which of the following should the nurse administer?
Glucagon subcutaneously (SQ)
The health-care provider orders 24 units of neutral protamine Hagedorn (NPH) insulin and 10 units of regular insulin. Place in order the steps the nurse should take to administer the insulin.
Inject 24 units of air into the vial of NPH insulin Inject 10 units of air into the vial of regular insulin Invert the vial of regular insulin and withdraw 10 units of insulin. Invert the vial of NPH insulin and withdraw 24 units
The nurse is caring for a client receiving canagliflozin. Which of the following interventions should the nurse implement?
Instruct the client to report vaginal yeast infections
