Diabetes

The three main clinical features of diabetic ketoacidosis hyperglycemia, dehydration with electrolyte loss, and ________

Acidosis

A client with type 2 diabetes asks the nurse why he can't have a pancreatic transplant. Which of the following would the nurse include as a possible reason? A. Need for lifelong immunosuppressive therapy B. Increased risk for urologic complications C. Underlying problem of insulin resistance D. Need for exocrine enzymatic drainage

C

A client is diagnosed with diabetes mellitus. The client reports visiting the gym regularly and is a vegetarian. Which of the following factors is important to consider when the nurse assesses the client? A. History of radiographic contrast studies that used iodine B. The client's exercise routine C. The client's mental and emotional status D. The client's consumption of carbohydrates

D

A client with diabetes mellitus is receiving an oral antidiabetic agent. When caring for this client, the nurse should observe for signs of: A. Polyuria B. Blurred vision C. Polydipsia D. Hypoglycemia

D

Which statement is correct regarding glargine insulin? A. Its peak action occurs in 2-3 hours B. It is given twice daily C. It is absorbed rapidly D. It cannot be mixed with any other type of insulin

D

The _______ phenomenon is an example of morning hyperglycemia that's characterized by relatively normal BG level until approximately 3:00 A.M. when blood glucose levels begin to rise

dawn

What is the only insulin that can be given intravenously? A. Regular B. NPH C. Ultralente D. Lantus

A

A nurse is reviewing the health history of a client who has diabetes mellitus type 2. Which of the following are risk factors for hyperglycemic hyperosmolar state (HHS)? Select all that apply A. Evidence of recent myocardial infarction B. BUN 35 mg/dL C. Takes a calcium channel blocker D. Age 77 years old E. Daily insulin injections

A, B, C, D

A nurse is providing discharge teaching to a client who had diabetic ketoacidosis. Which of the following information should the nurse include about preventing DKA? Select all that apply A. Drink 2 L fluids daily B. Monitor blood glucose every 4 hr when ill C. Administer 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 an illness

A, B, C, E

Which of the following is a risk factor for the development of diabetes mellitus? Select all that apply A. Family history B. Obesity C. Age greater of 45 years or older D. Hypertension E. History of gestational diabetes

A,B,C,D,E

A client with a 30- year history of type 2 diabetes is having an annual physical and blood work. Which test result would the physician be most concerned with when monitoring the client's treatment compliance? A. postprandial glucose B. glycosylated hemoglobin C. CAT scan D. hematocrit B1C

B

A nurse is review laboratory reports of a client who has HHS. Which of the following findings should the nurse expect? A. Blood pH 7.2 B. Blood osmolarity 350 mOsm/L C. Blood potassium 3.8 mg/dL D. Blood creatinine 0.8 mg/dL

B

During a class on exercise for clients with diabetes mellitus, a client asks the nurse educator how often to exercise. To meet the goals of planned exercise, the nurse educator should advise the client to exercise: A. Every day B. At least three times per week C. At least five times per week D. At least once per week

B

The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer? A. Lispro (Humalog) B. NPH C. Iletin II D. Glargine (Lantus)

B

A nurse is assessing a client who has diabetic ketoacidosis and ketones in the urine. The nurse should expect which of the following findings? Select all that apply A. Weight gain B. Fruity odor of breath C. Abdominal pain D. Kussmaul respirations E. Metabolic acidosis

B, C, D, E

A nurse is reviewing the medical record for a client who is to begin therapy for DKA. Which of the following prescriptions should the nurse expect? A. Administer an IV infusion of regular insulin at 0.3 unit/kg/hr B. Administer a slow IV infusion of 3% sodium chloride C. Rapidly administer an IV infusion of 0.9% sodium chloride D. Add glucose to the IV infusion when blood glucose is 350 mg/dL

C

The nurse is teaching a client about self-administration of insulin and about mixing regular and neutral protamine Hagedorn (NPH) insulin. Which information is important to include in the teaching plan? A. There is no need to inject air into the bottle of insulin before withdrawing the insulin. B. If two different types of insulin are ordered, they need to be given in separate injections. C. When mixing insulin, the NPH insulin is drawn up into the syringe first. D. When mixing insulin, the regular insulin is drawn up into the syringe first.

D

Which statement indicates that a client with diabetes mellitus understands proper foot care? A. "I'll go barefoot around the house to avoid pressure areas on my feet." B. "I'll schedule an appointment with my physician if my feet start to ache." C. "I'll rotate insulin injection sites from my left foot to my right foot." D. "I'll wear cotton socks with well-fitting shoes."

D

Classic clinical manifestations of diabetes include polyuria, polydipsia, and _________

Polyphagia

Proliferative retinopathy, a diabetic microvascular disease, represents the greatest threat to vision; it is characterized by the proliferation of new blood vessels growing from the retina into the vitreous True or False

True

When mixing a short-acting insulin and a longer-acting insulin, the ADA recommends the regular insulin be drawn up first True or False

True

The American Dietetic Association recommends that for all levels of caloric intake, the percentage of calories from carbohydrates should not exceed

50-60%

A nurse explains to a client that she will administer his first insulin in his abdomen. How does absorption at the abdominal site compare with absorption at other sites? A. Insulin is absorbed more rapidly at the abdominal injection site than at other sites B. Insulin is absorbed more slowly at abdominal injection sites than at other sites C. Insulin is absorbed unpredictably at all injection sites D. Insulin is absorbed rapidly regardless of the injection site

A

A nurse is preparing to administer insulin to a child who's just been diagnosed with type 1 diabetes. When the child's mother stops the nurse in the hall, she's crying and anxious to talk about her son's condition. The nurse's best response is: A. "I'm going to give your son some insulin. Then I'll be happy to talk with you." B. "Everything will be just fine. I'll be back in a minute and then we can talk." C. "If you'll wait in your son's room, the physician will talk with you as soon as he's free." D. "I can't talk now. I have to give your son his insulin as soon as possible."

A

The nurse is administering lispro insulin. Based on the onset of action, how long before breakfast should the nurse administer the injection? A. 10-15 minutes B. 30-40 minutes C. 1-2 hours D. 3 hours

A

Which is a characteristic of type 2 diabetes? A. Insulin resistance B. Little or no insulin C. Presence of islet antibodies D. Ketosis-prone when insulin absent

A

The pancreas continues to release a small amount of basal insulin overnight, while a person is sleeping. The nurse knows that if the body needs more sugar: A. Glycogenesis will be decreased by the liver. B. The pancreatic hormone glucagon will stimulate the liver to release stored glucose. C. Insulin will be released to facilitate the transport of sugar. D. he process of gluconeogenesis will be inhibited.

B

A client with diabetes comes to the clinic for a follow-up visit. The nurse reviews the client's glycosylated hemoglobin test results. Which result would indicate to the nurse that the client's blood glucose level has been well controlled? A. 8.5% B. 8.0% C. 6.5% D. 7.5%

C

A client with diabetes mellitus must learn how to self-administer insulin. The physician has ordered 10 units of U-100 regular insulin and 35 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction? A. "Inject insulin into healthy tissue with large blood vessels and nerves." B. "Administer insulin into areas of scar tissue or hypertrophy whenever possible." C. "Rotate injection sites within the same anatomic region, not among different regions." D. "Administer insulin into sites above muscles that you plan to exercise heavily later that day."

C

The nurse suspects that a patient with diabetes has developed proliferative retinopathy. The nurse confirms this by the presence of which of the following diagnostic signs? A. Decreased capillary permeability B. The leakage of capillary wall fragments into surrounding areas C. Neovascularization into the vitreous humor D. Microaneurysm formation

C

Regular insulin is a rapid-acting insulin that has a duration of 4-6 hours True or False

False

Type 1 diabetes, which affects approximately 90-95% of people with the disease, is characterized by insulin resistance and impaired insulin secretion. True or False

False

The main goal of diabetes treatment is to normalize insulin activity and blood glucose levels to reduce the development of vascular and _______ complications

Neuropathic

Latent autoimmune diabetes of adults (LADA) is a subtype of diabetes in which progression of autoimmune beta-cell destruction in the pancreas is slower than in types 1 and 2 diabetes True or False

True