Diabetes Q&A 2

A client who has type 2 diabetes mellitus asks the nurse. Why did i develop diabetes? which of the following responses should the nurse make?

"Your body has insulin resistance and decreased insulin secretion."

A nurse is providing teaching to a client who has a diabetes mellitus about carbohydrate intake needs when exercising. Which of the following foods should the nurse include as containing a 15 g serving of carbohydrates?

1 cup milk

A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client. What is the sequence of event the nurse should follow?

1- Inspect vials for contaminants.2- Roll NPH vial between palms of hands.3- Inject air into NPH insulin vial.4- Inject air into regular insulin vial.5- Withdraw short-acting insulin into syringe.6- Add intermediate insulin to syringe.

A nurse working for a home health agency is teaching a client who has diabetes mellitus about disease management. Which of the following glycosylated hemoglobin (HbA1c) Values should the nurse include in the teaching as an indicator that the client is appropriately controlling his glucose levels?

6.3% The best indicator of the average blood glucose for approximately 90-120 days. A finding greater than 7% indicates non-compliance.

A nurse is evaluating teaching with a client who is receiving continuous subcutaneous insulin via and external insulin pump. Which of the following statements by the client indicates a need for further teaching?

A I will change the needle every 3 days

A nurse is caring for a client who has diabetic ketoacidosis. Which of the following manifestations should the nurse expect?

Acetone odor to breath.

A nurse observes mild hand tremors in client who has diabetes mellitus. Which of the following actions should the nurse take after obtaining a glucose meter reading of 60 mg/dL?

Administer 15 g of carbohydrates

A nurse is providing dietary teaching to a client who has nephropathy secondary to diabetes mellitus and plans to make dietary adjustment. Which of the following instructions should the nurse include?

Consume less than 0.8% g/kg of body weight of protein per day.

A nurse is teaching a client how to draw up regular insulin and NPH insulin into the same syringe. Which of the following instructions should the nurse include?

Discard regular insulin that appears cloudy.

A nurse is teaching a client who has type 1 diabetes mellitus about exercise. Which of the following instructions should the nurse include?

Do not exercise if ketones are present in your urine.

A nurse is teaching a client who has a new prescription for NPH insulin. Which of the following instructions should the nurse include?

Eat a snack 8 hours after taking the medication

A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if her blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?

Expect the NPH insulin to peak in 6-14 hours. It is an intermediate acting insulin with an onset of 1-2 hors, peaking at 6-14 hours, and duration of 16-24 hours. The client is at risk for HYPOglycemia during the peak time.

A nurse is reviewing the laboratory results of a client who is at risk for developing diabetes mellitus. The nurse should recognize that wight of the following results indicate the client meets the criteria for diagnosis of diabetes mellitus?

Fasting blood glucose of 155 mg/dL

A nurse is caring for a client who is at 22 week of gestation and has been unable to control her gestational diabetes mellitus with diet and exercise. The nurse should anticipate a prescription from the provider for which of the following medications for the client?

Glipizide ** maybe **

A nurse is caring for a client with type 1 diabetes mellitus who reports feeling shaky and having palpitations. when the nurse finds the client's blood glucose to be 48 mg/dL on the glucometer, he should give the client which of the following?

Graham crackers.

A nurse is assessing a client who has type 1 diabetes mellitus and finds the client lying in bed, sweating and reporting feeling anxious. Which of the following complications should the nurse suspect?

Hypoglycemia

A nurse is caring for a client who is diabetic and reports a headache, restlessness, fatigue, and hunger. The nurse should identify that the client is likely experiencing which of the following conditions?

Hypoglycemia

A nurse in a provider's office is collecting a health history form a client who has a new prescription of glyburide to treat type 2 diabetes mellitus. Which of the following statements by the client indicates a contraindication for taking this medication?

I had strep throat about one year ago.

A nurse is providing teaching about foot care for a client who has type 2 diabetes mellitus which of the following statements by the client indicates an understanding of the teaching?

I should buy new shoes late in the day.

A nurse is providing teaching to a school-age child who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements by the child indicates an understanding of the teaching?

I should eat a snack half an hour before playing soccer.

A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client who has diabetes mellitus. When mixing the two types of insulin, which of the following actions should the nurse take first?

Inject 20 units of air into the NPH insulin vial because his insulin is the intermediate-acting insulin which will be drawn up last in order to avoid contaminating the regular insulin with the NPH insulin.

A nurse is providing discharge teaching to the parents of a child who has a new diagnosis of diabetes mellitus. Which of the following statements by the parents indicates an understanding of the teaching?

My son might complain of feeling shaky when he has a low blood glucose level.******maybe***

A nurse is performing a monofilament sensory assessment of a client who has diabetes mellitus. When performing this assessment, for which of the following complications is the nurse monitoring?

Neuropathy

A nurse is caring for a client who has type 1 diabetes mellitus. Which of the following recommendations should the nurse make to the client for a sweetner?

Nonutritive sugar substitute

A nurse is caring for a client who is on a 2000 calorie american diabetes association (ADA) diet and substitutes the whole milk on his breakfast tray with skim milk. Because of the substitution, the nurse should know that the client can add which of the following items to the oatmeal on his breakfast tray?

One tablespoon low fat margarine.

A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intalerance?

Prednisone

A nurse is reinforcing teaching with a client who has diabetes mellitus. Which of the following should the nurse include in the teaching? (select all that apply)

Reduce cholesterol and saturated fat intake, Increase physical activity and daily exercise, Enroll in a smoking-cessation program, maintain optimal blood pressure to prevent kidney damage.

A nurse is providing teaching to an adolescent who has type 1 diabetes mellitus. Which of the following should the nurse include in the teaching?

obtain an influenza vaccine

A nurse is providing dietary teaching for a client who has just learned she has type 2 diabetes mellitus. the nurse should explain that which of the following sweeteners will add calories to the client's carbohydrate cout?

sorbitol

A nurse is teaching a client who has a new diagnosis of type 1 diabetes mellitus about self-administration of insulin. Which of the following instructions should the nurse include?

"Store the current bottle of insulin at room temperature."

A nurse is providing teaching for a client who is newly diagnosed with type 2 diabetes mellitus has a prescription for glipizide. which of the following statements by the nurse best describes the action of glipizide?

"Glipizide stimulates your pancreas to release insulin." It is an oral antidiabetic medication that is classified as a sulfonylurea agent. These medications help to lower blood glucose levels in clients who have type 2 DM using several methods including reducing glucose output by the liver, increasing sensitivity to insulin, and stimulating the release of insulin form the functioning beta cell in the pancreas.

A nurse is teaching about disease management for a client who has type 1 diabetes mellitus. Which statement made by the client indicates an understanding of teaching?

"I give the insulin injection in my abdomen"

A nurse is teaching a client who has diabetes about which dietary source would provide the greatest percentage of calories. Which of the following statements indicates the client understands the teaching?

"I should eat more calories from complex carbohydrates than anything else."

A nurse is providing teaching about self-administration of insulin to the parent of a school age child who has a new of diabetes mellitus. Which of the following statements by the parent indicates a need for further teaching?

"I will be sure my child aspirates before injecting the insulin." This step is not necessary anymore.

A nurse is reviewing guidelines to prevent DKA during periods of illness with a client who has type 1 diabetes mellitus. Which of the following instructions should the nurse include in the teaching?

Check you urine for ketones when blood glucose levels are greater than 240 mg/dL

A nurse is caring for an adolescent client who has long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic Ketoacidosis is suspected. The nurse should anticipate using with of the following types of insulin to treat the client?

Regular insulin.

A school nurse is assessing an adolescent who reports feeling shaky and is having difficulty speaking and concentrating on the questions the nurse is asking. The nurse checks the adolescent's Blood glucose level and identifies a value of 55 mg/dL. Which of the following findings should the nurse expect?

Tachycardia.

A nurse is teaching a client who is taking metformin XR for type II diabetes mellitus. which of the following instructions should the nurse include in the teaching?

Take the medication with a meal.

A nurse is teaching a school-age child who has type 1 diabetes mellitus and his parents about the illness management. which of the following instructions should the nurse include?

Test the urine for ketones *** maybe**** or Notify the provider if blood glucose levels are over 350 mg/dL

A nurse is planning education for a female client who is at risk for developing type 2 diabetes mellitus. Which of the following increases the risk for developing type 2 diabetes?

blood pressure of 138/98

A nurse is assessing a client who has diabetes mellitus. Which of the following findings is a manifestation of hypoglycemia?

cool, clammy skin.

A nurse is preparing to administer lispro insulin to a client who has type 1 diabetes mellitus. Which of the following actions should the nurse take?

inject the insulin 15 min before a meal.

A nurse is teaching a client who has new prescription for regular insulin and NPH insulin. Which of the following instructions should the nurse include in the teaching?

keep the open vial of insulin at room temperature.

A nurse is caring for a 7 year old child who has an upper respiratory infection and type 1 diabetes mellitus. Which of the following statements by the the mother indicates need for further instructions?

"I will continue to check his blood sugar two times a day."

A nurse is reinforcing teaching on glucose monitoring with a client who has type 1 diabetes mellitus. Which of the following statement by the client indicates understanding?

I will check blood glucose every 4 hr when I am sick.

A nurse is teaching a client who has diabetes mellitus about the manifestations of hypoglycemia. Which of the following statements by the client indicates an understanding of the teaching?

I will feel shaky

A nurse is reinforcing teaching to client who has diabetes mellitus. which of the following statement by the client indicates an understanding of the manifestation of hypoglycemia?

I will feel shaky.

A nurse in prenatal clinic is teaching a client who is in her second trimester and has a new diagnosis of gestational diabetes. Which of the following statements by the client indicates a need for further teaching?

I will reduce my exercise schedule to 3 days a week

A nurse is teaching a client who has type 1 diabetes mellitus about foot care. which of the following statements by the client indicates and understanding of the teachings?

I'll check my feet every day for sores and bruises.

A nurse is teaching an older adult client who has diabetes mellitus about preventing the long-term complications of retinopathy and nephropath. which of the following instructions should the nurse include?

Maintain stable blood glucose levels