DM

Blood sugar is well controlled when Hemoglobin A1C is: A. Below 5.7% B. Between 12%-15% C. Less than 180 mg/dL D. Between 90 and 130 mg/dL

A. Below 5.7%

During the morning rounds, Nurse AJ accompanied the physician in every patient's room. The physician writes orders for the client with diabetes mellitus. Which order would the nurse validate with the physician? A. Use Humalog insulin for sliding scale coverage. B. Metformin (Glucophage) 1000 mg per day in divided doses. C. Administer regular insulin 30 minutes prior to meals. D. Lantus insulin 20U BID.

D. Lantus insulin 20U BID.

A 50-year-old widower is admitted to the hospital with a diagnosis of diabetes mellitus and complaints of rapid-onset weight loss, elevated blood glucose levels, and polyphagia. The gerontology nurse should anticipate which of the following secondary medical diagnoses? A. Impaired glucose tolerance B. Gestational diabetes mellitus C. Pituitary tumor D. Pancreatic tumor

D. Pancreatic tumor

An older woman with diabetes mellitus visits the clinic concerning her condition. Which of the following symptoms might an older woman with diabetes mellitus complain? A. Anorexia B. Pain intolerance C. Weight loss D. Perineal itching

D. Perineal itching

Nurse Pira is explaining to the client about type 2 diabetes mellitus. Risk factors of such condition include all of the following, except: A. Advanced age B. Physical inactivity C. Obesity D. Smoking

D. Smoking

A health care provider prescribed ondansetron (Zofran) 8 mg p.o. T.i.d to a patient with Type 1 diabetes mellitus with complaints of vomiting.; Available stock of Zofran in a 100 ml bottle labeled 4 mg/tsp.; How many ml will the nurse administer for each dose?

10 ml

Your patient has had the following intake: 8 oz glasses of iced tea, 4 oz cartons of grape juice, ¾ pt of ice cream, 32 oz of juice, 1 ½ L of D5W IV and 6 oz of cottage cheese. What will you record as the total intake in mL for this patient?

3,195 ml

Your patient has had the following intake: 2 ½ cups of coffee (240 mL/cup), 11.5 oz of grape juice, ¾ qt of milk, 320 mL of diet coke, 1 ¼ L of D5W IV and 2 oz of grits. What will you record as the total intake in mL for this patient?

3,265 ml

A patient was recently discharged after being hospitalized due to type 1 diabetes mellitus and was given ergocalciferol (Vitamin D) 225,000 units PO daily. The patient have on hand ergocalciferol in 50,000 unit tablets. How many tablet(s) should the patient take?

4.5 tablets

Give Regular insulin by continuous I.V. infusion at 20 units/hr. The solution is 250 ml NS with 100 units of Regular insulin. What rate on the infusion pump will deliver the correct dose?

50 ml/hr

During a visit to a community, the nurse will recommend routine screening for diabetes when the person has one or more of seven risk criteria. Which of the following persons that the nurse comes in contact with most needs to be screened for diabetes based on the seven risk criteria? A. A client with an HDL cholesterol level of 40 mg/dl and a triglyceride level of 300 mg/dl B. A woman who is at 90% of standard body weight after delivering an eight-pound baby C. A middle-aged Caucasian male D. An older client who is hypotensive

A. A client with an HDL cholesterol level of 40 mg/dl and a triglyceride level of 300 mg/dl

According to the National Diabetes Statistics Report, diabetes remains one of the leading causes of death in the United States since 2010. Which of the following factors are risks for the development of diabetes mellitus? Select all that apply. A. Age over 45 years B. Overweight with a waist/hip ratio >1 C. Having a consistent HDL level above 40 mg/dl D. Maintaining a sedentary lifestyle E. Polycystic ovary syndrome

A. Age over 45 years B. Overweight with a waist/hip ratio >1 D. Maintaining a sedentary lifestyle E. Polycystic ovary syndrome

Billy is being asked concerning his health in the emergency department. When obtaining a health history from a patient with acute pancreatitis, the nurse asks the patient specifically about the history of: A. Alcohol use B. Cigarette smoking C. Diabetes mellitus D. High-protein diet

A. Alcohol use

When reviewing the urinalysis report of a client with newly diagnosed diabetes mellitus, the nurse would expect which urine characteristics to be abnormal? Select all that apply. A. Amount. B. Odor. C. pH. D. Specific gravity. E. Glucose level. F. Ketone bodies.

A. Amount. B. Odor. E. Glucose level. F. Ketone bodies.

Mr. Wesley is newly diagnosed with Type I DM and is being seen by the home health nurse. The doctor's orders include: 1200 calorie ADA diet, 15 units NPH insulin before breakfast, and check blood sugar QID. When the nurse visits the patient at 5 pm, the nurse observes the man performing blood sugar analysis. The result is 50 mg/dL. The nurse would expect the patient to be: A. Anxiety, paleness, and pulse of 110 bpm B. Lethargic with hot dry skin and rapid deep respirations C. Alert and cooperative with BP of 130/80 mm Hg and respirations of 12 breaths per minute D. Short of breath, with distended neck veins and bounding pulse of 96 bpm

A. Anxiety, paleness, and pulse of 110 bpm

Nurse Shey is educating a pregnant client who has gestational diabetes. Which of the following statements should the nurse make to the client? Select all that apply. A. Cakes, candies, cookies, and regular soft drinks should be avoided. B. Gestational diabetes increases the risk that the mother will develop diabetes later in life. C. Gestational diabetes usually resolves after the baby is born. D. Insulin injections may be necessary. E. The mother should strive to gain no more weight during pregnancy. F. The baby will likely be born with diabetes

A. Cakes, candies, cookies, and regular soft drinks should be avoided. B. Gestational diabetes increases the risk that the mother will develop diabetes later in life. C. Gestational diabetes usually resolves after the baby is born. D. Insulin injections may be necessary.

Gregory is a 52-year-old man identified as high-risk for diabetes mellitus. Which laboratory test should a nurse anticipate a physician would order for him? Select all that apply. A. Fasting Plasma Glucose (FPG) B. Two-hour Oral Glucose Tolerance Test (OGTT) C. Glycosylated hemoglobin (HbA1C) D. Fingerstick glucose three times daily E. Urinalysis and urine culture

A. Fasting Plasma Glucose (FPG) B. Two-hour Oral Glucose Tolerance Test (OGTT)

After suffering an acute MI, a client with a history of type 1 diabetes is prescribed metoprolol (Lopressor) I.V. Which nursing interventions are associated with I.V. administration of metoprolol? Select all that apply. A. Monitor glucose levels closely. B. Monitor for heart block and bradycardia. C. Monitor blood pressure closely. D. Mix the drug in 50 ml of dextrose 5% in water and infuse over 30 minutes. E. Be aware that the drug is not compatible with morphine.

A. Monitor glucose levels closely. B. Monitor for heart block and bradycardia. C. Monitor blood pressure closely.

Which of the following is accurate pertaining to physical exercise and type 2 diabetes mellitus? A. Physical exercise can slow the progression of type 2 diabetes mellitus. B. Strenuous exercise is beneficial when blood glucose is high. C. Patients who take insulin and engage in strenuous physical exercise might experience hyperglycemia. D. Adjusting insulin regimen allows for safe participation in all forms of exercise.

A. Physical exercise can slow the progression of type 2 diabetes mellitus.

During the lecture, the clinical instructor tells the students that 50% to 60% of daily calories should come from carbohydrates. What should the nurse say about the types of carbohydrates that can be eaten? A. Try to limit simple sugars to between 10% and 20% of daily calories. B. Simple carbohydrates are absorbed more rapidly than complex carbohydrates. C. Simple sugars cause a rapid spike in glucose levels and should be avoided. D. Simple sugars should never be consumed by someone with diabetes.

A. Try to limit simple sugars to between 10% and 20% of daily calories.

Dr. Wijangco orders insulin lispro (Humalog) 10 units for Alicia, a client with diabetes mellitus. When will the nurse administer this medication? A. When the client is eating B. Thirty minutes before meals C. Fifteen minutes before meals D. When the meal trays arrive on the floor

A. When the client is eating

Which of the following, if stated by the nurse, is correct about Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)? A. "This syndrome occurs mainly in people with type 1 diabetes." B. "It has a higher mortality rate than diabetic ketoacidosis." C. "The client with HHNS is in a state of overhydration." D. "This condition develops very rapidly."

B. "It has a higher mortality rate than diabetic ketoacidosis."

A client was brought to the emergency room with complaints of slurring of speech, vomiting, dry mucosa, and dry skin turgor. Lab tests showing serum sodium 125 mEq/L and serum blood glucose of 350 mg/dL. Nurse Sophie will anticipate the physician to initially order which of the following intravenous solutions? A. 10% dextrose in water (D10W) B. 0.9% normal saline solution C. 5% dextrose in water (D5W) D. 0.45% normal saline solution

B. 0.9% normal saline solution

The goal of preprandial blood glucose for those with type 1 diabetes mellitus is: A. <80 mg/dl B. <130 mg/dl C. <180 mg/dl D. >8%

B. <130 mg/dl

The nurse is conducting a teaching session for a 25-year-old underweight and emaciated client with newly diagnosed type 1 diabetes mellitus. The client lives alone and is anxious about managing their condition, particularly self-administering insulin injections. Considering the client's physical condition and concerns, which is the most appropriate technique for self-administering insulin injections from the following options: A. Instruct the client to pinch the skin up and use a 90-degree angle for insulin injection. B. Advise the client to use a 45-degree angle with the skin pinched up during insulin injection. C. Teach the client to massage the area of injection after injecting the insulin to promote absorption. D. Recommend warming the skin with a warm towel or washcloth prior to the injection to improve circulation.

B. Advise the client to use a 45-degree angle with the skin pinched up during insulin injection.

When taking a health history, the nurse screens for manifestations suggestive of diabetes type 1. Which of the following manifestations are considered the primary manifestations of type 1 diabetes mellitus and would be most suggestive and require follow-up investigation? A. Excessive intake of calories, rapid weight gain, and difficulty losing weight B. An increase in three areas: thirst, intake of fluids, and hunger C. Poor circulation, wound healing, and leg ulcers D. Lack of energy, weight gain, and depression

B. An increase in three areas: thirst, intake of fluids, and hunger

Which of the following diabetes drugs acts by decreasing the amount of glucose produced by the liver? A. Alpha-glucosidase inhibitors B. Biguanides C. Meglitinides D. Sulfonylureas

B. Biguanides

The nurse working in the physician's office is reviewing lab results on the clients seen that day. One of the clients who has classic diabetic symptoms had an eight-hour fasting plasma glucose (FPG) test done. The nurse realizes that diagnostic criteria developed by the American Diabetes Association for diabetes include classic diabetic symptoms plus which of the following fasting plasma glucose levels? A. Higher than 106 mg/dl B. Higher than 126 mg/dl C. Higher than 140 mg/dl D. Higher than 160 mg/dl

B. Higher than 126 mg/dl

The nurse is admitting a client with newly diagnosed diabetes mellitus and left-sided heart failure. Assessment reveals low blood pressure, increased respiratory rate and depth, drowsiness, and confusion. The client complains of headache and nausea. Based on the serum laboratory results below, how would the nurse interpret the client's acid-base balance? Lab Results: pH: 7.34 HCO3-: 19 mEq/L PaCO2: 35 mm Hg PaO2: 88 mm Hg Potassium: 5.3 mEq/L Chloride: 102 mEq/L Calcium: 10.4 mg/dl Anion gap: 30 mEq/L A. Metabolic alkalosis. B. Metabolic acidosis. C. Respiratory acidosis. D. Respiratory alkalosis.

B. Metabolic acidosis.

Rosemary has been taking glargine (Lantus) to treat her condition. One of the benefits of glargine (Lantus) insulin is its ability to: A. Release insulin rapidly throughout the day to help control basal glucose. B. Release insulin evenly throughout the day and control basal glucose levels. C. Simplify the dosing and better control blood glucose levels during the day. D. Cause hypoglycemia with other manifestations of other adverse reactions.

B. Release insulin evenly throughout the day and control basal glucose levels.

Harry is a diabetic patient who is experiencing a reaction to alternating periods of nocturnal hypoglycemia and hyperglycemia. The patient might be manifesting which of the following? A. Uncontrolled diabetes B. Somogyi phenomenon C. Brittle diabetes D. Diabetes insipidus

B. Somogyi phenomenon

A nurse has a four-patient assignment in the medical step-down unit. When planning care for the clients, which client would have the following treatment goals: fluid replacement, vasopressin replacement, and correction of underlying intracranial pathology? A. The client with diabetes mellitus. B. The client with diabetes insipidus. C. The client with diabetic ketoacidosis. D. The client with syndrome of inappropriate antidiuretic hormone (SIADH) secretion.

B. The client with diabetes insipidus.

The guidelines for carbohydrate counting as medical nutrition therapy for diabetes mellitus includes all of the following, except: A. Flexibility in types and amounts of foods consumed B. Unlimited intake of total fat, saturated fat, and cholesterol C. Including adequate servings of fruits, vegetables, and the dairy group D. Applicable to with either Type 1 or Type 2 diabetes mellitus

B. Unlimited intake of total fat, saturated fat, and cholesterol

During a visit to the hospital, the student nurses are asked which of the following persons would most likely be diagnosed with diabetes mellitus. They are correct if they answered a 44-year-old: A. Caucasian woman. B. Asian woman. C. African-American woman. D. Hispanic male.

C. African-American woman.

A patient received 6 units of regular insulin three (3) hours ago. The nurse would be most concerned if which of the following was observed? A. Kussmaul respirations and diaphoresis B. Anorexia and lethargy C. Diaphoresis and trembling D. Headache and polyuria

C. Diaphoresis and trembling

Joko has recently been diagnosed with type 1 Diabetes Mellitus and asks nurse Jessica for help formulating a nutrition plan. Which of the following recommendations would the nurse make to help the client increase calorie consumption to offset absorption problems? A. Eat small meals with two or three snacks throughout the day to keep blood glucose levels steady B. Increase the consumption of simple carbohydrates C. Eating small meals with two or three snacks may be more helpful in maintaining blood glucose levels than three large meals. D. Skip meals to help lose weight

C. Eating small meals with two or three snacks may be more helpful in maintaining blood glucose levels than three large meals.

A 39-year-old company driver presents with shakiness, sweating, anxiety, and palpitations and tells the nurse he has type 1 diabetes mellitus. Which of the following actions should the nurse do first? A. Inject 1 mg of glucagon subcutaneously B. Administer 50 mL of 50% glucose I.V C. Give 4 to 6 oz (118 to 177 mL) of orange juice D. Give the client four to six glucose tablets

C. Give 4 to 6 oz (118 to 177 mL) of orange juice

Nurse Matt makes a home visit to the client with diabetes mellitus. During the visit, Nurse Matt notes the client's additional insulin vials are not refrigerated. What is the best action by the nurse at this time? A. Instruct the client to label each vial with the date when opened. B. Tell the client there is no need to keep additional vials. C. Have the client place the insulin vials in the refrigerator. D. Have the client discard the vials.

C. Have the client place the insulin vials in the refrigerator.

The nurse is working with an overweight client who has a high-stress job and smokes. This client has just received a diagnosis of type 2 diabetes mellitus and has just been started on an oral hypoglycemic agent. Which of the following goals for the client which if met, would be most likely to lead to an improvement in insulin efficiency to the point the client would no longer require oral hypoglycemic agents? A. Comply with medication regimen 100% for 6 months B. Quit the use of any tobacco products by the end of three months C. Lose a pound a week until the weight is within the normal range for height and exercise 30 minutes daily D. Practice relaxation techniques for at least five minutes five times a day for at least five months

C. Lose a pound a week until the weight is within the normal range for height and exercise 30 minutes daily

Dr. Hugo has prescribed sulfonylureas for Rebecca in the management of diabetes mellitus type 2. As a nurse, you know that the primary purpose of sulfonylureas, such as long-acting glyburide (Micronase), is to: A. Induce hypoglycemia by decreasing insulin sensitivity. B. Improve insulin sensitivity and decrease hyperglycemia. C. Stimulate the beta cells of the pancreas to secrete insulin. D. Decrease insulin sensitivity by enhancing glucose uptake.

C. Stimulate the beta cells of the pancreas to secrete insulin.

You are doing some teaching with a client who is starting on a sulfonylurea antidiabetic agent. The client mentions that he usually has a couple of beers each night and takes an aspirin each day to prevent heart attacks and/or strokes. Which of the following responses would be best on the part of the nurse? A. As long as you only drink two beers and take one aspirin, this should not be a problem B. The aspirin is alright but you need to give up drinking any alcoholic beverages C. Taking alcohol and/or aspirin with a sulfonylurea drug can cause the development of hypoglycemia D. Aspirin and alcohol will cause the stomach to bleed more when on a sulfonylurea drug

C. Taking alcohol and/or aspirin with a sulfonylurea drug can cause the development of hypoglycemia

Genevieve has diabetes type 1 and receives insulin for glycemic control. She tells the nurse that she likes to have a glass of wine with dinner. What will the best plan of the nurse for client education include? A. The alcohol could cause pancreatic disease. B. The alcohol could cause serious liver disease. C. The alcohol could predispose you to hypoglycemia. D. The alcohol could predispose you to hyperglycemia.

C. The alcohol could predispose you to hypoglycemia.

A medication nurse is about to give insulin to a patient with diabetes mellitus. Upon reviewing the medications of the patient, which of the following would cause a further decrease in the blood glucose level of the patient? A. hydrochlorothiazide (Microzide) B. levothyroxine (Synthroid) C. carvedilol (Coreg) D. hydrocortisone (SoluCortef)

C. carvedilol (Coreg) Carvedilol (Coreg) is a beta-blocker when given together with insulin would cause an increased hypoglycemic effect of insulin, resulting in a further decrease in the serum blood glucose level. Carvedilol has hyperglycemic potential when given orally for 5 days in normal albino rats. Though it may be beneficial in diabetics for various comorbid conditions, the glycemic control may worsen during its use in subjects with prediabetes, diabetes, high risk diabetes.

Gary has diabetes type 2. Nurse Martha has taught him about the illness and evaluates learning has occurred when the client makes which statement? A. "My cells have increased their receptors, but there is enough insulin." B. "My peripheral cells have increased sensitivity to insulin." C. "My beta cells cannot produce enough insulin for my cells." D. "My cells cannot use the insulin my pancreas makes."

D. "My cells cannot use the insulin my pancreas makes."

At the time Cherrie Ann found out that the symptoms of diabetes were caused by high levels of blood glucose, she decided to break the habit of eating carbohydrates. With this, the nurse would be aware that the client might develop which of the following complications? A. Retinopathy B. Atherosclerosis C. Glycosuria D. Acidosis

D. Acidosis

A nurse is caring for a client admitted with diabetic retinopathy. Which of the following would the nurse expect to note on the assessment of this client: A. Blurred or distorted vision B. Flashes of lights or floaters C. Sudden loss of vision D. All of the above

D. All of the above

The principal goals of therapy for older patients who have poor glycemic control are: A. Enhancing the quality of life. B. Decreasing the chance of complications. C. Improving self-care through education. D. All of the above.

D. All of the above.

An ailing 70-year-old woman with a diagnosis of type 2 diabetes mellitus has been ill with pneumonia. The client's intake has been very poor, and she is admitted to the hospital for observation and management as needed. What is the most likely problem with this patient? A. Insulin resistance has developed. B. Diabetic ketoacidosis is occurring. C. Hypoglycemia unawareness is developing. D. Hyperglycemic hyperosmolar nonketotic syndrome.

D. Hyperglycemic hyperosmolar nonketotic syndrome.

Tony is a night shift nurse who is assigned to a patient whose glucose levels remain normal at bedtime but experiences hypoglycemia at 3 am and hyperglycemia at 7 am. The patient is likely experiencing what kind of complication of insulin therapy? A. Insulin resistance B. Dawn phenomenon C. Insulin lipohypertrophy D. Somogyi phenomenon

D. Somogyi phenomenon

Which insulin can be administered through continuous intravenous infusion? A. insulin glargine (Lantus) B. insulin aspart (Novolog) C. insulin detemir (Levemir) D. insulin Afrezza E. regular insulin (Novolin R)

E. regular insulin (Novolin R)