Endocrine

The nursing is caring for a client who has normal glucose levels at bedtime, hypoglycemia in the morning. what is the client likely experiencing? 1.) dawn phenomenon 2.) somogi effect 3.)insulin spike 4.) excessive cortiosteriods

2.) Somogi Effect is when blood sugar drops too low in the morning causing rebound hyperglycemia in the morning

The nurse is caring for a client with long-term Type 2 diabetes and is assessing the feet. Which assessment data would warrant immediate intervention by the nurse? 1.) the client has crumbling toenails 2.) client has athelete feet 3.) The client has a necotic big toe 4.) The client has thickened toenail

3.) Client has a necotic toe

In educating a client with diabetes, what response would reveal need for further education? 1.) I should avoid tights 2.) I should take good care of my nails 3.) I should not go more than 3 days without washing my feet 4.) I should avoid going barefoot and should wear clean socks

3.) I should not go more than 3 days without washing my feet (NEEDS TO BE A DAILY THING)

Patients with Type 1 Diabetes Mellitus may require which of the following changes to their daily routine during times of infection? 1.) no change 2.) less insulin 3.) more insulin 4.) Oral diabetic agents

3.) more insulin

Risk factors for type 2 diabetes include all of the following except: 1.) advanced age 2.) obesity 3.) smoking 4.) physical inactivity

3.) smoking

The client diagnosed with type 1 diabets has a glycosylated hemoglobin (A1C) Which interpretation should the nurse make based on this result?: 1.) this result is below normal level 2.) this result is within acceptable levels 3.) this result is above recommended levels 4.) this result is dangerously high

3.) this result is above recommended levels (needs to be between 6-7%)

Excessive thirst and volume of very dilute may be symptoms of: 1.) UTI 2.) Diabetes Insipidus 3.) Viral gastroenteritis 4.) Hypoglycemia

2.) Diabetes Insipidus

During a diabetes screening program, a patient tells the nurse,"My mother died of complications of Type 2 Diabetes. Can I inherit the diabetes?" The nurse explains that: 1.) As long as the patient maintain normal weight and exercises, Type 2 Diabetes can be prevented 2.) The Patient is at a higher than normal risk for Type 2 Diabetes and should have periodic blood glucose level testing 3.)There is a greater risk for children developing type 2 diabetes when the father has type 2 diabetes 4.) Although there is a tendency for children of people with type 2 diabetes to develop diabetes, the risk is higher for those with type

2.) The patient is at a higher than normal risk for Type 2 Diabetes and should have periodic blood glucose level testing

The nurse is teaching a class on atherosclerosis. Which statement describes the scientific rationale as to why diabetes is a risk factor for developing atherosclerosis? 1.) Glucose combines with carbon monoxide, instead of oxygen, and this leads to oxygen deprivation of tissue 2.) Diabetes stimulates the SNS resulting in peripheralconstriction that increase the development of atherosclerosis 3.) Diabetes speeds the atherosclerosis process by thickening the basement membrane both large and small vessels 4.) Increased glucose combines with the hemoglobin, which causes deposits of plaque in the lining of the vessels

3

When taking a health history, the nurse screens for manifestations suggestive of diabetes type I. Which of the following manifestations are considered primary manifestations of diabetes type I and would be most suggestive of diabetes type I and require a follow up investigation? 1.) Excessive intake of calories, rapid weight gain, and difficult losing weight 2.) Poor circulation, wound healing, and leg ulcers 3.) Lack of energy, weight gain, and depression 4.) Increase in 3 areas: Thirst, intake of fluids, and hunger

4

The nurse is working with an overweight client who has a high-stress job and smokes. This client has just recieved a diagnosis of Type II Diabetes and has just been started on an oral hypoglycemic agents. Which of the following goals for the client which if met, would be most likely to lead to an improvement in insulin efficency to the point the client would no longer require oral hypoglycemic agents? 1.)Comply with medication regim 100% for 6 months 2.) Quit the use of any tobacoo products by the end of 3 months 3.) Lose a pound a week until weight is in normal range for height and exercise 30 minutes daily 4.) Practice relaxation technique for at least 5 minutes 5 times a day for at least 5 months

3.)

The nurse is caring for a patient whose blood glucose level is 55 mg/dl. What is the likely nursing response? 1.) Administer a glucagon injection 2.) give a small meal 3.) administer 10-15 of carbohydrate 4.) Give a small snack of high protein food

3.) Administer 10-15 of carbohydrate

An adolescent client with type 1 diabetes mellitus is admitted to the emergency department for treatment of diabetic ketoacidosis. Which assessment finding: 1.) sweating and tremors 2.) hunger and hypertension 3.) Cold, Clammy skin 4.) Fruity breath and decreasing level of consciousness

4.) Fruity breath and decreasing level of consciousness

The nurse is caring for a 54 year old patient hospitalized with Diabetes Mellitus would look for which of the following laboratory test result to obtain information on the patient's past glucose control? 1.) pre-albumin level 2.) urine ketone level 3.) fasting gluocse level 4.) glycosylated hemoglobin level

4.) glycosylated hemoglobin level (A1C)

An external insulin pump is prescribed for a client with DM. The client asks the nurse about functioning of the pump. The nurse bases the response on the information that the pump: 1.) Give small continuous dose of regular insulin subcutaneous, and the client can self-administer a bous with an additional dosage from the pump before each meal 2.) Is timed to release programmed doses of regular or NPH insulin into the bloodstream at specific intervals 3.) Is surgical attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases the insulin into the bloodstream 4.) Continuously infuses small amounts of NPH

A.) Give small continuous dose of regular insulin subcutaneous, and the client can self-administer a bolus with an additional dosage from the pump before each meal

Which of the follwoing person would most likely be diagnosed with diabetes mellitus? 1.) 44 year old 2.) caucasian women 3.) asian women 4.) african american 5.) Hispanic Male

African American

Analyze the following diagnostic findings for your patient with type 2 diabetes. Which result will need further assessment? 1.) BP 126/80 2.) AlC 9% 3.) FBG 130 mg/dl 4.) LDL cholesterol 100 mg/dl

B.) AlC

One of the benefits of Glargine (Lantus) insulin is it's 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 level C.) simplify the dosing and better control blood glucose levels during the day D.) Cause hypoglycemia with other manifestation or other adverse reactions

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

The guidelines for Carbohydrate Counting as medical nutrition therapy for Diabetes Mellitus include all of the following except: 1.) Flexibility in types and amounts of food consumed 2.) Unlimited intake of total fat, saturated fat, and cholesterol 3.) Including adequate serving of fruits and vegetables and the dairy group 4.) Applicable to win either Type 1 or Type 2 Diabetes Mellitus. Unlimited intake or total fat, saturated fat and cholesterol

B.) unlimited intake of total fat, saturated fat, and cholesterol (YOU WANT TO BE CAREFUL OF HOW MUCH YOU EAT IN ANY FOOD GROUP)

"Polydipsia and polyuria related to diabetes mellitus are primarily due to: "a. The release of ketones from cells during fat metabolism b. Fluid shifts resulting from the osmotic effect of hyperglycemia c. Damage to the kidneys from exposure to high levels of glucose d. Changes in RBCs resulting from attachment of excessive glucose to hemoglobin"

D.) Change of RBC resulting from attachment of excessive glucose to hemoglobin

Prediabetes is assoicated with all of the following EXCEPT: 1.) increased risk of developing type 2 diabetes 2.) impaired glucose 3.) increased risk of heart disease and stroke 4.) increased risk of developing type 1 diabetes

D.) increasing risk of developing Type 1 diabetes

When assessing the patient experience the onset of symptoms of Type 1 Diabetes, which question should the nurse ask? 1.) have you lost any weight lately? 2.) Do you crave fluids containing sugar? 3.) How long have you felt anorexic? 4.) Is your urine unusually dark colored

Have you lost any weight any more?

Which electrolyte replacement should the nurse anticipate being ordered by the health care provider in the client diagnosed with DKA who has just been admitted to the ICD? 1.) glucose 2.) potassium 3.) calcium 4.) Sodium

Potassium

The prinicpals goals of therapy for older patients who have poor glycemic controls are: 1.) Enhancing quality of life 2.) Decreasing the change of complications 3.) improving self-care through education 4.) all the above

all the above (4)

Which are symptoms of hypoglycemia? 1.) irritability 2.) Drowsiness 3.) Abdominal pain 4.) Nausea and vomit

irritability

What insulin type can be given by IV?

only the short insulin -Regular Insulin -Humulin N -Novolin N

The nurse assisting in the admission of a client with diabetic ketoacidosis will anticipate the physican ordering which of the following types of intravenous solutions if the client cannot take any fluid orally? 1.) 0.45% normal saline solution 2.) Lactated Ringer's solution 3.) 0.9 normal saline solution 4.) 5% dextrose in water (D5W)

0.45% normal saline solution (help to hydrate patient and keep electrolyte levels balanced)

The nurse is teaching a community class to people with Type 2 diabets Mellitus. Which explanation would explain the development of Type 2 Diabetes? 1.) The inslet cells in the pancreas stop producing insulin 2.) The client eats too much food that are high in sugar 3.) The pituitary glands does not produce vasopressin 4.) The cells become resistant to the circulating insulin

1.) (EATING TOO MUCH SUGAR DOES NOT CAUSE DIABETES MELLITUS)

What will the nurse teach the client with diabetes regarding exercise in his/her treatment program? 1.) during exercise the body will use carbohydrate for energy production, which in turn will decrease the need for insulin 2.) With an increase in activity, the body will use more carbohydrates; therefore more insulin will be required 3.) The increase in activity results in an increase in the use of insulin; therefore the client should decrease his/her carbohydrate intake 4.) Exercise will imporve pancreatic circulation and stimulates the islet of Langerhans to increase the production of intrinsitc insulin

1.) (carbohydrates are used for energy, insulin need will decrease)

Blood sugar is well controlled when Hemoglobin A1C is: 1.) A1C Below 7% 2.) between 12%-15% 3.) less than 180 mg/dl 4.) between 90 and 130 mg/dl

1.) A1C below 7%

The client diagnosed with Type 1 Diabetes is found lying unconscious on the floor of the bathroom. Which interventions should the nurse implement first? 1.) administer 50% dextrose IVB 2.) Notify the health-care provider 3.) Move the client to ICD 4.) Check the serum glucose level

1.) Administer 50% Dextrose IVB

Which statement by the patient with type 2 diabetes is accurate: 1.) "I am supposed to have a meal or snack if I drink alcohol." 2.) "i am not allowed to eat any sweets because of my diabetes." 3.) I do not need to watch what I eat because my diabetes is not the bad kind" 4.) the amount of fat in my diet is not important, it is just the carbohydrate that raise my blood sugar

1.) Alcohol should be consumed with food to reduce the risk of hypoglycemia

The nurse is educating a pregnant client who has gestational diabetes. Which of the following statement should the nurse make to the client. (Select all that apply0 1.) cakes, candies, cookies, and regular soft drinks should be avoided 2.) Gestational diabetes increase the risk that the mother will develop diabetes later in life 3.) Gestational Diabetes usually resolves after the baby is born 4.)Insulin injections may be necessary 5.) The baby will likely be born with diabetes 6.) The mother should strive to gain no more weight during the pregnancy

1.) Cakes, Candies, Cookies, and regular soft drinks should be avoided 2.) Gestational diabetes increase the risk that the mother will develop diabetes later in life 3.) Gestational Diabetes usually resolves after the baby is born 4.) Insulin Injections may be necessary

The nurse administerd 28 units of Humulin N an intermediate acting insulin, to a client diagnosed with Type 1 diabetes at 1600. What action should the nurse implement 1.)Ensure the client eats the bedtime snack 2.) Determine how much food the client at at lung 3.) Perform a glucometer reading at 0700 4.) Offer the client protein after administering insulin

1.) Ensure the client eats the bedtime snack

The client, an 18 year old female, 5'4" tall, weighing 113 kg, come to the clinic for a wound on her lower leg that has not healed for the last 2 weeks. Which disease process would the nurse suspect that the client has developed? 1.) Type 1 Diabetes 2.) Type 2 Diabetes 3.) Gestational Diabetes 4.) Acanthosis Nigricans

1.) Type 2 Diabetes

Which of the following factors are risks for the development of Diabetes Mellitus? (all that apply) 1.) Age over 45 2.) overweight with a waist/hip ratio>1 3.) Having a consistent HDL level above 30mg/dl 4.) Maintain a sedentary lifestyle

1.) age over 45 2.) overweight with a waist/hip ratio>1 4.) Maintain a sedentary lifestyle

The nurse is caring for a women at 37 weeks gestation. The client was diagnosed with insulin-dependent Diabetes MEllitus at age 7. The client states, "I am so thrilled that I will be breastfeeding my baby." Which of the following response by the nurse is best? 1.) you will probably need less insulin while you are brestfeeding 2.) you will need to initially increase your insulin after the baby is born 3.) You will be able to take an oral hyoglycemic instead of insulin after the baby is born 4.) you will probably require the same dose of insuulin that you are taking now

1.) breastfeeding has an antidiabetogenic effect, less insulin is needed

Which of the following is accurate pertaining to physical exercise and Type 1 Diabetes Mellitus? 1.) Physical exercise can slow the progression of diabetes mellitus 2.) Strenous exercise is beneficial when the blood gluocse is high 3.) Patients who take insulin and engage in strenuous physical exercise might experience hyperglycemia 4.) Adjusting insulin regimen allows for safe partifipation in all forms of exercise

1.) physical exercise can slow the progression of diabetes mellitus

The nurse is discharged a client diagnosed with diabetes insipidus. Which statement made by the client warrants further intervention? 1.) "I will keep a list of my medication in my wallet and wear a Medi bracelet." 2.) "I should take my medication in the morning and leave it refrigerated at home." 3.) "I should weigh myself every morning and record any weight gain." 4.) "If I develop a tightness in my chest, I will call my health-care provider."

2

Of which of the following symptoms might an older women with diabetes mellitus complain? 1.) anorexia 2.) pain intolerance 3.)weight loss 4.) perineal itching

4.) perineal itching

"The nurse is discussing the importance of exercising to a client diagnosed with Type 2 Diabetes whose diabetes is well controlled with diet and exercise. Which information should the nurse include in the teaching about diabetes 1.) Eat a simple carbohydrate snack before exercising 2.) Carry peanut putter crackers when exercising 3.) Encourage the client to talk 20 minutes 3 times a week 4.) Perform warmup and cooldown exercise

4.) this helps prevent muscle strain

When an older adult is admitted to the hospital with a diagnosis of diabetes mellitus and compliant of rapid-onset weight loss, elevated blood glucose levels, and polyphagia, the gernotology nurse should anticipate which of the following secondary medical diagnosis 1.) impaired glucose tolerance 2.) Gestational Diabetes Mellitus 3.) Pituitary Tumor 4.) Pancreatic Tumor

pancreatic tumor