Glucose EAQs
With which condition would the nurse associate the response of diaphoresis, weakness, and pallor at 3:30 units of neutral protamine Hagedorn (NPH) insulin at 7:00 AM?
Hypoglycemic reaction
Which short-term goal is the priority fora client with a new insulin pump who is receiving discharge instructions?
Demonstrate correct use of the insulin pump.
Which outcome is the best indication that a client with type 1 diabetes is successfully managing the disease?
Demonstrated knowledge of the disease
A client's breath has a sweet, fruity odor. Which condition is affecting this client?
Diabetic acidosis
A child with type 1 diabetes is receiving 15 units of regular insulin and 20 units of NPH insulin a 7:00AM each day. Which time would the nurse anticipate a hypoglycemic reaction from the NPH insulin to occur?
In the afternoon
Which insulin will the nurse prepare for the emergency treatment of ketoacidosis?
Insulin aspart
Which insulin would the nurse conclude has the fastest onset of action?
Insulin lispro
Which instruction will the nurse provide to a client with type 2 diabetes who develops gout when teaching about the administration of allopurinol?
"Monitor blood glucose levels more frequently."
Which factors can predispose a client with type 1 diabetes to a diabetic ketoacidotic coma? SATA
Excessive emotional stress Running a fever with the flu
Which intervention would the nurse complete first for the client found to have glucose in the urine?
Reporting the finding to the primary health care provider.
Which condition would the nurse identify as the likely cause of profound weakness and nervousness in a client that became confused shortly after self-administering the morning dose of 10 units of regular insulin and 25 units of NPH insulin after a light breakfast with no additional intake the 3 hours since that time?
Hypoglycemia
A continuous insulin infusion is started on an adolescent with a blood glucose level of 700 mg/dL. Which complication would the nurse make a priority of detecting while the adolescent is receiving the infusion?
Hypokalemia
Which statement by the nurse is most appropriate regarding the greatest advantage of using an insulin pump?
'Independence is fostered.'
The nurse is teaching a young adolescent with type 2 diabetes about nutritional needs. Which statement demonstrates that the adolescent understands what was taught?
'It's okay for me to eat one slice of pizza at a party.'
Which fasting plasma glucose (FPG) level would indicate a client has pre diabetes?
100 mg/dL
Which period of time would a nurse recognize as the greatest risk of hypoglycemia when caring for a client who receives regular insulin daily at 8:00am?
10:00AM to 1:00PM
The primary health care provider prescribes daily fasting blood glucose levels for a client with diabetes mellitus. What is the gal of fasting glucose levels for a client with diabetes mellitus?
70 to 105 mg/dL of blood
Which assessment finding would the nurse associate with a client with diabetic ketoacidosis? SATA
Acetone breath Decreased arterial carbon dioxide level
Which client would be taken by the nurse caring for a client with type 1 diabetes mellitus who has a finger-stick glucose level of 258 mg/dL at bedtime and a prescription for sliding-scale regular insulin?
Administer the insulin as prescribed.
A client has been on a hunger strike for 5 days. During this time, which hormones provide glucose as energy through catabolism? SATA
Cortisol Glucagon
The nurse is teaching a client about safe insulin administration. Which statement made by the client indicated the need for further education?
"I should administer insulin only if there are any symptoms."
Which information will the nurse include when providing education to the family of an adolescent who was recently diagnosed with type 2 diabetes mellitus?
"The most important interventions are good nutrition and portion control."
Which principle of teaching would the nurse consider when providing instructions to an older client recently diagnosed with diabetes mellitus
Continued reinforcement is important.
Which finding would lead the nurse to recheck the blood glucose level of a diabetic client before administering a mealtime insulin dose? SATA
Confusion Drowsiness Diaphoresis Nervousness Heart rate 110 beats/min
Which statement would a nurse make about older adults and type 2 diabetes?
Older adults seldom develop ketoacidosis
Which material condition would cause the nurse to expect signs of respiratory distress syndrome (RDS) in a neonate?
Type 1 diabetes
Which initial response would the nurse make to a 67-year-old man with type 2 diabetes who sadly confides in the nurse that he has been unable to have an erection for several years?
'You sound upset about not being able to have an erection.'
Which instruction about medications would the nurse include when teaching a client with type 1 diabetes who tells the nurse, "I take guaifenesin cough syrup when i have a cold."?
"Include the glucose in the cough syrup when calculating daily carbohydrate allowance."
Which response would a nurse give to a client who asks "why can't I take the insulin in pills instead of taking shots?" During a teaching session about insulin injections?
"Insulin is destroyed by gastric juices, rendering it ineffective."
A client's fasting plasma glucose levels are being evaluated. The nurse identifies that the client is considered to be diabetic if the results are within which range?
126 to 140 mg/dL
Which cause of tremors, pallor, and diaphoresis would be suspected in a client with type 1 diabetes?
Aerobic exercise
The nurse is caring for an alert client with diabetes whose blood glucose level is 30 mg/dL. Which would the nurse give to the client if the protocol calls for treatment of hypoglycemia with 15 g of a simple carbohydrate?
Ask the client to ingest 1 tube of glucose gel.
A client with type 2 diabetes has been receiving insulin in the hospital while being treated for sepsis. The client's infection is resolving and the primary health care provider writes a prescription to discontinue the 7:00 AM dose of insulin and to administer glyburide at 8:30 AM, the nurse sees that the insulin had already been administered at 7:00AM. Which initial action would the nurse take?
Check the blood glucose for hypoglycemia.
Client experiences ineffective control of type 1 diabetes. The client's study results indicate that a sudden decrease in blood glucose level is followed by rebound hyperglycemia. When this events occurs, which action would the nurse take?
Collaborate with the primary healthcare provider to alter the insulin prescription.
Which condition is likely being experienced by a client receiving NPH insulin every morning who reports feeling nervous at 4:30 PM and has skin that is moist and cool?
Hypoglycemia
Which factor contributes to a client's slow rate of healing? SATA
Diabetes Smoking Alcohol abuse
For which condition is an oral hypoglycemic agent indicated?
Reduced insulin production
Before having surgery, a client with type 1 diabetes insulin requirements are elevated but well controlled. Which insulin requirements would the nurse anticipate for this client postoperatively?
Remain elevated
Which eye problem is the leading cause of blindness in clients with diabetes?
Retinopathy
A 15-year-old adolescent with type 1 diabetes arrives at the diabetic outpatient clinic with a parent. The adolescent sits back in the chair it's his arms folded, frowns, and displays a withdrawn attitude. The adolescent and parent argue in front of the nurse. Which approach would be taken by the nurse?
Speaking separately with each of them, encouraging them to recognize and vent their anger
An adolescent who has had type 1 diabetes for 5 years stops adhering to the therapeutic regimen. Which developmental task would the nurse conclude is influencing this behavior?
Struggle for identity
Which medication is responsible for neonatal hypoglycemia?
Tolbutamdie
Which effects of exercise would the nurse share with a client with diabetes who asks how exercise will affect insulin and dietary needs?
Decreases the amount of insulin needed and increases the need for carbohydrates
When obtaining the history of a client recently diagnosed with type 1 diabetes, which symptom would the nurse expect to see?
Weight loss
The nurse is assessing a client admitted with diabetic ketoacidosis. Which statement made by the client indicates a need for further education on sick day management?
"I will stop taking my insulin when I am ill because I am not eating."
When teaching a client with type 2 diabetes, which statement by the nurse reflects accurate information about preparing for a serum glucose test?
"Do not inject anything before the test."
How will the nurse respond to a client with a diagnosis to type 1 diabetes who becomes agitated and says, "I am scared of shots. If that is my only option, I'll just have to go into a coma and die!" When told that lifelong insulin will be needed?
"Injections are not the only option available for insulin."
Which response would a nurse give to a client diagnosed with type 1 diabetes who states "I hate shots. Why can't I take the insulin in tablet form?"?
"Insulin is poorly absorbed orally, so it is not available in a tablet."
Which response would a nurse give to a client taking an oral hypoglycemic tablet daily who asks if an extra tablet should be taken before exercise?
"No, but you should observe for signs of hypoglycemia while exercising."
Which treatment would the nurse suggest to an adolescent with type 1 diabetes if an insulin reaction is experienced while the adolescent is at a basketball game?
'Buy a soda and a hamburger to eat.'
Between which weeks of gestation would a client with type 1 diabetes expect to increase her insulin dosage?
24th and 28th week of gestation
Which nursing intervention is appropriate when a client is first admitted with hyperglycemic hyperosmolar nonketoic syndrome (HHNS)?
Administering fluid replacement
A client with type 1 diabetes receives Humulin R insulin in the morning. Shortly before lunch the nurse identifies that the client is diaphoretic and trembling. Which intervention is appropriate?
Assess the client's blood glucose level.
The nurse is caring for a client with hypoglycemia. The nurse anticipates a prescription for which medications? SATA
Glucagon Intravenous (IV) glucose Oral hydrocortisone
Which statement will the nurse need to consider when developing the teaching plan for a client with type 2 diabetes prescribed an oral hypoglycemic medication?
Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control.
Upon assessment, the nurse finds the client is experiencing weight gain as well as elevated lipid and blood glucose levels. Which medication on the client's prescription list is most likely to cause these metabolic side effects? SATA
Clozapine Olanzapine
While caring for a client with diabetes, the registered nurse (RN) delegates the task of administering oral medications to the licensed practical nurse (LPN), but the LPN is reluctant to are the assignment. Which initial response by the RN is most appropriate in this situation?
Evaluate the reason for he behavior.
Which rationale will prompt the nurse to ask the provider for a different form of metformin when an older adult asks that extended-release metformin be crushed because it is difficult to swallow?
Extended-release formulations are designed to be released slowly and crushing the tablet will prevent this from occurring.
Which intervention would the nurse implement to relieve the symptoms associated with a hypoglycemic reaction?
Give 4 oz of fruit juice.
Which intervention would the nurse implement for a client who has type 1 diabetes an has an elevated blood glucose?
Give supplemental doses of regular insulin.
Which medication would be administered to a client who reports sweating, tachycardia, and tremors with a laboratory report that reveals serum cortisol less than normal and a blood glucose level of 60 mg/dL?
Glucagon
A woman with type 2 diabetes mellitus continues to take an oral hypoglycemic agent during her pregnancy. Which would the nurse assess for in the newborn?
Hypoglycemia
An adolescent with type 1 diabetes mellitus is admitted to the intensive care unit in ketoacidosis with blood glucose level of 170 mg/dL. A continuous insulin infusion is started. Which adverse reaction to the infusion is most important for the nurse to monitor?
Hypokalemia
Which information would the nurse include in a teaching plan when teaching a client with diabetes about the advantages of using an insulin pump? SATA
It can improve A1c levels Clients may be able to exercise without eating more carbohydrates.
Which explanation would the nurse share regarding the reversal of hypoglycemia after administering a tube of glucose gel to a client?
It provides a glucose source that is rapidly absorbed.
Which adverse effect of metformin will a nurse teach a client with type 2 diabetes to monitor for when used as monotherapy?
Lactic acidosis
The nurse plans to teach a fifth-grader with type 1 diabetes how to self-administer lispror and glargine insulin. Which action would the nurse include in the teaching plan?
Learn to use the needle and syringe by practicing on an insulin pad first.
Which condition would cause a nontender 5-cm indurated region on the upper arm of the client who says to the nurse, "That is where is give myself insulin shots."?
Lipodystrophy
Which time range would a nurse teach as the highest risk for hypoglycemia to a client with type 1 diabetes who self-administers neutral protamine Hagedorn (NPH) insulin every morning at 8:00AM?
Noon to 8:00PM
Which purpose of insulin would a nurse identify when caring for a client prescribed insulin added to a solution of 10% dextrose in water after an intravenous solution containing potassium inadvertently was infused too rapidly?
Potassium follows glucose into the cells of the body, thereby raising the intracellular potassium levels.
The nurse plans to teach a school-aged child with type 1 diabetes who is receiving both intermediate-acting insulin and regular insulin daily how to self-administer the insulin before discharge. Which procedure would the nurse teach the child?
Practice using the non medicated insulin pen first.
Which rationale explains why intravenous (IV) potassium is prescribed in addition to regular insulin for clients in diabetic ketosis?
Serum potassium levels will decrease as potassium ions shift from the extra cellular fluid to the intracellular fluid compartment.
The registered nurse (RN) delegates the task of administering oral antibiotics for a client with diabetes. Which statements are true in this scenario? SATA
The RN is accountable for the delegatee's work The licensed practical nurse (LPN) should report to the RN once the task is completed. The LPN can be held responsible for any failure in administration of oral medication.
The nurse is educating the client newly diagnosed with type 2 diabetes on oral anti diabetic medications. Which instruction would the nurse include in the teaching plan? SATA
The client should obtain a finger-stick blood glucose reading before each meal. The teaching plan should include signs and symptoms of hypoglycemia. The teaching plan should include sick day rules.
Which hormone would the nurse identify as inhibiting insulin and glucagon secretion?
somatostatin
A client with type 2 diabetes travels frequently and asks how to plan meals during trips. Which is the best response by the nurse?
"Choose the foods you normally do and follow your food plan wherever you are."
As the nurse plans to teach a 9-year-old boy with a learning disability about his diabetes, the parent intervenes and states, "That won't be necessary. With his learning issues, I recognize that he can't care for himself." Which is the best response by the nurse?
"Including your son now will help him take on more of his care in the future."
The nurse is interviewing a client admitted for uncontrolled diabetes. The client has been binging on alcohol for the past 2 weeks. The client states, "I am worried about how I am going to pay my bills for my family while I am hospitalized." Which statement by the nurse is therapeutic?
"You are worried about paying your bills?"
The nurse is. In the process of discharging a 9-year-old boy with recently diagnosed type 1 diabetes. Which parental statement would indicate a potential issue in future family dynamics?
'We know that our child is special, so we'll go easy on the discipline.'
A client with type 1 diabetes has an above-the-knee amputation because of severe lower extremity arterial disease. Two days after surgery, which intervention is appropriate when preparing the client to eat dinner?
Checking the client's serum glucose level
Which information would the nurse base a response on to a parent who asks for guidance regarding who to tell of the diagnosis of diabetes of their child who plays on the soccer team?
Children with diabetes who participate in active sports can have episodes of hypoglycemia.
Which action would the nurse take when a client with type 1 diabetes reports hunger, thirst, tiredness, and frequent urination?
Determine client's blood glucose level.
The nurse is planning to teach a school-ages child with newly diagnosed type 1 diabetes about self-care. After an assessment off what the child knows about diabetes, which is the next nursing intervention?
Developing a sequence of goals with the child and parent
The regulation of type 1 diabetes in an 8-year-old child is best attained with a combination of therapeutic modalities in addition to the administration of insulin. Which modalities should be included in the teaching plan? (Select all that apply.)
Dietary control Regular exercise Blood glucose monitoring
Which intervention would the nurse prioritize when planning a teaching program for a child who was recently diagnosed with type 1 diabetes?
Exploring the child's feelings about diabetes
A client is thought how to recognize signs of a hypoglycemic reaction. Which symptoms identified by the client indicate to the nurse that the teaching was effective? SATA
Fatigue Weakness Nervousness Increased perspiration
Which type of eye disorder will the nurse expect to read in the electronic medical record (EMR) of a client who has increase blood pressure, severe myopia, and high blood glucose levels?
Glaucoma
A student with type 1 diabetes asks the nurse which primary hormone causes the blood glucose level to rise. Which hormone would the nurse report?
Glucagon
Which information would lead a nurse to suspect that a client with uncontrolled diabetes is experiencing hypoglycemia in response to insulin administration? SATA
Headache Confusion Profuse sweating
Which is the priority concern of a 10-year-old child who was recently diagnosed with type 2 diabetes?
How much school might be missed
An adolescent with a history of type 1 diabetes is admitted in ketoacidosis. Which cause would the nurse suspect as precipitating this episode of ketoacidosis?
Infection
Which information would the nurse emphasize when teaching lifelong management of type 1 diabetes than adolescent?
Inspecting both feet frequently for signs of trauma
Which information would the nurse include in the teaching plan of an adolescent who is found to have type 1 diabetes? SATA
Insulin therapy Blood glucose monitoring Adherence to the treatment regimen
A 15-year-old adolescent is found to have type 1 diabetes. Which would the nurse include when teaching the adolescent about type 1 diabetes?
It has more rapid onset than does type 2 diabetes.
For a pregnant client with type 1 diabetes, which action is most likely or reduce the risks of disease-related complications?
Monitor and control blood glucose levels.
Which manifestation would the nurse expect to find when assessing a client with hypoglycemia? SATA
Palpitations Diaphoresis Slurred speech
Which responses would the nurse expect a client experiencing hypoglycemia to exhibit? SATA
Palpitations Tachycardia Nervousness
Which is an appropriate teaching goal for a client who is newly diagnosed as having type 2 diabetes?
To identify symptoms of hypoglycemia or hyperglycemia
A 9-year-old child with type 1 diabetes is prone to having hypoglycemic episodes in the morning. Which intervention would be included in the school nurse's plan of care for this child?
Asking the child each day what was eaten for breakfast
Which laboratory test would the nurse expect to be prescribed that will reveal the effectiveness of a diabetic regimen for a child with type 1 diabetes?
Glycosylated hemoglobin
A client with type 1 diabetes has dry, hot, flushed skin; a fruity odor to the breath; and is having Kussmaul respirations. Which complication does the nurse expect the client is experiencing?
Ketoacidosis
Which complication associated with type 1 diabetes should the nurse include in the teaching plan for the parent of a newly diagnosed child?
Ketoacidosis
Which molecule excessively accumulates in he blood to precipitate the signs and symptoms associated with a diabetic coma?
Ketones as a result of rapid fat breakdown, causing acidosis
Which side would the nurse expect a newborn to be of a client who had inadequately controlled type 1 diabetes during pregnancy?
Large for gestational age, near term
A client with type 1 diabetes for 25 years states, "I have been really bad for the past 15 years. I have not paid attention to my diet and have done little to control my diabetes." Which common complications of diabetes might the nurse expect to identify when assessing this client? SATA
Leg ulcers Loss of visual acuity Thick, yellow toenails Decreased sensation in the feet
Which common cause of diabetic ketoacidosis would the nurse consider when caring for postoperative client with diabetes?
Presence of infection
The nurse teaches a client with type 2 diabetes how to provide self-care to prevent infections of the feet. Which statement made by the client shows that teaching was effective?
"I should control my blood glucose with diet, exercise, and medication."
A mother asks the neonatal nurse why her infant must be monitored so closely for hypoglycemia when her type 1 diabetes was in excellent control during the entire pregnancy. How would the nurse best respond?
'Babies of mothers with diabetes have a higher-than-average insulin level because of the excess glucose received from the mother during pregnancy, so the glucose level may drop.'
Which statement made by a client recently diagnosed with type 1 diabetes indicates that further education is necessary regarding the teaching plan?
'Once I get my glucose levels under control, there is a goof chance that I will be able to switch from insulin to an oral medication.'
Which child would the nurse recommend screening for type 2 diabetes mellitus (T2DM) during a local health screening? SATA
Child who recently turned 10 years old, has not yer entered puberty, and has no other risk factors African-American child, BMI in the 87th percentile, family history of diabetes Caucasian child, BMI in the 96th percentile, signs of insulin resistance
The nurse is formulating a teaching plan for a client recently diagnosed with type 2 diabetes. Which interventions would the nurse include to decrease the risk of complications? SATA
Examine the feet daily Wear well-fitting shoes Perform regular exercise
The nurse teaching a prenatal class is asked why infants of a diabetic mother are larger than those born to women who do not have diabetes. On which information about pregnancy and diabetes would the nurse base the response?
Extra circulating glucose causes the fetus to acquire fatty deposits.
Which purpose is served by an evening snack of milk, crackers, and cheese for a client who is receiving NPH insulin?
Food to counteract late insulin activity
Which laboratory value supports the presence of diabetic ketoacidosis in a client with type 1 diabetes?
Increased blood urea nitrogen levels
Which laboratory value supports the presence of diabetic ketoacidosis?
Increased serum lipids
An increase in which blood component is responsible for acidosis related to untreated diabetes mellitus?
Ketones
Which unique response is associated with diabetic ketoacidosis (DKA) that is not exhibited with hyperglycemic hyperosmolar nonketonic syndrome (HHNS)?
Kussmaul respirations
The nurse is teaching a client newly diagnosed with type 1 diabetes about self-care. Which is the priority long-term goal?
Maintaining normoglycemia
The nurse is caring for the newborn of a mother with diabetes. For which signs of hypoglycemia would the nurse assess the newborn? SATA
Pallor Irritability Hypotonia Ineffective sucking
When planning care for a client with type 1 diabetes, which change in insulin requirements would the nurse anticipate on the first postpartum day?
Sudden decrease
A client with diabetes mellitus complains of difficulty seeing. Which factor would the nurse suspect as being the cause?
The lack of growth of new retina blood vessels or "neovascularization"
Why is 15 g of a simple sugar administered when a client with diabetes experiences hypoglycemia?
increase blood glucose levels
Which clinical finding supports the conclusion by a nurse that a client had had a hypoglycemic reaction to insulin? SATA
Irritability Heart palpitations
The nurse is teaching a school-age child how to use an insulin pump. Which instruction by the nurse is most important for the child to understand?
The pump is an attempt to mimic the way a healthy pancreas works.
Which manifestation would the nurse include when teaching a client about keto acidosis?
Confusion Excessive thirst Fruity-scented breath
Which cellular process associated with type 1 diabetes mellitus results in increased client fatigue?
Decreased production of insulin by the pancreas
Which finding would lead the nurse to recheck the blood glucose level of a diabetic client before administering a mealtime insulin dose? SATA
Confusion Drowsiness Diaphoresis Nervousness Heart rate 110 beats/min
The nurse is planning to teach a 9-year-old child with type 1 diabetes to perform blood glucose monitoring. Which information would the nurse use as a basis for the teaching?
A child this age can maintain the glucose level in the normal range by changing insulin needs accordingly.
The nurse is explaining insulin needs to a client with gestational diabetes who is in her second trimester of pregnancy. Which information would the nurse give to this client?
Insulin needs will increase during the second trimester.
The nurse teaches an adolescent with type 1 diabetes about peak action of NPH insulin and the risk for hypoglycemia. The nurse determines teaching has been effective when the adolescent identifies insulin peak action within which time frame?
4 to 12 hours
Which angle would an obese client be taught to self-administer an insulin injection at?
90-degree angle
Which information is important for the nurse to include concerning insulin administration when discussing insulin needs with an adolescent with recently diagnosed type 1 diabetes?
Insulin will be required throughout life.
Which complication of diabetes would the nurse suspect when a health care provider prescribes one tube of glucose gel for a client with type 1 diabetes?
Insulin-induced hypoglycemia
Which initial intervention would the nurse expect the primary health care provider to order for a client admitted to the hospital with a diagnosis of diabetic ketoacidosis?
Intravenous (IV) fluids
Which nursing intervention is appropriate to include in the plan o care for a client with diabetic ketoacidosis (DKA)?
Intravenous administration of regular insulin
When taking a health history of a 5-year-old boy who recently was found to have type 1 diabetes, the nurse would anticipate which reaction from the child?
Must revive continual health teaching based on cognitive ability
Which result would the nurse expect to find when assessing the laboratory values of a client with type 2 diabetes?
Urine negative for ketones and positive glucose in the blood
Which education would the nurse provide the parents of a child with type 1 diabetes who ask why they should test the child's urine for ketones during periods of stress or illness, even though blood glucose testing is being done four times a day?
Urine should be tested for ketones during illness and when the blood glucose level is increased.
The nurse observes that a client's urine has a sweet fruity odor. Which information is important to evaluate when performing a further client assessment?
Serum glucose level
A teaching plan was developed for a 12-year-old child who has been hospitalized for treatment of newly diagnosed type 1 diabetes. Which would cause the nurse to be concerned about the effectiveness of the program?
The parent is having difficulty accepting the diagnosis.
Which action would help foster acceptance of the diabetic regimen by an adolescent with type 1 diabetes who is brought to the emergency department in ketoacidosis and admits to not adhering to the diabetic regimen?
Encourage the adolescent to express feelings about having diabetes.
Which advice will the ruse give the client to avoid lipodystrophy when self-administering insulin therapy?
Rotate injection sites
List the actions in order the nurse will perform them when mixing a short-acting and intermediate-acting insulin in the same syringe.
1. Put air into the intermediate-acting insulin vail. 2. Put air into the short acting insulin vail. 3. Withdraw the prescribed amount of short-acting insulin. 4. Withdraw the prescribed amount of intermediate-acting insulin.
For which reason may insulin requirements of a client with type 1 diabetes decrease during the first trimester?
Morning sickness may result in decreased food intake.
Which newborn would the nurse anticipate will experience hypoglycemia? SATA
Preterm infant Small-for-gestational-age infant Large-for-gestational-age infant
Which fluid shift will the nurse take into consideration when assessing a client with type 1 diabetes who is experiencing a fluid imbalance?
Intracellular to intravascular as a result of hyperosmolarity
A client who is 60 pounds more than the ideal body weight is admitted to the hospital with a diagnosis of type 1 diabetes. Which concept should the nurse include in teaching about diabetes when discussing strategies to lose weight?
Obesity leads to insulin resistance
Which nursing intervention would be included in the treatment of an adolescent who is diagnosed with type 2 diabetes mellitus, has a body mass index (BMI) of 30, and reports fatigue, frequent urination, and tingling sensation in the feet? SATA
Physical activities Dietary counseling Behavior modification
Which client is at risk for developing type 2 diabetes mellitus (DM)? SATA
15-year-old male who plays video games 6 hours per day 36-year-old female with history of gestational diabetes 47-year-old male who weighs 250 pounds and is 5'9" tall 28-year-old female with poly cystic ovarian syndrome (POS) 60-year-old male of Native American descent who abuses alcohol
While obtaining a client's health history, which factor would the nurse identify as predisposing the client to type 2 diabetes?
Being 20 pounds overweight
Which is the priority short-term goal when teaching a client with type 1 diabetes who is placed on an insulin pump to control the diabetes?
"The client will demonstrate correct use of the insulin pump."
Which response will the nurse provide to a client with type 2 diabetes taking one glyburide tablet daily who asks whether an extra tablet should be taken before exercise?
"Do not take an extra pill because you may become hypoglycemic when exercising."
Which response would be given by the nurse of an adolescent who has just been found to have type 1 diabetes and asks about exercise?
"Extra snacks are needed before exercise."
The nurse suspects that a client has diabetes mellitus. Which statements made by the client helped the nurse reach this conclusion? SATA
"I am 65 years old." "I quite often feel thirsty." "I eat food every 2 hours."
Which statement made by a client prescribed metformin extended release to control type 2 diabetes mellitus indicated the need for further education?
"I will stop taking metformin for 24 hours before and after having a teat involving dye."
Child is prescribed insulin glargine before breakfast. Which instruction is most appropriate for the nurse to give the parent regarding a bedtime snack?
"Offer a snack to prevent hypoglycemia during the night."
Which information would the nurse provide to a client with type 1 diabetes who requests information about the differences between penlike insulin delivery devices and syringes?
"Penlike devices provide a more accurate dose delivery."
A client is receiving 45 units of intermediate-acting insulin at 7:00AM and 7:00PM. Which statement by the nurse is most appropriate when discussing bedtime snacks with the parent?
"Provide a bedtime sack to prevent hypoglycemia during the night."
Which information would the nurse include when teaching a type 2 diabetic controlled with oral anti diabetic medications who is prescribed regular insulin when admitted for elective surgery?
"With insulin, dosage can be adjusted to your changing needs during recovery from surgery."
The nurse is teaching a 12-year-old child about the action of insulin injections. Which statement indicated the child understands how insulin works in the body?
'Glucose is carried into cells where it is used for energy.'
Which statement by a client with type 2 diabetes indicates to the nurse that additional dietary teaching is needed?'
'I can eat as much diabetic fruit as I want.'
The nurse is teaching a 10-year-old child with type 1 diabetes about insulin requirements. Which statement by the nurse correctly identifies when insulin needs decrease?
'Increased muscle activity such as exercise, cause insulin needs to decrease.'
Which is an appropriate response to a 24-year-old client with type 1 diabetes who asks how her pregnancy will affect her diet and insulin needs?
'Insulin dosage and dietary needs will be adjusted in accordance with the results of blood glucose monitoring.'
Which statement made by a diabetic client shows that dietary teaching by the nurse was effective?
'My diet can be planned around a wide variety of commonly used foods.'
In which order will the nurse perform the actions associated with insulin administration?
1. Wash hands with soap and water. 2. Rotate the vial of insulin between the palms of the hands. 3. Wipe the top of the insulin vail with an alcohol swab. 4. Instill if into the vial of insulin equal to the desired dose. 5. Withdraw the correct amount of insulin from the inverted vial.
When teaching an adolescent with type 1 diabetes about dietary management, which instruction would the nurse include?
A ready source of glucose should be available.
An obese client with type 2 diabetes asks about the intake of alcohol or special "diabetic" food in the diet. Which instruction would be included in the teaching plan?
Alcohol can be consumed, with its calories counted in the diet.
When determining the main difference between type 1 and type 2 diabetes, the nurse recognizes which clinical presentation about type 1?
Complications are not present at the time of diagnosis.
When will the nurse monitor for potential hypoglycemic reaction after administering daily regular insulin to a client with type 1 diabetes at 8 AM?
Before lunch
Which assessment finding would the nurse identify as significant in an infant of a diabetic birth parent who is large for gestational age (LGA)?
Blood glucose level less than 40 mg/dL
Which labratory results support the nurse's suspicion that a client diagnosed with type 1 diabetes is experiencing ketoacidosis?
Blood glucose of 300 mg/100 mL, blood pH of 7.20
Which physiological changes would the nurse expect to find in a client with a 20-year history of the 2 diabetes?
Blurry, spotty, or hazy vision
Which advice will the nurse provide to a client who is taking an oral hypoglycemia daily for type 2 diabetes who develops an infection with anorexia? SATA
Continue to take the oral medication. Drink fluids throughout the day. Monitor capillary glucose levels.
Which clinical finding supports the diagnosis of diabetic ketoacidosis DKA?
Deep respirations and fruity odor to the breath
The nurse is assessing a client with diabetic ketoacidosis. Which clinical manifestations would the nurse expect? SATA
Dry skin Abdominal pain Kussmaul respirations
One principle to be followed for children with type 1 diabetes is to provide for the variability of the child's activity. Which would the nurse teach the child about how to compensate for increased physical activity?
Eat more food when plan on to exercise more than usual.
An adolescent with diabetes had a 6:30AM fasting glucose level of 180 mg/dL. Which nursing action is a priority?
Tell the adolescent that the prescribed dose of rapid-acting insulin should be administered.
The nurse is monitoring the newborn of a diabetic mother for tremors, periods of apnea, cyanosis, and poorly sucking ability. With which complication are these manifestations associated?
Hypoglycemia
Which type of insulin would the nurse recognize as compatible with IV solutions when caring for a client with diabetes mellitus who is scheduled to receive an intravenous (IV) administration of 25 units of insulin in 250 mL normal saline?
Insulin lispro
Which information will the nurse include when teaching a client with type 1 diabetes about the use of an insulin pump?
Insulin pumps mimic the way a healthy pancreas works.
The laboratory findings of an obese hypertensive adolescent reveal hyperinsulinemia and dyslipidemia. Which condition would the nurse anticipate incorporating into the plan of care?
Insulin resistance syndrome
Which complication of diabetes would the nurse assess for in a client with a long history of the disease? SATA
Leg ulcers Loss of visual acuity Prolonged capillary refill in the toes Decreased sensation in the lower extremities
The nurse is planning an evening snack for a child receiving NPH insulin. The nurse offers a snack for which reason?
Nourishment helps counteract late insulin activity.
Which instruction would the nurse provide to a 6'0", 160-pound client newly diagnosed with type 1 diabetes who wants to self-administer injections with an insulin pen? SATA
Prime the needle with 2 units Use a 29-gauge insulin needle. Give the injection at 45-degree angle. Refrain from recapping the needle. Dial the pen to deliver the unit dose.
Which mechanism of action explains how glyburide decreases serum glucose levels?
Stimulates the pancreas to produce insulin
When teaching a client with diabetes about monitoring for episodes of hypoglycemia, which symptom would the nurse include in the teaching plan?
Sweating
Which instruction would the nurse include in a teaching plan for a client who is taking an oral hypoglycemic daily for type 2 diabetes and is concerned about the need for special care at home if they develop the flu?
Take the oral hypoglycemic pill, drink warm fluids, and check blood sugar before meals at bedtime.
A child with type 2 diabetes is scheduled for abdominal surgery. Which factors are most important for the nurse to consider during the postoperative period? SATA
The blood glucose level will increase because of the stress of surgery. Diabetic control is usually maintained with insulin after surgery.
Which information about the teenager's developmental stage would be considered before starting a counseling program for 15-year-old with type 1 diabetes who has a history of noncompliance with the therapy regimen?
The struggle for identity is typical.
The nurse is providing instructions about foot care for a client with diabetes mellitus. Which would the nurse include in the instructions? SATA
Wear shoes when out of bed Dry between the toes after bathing.