Med-Surge: Caring for Clients with Diabetes Mellitus

A client with diabetes is asking the nurse what causes diabetic ketoacidosis (DKA). Which of the following is a correct statement by the nurse? "DKA can be caused by taking too much insulin." "DKA can happen without a cause." "DKA can be caused by taking too little insulin." "DKA will not happen with type 1 diabetes."

"DKA can be caused by taking too little insulin."

A nurse is educating a client about the benefits of fruit versus fruit juice in the diabetic diet. The client states, "What difference does it make if you drink the juice or eat the fruit? It is all the same." What are the best responses by the nurse? Select all that apply. "Eating the fruit will lead to hyperglycemia and the fruit juice will not lead to hyperglycemia." "Eating the fruit is more satisfying than drinking the juice. You will get full faster." "Eating the fruit will give you more vitamins and minerals than the juice will." "Eating the fruit instead of drinking juice decreases the glycemic index by slowing absorption." "The fruit has less sugar than the juice."

"Eating the fruit instead of drinking juice decreases the glycemic index by slowing absorption." "The fruit has less sugar than the juice."

A client is taking glyburide (DiaBeta), 1.25 mg P.O. daily, to treat type 2 diabetes. Which statement indicates the need for further client teaching about managing this disease? "I skip lunch when I don't feel hungry." "I avoid exposure to the sun as much as possible." "I always carry hard candy to eat in case my blood sugar level drops." "I always wear my medical identification bracelet."

"I skip lunch when I don't feel hungry."

A diabetes educator is teaching a client about type 2 diabetes. The educator recognizes that the client understands the primary treatment for type 2 diabetes when the client states: "I will take my oral antidiabetic agents when my morning blood sugar is high." "I will make sure to follow the weight loss plan designed by the dietitian." "I read that a pancreas transplant will provide a cure for my diabetes." "I will make sure I call the diabetes educator when I have questions about my insulin."

"I will make sure to follow the weight loss plan designed by the dietitian."

A diabetic educator is discussing "sick day rules" with a newly diagnosed type 1 diabetic. The educator is aware that the client will require further teaching when the client states what? I will call the doctor if I am not able to keep liquids in my body due to vomiting or diarrhea." "I will call the doctor if my blood sugar is over 300 mg/dL (16.6 mmol/L) or if I have ketones in my urine." "If I cannot eat a meal, I will eat a soft food such as soup, gelatin, or pudding six to eight times a day." "I will not take my insulin on the days when I am sick, but I will certainly check my blood sugar every 2 hours."

"I will not take my insulin on the days when I am sick, but I will certainly check my blood sugar every 2 hours."

A client with diabetes mellitus has a blood glucose level of 40 mg/dL. Which rapidly absorbed carbohydrate would be most effective? three to six LifeSavers candies 1/2 tbsp honey or syrup 4 oz of skim milk 1/2 cup fruit juice or regular soft drink

1/2 cup fruit juice or regular soft drink

An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting: 25 to 30 g of a simple carbohydrate. 2 to 5 g of a simple carbohydrate. 18 to 20 g of a simple carbohydrate. 10 to 15 g of a simple carbohydrate.

10 to 15 g of a simple carbohydrate.

A nurse is caring for a diabetic patient with a diagnosis of nephropathy. What would the nurse expect the urinalysis report to indicate? Albumin Bacteria Red blood cells White blood cells

Albumin

Which would be included in the teaching plan for a client diagnosed with diabetes mellitus? An elevated blood glucose concentration contributes to complications of diabetes, such as diminished vision. Sugar is found only in dessert foods. Once insulin injections are started in the treatment of type 2 diabetes, they can never be disco

An elevated blood glucose concentration contributes to complications of diabetes, such as diminished vision.

A client is admitted to the health care center with abdominal pain, nausea, and vomiting. The medical reports indicate a history of type 1 diabetes. The nurse suspects the client's symptoms to be those of diabetic ketoacidosis (DKA). Which action will help the nurse confirm the diagnosis? Assess for excessive sweating Assess the client's breath odor Assess the client's ability to move all extremities Assess the client's ability to take a deep breath

Assess the client's breath odor

A client has received a diagnosis of type 2 diabetes. The diabetes nurse has made contact with the client and will implement a program of health education. What is the nurse's priority action? Ensure that the client understands the basic pathophysiology of diabetes. Teach the client "survival skills" for diabetes. Assess the client's readiness to learn. Identify the client's body mass index.

Assess the client's readiness to learn.

A nurse expects to note an elevated serum glucose level in a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which other laboratory finding should the nurse anticipate? Elevated serum acetone level Below-normal serum potassium level Serum alkalosis Serum ketone bodies

Below-normal serum potassium level

Which clinical characteristic is associated with type 2 diabetes (previously referred to as non-insulin-dependent diabetes mellitus)? Client is prone to ketosis Clients demonstrate islet cell antibodies Client is usually thin at diagnosis Blood glucose can be controlled through diet and exercise

Blood glucose can be controlled through diet and exercise

During a follow-up visit 3 months after a new diagnosis of type 2 diabetes, a client reports exercising and following a reduced-calorie diet. Assessment reveals that the client has only lost 1 pound and did not bring the glucose-monitoring record. Which value should the nurse measure? Fasting blood glucose level Glucose via a urine dipstick test Glycosylated hemoglobin level Glucose via an oral glucose tolerance test

Glycosylated hemoglobin level

A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and symptoms? Polyuria, polydipsia, hypotension, and hypernatremia Coma, anxiety, confusion, headache, and cool, moist skin Kussmaul respirations, dry skin, hypotension, and bradycardia Polyuria, polydipsia, polyphagia, and weight loss

Coma, anxiety, confusion, headache, and cool, moist skin

A nurse is preparing a client with type 1 diabetes for discharge. The client can care for himself; however, he's had a problem with unstable blood glucose levels in the past. Based on the client's history, he should be referred to which health care worker? Social worker Psychiatrist Dietitian Home health nurse

Dietitian

Which information should be included in the teaching plan for a client receiving glargine, which is "peakless" basal insulin? Glargine is rapidly absorbed and has a fast onset of action. Draw up the drug first, then add regular insulin. Do not mix with other insulins. Administer the total daily dosage in 2 doses.

Do not mix with other insulins.

A client with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which condition when caring for this client? Polyuria Polydipsia Blurred vision Hypoglycemia

Hypoglycemia

A student with diabetes reports feeling nervous and hungry. The school nurse assesses the student and finds the child has tachycardia and is diaphoretic with a blood glucose level of 50 mg/dL (2.8 mmol/L). What should the school nurse administer? Half a sandwich with a protein-based filling A combination of protein and carbohydrates, such as a small cup of yogurt Two teaspoons of sugar dissolved in a cup of apple juice Half of a cup of juice, followed by cheese and crackers

Half of a cup of juice, followed by cheese and crackers

Which combination of adverse effects should a nurse monitor for when administering IV insulin to a client with diabetic ketoacidosis? Hypocalcemia and hyperkalemia Hypokalemia and hypoglycemia Hyperkalemia and hyperglycemia Hypernatremia and hypercalcemia

Hypokalemia and hypoglycemia

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

Insulin is absorbed more rapidly at abdominal injection sites than at other sites.

A client has been living with type 2 diabetes for several years, and the nurse realizes that the client is likely to have minimal contact with the health care system. In order to ensure that the client maintains adequate blood sugar control over the long term, what should the nurse recommend? Participation in a support group for persons with diabetes Regular consultation of websites that address diabetes management Weekly telephone "check-ins" with an endocrinologist Participation in clinical trials relating to antihyperglycemics

Participation in a support group for persons with diabetes

Which clinical characteristic is associated with type 1 diabetes (previously referred to as insulin-dependent diabetes mellitus)? Obesity Rare ketosis Presence of islet cell antibodies Requirement for oral hypoglycemic agents

Presence of islet cell antibodies

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

Rotate injection sites within the same anatomic region, not among different regions.

A client with status asthmaticus requires endotracheal intubation and mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose levels hourly and watch for which early signs and symptoms associated with hypoglycemia? Bradycardia, thirst, and anxiety Polyuria, polydipsia, and polyphagia Sweating, tremors, and tachycardia Dry skin, bradycardia, and somnolence

Sweating, tremors, and tachycardia

A pregnant client has been diagnosed with gestational diabetes. The client is shocked by the diagnosis, stating that they are conscientious about their health, and asks the nurse what causes gestational diabetes. The nurse should explain that gestational diabetes is a result of what etiologic factor? Increased caloric intake during the first trimester Overconsumption of carbohydrates during the first two trimesters The effects of hormonal changes during pregnancy Changes in osmolality and fluid balance

The effects of hormonal changes during pregnancy

A nurse is assessing a client who has diabetes for the presence of peripheral neuropathy. The nurse should question the client about what sign or symptom that would suggest the possible development of peripheral neuropathy? Pain that does not respond to analgesia Persistently cold feet The presence of a tingling sensation Acute pain, unrelieved by rest

The presence of a tingling sensation

A visiting nurse is setting up an insulin schedule for an older adult who has diabetes mellitus. What should the nurse consider when determining the dosing time? client's history client's eating and sleeping habits client's ability to self-administer insulin cognitive problems

client's eating and sleeping habits

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

glycosylated hemoglobin

A client tells the nurse that she has been working hard for the past 3 months to control her type 2 diabetes with diet and exercise. To determine the effectiveness of the client's efforts, the nurse should check: glycosylated hemoglobin level. urine glucose level. serum fructosamine level. fasting blood glucose level.

glycosylated hemoglobin level.

A nursing instructor is giving a lecture on the symptoms associated with hypoglycemia versus hyperglycemia. Which symptoms will be included when discussing hypoglycemia? Select all that apply. rapid, weak pulse slow onset pale, moist, cool skin normal blood pressure

normal blood pressure pale, moist, cool skin

A client has been diagnosed with prediabetes. How can the client delay or avoid type 2 diabetes? weight loss increased physical activity decreased sleep hydrotherapy Increased vitamins

weight loss increased physical activity

A nurse educator been invited to local seniors center to discuss health-maintaining strategies for older adults. The nurse addresses the subject of diabetes mellitus, its symptoms, and consequences. What should the educator teach the participants about type 1 diabetes? The participants are unlikely to develop a new onset of type 1 diabetes. Type 1 diabetes always develops before the age of 20. New cases of diabetes are highly uncommon in older adults. New cases of diabetes will be split roughly evenly between type 1 and type 2.

The participants are unlikely to develop a new onset of type 1 diabetes.