nur 316

A nurse is providing client education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which statement by the client will alert the nurse that special instructions regarding insulin are necessary?

"I am on the middle school track team."

The nurse has just completed discharge instructions to a client who will be using a pen device to deliver his insulin dose. What statement by the client indicates a need for further instruction?

"If I forget to take my insulin pen, I will be able to use the one that my wife uses."

The nurse is discussing diabetes with a group of individuals who are at risk for the disease. Which statement by a participant indicates an understanding of the role of insulin in the disease?

"Insulin assists glucose molecules to enter the cells of muscle and fat tissues."

A 42-year-old male client is prescribed glargine insulin for management of his type 2 diabetes mellitus. The nurse caring for the client develops a teaching plan regarding glargine insulin therapy. Which statement made by the client indicates that the client needs additional teaching?

"The medication will peak in 3 hours."

When preparing to administer an insulin injection, the nurse would use which sized needle?

25 gauge, ½ inch

The nurse assesses a client's blood glucose level after administering insulin. Which result would the nurse interpret as indicative of severe hypoglycemia?

34 mg/dL

The nurse is educating a newly diagnosed diabetic who must learn how to give himself insulin injections. The nurse tells the client that insulin is absorbed fastest from which area of injection?

Abdomen

Oral anti-diabetic agents can be used in various combinations for what purpose?

Additive effects

A client has been prescribed glucagon for the management of hypoglycemia. Which nursing interventions should the nurse be prepared to provide this client for the management of possible adverse effects? Select all that apply.

Administration of a prescribed suppository for the management of nausea Implementation of aspiration precautions Ready access to supplemental oxygen

A nurse diabetes educator is planning an initial visit to a home care client who was recently diagnosed with diabetes mellitus. Which skills would the nurse help the client learn?

All the above

A nurse is assigned to administer glargine to a patient at a health care facility. What precaution should the nurse take when administering glargine?

Avoid mixing glargine with other insulin.

A client receives a dose of insulin lispro at 8 AM. The nurse would be alert for signs and symptoms of hypoglycemia at which time?

Between 8:30 AM and 9:30 AM

The nurse is aware that premixed insulins (those that contain both regular and NPH insulin) are least effective in what type of client?

Client who has difficulty controlling his diabetes

A client has been noncompliant with the diabetic medication regimen and develops diabetic ketoacidosis. Which would the nurse assess?

Deep respirations

As the nurse caring for a young child is diagnosed with type 1 diabetes (IDDM), you know that they become at high risk for what and you include assessment and management of this in their care plan?

Delayed growth and development

During ongoing assessment of clients receiving insulin detemir (Levemir), the nurse assesses the client for symptoms of hypoglycemia that include which symptoms? (Select all that apply.)

Diaphoresis Confusion Headache

The nurse is providing teaching to a client with type 1 diabetes. The client requires additional teaching when he learns that his insulin needs may increase because of what condition? (Select all that apply.)

Exercise Decreased food intake

What distinguishing characteristic is associated with type 1 diabetes?

Exogenous insulin is required for life

Clients with type 2 diabetes have nonfunctioning beta pancreatic cells

False

Which insulin would the nurse need to administer as a separate injection if the order also included NPH insulin?

Glargine

Diabetic retinopathy is a disorder diabetics develop as a result of a thickening of the basement membrane. What is this caused by?

Inability of oxygen to diffuse across vessel membrane to tissues in the eye

A client is brought to the Emergency Department (ED) with severe hypoglycemia. What drug would the nurse prepare to administer intravenously?

Glucagon (GlucaGen)

The health care provider has ordered a change of prescription from rapid-acting insulin to an intermediate-acting type. Which adverse effect must the nurse closely monitor for in the client?

Hypoglycemia

Which would be appropriate to include in teaching a client with type 2 diabetes?

It is possible with weight loss and exercise to discontinue the use of antidiabetic medication.

The nurse who has admited a client with diabetic ketoacidosis should look for what assessment findings that are consistent with this diagnosis? (Select all that apply.)

Ketones in the urine Flushed, dry skin

After teaching a class about the various drugs used to control blood glucose, the instructor determines that the teaching was successful when the class identifies what as a biguanide?

Metformin

A nurse is caring for a patient diagnosed with type 2 diabetes. What should the nurse inform the patient are risk factors associated with type 2 diabetes?

Obesity

A nurse is caring for a patient with diabetes mellitus who is receiving an oral antidiabetic drug. Which of following ongoing assessments should the nurse perform when caring for this patient?

Observe the patient for hypoglycemic episodes.

What best describes type 1 diabetes? (Select all that apply.)

Occurs before age 20 Insulin supplementation is required for survival

A female client is diagnosed with type 1 diabetes. She suddenly reports feeling weak, shaky, and dizzy. What should the nurse's first response be?

Perform a blood sugar analysis

After the nurse makes an initial assessment of patients, the nurse reviews their medications. What medication order should the nurse question for a diabetic patient who takes insulin to control their diabetes?

Propranolol (Inderal) 10 mg PO t.i.d.

A client is admitted to the intensive care unit with diabetic ketoacidosis. The nurse knows that the client will be placed on an intravenous insulin drip. The only type of insulin that can be administered intravenously is:

Regular

Which produce their glucose lowering effect by decreasing insulin resistance and increasing insulin sensitivity? (Select all that apply.)

Rosiglitazone (Avandia) Pioglitazone (Actos)

Regular insulin may be administered intravenously or intramuscularly in an emergency situation.

True

The nurse is providing discharge instructions to a client who has just been diagnosed with type 1 diabetes. What instructions are most important for the client to follow related to diet? (Select all that apply.)

Use artificial sweeteners instead of sugar in tea and coffee. Avoid drinking beer, wine, or liquor. Read food labels carefully to look for hidden sources of sugar

Because of the risk for lactic acidosis, metformin is contraindicated in which client?

an 82-year-old diagnosed with type 2 diabetes

Stress typically results in hypoglycemia

false

A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse most likely administer?

insulin lispro

After teaching a group of nursing students about insulin, the instructor determines that the teaching was successful when the students identify that insulin is produced by which organ in the human body?

pancreas

A 58-year-old male client, diagnosed with diabetes at age 14, reports having pain in both feet and hands. What is this pain most likely a result of?

peripheral neuropathy

Glycosylated hemoglobin levels provide reliable evidence of blood glucose control.

true

The nurse is caring for a client taking insulin. The nurse realizes the client is experiencing symptoms of hypoglycemia when the client displays:

weakness, sweating, and decreased mentation

A patient receives 25 units of NPH insulin at 7 AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?

Late afternoon

The two major classifications of diabetes are type 1 and type 2. What is a distinguishing characteristic of type 1 diabetes?

Lifelong exogenous insulin is required.

A client diagnosed with diabetes is demonstrating slow, deep respirations and is difficult to arouse. Which nursing intervention is directed specifically at treating this serious complication of diabetes

Maintaining adequate intravenous fluid delivery