NUR 325 Exam 2: Diabetes Questions

A nurse is providing teaching to a school-age child who has a new diagnosis of Type 1 DM. Which of the following statements by the clind indicates an understanding of the teaching? A. My morning blood glucose should be between 90 and 130 B. I should eat a snack half an hour before playing soccer C. I should not take my regular insulin when I am sick D. I can store unopened bottles of insulin in the freezer

B. I should eat a snack half an hour before playing soccer

A nurse is providing teaching to a client who has type 2 diabetes mellitus and is starting repaglinide. Which of the following statement by the client indicates understanding of the administration of this medication? A. I'll take this medication after I eat B. I'll take this medicine 30 mins before I eat C. I'll take this medicine just before I go to bed D. I'll take this medication at least 1 hour before I eat.

B. I'll take this medicine 30 mins before I eat

Insulin is important for the body because ______? A. It helps keep sucrose levels stable B. It helps glucose enter the cells C. It lowers cholesterol levels D. helps glucose out of the cells

B. It helps glucose enter the cells

A nurse is providing teaching to a female client who has type 2 diabetes and a new prescription for pioglitazone. Which of the following instructions should the nurse include in the teaching? (select all that apply) A. Expect urine to be darkened B. Monitor weight daily C. Increase calcium intake D. Use oral contraceptives to avoid pregnancy E. Take tablets whole

B. Monitor weight daily C. Increase calcium intake

A nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and hyperglycemia. The client demonstrates an understanding of hypoglycemia by stating that the glucose will be taken if which of the following symptoms develops? A. Polyuria B. Shakiness C. Blurred Vision D. Fruity breath odor

B. Shakiness

A nurse is teaching about self-monitoring to a client who has Type 1 DM. Which of the following statement by the client indicates an understanding of the teaching? A. " I will check my urine once a day for ketones" B. " I will notify my provider if per-meal glucose is 120 mg/dL" C. " I will check my blood glucose every 4 hours when I am sick" D. " I will check blood glucose every 5 minutes when lightheaded"

C. " I will check my blood glucose every 4 hours when I am sick"

Type 1 diabetes is caused by______? A. Sedentary lifestyle B. BMI of over 35 C. Body attacking itself D. Pregnancy

C. Body attacking itself

A nurse is teaching a client who has diabetes mellitus and receives 25 units of insulin every morning if her blood glucose level is above 200 mg/dL. Which of the following information should the nurse include? A. Discard the NPH solution if it appears cloudy B. Shake the insulin vigorously before loading the syringe C. Expect the NPH insulin to peak 6-14 hr. D. Freeze unopened insulin vials.

C. Expect the NPH insulin to peak 6-14 hr.

A nurse is reviewing the laboratory results of a client who is at risk for developing DM. The nurse should recognize that which of the following results indicates the client meets the criteria fr diagnosis of DM? A. HbA1c 5.5% B. 2 hr blood glucose 170 mg/dL C. Fasting blood glucose 155 mg/dL D. casual blood glucose 180 mg/dL

C. Fasting blood glucose 155 mg/dL

What is not a risk factor for impaired glucose regulation? A. Pregnancy B. Age extreme ( older adults, infants) C. Low socioeconomic status D. Alaska Native

C. Low socioeconomic status

Insulin can not be given by _______? A. Subcutaneous route B. Inhalation C. Oral D. Intravenous

C. Oral

A nurse is providing teaching for a client who has diabetes and a new prescription for insulin glargine. Which of the following instructions should the nurse provide regarding this type of insulin? A. Insulin glargine has a duration of 3-6 hrs. B. Insulin glargine has a duration of 6-10 hrs C. Insulin glargine has a duration of 16-24 hrs D. Insulin glargine has a duration of 18-24 hrs

D. Insulin glargine has a duration of 18-24 hrs

Which of the following is not a beneficial effect of exercise in people with diabetes: A. weight loss B. reduction of triglycerides C. help control hypertension D. hypoglycemia

D. hypoglycemia

Glargine insulin (Lantus)

Long- Acting Onset: 70 min Peak: non Duration: 18-24 hr Promotes cellular uptake of glucose - do NOT mix in same syringe with other insulins -given for basal glycemic control, same time each day

Repanglindine

Meglitinides -Promotes insulin release from pancreas -Administer within 30 min of meal (PO, x3)

The most important vehicle for transport of electrolytes and nutrients is ...

WATER

colloid osmotic pressure

pressure created by Plasma proteins. Pulls fluid back into blood vessels at venous end of the capillary bed. Also called oncotic pressure. - created primarily by sodium

Lispro insulin (Humalog)

Rapid- Acting Onset: 15-30 min Peak: 30 mins- 2.5 hours Duration: 3-6 hr Promotes cellular uptake of glucose - give subQ 5-15 mins before meals

Humilin R Insulin (Regular)

Short- Acting Onset: .5- 1hr Peak: 1-5 hr Duration: 6-10 hr -Promotes cellular uptake of glucose -Can be mixed with NPH insulin - give subQ 30 mins before meals

Diabetes - related retinopathy is the leading cause of new cases of adult blindness True or False

TRUE

If you have a parent with Type 2 diabetes-you are at a higher risk of developing it, too. TRUE OR FALSE

TRUE

People in DKA may have ketonuria. TRUE OR FALSE

TRUE

Difussion

The movement of molecules from an area of higher concentration to an area of lower concentration

Which cells are destroyed in type 1 diabetes? A. Alpha B. Neurologia C. Stem D. Beta

D. Beta

__________ is a result of damage to the autonomic nervous system. A. Renal failure B. Blindness C. Peripheral neuropathy D. Diabetic gastroparesis

D. Diabetic gastroparesis

What is the correct order of drawing NPH and short acting insulin?

- Inspect vials for contaminants - Roll NPH vial between palms of hands -Inject air into the NPH insulin vial - Inject air into the regular insulin vial - Withdraw short-acting insulin into syringe - Add intermediate insulin to syringe

Characteristics of Type 1 Diabetes

- new diagnosis more common in children and adolescents - most individuals are thin or normal weight -require lifelong insulin replacement -autoimmune disorder -insulin deficiency

Metformin

-Biguanides -Reduces production of glucose in liver - Client with renal insufficiencies should. not use - Use with contrast medium may cause kidney damage

Glipizide

-Sulfonylureas- Second generation -Promotes insulin release form pancreas -May cause disulfiram -Administer 30 mins before breakfast

Characteristics of Type 2 Diabetes

-becoming more common in children and adolescents - insulin resistance - can be managed with diet/ exercise, oral medication, and or insulin therapy - most individuals are overweight or obese - most common type of diabetes

An alert and oriented client has a blood glucose of 56 mg/dL following the 15/15 rule what would be appropriate to give the client? A. 3-4 glucose tablets B. 1 tablespoon of honey C. 1 cup of milk D. 1/2 cup regular soda or juice E. 15 jelly beans

A. 3-4 glucose tablets B. 1 tablespoon of honey C. 1 cup of milk D. 1/2 cup regular soda or juice E. 15 jelly beans

What is the onset of a short acting insulin? A. 30-60 min B. 15-30 min C. 10-20 min D. 1-2 hours

A. 30-60 min

What lab shows no fluctuations in the blood sugars? A. HgbA1C B. OGTT C. Fasting blood glucose D. Random blood glucose

A. HgbA1C

A nurse is assessing a client who has type 1 diabetes mellitus and finds the client laying in bed, sweating, and reporting feeling anxious. Which of the following complications should the nurse suspect? A. Hypoglycemia B. Nephropathy C. Hyperglycemia D.Ketoacidosis

A. Hypoglycemia

A nurse is teaching a client who has a new prescription for regular insulin and NPH insulin. Which of the following instructions should the nurse include in the teaching? A. Keep the open vial of insulin at room temperature B. Inject the insulin into a large muscle C. Aspirate the medication prior to administration D. Administer the insulin in two separate injections

A. Keep the open vial of insulin at room temperature

How many Americans have diabetes? A. Over 34 million B. Over 20 million C. Under 10 million D. Over 90 million

A. Over 34 million

A nurse is monitoring a client newly diagnosed with diabetes mellitus for signs of complications. Which of the following, if exhibited in the client would indicate hyperglycemia and warrant physician notification? A. Polyuria B. Diaphoresis C. Hypertension D. Increased pulse rate

A. Polyuria

When patients with diabetes drink alcohol, it can cause _________? A. hypoglycemia B. hyperglycemia C. increased risk for infection D. increased risk for toxicity

A. hypoglycemia

A 2 hour postpranadial blood glucose is normal if A. less than 140mg/dL B. over 180 mg/dL C. under 6.0% D. Over 7.5%

A. less than 140mg/dL

Which disease processes are related to diabetes mellitus? (select all that apply) A. retinopathy B. neuropathy C. osteopathy D. nephropathy E. allelopathy

A. retinopathy B. neuropathy D. nephropathy

A nurse is providing teaching for a client who has a new prescription for metformin. Which of the following findings should the nurse instruct the client to report as an adverse effect of metformin? A. somnolence B. constipation C. fluid retention D. weight gain

A. somnolence - can indicate lactic acidosis, which is manifested by extreme drowsiness, hyperventilation, and muscle pain. it is rare but a serious adverse effect

A client who has Type 2 diabetes mellitus asks the nurse, "Why did I develop diabetes?" Which of the following responses should the nurse make? A. "Your body is destroying the cells that secrete insulin" B. " Your body has insulin resistance and decreases insulin secretion" C. "An infection in your pancreas destroyed the cells that make insulin" D. " Your kidneys are not able to reabsorb water which leads to Type 2 Diabetes Mellitus"

B. " Your body has insulin resistance and decreases insulin secretion" A client genetically susceptible can develop Type 2 DM when obesity and physical inactivity lead to insulin resistance at cells as well as ↓ secretion of insulin by pancreatic beta-cells.

The family of a bedridden client with type 2 Diabetes Mellitus and chronic renal failure calls a nurse to report the following symptoms: headache, polydipsia, and increased lethargy. Which question is most important to ask the family? A. "What is the client's urine output?" B. "What is the client's capillary blood glucose level?" C. " Has there been any changes in dietary intake?" D. "Have you increased the amount of fluids provided?"

B. "What is the client's capillary blood glucose level?"

How many grams of carbohydrates should a person with diabetes take initially when hypoglycemic? A. 30 grams B. 15 grams C. 10 grams D. 60 grams

B. 15 grams

A prolonged inflammatory phase in patients with prolonged hyperglycemia can lead to_____? A. Hyperosmoloar hyperglycemic state (HHS) B. Atherogenesis C. Diabetic retinopathy D. Autonomic neuropathy

B. Atherogenesis

A nurse is teaching a client how to draw up regular insulin and NPH insulin into the same syringe. Which of the following instructions should the nurse include? A. Draw up the NPH insulin into the syringe first B. Inject air into the regular insulin first C. Shake the NPH insulin until it is well mixed D. Discard the regular insulin that appears cloudy

D. Discard the regular insulin that appears cloudy

Which is not a sign or symptom of hypoglycemia A. Irritability B. Hunger C. Seizure D. Increased energy

D. Increased energy

A nurse is teaching a client who has a new prescription for NPH insulin. Which of the following instructions should the nurse include? A. " Discard the medication if it is cloudy" B. " Briskly shake the medication before filling the syringe" C. "Take this medication 15 mins before meals" D. "Eat a snack 8 hr after taking this medication"

D. "Eat a snack 8 hr after taking this medication"

A nurse is evaluating teaching with a client who is receiving continuous subcutaneous insulin via and external insulin pump. Which of the following statements by the client indicates a need for further teaching? A. "I will change the needle every 3 days" B. "I should store all unused insulin in the refrigerator" C. "If i skip lunch, I will skip my mealtime dose of insulin" D. "I will use insulin glargine in my insulin pump"

D. "I will use insulin glargine in my insulin pump"

What is the most typical insulin concentration? A. 50 units/ml B. 30 units/ml C. 75 units/ml D. 100 units/ml

D. 100 units/ml

A nurse is caring for a client who has diabetes and a new prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe? A. 14 units B. 28 units C. 32 units D. 42 units

D. 42 units

Type 2 diabetes makes up ______% of diagnosed cases of diabetes? A. 50% B. 70% C. 30% D. 90%

D. 90%

Diabetic Ketoacidosis (DKA) will lead to Cheyne-Stokes breathing. A. True B. False

FALSE

Patients with Type 2 diabetes always need medications. TRUE OR FALSE

FALSE

People with any diabetes cannot have desserts TRUE OR FALSE

FALSE

There are modifiable and non-modifiable risk factors for Type 1 diabetes. TRUE OR FALSE

FALSE

Pramlintide

amylin mimetic -mimics amylin-decrease gastric emptying time - clients with renal insufficiencies should not use - avoid using with medications that slow gastric emptying

A nurse is preparing a teaching session about reducing the risk of complications of DM. Which of the following information should the nurse plan to include in the teaching? (select all) A. Reduce cholesterol and saturated fat intake B. Increase physical activity and daily exercise C. Enroll in a smoking-cessation program. D. Sustain hyperglycemia to reduce deterioration of nerve cells E. Maintain optimal blood pressure to prevent kidney damage

A. Reduce cholesterol and saturated fat intake B. Increase physical activity and daily exercise C. Enroll in a smoking-cessation program. E. Maintain optimal blood pressure to prevent kidney damage

A nurse is preparing a teaching plan for a client with diabetes mellitus regarding proper footcare. Which instructions is included in the plan? A. Soak feet in hot water B. Avoid using a mild soap on feet C. Apply a moisturizing lotion to dry feet but not between toes D. Always have a podiatrist cut your toenails; never cut them yourself

C. Apply a moisturizing lotion to dry feet but not between toes

A nurse is providing teaching for a client who is newly diagnosed with type 2 diabetes mellitus and has a prescription for glipizide. Which of the following statements by the nurse best describes the action of glipizide? A. Glipizide absorbs the excess carbohydrates in your system B. Glipizide stimulates your pancreas to release insulin C. Glipizide replaces insulin that is not being produced by your pancreas D. Glipizide prevents your liver from destroying your insulin

B. Glipizide stimulates your pancreas to release insulin

A nurse is assessing a client who has DM. Which of the following findings is a manifestation of hypoglycemia? A. Bradycardia B. cool, clammy skin C. Vomiting D. Fruity odor on the client's breath

B. cool, clammy skin

DKA can result in __________? A. metabolic alkalosis B. metabolic acidosis C. respiratory acidosis D. respiratory alkalosis

B. metabolic acidosis

The management of diabetes is most successful when ___? A. there is a priority focus on medications B. patient commitment to self management C. a priority focus on appropriate diet D. a focus on regular healthcare provider check ups

B. patient commitment to self management

A nurse is teaching a client who has type 1 diabetes mellitus about foot care. Which of the following statements by the client indicates an understanding of the teaching? A. "I'll wear sandals in warm weather" B. "I'll put lotion between my toes after drying my feet." C. "I'll check my feet everyday for sores and bruises." D. " I'll soak my feet in cool water everynight before I go to bed"

C. "I'll check my feet everyday for sores and bruises." The client should check his feet daily to monitor for any problems and observe any other changes before they become serious. He can use a hand mirror to examine areas that are difficult for him to see.

A nurse is providing teaching to a client who has a prescription for pramlintide for type 1 DM. which of the following should the nurse include in the teaching? (select all that apply) A. Take oral medications 30 min before injection B. use upper arms as preferred injection sites C. Mix pramlintide just before a meal D. Discard open vials after 28 days

C. Mix pramlintide just before a meal D. Discard open vials after 28 days

A nurse is caring for a client who has Type 1 DM. Which of the following recommendations should the nurse make to the client for a sweetener? A. corn syrup B. Natural honey C. Non Nutritive sugar substitute D. Guava nectar

C. Non Nutritive sugar substitute

A nurse is reviewing the medication list for a client who has a newly diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance? A. Ranitidine B. Guaifenesin C. Prednisone D. Atorvastatin

C. Prednisone

Novolog is a ________ insulin A. Short acting B. Intermediate acting C. Rapid acting D. Long acting

C. Rapid acting

A nurse is teaching clients about the use of insulin to treat type 1 diabetes mellitus. For which of the following types of insulin should the nurse tell the clients to expect a peak effect 1 to 5 hr after administration? A. Insulin glargine B. NPH insulin C. Regular insulin D. Insulin lispro

C. Regular insulin - regular insulin has a peak effect around 1- 5 hr following administration

A nurse is teaching a client who has diabetes mellitus and a new prescription for glimepiride. The nurse should teach the client to avoid which of the following drinks while taking this medication ? A. Grapefruit B. Milk C. alcohol D. coffee

C. alcohol

Insulin pumps deliver insulin how? A. basal mode B. bolus mode C. basal and bolus modes D. none of the above

C. basal and bolus modes

A nurse is caring for a client who has been taking acarbose for type 2 DM. Which of the following laboratory tests should the nurse plan to monitor? A. WBC B. Amylase C. platelet count D. Liver function test

D. Liver function test

A nurse is teaching an older adult client who has DM about preventing the long-term complications or retinopathy and nephropathy. Which of the following instructions should the nurse include? A. Have and eye examination once per year B. Examine your feet carefully everyday C. Wear compression stockings daily D. Maintain stable blood glucose levels

D. Maintain stable blood glucose levels

Clients with type 1 diabetes may require which of the following changes to their daily routine during periods of infection? A. Meticulous foot care B. Oral antidiabetic agents C. Less Insulin D. Monitoring keytones frequently

D. Monitoring keytones frequently

Microvascular complications include ________? A. Myocardial infarction B. Stroke C. Athrosclerosis D. Retinopathy

D. Retinopathy

Type 2 diabetes differs from Type 1 by _______? A. People with Type 2 require more insulin B. Type 1 diabetes is caused by insulin resistance C. People with Type 2 diabetes have chronic complications occur more rapidly D. Type 1 diabetes is caused by an over active autoimmune response

D. Type 1 diabetes is caused by an over active autoimmune response

NPH insulin

Intermediate-Acting Onset: 1-2 hr Peak: 6-14 hr Duration: 16-24 hr -promotes cellular uptake of glucose - can be mixed with regular insulin -only cloudy insulin - May mix in syringe with short duration insulins: rapid-acting & slower acting. - before breakfast and dinner