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PrepU Nutrition, Honan Chapter 30: Nursing Management: Diabetes Mellitus, Med Surg 2 Test 5 Chapter 51, Chapter 51-1, Diabetes PrepU, Chapter 51 Diabetes PrepU, Diabetes, PREPU Chapter 46 Assessment and Management of Patients with Diabetes, Chapter 5…

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Which instruction about insulin administration should a nurse give to a client?

"Always follow the same order when drawing the different insulins into the syringe."

Which instruction about insulin administration should a nurse give to a client? "Discard the intermediate-acting insulin if it appears cloudy." "Always follow the same order when drawing the different insulins into the syringe." "Shake the vials before withdrawing the insulin." "Store unopened vials of insulin in the freezer at temperatures well below freezing."

"Always follow the same order when drawing the different insulins into the syringe."

Which instruction about insulin administration should a nurse give to a client? "Always follow the same order when drawing the different insulins into the syringe." "Shake the vials before withdrawing the insulin." "Store unopened vials of insulin in the freezer at temperatures well below freezing." "Discard the intermediate-acting insulin if it appears cloudy."

"Always follow the same order when drawing the different insulins into the syringe."

The nurse is providing information about foot care to a client with diabetes. Which of the following would the nurse include? A) "Wash your feet in hot water every day." B) "Use a razor to remove corns or calluses." C) "Be sure to apply a moisturizer to feet daily." D) "Wear well-fitting comfortable rubber shoes."

"Be sure to apply a moisturizer to feet daily."

The nurse is providing information about foot care to a client with diabetes. Which of the following would the nurse include?

"Be sure to apply a moisturizer to feet daily."

A controlled type 2 diabetic client states, "The doctor said if my blood sugars remain stable, I may not need to take any medication." Which response by the nurse is most appropriate? A) "Diet, exercise, and weight loss can eliminate the need for medication." B) "You will be placed on a strict low-sugar diet for better control." C) "Some doctors do not treat blood sugar elevation until symptoms appear." D) "You misunderstood the doctor. Let's ask for clarification."

"Diet, exercise, and weight loss can eliminate the need for medication."

A controlled type 2 diabetic client states, "The doctor said if my blood sugars remain stable, I may not need to take any medication." Which response by the nurse is most appropriate?

"Diet, exercise, and weight loss can eliminate the need for medication."

A controlled type 2 diabetic client states, "The doctor said if my blood sugars remain stable, I may not need to take any medication." Which response by the nurse is most appropriate? "Some doctors do not treat blood sugar elevation until symptoms appear." "You will be placed on a strict low-sugar diet for better control." "You misunderstood the doctor. Let's ask for clarification." "Diet, exercise, and weight loss can eliminate the need for medication."

"Diet, exercise, and weight loss can eliminate the need for medication." Dieting, exercise, and weight loss can control and/or delay the need for medication to treat type 2 diabetes mellitus in some clients. Because the client is controlling blood sugars, changing the diet is not indicated. Controlling blood glucose levels will prevent multisystem complications and should be the mainstay of treatment for diabetes mellitus. Although clarification is appropriate, stating the client misunderstood can close the line of communication between client and nurse.

The nurse is educating a patient about the benefits of fruit versus fruit juice in the diabetic diet. The patient states, "What difference does it make if you drink the juice or eat the fruit? It is all the same." What is the best response by the nurse?

"Eating the fruit instead of drinking juice decreases the glycemic index by slowing absorption."

An active type 2 diabetic reports recurrent symptoms of weakness and nervousness. Which is the best response from the nurse? A) "These symptoms are related to added stress." B) "Maybe you should eat simple carbohydrates." C) "Sounds like high blood sugar symptoms." D) "Exercise and activity can lower glucose levels."

"Exercise and activity can lower glucose levels."

the ER nurse is caring for a client diagnosed with HHNS who has a blood glucose level of 680mg/dL. Which question should the nurse ask the client to determine the cause of this acute complication?

"Have you has some type of infection lately?"

The nurse is caring for a client diagnosed with bulimia. The client is being treated for a serum potassium concentration of 2.9 mEq/L (2.9 mmol/L). Which statement made by the client indicates the need for further teaching?

"I can use laxatives and enemas but only once a week." The client is experiencing hypokalemia, most likely due to the diagnosis of bulimia. Hypokalemia is defined as a serum potassium concentration <3.5 mEq/L (3.5 mmol/L), and usually indicates a deficit in total potassium stores. Clients diagnosed with bulimia frequently suffer increased potassium loss through self-induced vomiting and misuse of laxatives, diuretics, and enemas; thus, the client should avoid laxatives and enemas. Prevention measures may involve encouraging the client at risk to eat foods rich in potassium (when the diet allows), including fruit juices and bananas, melon, citrus fruits, fresh and frozen vegetables, lean meats, milk, and whole grains. If the hypokalemia is caused by abuse of laxatives or diuretics, client education may help alleviate the problem.

A client is placed on a low-sodium (500 mg/day) diet. Which client statement indicates that the nurse's nutrition teaching plan has been effective?

"I chose broiled chicken with a baked potato for dinner."

After teaching a client with type 1 diabetes, who is scheduled to undergo an islet cell transplant, which client statement indicates successful teaching?

"I might need insulin later on but probably not as much or as often."

After teaching a client with type 1 diabetes, who is scheduled to undergo an islet cell transplant, which client statement indicates successful teaching? "I will receive a whole organ with extra cells to produce insulin." "I might need insulin later on but probably not as much or as often." "This transplant will provide me with a cure for my diabetes." "They'll need to create a connection from the pancreas to allow enzymes to drain."

"I might need insulin later on but probably not as much or as often."

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."

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

Which statement indicates that a client with diabetes mellitus understands proper foot care?

"I'll wear cotton socks with well-fitting shoes."

A nurse is preparing to administer insulin to a child who's just been diagnosed with type 1 diabetes. When the child's mother stops the nurse in the hall, she's crying and anxious to talk about her son's condition. The nurse's best response is: "I can't talk now. I have to give your son his insulin as soon as possible." "I'm going to give your son some insulin. Then I'll be happy to talk with you." "If you'll wait in your son's room, the physician will talk with you as soon as he's free." "Everything will be just fine. I'll be back in a minute and then we can talk."

"I'm going to give your son some insulin. Then I'll be happy to talk with you."

"I'm going to give your son some insulin. Then ill be happy to talk with you"

A client with type 1 diabetes has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse is most accurate in stating:

"It tells us about your sugar control for the last 3 months"

A client with type 1 diabetes has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse is most accurate in stating:

"It tells us about your sugar control for the last 3 months."

A client with type 1 diabetes has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse is most accurate in stating: "The test must be repeated following a 12-hour fast." "It tells us about your sugar control for the last 3 months." "Your insulin regimen must be altered significantly." "It looks like you aren't following the ordered diabetic diet."

"It tells us about your sugar control for the last 3 months."

A nurse is teaching a client recovering from diabetic ketoacidosis (DKA) about management of "sick days." The client asks the nurse why it is important to monitor the urine for ketones. Which statement is the nurse's best response?

"Ketones accumulate in the blood and urine when fat breaks down in the absence of insulin. Ketones signal an insulin deficiency that will cause the body to start breaking down stored fat for energy."

"Ketones accumulate in the blood and urine when fat breaks down in the absence of insulin. Ketones signal an insulin deficiency that will cause the body to start breaking down stored fat for energy." Ketones (or ketone bodies) are by-products of fat breakdown in the absence of insulin, and they accumulate in the blood and urine. Ketones in the urine signal an insulin deficiency and that control of type 1 diabetes is deteriorating. When almost no effective insulin is available, the body starts to break down stored fat for energy.

A client newly diagnosed with diabetes mellitus asks why he needs ketone testing when the disease affects his blood glucose levels. How should the nurse respond?

"Ketones will tell us if your body is using other tissues for energy."

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

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." "Administer insulin into areas of scar tissue or hypertrophy whenever possible." "Inject insulin into healthy tissue with large blood vessels and nerves." "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 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? "Inject insulin into healthy tissue with large blood vessels and nerves." "Rotate injection sites within the same anatomic region, not among different regions." "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."

Which instruction should a nurse give to a client with diabetes mellitus when teaching about "sick day rules"?

"Test your blood glucose every 4 hours."

Which instruction should a nurse give to a client with diabetes mellitus when teaching about "sick day rules"? "Don't take your insulin or oral antidiabetic agent if you don't eat." "Test your blood glucose every 4 hours." "Follow your regular meal plan, even if you're nauseous." "It's okay for your blood glucose to go above 300 mg/dl while you're sick."

"Test your blood glucose every 4 hours."

The client asks the nurse if dipstick of urine can be used for monitoring glucose levels. Which is the best response by the nurse? A) "Yes, it is a cheaper method of monitoring glucose and ketones in the urine." B) "This test can detect ketones but not glucose levels." C) "The most accurate way to monitor glucose levels is by blood testing." D) "Dipstick of urine will only indicate lower levels of glucose and ketones."

"The most accurate way to monitor glucose levels is by blood testing."

The client asks the nurse if dipstick of urine can be used for monitoring glucose levels. Which is the best response by the nurse?

"The most accurate way to monitor glucose levels is by blood testing."

A recently widowed diabetic comments that blood sugar levels are running higher than usual. Which is the best response from the nurse? A) "People who eat alone tend to eat more." B) "Cooking lower carbohydrate meals for one person is a challenge." C) "This must be a stressful time for you." D) "Quit checking your blood sugars for now."

"This must be a stressful time for you."

A recently widowed diabetic comments that her blood sugar levels are running higher than usual. Which is the best response from the nurse?

"This must be a stressful time for you."

After a school-age child with type 1 diabetes attends a teaching session about nutrition, the nurse determines that the teaching has been effective when the child makes which statement?

"When I do not finish a meal, I must make up the carbohydrates right then." The diabetic diet usually is based on an exchange system that takes into account the fact that some foods have similar fat, carbohydrate, and protein components and therefore can be exchanged one for another. The meal or snack must be eaten in its entirety because it is calculated together with the dose of insulin. If a child does not eat all the meal or snack, then a make-up meal should be given.

A 16-year-old patient newly diagnosed with type 1 diabetes has a very low body weight despite eating regular meals. The patient is upset because friends frequently state, "You look anorexic." Which of the following statements would be the best response by the nurse to help this patient understand the cause of weight loss due to this condition? "You may be having undiagnosed infections causing you to lose extra weight." "I will refer you to a dietician who can help you with your weight." "Your body is using protein and fat for energy instead of glucose." "Don't worry about what your friends think; the carbohydrates you eat are being quickly digested, increasing your metabolism."

"Your body is using protein and fat for energy instead of glucose."

A physician orders blood glucose levels every 4 hours for a 4-year-old child with brittle type 1 diabetes. The parents are worried that drawing so much blood will traumatize their child. How can the nurse best reassure the parents?

"Your child will need less blood work as his glucose levels stabilize."

A nurse is assigned to care for a patient who is suspected of having type 2 diabetes. Select all the clinical manifestations that the nurse knows could be consistent with this diagnosis.

- Fatigue and irritability - Wounds that heal slowly or respond poorly to treatment - Polyuria and polydipsia - Blurred or deteriorating vision

Exercise lowers blood glucose levels. Which of the following are the physiologic reasons that explain this statement. Select all that apply.

- Increases lean muscle mass - Increases resting metabolic rate as muscle size increases - Decreases total cholesterol - Increases glucose uptake by body muscles

A hospitalized, insulin-dependent patient with diabetes has been experiencing morning hyperglycemia. The patient will be awakened once or twice during the night to test blood glucose levels. The health care provider suspects that the cause is related to the Somogyi effect. Which of the following indicators support this diagnosis? Select all that apply.

- Normal bedtime blood glucose - Increase in blood glucose from 3:00 AM until breakfast - Decrease in blood sugar to a hypoglycemic level between 2:00 to 3:00 AM - Elevated blood glucose at bedtime

A nurse is assigned to care for a patient who is suspected of having type 2 diabetes. Select all the clinical manifestations that the nurse knows could be consistent with this diagnosis.

-Blurred or deteriorating vision -Fatigue and irritability -Polyuria and polydipsia -Wounds that heal slowly or respond poorly to treatment

A client is admitted with the diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNKS) following steroids therapy. Which of the following symptoms are associated with HHNKS? Select all that apply. A) High blood pressure B) Extreme thirst C) Bradycardia D) Poor skin turgor E) Acidosis F) Hypoglycemia

-Extreme thirst -Poor skin turgor

A client has been diagnosed with prediabetes. How can the client delay or avoid type 2 diabetes?

-weight loss -increased physical activity

The nurse is preparing to administer IV fluids for a patient with ketoacidosis who has a history of hypertension and congestive heart failure. What order for fluids would the nurse anticipate infusing for this patient?

0.45 normal saline Half-strength NS (0.45%) solution (also known as hypotonic saline solution) may be used for rehydration of patients with hypertension or hypernatremia and those at risk for heart failure.

the client is admitted to the ICU diagnosed with DKA. Which intervention should the nurse implement?

1. maintain adequate ventilation 2. assess fluid volume status 3. administer IV potassium 4. check for urinary ketones 5. monitor I&O

The diabetic educator is teaching a class on diabetes type 1 and is discussing sick-day rules. Which interventions should the diabetes educator include in the discussion? select all that apply

1. take diabetic medication even if unable to eat the client's normal diabetic diet 2. if unable to eat, drink liquids equal to the client's normal caloric intake 5. call the HCP if glucose levels are higher than 180mg/dL

A client with diabetes mellitus has a blood glucose level of 40 mg/dL. Which rapidly absorbed carbohydrate would be most effective?

1/2 cup fruit juice or regular soft drink

A nurse is caring for a client with diabetes mellitus. The client has a blood glucose level of 40 mg/dL. Which of the following rapidly absorbed carbohydrate would be most effective? 1/2 cup fruit juice or regular soft drink 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

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:

10 to 15 g of a simple carbohydrate

The nurse is administering lispro (Humalog) insulin. Based on the onset of action, how soon should the nurse administer the injection prior to breakfast? 10 to 15 minutes 1 to 2 hours 30 to 40 minutes 3 hours

10 to 15 minutes

The nurse is administering lispro insulin. Based on the onset of action, how long before breakfast should the nurse administer the injection?

10 to 15 minutes

The nurse is administering lispro insulin. Based on the onset of action, how long before breakfast should the nurse administer the injection? 10 to 15 minutes 30 to 40 minutes 1 to 2 hours 3 hours

10 to 15 minutes

The nurse is administering lispro insulin. Based on the onset of action, how long before breakfast should the nurse administer the injection? 10 to 15 minutes 30 to 40 minutes 1 to 2 hours 3 hours

10 to 15 minutes The onset of action of rapid-acting lispro insulin is within 10 to 15 minutes. It is used to rapidly reduce the glucose level.

The nurse is administering lispro insulin. Based on the onset of action, how long before breakfast should the nurse administer the injection?

10-15 minutes The onset of action of rapid-acting lispro insulin is within 10 to 15 minutes. It is used to rapidly reduce the glucose level.

A nurse is preparing a continuous insulin infusion for a child with diabetic ketoacidosis and a blood glucose level of 800 mg/dl. Which solution is the most appropriate at the beginning of therapy?

100 units of regular insulin in normal saline solution

A nurse is preparing a continuous insulin infusion for a child with diabetic ketoacidosis and a blood glucose level of 800 mg/dl. Which solution is the most appropriate at the beginning of therapy? 100 units of NPH insulin in dextrose 5% in water 100 units of regular insulin in dextrose 5% in water 100 units of regular insulin in normal saline solution 100 units of neutral protamine Hagedorn (NPH) insulin in normal saline solution

100 units of regular insulin in normal saline solution

A medical nurse is caring for a client with type 1 diabetes. The client's medication administration record includes the administration of regular insulin three times daily. Knowing that the client's lunch tray will arrive at 11:45 AM, when should the nurse administer the client's insulin?

11:15 AM

A 6 months' pregnant patient was evaluated for gestational diabetes mellitus. The doctor considered prescribing insulin based on the serum glucose result of:

138 mg/dL, 2 hours postprandial.

A 6 months' pregnant patient was evaluated for gestational diabetes mellitus. The doctor considered prescribing insulin based on the serum glucose result of: 120 mg/dL, 1 hour postprandial. 80 mg/dL, 1 hour postprandial. 90 mg/dL before meals. 138 mg/dL, 2 hours postprandial.

138 mg/dL, 2 hours postprandial.

The nurse performs a fingerstick blood glucose level of a client with diabetes before lumch. The nurse would notify the physician for which blood glucose level?

145 mg/dL

The nurse performs a fingerstick blood glucose level of a client with diabetes before lunch. The nurse would notify the physician for which blood glucose level?

145 mg/dL

A nurse is teaching a client with diabetes mellitus about self-management of his condition. The nurse should instruct the client to administer 1 unit of insulin for every:

15 g of carbohydrates

A nurse is teaching a client with diabetes mellitus about self-management of his condition. The nurse should instruct the client to administer 1 unit of insulin for every:

15 g of carbohydrates.

A nurse is teaching a client with diabetes mellitus about self-management of his condition. The nurse should instruct the client to administer 1 unit of insulin for every: 20 g of carbohydrates. 25 g of carbohydrates. 10 g of carbohydrates. 15 g of carbohydrates.

15 g of carbohydrates.

A nurse is caring for a client with type 1 diabetes who exhibits confusion, light-headedness, and aberrant behavior. The client is conscious. The nurse should first administer:

15 to 20 g of a fast-acting carbohydrate such as orange juice

A nurse is caring for a client with type 1 diabetes who exhibits confusion, light-headedness, and aberrant behavior. The client is conscious. The nurse should first administer:

15 to 20 g of a fast-acting carbohydrate such as orange juice.

A nurse is caring for a client with type 1 diabetes who exhibits confusion, light-headedness, and aberrant behavior. The client is conscious. The nurse should first administer:

15-20g of a fast acting carbohydrate such as orange juice This client is experiencing hypoglycemia. Because the client is conscious, the nurse should first administer a fast-acting carbohydrate, such as orange juice, hard candy, or honey. If the client has lost consciousness, the nurse should administer I.M. or subcutaneous glucagon or an I.V. bolus of dextrose 50%. The nurse shouldn't administer insulin to a client who's hypoglycemic; this action will further compromise the client's condition.

Carbohydrate counting is a flexible alternative to using the exchange system. Each choice of carbohydrates equals how many grams of carbohydrate?

15g

A nurse knows to assess a patient with type 1 diabetes for postprandial hyperglycemia. The nurse knows that glycosuria is present when the serum glucose level exceeds: 120 mg/dL 140 mg/dL 160 mg/dL 180 mg/dL

180 mg/dL

As a nurse educator, you have been invited to your local senior center to discuss health-maintaining strategies for older adults. During your education session on nutrition, you approach the subject of diabetes mellitus, its symptoms and consequences. What is the incidence of Type 2 diabetes in newly diagnosed cases?

20%

The nurse is instructing the client on insulin administration. The client is performing a return demonstration for preparing the insulin. The client's morning dose of insulin is 10 units of regular and 22 units of NPH. The nurse checks the dose accuracy with the client. The nurse determines that the client has prepared the correct dose when the syringe reads how many units?

What is the duration of regular insulin?

4 to 6 hours

What is the duration of regular insulin?

4 to 6 hours The duration of regular insulin is 4 to 6 hours; 3 to 5 hours is the duration for rapid-acting insulin such as Novolog. The duration of NPH insulin is 12 to 16 hours. The duration of Lantus insulin is 24 hours.

What is the duration of regular insulin?

4-6 hours

A client with diabetes comes to the clinic for a follow-up visit. The nurse reviews the client's glycosylated hemoglobin test results. Which result would indicate to the nurse that the client's blood glucose level has been well controlled? A) 6.5% B) 7.5% C) 8.0% D) 8.5%

6.5

6.5%

Every morning, a client with type 1 diabetes receives 15 units of Humulin 70/30. What does this type of insulin contain?

70% NPH insulin and 30% regular insulin

A client is receiving insulin lispro at 7:30 AM. The nurse ensures that the client has breakfast by which time?

7:45 AM

A health care provider prescribes short-acting insulin for a patient, instructing the patient to take the insulin 20 to 30 minutes before a meal. The nurse explains to the patient that Humulin-R taken at 6:30 AM will reach peak effectiveness by: 8:30 AM. 10:30 AM. 12:30 PM. 2:30 PM.

8:30 AM

A health care provider prescribes short-acting insulin for a patient, instructing the patient to take the insulin 20 to 30 minutes before a meal. The nurse explains to the patient that Humulin-R, taken at 6:30 AM will reach peak effectiveness by:

8:30 AM

8:30 AM.

A health care provider prescribes short-acting insulin for a patient, instructing the patient to take the insulin 20 to 30 minutes before a meal. The nurse explains to the patient that Humulin-R, taken at 6:30 AM will reach peak effectiveness by: 10:30 AM. 2:30 PM. 8:30 AM. 12:30 PM.

8:30 AM.

A diabetes nurse educator is teaching a group of clients with type 1 diabetes about "sick day rules." What guideline applies to periods of illness in a diabetic client? A. Do not eliminate insulin when nauseated and vomiting. B. Report elevated glucose levels greater than 150 mg/dL (8.3 mmol/L). C. Eat three substantial meals a day, if possible. D. Reduce food intake and insulin doses in times of illness.

A The most important issue to teach clients with diabetes who become ill is not to eliminate insulin doses when nausea and vomiting occur. Rather, they should take their usual insulin or oral hypoglycemic agent dose, and then attempt to consume frequent, small portions of carbohydrates. In general, blood sugar levels will rise but should be reported if they are greater than 300 mg/dL (16.6 mmol/L).

Which statement is true regarding gestational diabetes?

A Glucose challenge test should be performed between 24-28 weeks A glucose challenge test should be performed between 24 and 48 weeks in women at average risk. It occurs in 2% to 5% of all pregnancies. Onset usually occurs in the second or third trimester. There is an above-normal risk for perinatal complications.

Which of the following statements is true regarding gestational diabetes? It occurs in most pregnancies. There is a low risk for perinatal complications. A glucose challenge test should be performed between 24 and 28 weeks. Its onset is usually in the first trimester.

A glucose challenge test should be performed between 24 and 28 weeks.

Which of the following is true regarding gestational diabetes?

A glucose challenge test should be performed between 24 to 28 weeks

When administering insulin, which of the following is most important to keep in mind?

Accuracy of dose

When administering insulin to a client with type 1 diabetes, which of the following would be most important for the nurse to keep in mind?

Accuracy of the dosage

When administering insulin to a client with type 1 diabetes, which of the following would be most important for the nurse to keep in mind? Accuracy of the dosage Area for insulin injection Technique for injecting Duration of the insulin

Accuracy of the dosage

Which of the following medications is considered a glitazone?

Actos

A hospitalized client is found to be comatose and hypoglycemic with a blood sugar of 50 mg/dL. Which of the following would the nurse do first?

Administer 50% glucose intravenously

A client with diabetic ketoacidosis has been brought into the ED. Which intervention is not a goal in the initial medical treatment of diabetic ketoacidosis?

Administer glucose.

A client with type 1 diabetes must undergo bowel resection in the morning. How should the nurse proceed while caring for him on the morning of surgery?

Administer half of the client's typical morning insulin dose as ordered.

A child is brought into the emergency department with vomiting, drowsiness, and blowing respirations. The father reports that the symptoms have been progressing throughout the day. The nurse suspects diabetic ketoacidosis (DKA). Which nursing action is most important in the management of DKA? A) Give prescribed antiemetics. B) Begin fluid replacements. C) Administer prescribed dose of insulin. D) Administer bicarbonate to correct acidosis.

Administer prescribed dose of insulin.

A client with type 1 diabetes presents with a decreased level of consciousness and a fingerstick glucose level of 39 mg/dl. His family reports that he has been skipping meals in an effort to lose weight. Which nursing intervention is most appropriate? Administering a 500-ml bolus of normal saline solution Inserting a feeding tube and providing tube feedings Administering 1 ampule of 50% dextrose solution, per physician's order Observing the client for 1 hour, then rechecking the fingerstick glucose level

Administering 1 ampule of 50% dextrose solution, per physician's order

A patient newly diagnosed with type 1 diabetes has an unusual increase in blood glucose from bedtime to morning. The physician suspects the patient is experiencing insulin waning. Based on this diagnosis, the nurse will expect which of the following changes to the patient's medication regimen? Administering a dose of intermediate-acting insulin before the evening meal Decreasing evening bedtime dose of intermediate-acting insulin and administering a bedtime snack Changing the time of injection of evening intermediate-acting insulin from dinnertime to bedtime Increasing morning dose of long-acting insulin

Administering a dose of intermediate-acting insulin before the evening meal

A nurse is caring for a diabetic patient with a diagnosis of nephropathy. What would the nurse expect the urinalysis report to indicate?

Albumin

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

Albumin

Matt Thompson, a 37-year-old farmer, has been diagnosed with pre diabetes. Following his visit with his primary care provider, you begin your client education session to discuss treatment strategies. What can be the consequences of untreated pre diabetes? CVA Cardiac disease All options are correct. Type 2 diabetes

All options are correct.

A diabetic nurse is working for the summer at a camp for adolescents with diabetes. When providing information on the prevention and management of hypoglycemia, what action should the nurse promote?

Always carry a form of fast-acting sugar.

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.

After recently being admitted to the emergency department with signs and symptoms of hyperglycemia, a 33-year-old man was subsequently diagnosed with diabetes. The patient's blood sugars have been stabilized, and the man has begun diabetes education with a nurse educator. When working with this patient, the nurse educator should first: Teach the patient about the essential concepts of nutrition Explain the various insulin delivery devices to the patient Ask the patient what questions he currently has about diabetes Ascertain the patient's readiness and willingness to learn

Ascertain the patient's readiness and willingness to learn

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 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?

Assess the client's readiness to learn.

What should be the first step in developing a teaching plan for a 9-year-old who needs education about a gluten-free diet for the treatment of celiac disease?

Assessing the child's current level of understanding

Why will it be necessary for the nurse to be very supportive of parents' attempts to feed the infant with recently repaired myelomeningocele?

Assuming the usual feeding position will be difficult.

A client who has AIDS reports having diarrhea after every meal, and wants to know what can be done to stop this symptom. What should the nurse advise?

Avoid fibrous foods, lactose, fat, and caffeine. Diarrhea may subside when the client avoids fibrous foods, lactose, fat, and caffeine. Although eating may seem to cause diarrhea, the client must understand that limiting the intake of food to control diarrhea only exacerbates wasting. The client will tolerate a low-fat, high-carbohydrate, and soft or liquid diet better than large, high-fat meals. The client should be advised to avoid large doses of iron and zinc because they can impair the functioning of the immune system.

B Regular insulin is usually given 20 to 30 minutes before a meal. Earlier administration creates a risk for hypoglycemia; later administration creates a risk for hyperglycemia.

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? A. Home health nurse B. Dietitian C. Psychiatrist D. Social worker

B The client should be referred to a dietitian, who will help him gain better control of his blood glucose levels. The client can care for himself, so a home health agency isn't necessary. The client shows no signs of needing a psychiatric referral, and referring the client to a psychiatrist isn't in the nurse's scope of practice. Social workers help clients with financial concerns; the scenario doesn't indicate that the client has a financial concern warranting a social worker at this time.

Using a sliding-scale schedule, the nurse is preparing to administer an evening dose of regular insulin to a client who is receiving total parenteral nutrition (TPN). Which action is most appropriate for the nurse to take to determine the amount of insulin to give?

Base the dosage on the glucometer reading of the client's glucose level obtained immediately before administering the insulin.

A child is brought into the emergency department with vomiting, drowsiness, and blowing respirations. The father reports that the symptoms have been progressing throughout the day. The nurse suspects diabetic ketoacidosis (DKA). Which action should the nurse take first in the management of DKA? Give prescribed antiemetics. Begin fluid replacements. Administer bicarbonate to correct acidosis. Administer prescribed dose of insulin.

Begin fluid replacements.

Which clinical characteristic is associated with type 2 diabetes (previously referred to as non-insulin-dependent diabetes mellitus)?

Blood glucose can be controlled through diet and exercise

A client is admitted with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which laboratory finding should the nurse expect in this client?

Blood glucose level 1,100 mg/dl

A client is admitted with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which laboratory finding should the nurse expect in this client? Arterial pH 7.25 Blood urea nitrogen (BUN) 15 mg/dl Plasma bicarbonate 12 mEq/L Blood glucose level 1,100 mg/dl

Blood glucose level 1,100 mg/dl

Which clinical manifestation of type 2 diabetes occurs if glucose levels are very high?

Blurred vision

Which of the following clinical manifestations of type 2 diabetes occurs if glucose levels are very high? Oliguria Increased energy Hyperactivity Blurred vision

Blurred vision

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 what? A. "I read that a pancreas transplant will provide a cure for my diabetes." B. "I will take my oral antidiabetic agents when my morning blood sugar is high." C. "I will make sure to follow the weight loss plan designed by the dietitian." D. "I will make sure I call the diabetes educator when I have questions about my insulin."

C Insulin resistance is associated with obesity; thus the primary treatment of type 2 diabetes is weight loss. Oral antidiabetic agents may be added if diet and exercise are not successful in controlling blood glucose levels. If maximum doses of a single category of oral agents fail to reduce glucose levels to satisfactory levels, additional oral agents may be used. Some clients may require insulin on an ongoing or on a temporary basis during times of acute psychological stress, but it is not the central component of type 2 treatment. Pancreas transplantation is associated with type 1 diabetes.

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? A. Insulin is absorbed more slowly at abdominal injection sites than at other sites. B. Insulin is absorbed rapidly regardless of the injection site. C. Insulin is absorbed more rapidly at abdominal injection sites than at other sites. D. Insulin is absorbed unpredictably at all injection sites.

C Subcutaneous insulin is absorbed most rapidly at abdominal injection sites, more slowly at sites on the arms, and slowest at sites on the anterior thigh. Absorption after injection in the buttocks is less predictable.

Which of the following clinical characteristics is associated with type 2 diabetes (previously referred to as non-insulin dependent diabetes mellitus [NIDDM])? Usually thin at diagnosis Demonstrate islet cell antibodies Can control blood glucose through diet and exercise Ketosis-prone

Can control blood glucose through diet and exercise

A nurse is teaching a client about insulin infusion pump use. What intervention should the nurse include to prevent infection at the injection site? Use clean technique when changing the needle. Wear sterile gloves when inserting the needle. Take the ordered antibiotics before initiating treatment. Change the needle every 3 days.

Change the needle every 3 days.

The nurse is providing dietary instruction for the client with fibrocystic breast disease. Which of the client's favorite foods are discouraged? Select all that apply.

Chocolate pudding Cola products When instructing the client on appropriate food choices, the nurse instructs the client to avoid caffeine. Caffeine is in products such as chocolate and cola drinks. Lasagna is discouraged in clients with digestive disorders. Organ meats are discouraged in clients with high cholesterol. Popcorn and nuts are discouraged in clients with disorders such as diverticulitis.

The nurse is educating a client who is required to restrict potassium intake. What foods would the nurse suggest the client eliminate that are rich in potassium?

Citrus fruits

Which factors will cause hypoglycemia in a client with diabetes? Select all that apply.

Client has not consumed food and continues to take insulin or oral antidiabetic medications. Client has not consumed sufficient calories. Client has been exercising more than usual.

A client reports taking oral medication for control of sugar problems. Which is the best nursing interpretation of this verbal accounting? A) Lack of knowledge of disease process B) Client has type 2 diabetes mellitus. C) Client has prediabetes mellitus. D) Lack of knowledge on medication regime

Client has type 2 diabetes mellitus.

A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and symptoms?

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

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

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

A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and symptoms?

Coma, anxiety, headache and cool and moist skin Signs and symptoms of hypoglycemia (indicated by a blood glucose level of 45 mf/dl) include anxiety, restlessness, headache, irritability, confusion, diaphoresis, cool skin, tremors, coma, and seizures. Kussmaul's respirations, dry skin, hypotension, and bradycardia are signs of diabetic ketoacidosis. Excessive thirst, hunger, hypotension, and hypernatremia are symptoms of diabetes insipidus. Polyuria, polydipsia, polyphagia, and weight loss are classic signs and symptoms of diabetes mellitus.

Which of the following would be inconsistent as a cause of DKA?

Competency in injecting insulin

A nurse educates a group of clients with diabetes mellitus on the prevention of diabetic nephropathy. Which of the following suggestions would be most important?

Control blood glucose levels

A nurse educates a group of clients with diabetes mellitus on the prevention of diabetic nephropathy. Which of the following suggestions would be most important?

Control blood glucose levels Controlling blood glucose levels and any hypertension can prevent or delay the development of diabetic nephropathy. Drinking plenty of fluids does not prevent diabetic nephropathy. Taking antidiabetic drugs regularly may help to control blood glucose levels, but it is the control of these levels that is most important. A high-fiber diet is unrelated to the development of diabetic nephropathy.

A nurse educates a group of clients with diabetes mellitus on the prevention of diabetic nephropathy. Which of the following suggestions would be most important? Control blood glucose levels. Take the antidiabetic drugs regularly. Drink plenty of fluids. Eat a high-fiber diet.

Control blood glucose levels.

A client is diagnosed with diabetes mellitus. Which assessment finding best supports a nursing diagnosis of Ineffective coping related to diabetes mellitus?

Crying whenever diabetes is mentioned

Which of the following is an age-related change that may affect diabetes? Select all that apply. Increased bowel motility Decreased vision Decreased renal function Taste changes Increased proprioception

Decreased renal function Taste changes Decreased vision

A client with long-standing type 1 diabetes is admitted to the hospital with unstable angina pectoris. After the client's condition stabilizes, the nurse evaluates the diabetes management regimen. The nurse learns that the client sees the physician every 4 weeks, injects insulin after breakfast and dinner, and measures blood glucose before breakfast and at bedtime. Consequently, the nurse should formulate a nursing diagnosis of:

Deficient knowledge (treatment regimen)

Deficient knowledge (treatment regimen).

An obese Hispanic client, age 65, is diagnosed with type 2 diabetes. Which statement about diabetes mellitus is true?

Diabetes mellitus is more common in Hispanics and Blacks than in Whites

An obese Hispanic client, age 65, is diagnosed with type 2 diabetes. Which statement about diabetes mellitus is true? Diabetes mellitus is more common in Hispanics and Blacks than in Whites. Type 2 diabetes mellitus is less common than type 1 diabetes mellitus. Nearly two-thirds of clients with diabetes mellitus are older than age 60. Approximately one-half of the clients diagnosed with type 2 diabetes are obese.

Diabetes mellitus is more common in Hispanics and Blacks than in Whites.

A nurse is assessing a patient receiving tube feedings and suspects dumping syndrome. Which of the following would lead the nurse to suspect this? Select all that apply.

Diarrhea Tachycardia Diaphoresis

Dietitian

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? Psychiatrist Home health nurse Social worker Dietitian

Dietitian

A diabetes nurse educator is teaching a group of clients with type 1 diabetes about "sick day rules." What guideline applies to periods of illness in a diabetic client?

Do not eliminate insulin when nauseated and vomiting.

Which information should be included in the teaching plan for a client receiving glargine, a "peakless" basal insulin?

Do not mix with other insulins.

An infant diagnosed with nonorganic failure to thrive (NFTT) is being treated in the hospital. Which intervention would the nurse implement for this child to provide increased nutritional intake?

Document all feedings and the infant's response to the feeding.

After teaching a group of students about diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic nonketotic syndrome (HHNKS), the instructor determines that additional teaching is needed when the students identify which of the following as characteristic of HHNKS?

Elevated serum potassium levels

A diabetic client is having difficulty with blood glucose control even though the client claims to be following a strict diet, exercise, and medication regime. Which of the following conditions would the nurse suspect to be the most likely cause of poor control? A) Hypertension B) Retinopathy C) Peripheral vascular disease D) Emphysema

Emphysema

Which is the primary dietary consideration for a client receiving insulin isophane suspension (NPH) at breakfast? A) Make sure breakfast is not delayed. B) Provide fewest amount of carbohydrates at lunch meal. C) Encourage midday snack. D) Delay dinner meal.

Encourage midday snack.

Which is the primary dietary consideration for a client receiving insulin isophane suspension (NPH) at breakfast?

Encourage midday snack.

The nurse is planning an education program for women of childbearing years. The nurse recognizes that primary prevention of osteoporosis includes:

Ensuring adequate calcium and vitamin D intake

Which of the following would the nurse most likely assess in a client with diabetes who is experiencing autonomic neuropathy? A) Skeletal deformities B) Paresthesias C) Erectile dysfunction D) Soft tissue ulceration

Erectile dysfunction

Which of the following would the nurse most likely assess in a client with diabetes who is experiencing autonomic neuropathy?

Erectile dysfunction Autonomic neuropathy affects organ functioning. According the American Diabetes Association, up to 50% of men with diabetes develop erectile dysfunction when nerves that promote erection become impaired. Skeletal deformities and soft tissue ulcers may occur with motor neuropathy. Paresthesias are associated with sensory neuropathy.

A nurse practitioner ordered blood work for a 65-year-old man who is hypertensive and obese. Which of the following results is consistent with a diagnosis of prediabetes?

Fasting plasma glucose of 128 mg/dL

A client with type 1 diabetes mellitus is receiving short-acting insulin to maintain control of blood glucose levels. In providing glucometer instructions, the nurse would instruct the client to use which site for most accurate findings?

Finger

Which condition in a client with pancreatitis makes it necessary for the nurse to check fluid intake and output, check hourly urine output, and monitor electrolyte levels?

Frequent vomiting, leading to loss of fluid volume

What foods can the nurse recommend for the patient with hypokalemia?

Fruits such as bananas and apricots

Which assessment finding is most important in determining nursing care for a client with diabetes mellitus? A) Respirations of 12 breaths/minute B) Cloudy urine C) Blood sugar 170 mg/dL D) Fruity breath

Fruity breath

Which assessment finding is most important in determining nursing care for a client with diabetes mellitus?

Fruity breath

A student with type 1 diabetes tells the nurse she is feeling light-headed. The student's blood sugar is 60mg/dl. Using the 15-15 rule, the nurse should:

Give 15 grams of carbohydrate and retest the blood sugar in 15 minutes

A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously? A) Glargine B) Regular C) NPH D) Lente

Glargine

Which of the following insulins are used for basal dosage?

Glarginet (Lantus)

A nurse is teaching a client with type 1 diabetes how to treat adverse reactions to insulin. To reverse hypoglycemia, the client ideally should ingest an oral carbohydrate. However, this treatment isn't always possible or safe. Therefore, the nurse should advise the client to keep which alternate treatment on hand?

Glucagon

A 53-year-old client is being seen by a physician in the primary care group where you practice nursing. It is time for her annual physical and her pre-examination blood work results have arrived for the physician's use. The client has a 30-year-history of type 2 diabetes. What blood test would you expect the physician to order to monitor her treatment compliance?

Glycosylated hemoglobin

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

During a follow-up visit 3 months following a new diagnosis of type 2 diabetes, a patient reports exercising and following a reduced-calorie diet. Assessment reveals that the patient has only lost 1 pound and did not bring the glucose-monitoring record. Which of the following tests will the nurse plan to obtain? Urine dipstick for glucose Glycosylated hemoglobin level Oral glucose tolerance test Fasting blood glucose level

Glycosylated hemoglobin level

Glycosylated hemoglobin level Glycosylated hemoglobin is a blood test that reflects the average blood glucose concentration over a period of approximately 2 to 3 months. When blood glucose is elevated, glucose molecules attach to hemoglobin in red blood cells. The longer the amount of glucose in the blood remains above normal, the more glucose binds to hemoglobin and the higher the glycosylated hemoglobin level becomes.

Glycosylated hemoglobin level Because some of the glucose in the bloodstream attaches to some of the hemoglobin and stays attached during the 120-day life span of red blood cells, glycosylated hemoglobin levels provide information about blood glucose levels during the previous 3 months. Fasting blood glucose and urine glucose levels give information only about glucose levels at the point in time when they were obtained. Serum fructosamine levels provide information about blood glucose control over the past 2 to 3 weeks.

The nurse who is caring for a client with type 1 diabetes mellitus should use which of the following to determine how well the insulin, diet, and exercise are balanced?

Glycosylated hemoglobin level.

Which clinical characteristic is associated with type 2 diabetes (previously referred to as non-insulin-dependent diabetes mellitus)?

HTN, tachycardia, stroke

A student with diabetes tells the school nurse that he is feeling nervous and hungry. The nurse assesses the child and finds he 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 of a cup of juice, followed by cheese and crackers

What foods should the nurse suggest that the patient consume less of in order to reduce nitrate intake because of the possibility of carcinogenic action?

Ham and bacon Dietary substances that appear to increase the risk of cancer include fats, alcohol, salt-cured or smoked meats, nitrate and nitrite-containing foods, and red and processed meats. Nitrates are added to cured meats, such as ham and bacon.

A type 2 diabetic is ordered metformin (Glucophage) as part of the management regime. Which is the best nursing explanation for the action of this drug in controlling glucose levels? A) Delays digestion of carbohydrates B) Helps tissues use insulin more efficiently C) Stimulates insulin release D) Reduces the production of glucose by the liver

Helps tissues use insulin more efficiently

A type 2 diabetic is ordered metformin (Glucophage) as part of the management regime. Which is the best nursing explanation for the action of this drug in controlling glucose levels? Stimulates insulin release Helps tissues use insulin more efficiently Delays digestion of carbohydrates Reduces the production of glucose by the liver

Helps tissues use insulin more efficiently

When the nurse inspects the feet of a diabetic, a tack is found sticking in the sole of one foot. The client denies feeling anything unusual in the foot. Which is the best rationale for this finding? A) In diabetes, the autonomic nerves are affected. B) Motor neuropathy causes muscles to weaken and atrophy. C) High blood sugar decreases blood circulation to nerves. D) Nephropathy is a common complication of diabetes mellitus.

High blood sugar decreases blood circulation to nerves.

Which is the best nursing explanation for the symptom of polyuria in a client with diabetes mellitus? A) With diabetes, drinking more results in more urine production. B) Increased ketones in the urine promote the manufacturing of more urine. C) High sugar pulls fluid into the bloodstream, which results in more urine production. D) The body's requirement for fuel drives the production of urine.

High sugar pulls fluid into the bloodstream, which results in more urine production.

Which is the best nursing explanation for the symptom of polyuria in a client with diabetes mellitus?

High sugar pulls fluid into the bloodstream, which results in more urine production.

Which of the following is the most rapid acting insulin?

Humalog

Which of the following is the most rapid acting insulin? Humalog Ultralente NPH Regular

Humalog

Which of the following is a risk factor for the development of diabetes mellitus? Select all that apply.

Hypertension Age greater of 45 years or older History of gestational diabetes Family history Obesity

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

Hypoglycemia

A client with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which symptom when caring for this client?

Hypoglycemia

A patient with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which of the following symptoms when caring for this patient? Hypoglycemia Polyuria Polydipsia Blurred vision

Hypoglycemia

The nurse has been assigned to a client who has had diabetes for 10 years. The nurse gives the client's usual dose of Humulin Regular insulin at 7 a.m. At 10:30 a.m., the client has light-headedness and sweating. The nurse should contact the physician, report the situation, background, and assessment, and recommend intervention for:

Hypoglycemia

When the nurse is caring for a patient with type 1 diabetes, what clinical manifestation would be a priority to closely monitor?

Hypoglycemia

When the nurse is caring for a patient with type 1 diabetes, what clinical manifestation would be a priority to closely monitor? Polyphagia Hypoglycemia Hyponatremia Ketonuria

Hypoglycemia

A client with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which symptom when caring for this client?

Hypoglycemia The nurse should observe the client receiving an oral antidiabetic agent for signs of hypoglycemia. The time when the reaction might occur is not predictable and could be from 30 to 60 minutes to several hours after the drug is ingested.

Which combination of adverse effects should a nurse monitor for when administering I.V. insulin to a client with diabetic ketoacidosis?

Hypokalemia and hypoglycemia

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

Hypokalemia and hypoglycemia

Which combination of adverse effects should a nurse monitor for when administering IV insulin to a client with diabetic ketoacidosis?

Hypokalemia and hypoglycemia

Which of the following assessment findings is most important in determining nursing care for a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNKS)? A) Hypotension B) Blood pH 7.38 C) Mental changes D) Fever

Hypotension

A diabetic client maintains glucose control with the use of long-acting and short-acting insulin. Which nursing instruction would be considered a priority teaching issue for this client? A) Mix short-acting and long-acting insulin. B) Monitor blood glucose levels immediately following injection. C) Use stomach for nighttime injections. D) If using Lantus or Levemir, give in separate syringe.

If using Lantus or Levemir, give in separate syringe.

A diabetic client maintains glucose control with the use of long-acting and short-acting insulin. Which nursing instruction would be considered a priority teaching issue for this client?

If using Lantus or Levemir, give in separate syringe.

Increase frequency of glucose self monitoring Minor illnesses such as influenza can present a special challenge to a diabetic client. The body's need for insulin increases during illness. Therefore, the client should take the prescribed insulin dose, increase the frequency of glucose monitoring, and maintain adequate fluid intake to counteract the dehydrating effects of hyperglycemia. Clear liquids and juices are encouraged. Taking less than normal dose of insulin may lead to ketoacidosis.

Increase frequency of glucose self-monitoring.

The nurse is educating the client with diabetes on setting up a sick plan to manage blood glucose control during times of minor illness such as influenza. Which is the most important teaching item to include? Increase frequency of glucose self-monitoring. Decrease food intake until nausea passes. Do not take insulin if not eating. Take half the usual dose of insulin until symptoms resolve.

Increase frequency of glucose self-monitoring.

The nurse is educating the diabetic client on setting up a sick plan to manage blood glucose control during times of minor illness such as influenza. Which is the most important teaching item to include? A) Increase frequency of glucose self-monitoring. B) Decrease food intake until nausea passes. C) Do not take insulin if not eating. D) Take half the usual dose of insulin until symptoms resolve.

Increase frequency of glucose self-monitoring.

The nurse is educating the diabetic client on setting up a sick plan to manage blood glucose control during times of minor illness such as influenza. Which is the most important teaching item to include? Do not take insulin if not eating. Increase frequency of glucose self-monitoring. Decrease food intake until nausea passes. Take half the usual dose of insulin until symptoms resolve.

Increase frequency of glucose self-monitoring.

A client with type 1 diabetes mellitus has influenza. The nurse should instruct the client to:

Increase the frequency of self-monitoring bg testing

A 60-year-old client comes to the ED reporting weakness, vision problems, increased thirst, increased urination, and frequent infections that do not seem to heal easily. The physician suspects that the client has diabetes. Which classic symptom should the nurse watch for to confirm the diagnosis of diabetes?

Increased hunger

A 60-year-old patient comes to the ED with complaints of weakness, vision problems, increased thirst, increased urination, and frequent infections that do not seem to heal easily. The physician suspects that the patient has diabetes. Which of the following classic symptoms should the nurse watch for to confirm the diagnosis of diabetes?

Increased hunger

Increased hunger The classic symptoms of diabetes are the three Ps: polyuria (increased urination), polydipsia (increased thirst), and polyphagia (increased hunger). Some of the other symptoms include tingling, numbness, and loss of sensation in the extremities and fatigue.

A nurse is providing education to a client who is newly diagnosed with diabetes mellitus. Which of the following symptoms would she include when reviewing classic symptoms associated with diabetes? Increased weight gain, increased appetite, and increased thirst Increased weight loss, increased dehydration, and increased fatigue Loss of appetite, increased urination, and dehydration Increased thirst, increased hunger, and increased urination

Increased thirst, increased hunger, and increased urination

A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which finding suggests that the client has developed hyperglycemia?

Increased urine output

The client who is managing diabetes through diet and insulin control asks the nurse why exercise is important. Which is the best response by the nurse to support adding exercise to the daily routine? A) Increases ability for glucose to get into the cell and lowers blood sugar B) Creates an overall feeling of well-being and lowers risk of depression C) Decreases need for pancreas to produce more cells D) Decreases risk of developing insulin resistance and hyperglycemia

Increases ability for glucose to get into the cell and lowers blood sugar

The client who is managing diabetes through diet and insulin control asks the nurse why exercise is important. Which is the best response by the nurse to support adding exercise to the daily routine?

Increases ability for glucose to get into the cell and lowers blood sugar

The client who is managing diabetes through diet and insulin control asks the nurse why exercise is important. Which is the best response by the nurse to support adding exercise to the daily routine? Decreases risk of developing insulin resistance and hyperglycemia Decreases need for pancreas to produce more cells Increases ability for glucose to get into the cell and lowers blood sugar Creates an overall feeling of well-being and lowers risk of depression

Increases ability for glucose to get into the cell and lowers blood sugar

The client who is managing diabetes through diet and insulin control asks the nurse why exercise is important. Which is the best response by the nurse to support adding exercise to the daily routine?

Increases the ability of glucose to get into the cell and decreases blood sugar Exercise increases trans membrane glucose transporter levels in the skeletal muscles. This allows the glucose to leave the blood and enter into the cells where it can be used as fuel. Exercise can provide an overall feeling of well-being but is not the primary purpose of including in the daily routine of diabetic clients. Exercise does not stimulate the pancreas to produce more cells. Exercise can promote weight loss and decrease risk of insulin resistance but not the primary reason for adding to daily routine.

Crohn's disease is a condition of malabsorption caused by which pathophysiological process?

Inflammation of all layers of intestinal mucosa Crohn's disease, also known as regional enteritis, can occur anywhere along the gastrointestinal tract but most commonly at the distal ileum and in the colon. Infectious disease causes problems such as small-bowel bacterial overgrowth, leading to malabsorption. Disaccharidase deficiency leads to lactose intolerance. Postoperative malabsorption occurs after gastric or intestinal resection.

A patient is prescribed Glucophage, an oral antidiabetic agent classified as a biguanide. The nurse knows that a primary action of this drug is its ability to:

Inhibit the production of glucose by the liver

A client is diagnosed with diabetes mellitus. The physician orders 15 units of U-100 regular insulin and 35 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. The nurse checks the medication order, assembles equipment, washes her hands, rotates the NPH insulin vial, puts on disposable gloves, and cleans the stoppers. To draw the two insulin doses into the single U-100 insulin syringe, which sequence should the nurse use?

Inject 35 units air into NPH vial; inject 15 units air into regular insulin vial, withdraw 15 units regular insulin; withdraw 35 units NPH.

When preparing to draw up 8 units of a short-acting insulin and 20 units of a long-acting insulin in the same syringe, the nurse should:

Inject air in the vial with the long-acting insulin first

The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which of the following would the nurse include as associated with type 2 diabetes? A) Onset most common during adolescence B) Insufficient insulin production C) Less common than type 1 diabetes D) Little relation to prediabetes

Insufficient insulin production

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

Which factor presents the most likely cause for weight gain in a diabetic client who is controlled with insulin? A) Insulin is an anabolic hormone. B) Insulin provides more efficient use of glucose. C) Faulty fat metabolism is shut off. D) Weight gain is attributed to fluid retention.

Insulin is an anabolic hormone.

Which factor presents the most likely cause for weight gain in a diabetic client who is controlled with insulin?

Insulin is an anabolic hormone.

The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which of the following would the nurse include as associated with type 2 diabetes?

Insulin production insufficient

The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which of the following would the nurse include as associated with type 2 diabetes? Insulin production insufficient Little to relation to pre-diabetes Onset most common during adolescence Less common than type 1 diabetes

Insulin production insufficient

The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which of the following would the nurse include as associated with type 2 diabetes?

Insulin production insufficient Type 2 diabetes is characterized by insulin resistance or insufficient insulin production. It is more common in aging adults, and now accounts for 20% of all newly diagnosed cases. Type 1 diabetes is more likely in childhood and adolescence although it can occur at any age. It accounts for approximately 5% to 10% of all diagnosed cases of diabetes. Pre-diabetes can lead to type 2 diabetes.

The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which of the following would the nurse include as associated with type 2 diabetes?

The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which characteristic would the nurse inform the group is associated with type 2 diabetes?

Insulin resistance or insufficient insulin production

The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which of the following would the nurse include as associated with type 2 diabetes?

Insulin resistance or insufficient insulin production

NPH is an example of which type of insulin?

Intermediate-acting

NPH is an example of which type of insulin? Intermediate-acting Long-acting Short-acting Rapid-acting

Intermediate-acting

Which of the following statements is correct regarding glargine (Lantus) insulin?

It cannot be mixed with any other type of insulin

Which statement is correct regarding glargine insulin?

It cannot be mixed with any other type of insulin.

The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action? A) It carries glucose into body cells. B) It aids in the process of gluconeogenesis. C) It stimulates the pancreatic beta cells. D) It decreases the intestinal absorption of glucose.

It carries glucose into body cells.

The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action?

It carries glucose into body cells.

The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action?

It enhances transport of glucose across the cell wall

The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action? It aids in the process of gluconeogenesis. It decreases the intestinal absorption of glucose. It enhances transport of glucose across the cell wall. It stimulates the pancreatic beta cells.

It enhances transport of glucose across the cell wall.

The nurse is performing an assessment for a client with anemia admitted to the hospital to have blood transfusions administered. Why would the nurse need to include a nutritional assessment for this patient?

It may indicate deficiencies in essential nutrients.

A client with type 1 diabetes has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse is most accurate in stating:

It tells us about your sugar control for the last 3 months

A 53-year-old client is brought to the ED, via squad, where you practice nursing. He is demonstrating fast, deep, labored breathing and has a fruity odor to his breath. He has a history of type 1 diabetes. What could be the cause of his current serious condition?

Ketoacidosis

Which of the following are byproducts of fat breakdown, which accumulate in the blood and urine?

Ketones

Which of the following are byproducts of fat breakdown, which accumulate in the blood and urine? Ketones Creatinine Cholesterol Hemoglobin

Ketones

A patient is diagnosed with type 1 diabetes. What clinical characteristics does the nurse expect to see in this patient? (Select all that apply.) Ketosis-prone Older than 65 years of age Little endogenous insulin Obesity at diagnoses Younger than 30 years of age

Ketosis-prone Little endogenous insulin Younger than 30 years of age

A patient is diagnosed with type 1 diabetes. What clinical characteristics does the nurse expect to see in this patient? Select all that apply.

Ketosis-prone Little or no endogenous insulin Younger than 30 years of age

The nurse is assessing a patient with nonproliferative (background) retinopathy. When examining the retina, what would the nurse expect to assess? (Select all that apply.) Microaneurysms Detachment Focal capillary single closure Leakage of fluid or serum (exudates) Blurred optic discs

Leakage of fluid or serum (exudates) Microaneurysms Focal capillary single closure

Which type of insulin acts most quickly?

Lispro

Examination of a client's bladder stones reveals that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet?

Low purine

The nurse is educating the patient with diabetes about the importance of increasing dietary fiber. What should the nurse explain is the rationale for the increase? Select all that apply.

May improve blood glucose levels Increase potassium levels Help reduce cholesterol levels

A client with diabetes is receiving an oral anti diabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer?

Metformin

A client with diabetes is receiving an oral antidiabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer? A) Metformin B) Glyburide C) Repaglinide D) Glipizide

Metformin

A client with diabetes is receiving an oral antidiabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer?

Metformin

A client with type 1 diabetes is experiencing polyphagia. The nurse knows to assess for which additional clinical manifestation(s) associated with this classic symptom?

Muscle waisting and tissue loss Polyphagia results from the catabolic state induced by insulin deficiency and the breakdown of proteins and fats. Although clients with type 1 diabetes may experience polyphagia (increased hunger), they may also exhibit muscle wasting, subcutaneous tissue loss, and weight loss due to impaired glucose and protein metabolism and impaired fatty acid storage.

A client with type 1 diabetes is experiencing polyphagia. The nurse knows to assess for which additional clinical manifestation(s) associated with this classic symptom?

Muscle wasting and tissue loss

The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer?

NPH

The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer? NPH Iletin II Glargine (Lantus) Lispro (Humalog)

NPH Intermediate-acting insulins are called NPH insulin (neutral protamine Hagedorn) or Lente insulin. Lispro (Humalog) is rapid acting, Iletin II is short acting, and glargine (Lantus) is very long acting.

A patient who is diagnosed with type 1 diabetes would be expected to:

Need exogenous insulin

A patient who is diagnosed with type 1 diabetes would be expected to:

Need exogenous insulin.

A patient who is diagnosed with type 1 diabetes would be expected to: Receive daily doses of a hypoglycemic agent. Have no damage to the islet cells of the pancreas. Need exogenous insulin. Be restricted to an American Diabetic Association diet.

Need exogenous insulin.

A nurse expects to find which signs and symptoms in a client experiencing hypoglycemia?

Nervousness, diaphoresis, and confusion

A nurse expects to find which signs and symptoms in a client experiencing hypoglycemia? Nervousness, diaphoresis, and confusion Polyuria, headache, and fatigue Polydipsia, pallor, and irritability Polyphagia and flushed, dry skin

Nervousness, diaphoresis, and confusion

A characteristic of type 2 diabetes includes which of the following? Little insulin Often have islet antibodies No islet cell antibodies Ketosis-prone when insulin absent

No islet cell antibodies

Which of the following conditions is the most significant risk factor for the development of type 2 diabetes mellitus?

Obesity

On initial nursing rounds, the diabetic client reports "not feeling well." Later, the nurse finds the client to be diaphoretic and in a stuporous state. Which is the immediate action taken by the nurse? A) Call the physician. B) Obtain a glucometer reading. C) Administer fruit juice. D) Start an IV of dextrose.

Obtain a glucometer reading.

An older adult patient that has diabetes type 2 comes to the emergency department with second-degree burns to the bottom of both feet and states, "I didn't feel too hot but my feet must have been too close to the heater." What does the nurse understand is most likely the reason for the decrease in temperature sensation?

Peripheral neuropathy

An older adult patient that has type 2 diabetes comes to the emergency department with second-degree burns to the bottom of both feet and states, "I didn't feel too hot but my feet must have been too close to the heater." What does the nurse understand is most likely the reason for the decreasonane in temperature sensation?

Peripheral neuropathy As the neuropathy progresses, the feet become numb. In addition, a decrease in proprioception (awareness of posture and movement of the body and of position and weight of objects in relation to the body) and a decreased sensation of light touch may lead to an unsteady gait. Decreased sensations of pain and temperature place patients with neuropathy at increased risk for injury and undetected foot infections.

A client undergoing a diagnostic examination for gastrointestinal disorder was given polyethylene glycol/electrolyte solution as a part of the test preparation. Which of the following measures should the nurse take once the solution is administered?

Permit the client to drink only clear liquids.

A client with moderate Alzheimer's disease has been eating poorly, losing weight, and playing with food at meals. The nurse best intervenes by

Placing one food at a time in front of the client during meals Tasks should be simplified for the client with Alzheimer's disease. All options are steps the nurse can take to promote eating for the client with Alzheimer's disease. Offering one food at a time, however, helps to prevent the client from playing with food.

The three classic symptoms of both types of diabetes include all of the following EXCEPT:

Polycythemia

A 36-year-old mother of six has been recently diagnosed with type 2 diabetes. She reports increased hunger and food consumption while continuing to lose weight. What is the term used to describe this condition?

Polyphagia

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 ICU? 1.Glucose. 2.)Potassium. 3.Calcium. 4.Sodium

Potassium

Mrs. Shields is a 46-year-old obese woman diagnosed with hypertension and type 2 diabetes. She tells the nurse that she knows she needs to lose weight. She recently visited her local fitness club, obtained a membership and has signed up for their next water aerobics class. According to the Transtheoretical Model of Change, what stage of change is Mrs. Shields in related to her weight loss?

Preparation

Presence of autoantibodies against islet cells

A nurse is teaching a diabetic support group about the causes of type 1 diabetes. The teaching is determined to be effective when the group is able to attribute which of the following factors as a cause of type 1 diabetes?

Presence of autoantibodies against islet cells

Presence of autoantibodies against islet cells. There is evidence of an autoimmune response in type 1 diabetes. This is an abnormal response in which antibodies are directed against normal tissues of the body, responding to these tissues as if they were foreign. Autoantibodies against islet cells and against endogenous (internal) insulin have been detected in people at the time of diagnosis and even several years before the development of clinical signs of type 1 diabetes.

Which clinical characteristic is associated with type 1 diabetes (previously referred to as insulin-dependent diabetes mellitus)?

Presence of islet cell antibodies

Which of the following clinical characteristics is associated with Type 1 diabetes (previously referred to as insulin-dependent diabetes mellitus [IDDM])?

Presence of islet cell antibodies

Which is the primary reason for encouraging injection site rotation in an insulin dependent diabetic? A) Avoid infection. B) Promote absorption. C) Minimize discomfort. D) Prevent muscle destruction.

Promote absorption.

Which is the primary reason for encouraging injection site rotation in an insulin dependent diabetic?

Promote absorption.

A client is to receive glargine (Lantus) insulin in addition to a dose of aspart (NovoLog). When the nurse checks the blood glucose level at the bedside, it is greater than 200 mg/dl. How should the nurse administer the insulins?

Put air into the glargine insulin vial, and draw up the correct dose in an insulin syringe; then, with a different insulin syringe, put air into the aspart vial and draw up the correct dose.

A 30-year-old type 1 diabetic has been admitted to the critical care unit with a diagnosis of diabetic ketoacidosis following a drinking binge over the course of a weekend. The nurse should anticipate that this patient will require what immediate intervention? IV administration of calcium gluconate Subcutaneous administration of 30 units of insulin glargine (Lantus) Oral administration of 2 g of metformin (Glucophage) Rapid administration of intravenous normal saline

Rapid administration of intravenous normal saline

A client who was diagnosed with type 1 diabetes 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blood glucose level? Arm and leg trembling Slow, shallow respirations Rapid, thready pulse Cool, moist skin

Rapid, thready pulse

Lispro (Humalog) is an example of which type of insulin?

Rapid-acting

Lispro (Humalog) is an example of which type of insulin? Rapid-acting Intermediate-acting Short-acting Long-acting

Rapid-acting

The nurse is explaining glycosylated hemoglobin testing to a diabetic client. Which of the following provides the best reason for this order? A) Provides best information on the body's ability to maintain normal blood functioning B) Best indicator for the nutritional state of the client C) Is less costly than performing daily blood sugar test D) Reflects the amount of glucose stored in hemoglobin over past several months

Reflects the amount of glucose stored in hemoglobin over past several months

The nurse is explaining glycosylated hemoglobin testing to a diabetic client. Which of the following provides the best reason for this order?

Reflects the amount of glucose stored in hemoglobin over past several months.

The nurse is explaining glycosylated hemoglobin testing to a diabetic client. Which of the following provides the best reason for this order? Best indicator for the nutritional state of the client Provides best information on the body's ability to maintain normal blood functioning Reflects the amount of glucose stored in hemoglobin over past several months. Is less costly than performing daily blood sugar test

Reflects the amount of glucose stored in hemoglobin over past several months.

A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously?

Regular

The nurse is administering an insulin drip to a patient in ketoacidosis. What insulin does the nurse know is the only one that can be used intravenously?

Regular

The nurse is administering an insulin drip to a patient in ketoacidosis. What insulin does the nurse know is the only one that can be used intravenously? Lantus Regular Lispro NPH

Regular

What is the only insulin that can be given intravenously?

Regular

A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously? NPH Lente Regular Glargine

Regular Regular insulin is administered intravenously to treat DKA. It is added to an IV solution and infused continuously. Glargine, NPH, and Lente are only administered subcutaneously.

A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously?

Regular Regular insulin is administered intravenously to treat DKA. It is added to an IV solution and infused continuously. Glargine, NPH, and Lente are only administered subcutaneously.

A client with type 2 diabetes has been managing his blood glucose levels using diet and metformin. Following an ordered increase in the client's daily dose of metformin, the nurse should prioritize which of the following assessments?

Reviewing the client's creatinine and BUN levels

A patient has been newly diagnosed with type 2 diabetes, and the nurse is assisting with the development of a meal plan. What step should be taken into consideration prior to making the meal plan?

Reviewing the patient's diet history to identify eating habits and lifestyle and cultural eating patterns

The client with diabetes asks the nurse why shoes and socks are removed at each office visit. The nurse gives which assessment finding as the explanation for the inspection of feet?

Sensory neuropathy

The diabetic client asks the nurse why shoes and socks are removed at each office visit. Which assessment finding is most significant in determining the protocol for inspection of feet? A) Autonomic neuropathy B) Retinopathy C) Sensory neuropathy D) Nephropathy

Sensory neuropathy

The diabetic client asks the nurse why shoes and socks are removed at each office visit. Which assessment finding is most significant in determining the protocol for inspection of feet? Retinopathy Sensory neuropathy Autonomic neuropathy Nephropathy

Sensory neuropathy

Serum glucose level less then 70

Serum glucose level of 52 mg/dl

A client with diabetes mellitus has a prescription for 5 units of U-100 regular insulin and 25 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. At about 4:30 p.m., the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms? Serum calcium level of 8.9 mg/dl Serum calcium level of 10.2 mg/dl Serum glucose level of 52 mg/dl Serum glucose level of 450 mg/dl

Serum glucose level of 52 mg/dl

Serum glycosylated hemoglobin (Hb A1c)

A client with a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNS) has a history of type 2 diabetes that is being controlled with an oral diabetic agent, tolazamide (Tolinase). Which laboratory test is the most important for confirming this disorder?

Serum osmolarity

After being sick for 3 days, a client with a history of diabetes mellitus is admitted to the hospital with diabetic ketoacidosis (DKA). The nurse should evaluate which diagnostic test results to prevent arrhythmias? Serum calcium level Serum chloride level Serum potassium level Serum sodium level

Serum potassium level

A patient with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which of the following symptoms when caring for this patient?

Signs of hypoglycemia

A client reports she has lactose intolerance and questions the nurse about alternative sources of calcium. What options can be provided by the nurse?

Spinach Sardines, whole grains, and green leafy vegetables also provide calcium.

Stress has likely caused an increase in the client's blood sugar levels.

Sweating, tremors, and tachycardia

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? Sweating, tremors, and tachycardia Dry skin, bradycardia, and somnolence Bradycardia, thirst, and anxiety Polyuria, polydipsia, and polyphagia

Sweating, tremors, and tachycardia

Sweating, tremors, and tachycardia Sweating, tremors, and tachycardia, thirst, and anxiety are early signs of hypoglycemia. Dry skin, bradycardia, and somnolence are signs and symptoms associated with hypothyroidism. Polyuria, polydipsia, and polyphagia are signs and symptoms of diabetes mellitus.

Sweating, tremors, tachycardia

After taking glipizide (Glucotrol) for 9 months, a client experiences secondary failure. What should the nurse expect the physician to do? Restrict carbohydrate intake to less than 30% of the total caloric intake. Order an additional oral antidiabetic agent. Initiate insulin therapy. Switch the client to a different oral antidiabetic agent.

Switch the client to a different oral antidiabetic agent.

Insulin is a hormone secreted by the Islets of Langerhans and is essential for the metabolism of carbohydrates, fats, and protein. The nurse understands the physiologic importance of gluconeogenesis, which refers to the:

Synthesis of glucose from noncarbohydrate sources

Synthesis of glucose from noncarbohydrate sources.

The nurse is teaching an older client how to self-administer insulin. Which of the following would be most helpful to the client who is having difficulty drawing up the correct dosage of insulin in the syringe? A) Syringe magnifier B) Insulin pen C) Jet injector D) Insulin pump

Syringe magnifier

Which of the following factors would a nurse identify as a most likely cause of diabetic ketoacidosis (DKA) in a client with diabetes?

The client has eaten and has not taken or received insulin

Which of the following factors would a nurse identify as a most likely cause of diabetic ketoacidosis (DKA) in a client with diabetes?

The client has eaten and has not taken or received insulin.

Which may be a potential cause of hypoglycemia in the client diagnosed with diabetes mellitus?

The client has not eaten but continues to take insulin or oral antidiabetic medications.

A male client, aged 42 years, is diagnosed with diabetes mellitus. He visits the gym regularly and is a vegetarian. Which of the following factors is important when assessing the client? A) The client's consumption of carbohydrates B) History of radiographic contrast studies that used iodine C) The client's mental and emotional status D) The client's exercise routine