Assessment and Management of Patients with Diabetes PrepU

Which factor is the focus of nutrition intervention for clients with type 2 diabetes? A. weight loss B. blood glucose level C. carbohydrate intake D. protein metabolism``

A. weight loss

Insulin is secreted by which of the following types of cells? A. Melanocytes B. Beta cells C. Basal cells D. Neural cells

B. Beta cells

A client with type 1 diabetes asks the nurse about taking an oral antidiabetic agent. The nurse explains that these medications are effective only if the client: A. has type 2 diabetes. B. is pregnant and has type 2 diabetes. C. has type 1 diabetes. D. prefers to take insulin orally.

A. has type 2 diabetes.

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

A. 10 to 15 minutes

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

A. Below-normal serum potassium level

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

C. Regular

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. Glipizide B. Repaglinide C. Glyburide D. Metformin

D. Metformin

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

A. Hypoglycemia

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? A. Increased hunger B. Dizziness C. Fatigue D. Numbness

A. Increased hunger

Which term refers to the progressive increase in blood glucose from bedtime to morning? A. Insulin waning B. Somogyi effect C. Diabetic ketoacidosis (DKA) D. Dawn phenomenon

A. Insulin waning

A nurse is caring for a client with an abnormally low blood glucose concentration. What glucose level should the nurse observe when assessing laboratory results? A. Less than 70 mg/dL (3.7 mmol/L) B. Between 70 and 75 mg/dL (3.9 to 4.16 mmol/L) C. Between 75 and 90 mg/dL (4.16 to 5.00 mmol/L) D. 95 mg/dL (5.27 mmol/L)

A. Less than 70 mg/dL (3.7 mmol/L)

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

A. Presence of islet cell antibodies

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? A. Sweating, tremors, and tachycardia B. Dry skin, bradycardia, and somnolence C. Polyuria, polydipsia, and polyphagia D. Bradycardia, thirst, and anxiety

A. Sweating, tremors, and tachycardia

Which may be a potential cause of hypoglycemia in the client diagnosed with diabetes mellitus? A. The client has not eaten but continues to take insulin or oral antidiabetic medications. B. The client has not been exercising. C. The client has not complied with the prescribed treatment regimen. D. The client has eaten but has not taken or received insulin.

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

During a class on exercise for clients with diabetes mellitus, a client asks the nurse educator how often to exercise. To meet the goals of planned exercise, the nurse educator should advise the client to exercise: A. at least three times per week. B. at least five times per week. C. every day. D. at least once per week.

A. at least three times per week.

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

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

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? A. "I always wear my medical identification bracelet." B. "I skip lunch when I don't feel hungry." C. "I always carry hard candy to eat in case my blood sugar level drops." D. "I avoid exposure to the sun as much as possible."

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

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

B. Do not mix with other insulins.

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

B. Hypoglycemia

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? A. Decrease food intake until nausea passes. B. Increase frequency of glucose self-monitoring. C. Take half the usual dose of insulin until symptoms resolve. D. Do not take insulin if not eating.

B. Increase frequency of glucose self-monitoring.

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? A. NPH B. Regular C. Lispro D. Lantus

B. Regular

Which intervention is essential when performing dressing changes on a client with a diabetic foot ulcer? A. Debriding the wound three times per day B. Using sterile technique during the dressing change C. Applying a heating pad D. Cleaning the wound with a povidone-iodine solution

B. Using sterile technique during the dressing change

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

C. 1/2 cup fruit juice or regular soft drink

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

C. 138 mg/dL, 2 hours postprandial.

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. Social worker C. Dietitian D. Psychiatrist

C. Dietitian

NPH is an example of which type of insulin? A. Rapid-acting B. Short-acting C. Intermediate-acting D. Long-acting

C. Intermediate-acting

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

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

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

C. glycosylated hemoglobin level.

A client with a serum glucose level of 618 mg/dl is admitted to the facility. He's awake and oriented, has hot dry skin, and has the following vital signs: temperature of 100.6° F (38.1° C), heart rate of 116 beats/minute, and blood pressure of 108/70 mm Hg. Based on these assessment findings, which nursing diagnosis takes highest priority? A. Ineffective thermoregulation related to dehydration B. Imbalanced nutrition: Less than body requirements related to insulin deficiency C. Decreased cardiac output related to elevated heart rate D. Deficient fluid volume related to osmotic diuresis

D. Deficient fluid volume related to osmotic diuresis

A nurse is preparing to discharge a client with coronary artery disease and hypertension who is at risk for type 2 diabetes. Which information is important to include in the discharge teaching? A. How to recognize signs of diabetic ketoacidosis B. How to monitor ketones daily C. How to self-inject insulin D. How to control blood glucose through lifestyle modification with diet and exercise

D. How to control blood glucose through lifestyle modification with diet and exercise

A nurse is providing education to a client who is newly diagnosed with diabetes mellitus. What are classic symptoms associated with diabetes? A. Increased weight loss, dehydration, and fatigue B. Increased weight gain, appetite, and thirst C. Loss of appetite, increased urination, and dehydration D. Increased thirst, hunger, and urination

D. Increased thirst, hunger, and urination

A young adult client with type 1 diabetes does not want to have to self-administer insulin injections several times a day. Which medication approach would the nurse recommend that best controls the condition and meets the client's needs? A. 1 injection per day B. Injection before each meal C. 2 injections premixed D. Insulin pump

D. Insulin pump

A client with type 2 diabetes asks the nurse why he can't have a pancreatic transplant. Which of the following would the nurse include as a possible reason? A. Increased risk for urologic complications B. Need for exocrine enzymatic drainage C. Need for lifelong immunosuppressive therapy D. Underlying problem of insulin resistance

D. Underlying problem of insulin resistance