Chapter 25: Diabetes Mellitus and the Metabolic Syndrome

The nurse is assessing the medical records of different clients with diabetes. Which client has a reduced risk of cardiovascular disease?

c. Client 3 115/75 mm Hg

The nurse observes hyperpigmented, velvety macular lesions on the neck during the assessment of a diabetic client. What does the nurse infer from this observation?

c. The client has acanthosis nigricans

The nurse is reviewing the medical records of different clients. Which client does the nurse expect to have metabolic syndrome?

b. Client 2. Female, 37 inches, 130 mg/dL

Which symptoms are associated with autonomic neuropathy? Select all that apply

1. Anhidrosis 2. Gastroparesis 5. Postural hypotension

After reviewing the laboratory reports of a client with diabetes, the nurse finds that the client has diabetic ketoacidosis. Which findings support the nurse's conclusion? Select all that apply.

1. Client's arterial blood pH of 6 3. Serum bicarbonate level of 12 mEq/L 4. Blood glucose level of 300 mg/dL

Which symptoms does the nurse observe in a client with hyperosmolar hyperglycemic syndrome (HHS)? Select all that apply.

1. Polyuria 2. Confusion 3. Polydipsia

The nurse suspects nocturnal hypoglycemia in a diabetic client. Which symptoms can the nurse expect to observe in this client? Select all that apply.

1. Sleep disturbance 2. Vivid nightmares 4. Morning headache

A client with diabetes is prescribed exenatide (Byetta). What are the immediate effects of the drug that could be observed in the client? Select all that apply.

2. Delay in gastric emptying 3. Glucose-dependent insulin secretion 5. Suppression of postprandial glucagon

After reviewing the medical records of a 35-year-old female client, the nurse concludes that the client has metabolic syndrome. Which findings helped the nurse to reach this conclusion?

b. HIGH-DENSITY LIPOPROTEIN (HDL) cholesterol of 40 mg/dL, blood pressure of 138/90 mm Hg, and fasting blood glucose level of 130 mg/dL

The nurse is caring for a client with immune mediated type 1 diabetes. What would the nurse expect to be the cause for this condition in the client?

b. The client has destruction of beta cells.

The laboratory report of a client shows arterial blood pH of 7.6, blood glucose level of 650 mg/dL, and serum bicarbonate level of 17 mEq/L. What does the nurse infer from these laboratory findings?

b. The client has hyperosmolar hyperglycemic syndrome.

While preparing a client for the oral glucose tolerance test (OGTT), the nurse asks the client to ingest soda which contains 80 g of carbohydrates. After 2 hours, the nurse measures the postprandial blood glucose level and concludes that the client has diabetes. Which blood glucose finding supports the nurse's conclusion?

c. 250 mg/dL

The nurse observes sweating, dizziness, and disorientation in the client and consults the primary health-care provider while caring for a diabetic client. Which treatment option would be most beneficial to the client?

c. Administering 50 mL of 50% dextrose intravenously

The nurse reviews the laboratory reports of a diabetic client and concludes that the client has diabetic nephropathy. Which finding supports the nurse's conclusion?

c. Albumin in urine

The registered nurse is teaching a group of student nurses about managing hyperosmolar hyperglycemic syndrome (HHS) in clients. Which response of a student nurse indicates effective learning?

a. "Fluids should be administered BEFORE administering intravenous (IV) insulin to the client."

Which is the most common complication expected in clients with type 1 diabetes?

a. Diabetic ketoacidosis

Which antidiabetic medication is a sulfonylurea?

a. Glipizide (Glucotrol)

The nurse observes a diabetic client who has a wound that has not healed for a long time. Which condition does the nurse suspect in the client?

a. Immunosuppression

The mother of an adolescent diabetic client tells the nurse, "My daughter is skipping insulin doses frequently because she is concerned about weight gain." Which condition does the nurse document for this client?

a. Insulin purging

The nurse is assessing the blood glucose levels of a client at regular intervals. The nurse finds 55 mg/dL of blood glucose at 2 am and150 mg/dL at 7 am. Which mechanism does the nurse suspect behind the change in the glucose levels in the client?

a. Somogyi effect

Why does the nurse use the C-peptide test for a type 1 diabetic client?

a. To ELEVATE residual pancreatic function

The nurse reviews the laboratory reports of a client and concludes that the client has diabetes. Which finding helped the nurse to reach this conclusion?

b. A glycated hemoglobin (HbA1c) value of 7

Which diagnostic test helps in detecting the natural insulin secretion from the pancreas?

b. C-peptide test

Which symptom is associated with hyperosmolar hyperglycemic syndrome?

d. All of the above - Severe dehydration - Stupor - Confusion

Which complication is suspected in a client whose blood sugar is less than 30 mg/dL?

d. Seizure