Diabetes AQ questions
Which action would the nurse take when a client with type 1 diabetes reports hunger, thirst, tiredness, and frequent urination? 1 Notify the health care provider immediately about the client's symptoms. 2 Determine the client's blood glucose level. 3 Administer the client's prescribed insulin. 4 Give the client a peanut butter and graham cracker snack.
2 Polyphagia, polydipsia, lethargy, and polyuria indicate hyperglycemia. The nurse will need to determine the client's glucose level. The nurse must determine the glucose level before notifying the health care provider, because these are common symptoms of hyperglycemia. The nurse must then look at medication prescriptions after obtaining the glucose reading. The client may have a sliding-scale short-acting insulin prescription in addition to the prescribed insulin. Administering the prescribed insulin will not affect the blood glucose level immediately. Administering a peanut butter and graham cracker snack would increase the glucose level. STUDY TIP: Identify your problem areas that need attention. Do not waste time on restudying information you know.
A client with type 1 diabetes mellitus has a finger-stick glucose level of 258 mg/dL (14.3 mmol/L) at bedtime. A prescription for sliding-scale regular insulin exists. Which would the nurse do? 1 Call the health care provider. 2 Encourage intake of fluids. 3 Administer the insulin as prescribed. 4 Give the client 4 ounces of orange juice.
3 A value of 258 mg/dL (14.3 mmol/L) is above the expected range of 70 to 100 mg/dL (3.6-5.6 mmol/L); the nurse would administer the regular insulin as prescribed. Calling the health care provider is unnecessary; a prescription for insulin exists and should be implemented. Encouraging the intake of fluids is insufficient to lower a glucose level this high. Giving the client orange juice is contraindicated, because this will increase the glucose level further; orange juice, a complex carbohydrate, and a protein should be given if the glucose level is too low.
A client with diabetes asks how exercise will affect insulin and dietary needs. Which effects of exercise would the nurse share? 1 Increases the amount of insulin needed and increases the need for carbohydrates 2 Increases the amount of insulin needed and decreases the need for carbohydrates 3 Decreases the amount of insulin needed and increases the need for carbohydrates 4 Decreases the amount of insulin needed and decreases the need for carbohydrates
3 Exercise increases the uptake of glucose by active muscle cells; carbohydrates are needed to supply energy for the increased metabolic rate associated with exercise. The need for insulin is decreased. Test-Taking Tip: Being emotionally prepared for an examination is key to your success. Proper use of resources over an extended period of time ensures your understanding and increases your confidence about your nursing knowledge. Your lifelong dream of becoming a nurse is now within your reach! You are excited, yet anxious. This feeling is normal. A little anxiety can be good because it increases awareness of reality; but excessive anxiety has the opposite effect, acting as a barrier and keeping you from reaching your goal. Your attitude about yourself and your goals will help keep you focused, adding to your strength and inner conviction to achieve success.
A client is prescribed metformin extended release to control type 2 diabetes mellitus. Which statement made by this client indicates the need for further education? 1 "I will take the medication with food." 2 "I must swallow my medication whole and not crush or chew it." 3 "I will notify my doctor if I develop muscular or abdominal discomfort." 4 "I will stop taking metformin for 24 hours before and after having a test involving dye."
4 Metformin must be withheld for 48 hours before the use of iodinated contrast materials to prevent lactic acidosis. Metformin is restarted when kidney function has returned to normal. Metformin is taken with food to avoid adverse gastrointestinal effects. If crushed or chewed, metformin XL will be released too rapidly and may lead to hypoglycemia. Muscular and abdominal discomfort is a potential sign of lactic acidosis and must be reported to the health care provider. Test-Taking Tip: Practicing a few relaxation techniques may prove helpful on the day of an examination. Relaxation techniques such as deep breathing, imagery, head rolling, shoulder shrugging, rotating and stretching of the neck, leg lifts, and heel lifts with feet flat on the floor can effectively reduce tension while causing little or no distraction to those around you. It is recommended that you practice one or two of these techniques intermittently to avoid becoming tense. The more anxious and tense you become, the longer it will take you to relax.
Which information would the nurse provide a client with diabetes mellitus (DM) regarding alcohol consumption? 1 Before meals 2 One drink per week 3 Complete abstinence 4 With or shortly after meals
4 A person with DM should only drink alcohol with or shortly after meals to prevent alcohol-induced delayed hypoglycemia. Alcohol should not be consumed before meals. The client with DM does not need to limit to one drink per week nor completely abstain from drinking. Test-Taking Tip: Key words or phrases in the stem of the question such as first, primary, early, or best are important. Similarly, words such as only, always, never, and all in the alternatives are frequently evidence of a wrong response. As in life, no real absolutes exist in nursing; however, every rule has its exceptions, so answer with care.
An adolescent with type 1 diabetes mellitus is admitted to the intensive care unit in ketoacidosis with a blood glucose level of 170 mg/dL (9.4 mmol/L). A continuous insulin infusion is started. Which adverse reaction to the infusion is most important for the nurse to monitor 1 Hypokalemia 2 Hypovolemia 3 Hypernatremia 4 Hypercalcemia
1 Insulin moves potassium into the cells along with glucose, thus lowering the serum potassium level. Insulin does not lead to a reduced blood volume. Insulin does not directly alter the sodium levels. Insulin does not affect the calcium levels. Test-Taking Tip: Start by reading each of the answer options carefully. Usually at least one of them will be clearly wrong. Eliminate this one from consideration. Now you have reduced the number of response choices by one and improved the odds. Continue to analyze the options. If you can eliminate one more choice in a four-option question, you have reduced the odds to 50/50. While you are eliminating the wrong choices, recall often occurs. One of the options may serve as a trigger that causes you to remember what a few seconds ago had seemed completely forgotten.
The nurse provides education about signs and symptoms of hypoglycemia to a client with newly diagnosed type 1 diabetes. The nurse concludes that the teaching was effective when the client acknowledges the need to drink orange juice when experiencing which symptoms? 1 Nervous and weak 2 Thirsty with a headache 3 Flushed and short of breath 4 Nausea and abdominal cramps
1 Nervousness and weakness are the most commonly reported symptoms of hypoglycemia and are related to increased sympathetic nervous system activity. Feeling flushed and short of breath are adaptations of hyperglycemia. Being thirsty, having a headache, being nauseated, or having abdominal cramps are symptoms of hyperglycemia.
A client is newly diagnosed with diabetes. The nurse would instruct the client to monitor for which indication of hypoglycemia? 1 Kussmaul respirations 2 Tachycardia 3 Confusion 4 Anorexia
3 The most common symptoms of hypoglycemia are nervousness, weakness, perspiration, and confusion. Kussmaul respirations are associated with hyperglycemia or ketoacidosis. Bradycardia is associated with hypoglycemia; tachycardia is not. Anorexia is associated with hyperglycemia.
A client with type 2 diabetes takes one glyburide tablet daily. The client asks whether an extra tablet should be taken before exercise. Which response will the nurse provide? 1 "You will need to decrease how much you are exercising." 2 "An extra pill will help your body use glucose when exercising." 3 "The amount of medication you need to take is not related to exercising." 4 "Do not take an extra pill because you may become hypoglycemic when exercising."
4 Exercise improves glucose metabolism. Exercise is associated with a risk for hypoglycemia, not hyperglycemia; an additional antidiabetic agent is contraindicated. Exercise should not be decreased because it improves glucose metabolism. Also, this response does not answer the client's question. An extra tablet probably will result in hypoglycemia because exercise alone improves glucose metabolism. Control of glucose metabolism is achieved through balanced diet, exercise, and pharmacological therapy. STUDY TIP: Begin studying by setting goals. Make sure they are realistic. A goal of scoring 100% on all exams is not realistic but scoring an 85% may be a better goal.
A client with diabetes presents to the emergency department with a 3-hour history of profound weakness and nervousness. According to the spouse, the client became confused shortly after self-administering the morning dose of 10 units of regular insulin and 25 units of NPH insulin. The client had a light breakfast and no additional intake since that time. Which condition would the nurse identify as the likely cause of the client's signs and symptoms? 1 Hyperglycemia 2 Hyperinsulinemia 3 Hypoglycemia 4 Hypoinsulinemia
3 Severe hypoglycemia is a finding in diabetic clients who take insulin and miss a meal. Signs and symptoms of hypoglycemia are nervousness, weakness, confusion, and disorientation. Hyperglycemia is rare in clients who are on insulin therapy and decrease their intake. Hyperinsulinemia is a condition where an excess of insulin is produced by the pancreas in response to conditions such as insulin resistance or insulinomas. Hypoinsulinemia refers to abnormally low levels of insulin in the blood.
