Elsevier Nutrition/ DM Quiz- Final

Which intervention would the nurse implement for a client who has type 1 diabetes and has an elevated blood glucose?

give supplemental doses of regular insulin

The nurse is teaching a client about safe insulin administration. Which statement made by the client indicates the need for further education?

"I should administer insulin only if there are symptoms"

Which treatment would the nurse suggest to an adolescent with type 1 diabetes if an insulin reaction is experienced while the adolescent is at a basketball game?

"Buy a soda and hamburger to eat"

Which clinical findings are commonly associated with hyperglycemia? (select all that apply)

-polyuria -polydipsia -polyphagia

While obtaining the client's health history, which factor would the nurse identify that predisposes the client to type 2 diabetes?

Being 20 pounds (9 kg) overweight

Which eye problems is the leading cause of blindness in clients with diabetes?

retinopathy

A child is prescribed insulin glargine before breakfast. Which instruction is most appropriate for the nurse to give the parents regarding a bedtime snack?

"Offer a snack to prevent hypoglycemia during the night"

Which statement made by a client recently diagnosed with type 1 diabetes indicates that further education is necessary regarding the teaching plan?

"Once I get my glucose levels under control, there is a good chance that I will be able to switch from insulin to an oral medication"

The nurse is caring for a client who is receiving total parenteral nutrition (TPN) after extensive colon surgery. The nurse concludes that the client understands teaching about the purpose of TPN when the client makes which statement?

"TPN provides total nutrition when gastrointestinal function is questionable"

A client newly diagnosed with type 1 diabetes asks why it is necessary to exercise on a regular basis. Which response is sccurate?

"exercise improves the cellular uptake of glucose"

An adolescent who has just been found to have type 1 diabetes asks the nurse about exercise. Which is the best response by the nurse?

"extra snacks are needed before exercise"

The nurse is performing a weight assessment for different people in a community. Which question would the nurse ask a client to determine a disease-related change in weight?

"have you noticed any unintentional weight loss in the past 6 months?"

A child is receiving 45 units of intermediate-acting insulin at 7:00 am and 7:00 pm. which statement by the nurse is most appropriate when discussing bedtime snacks with the parents?

"provide a bedtime snack to prevent hypoglycemia during the night"

An adolescent is found to have type 1 diabetes. The nurse plans to teach the adolescent that dietary control and exercise can help regulate the disorder. Which additional information would the nurse include in the teaching plan? (select all that apply)

-Insulin therapy -Blood glucose monitoring -Adherence to treatment regimen

A client with type 1 diabetes for 25 yrs states, "I have been really bad for the past 15 yrs. I have not paid attention to my diet and have done little to control my diabetes." Which common complications of diabetes might the nurse expect to identify when assessing this client? (select all that apply)

-Leg ulcers -Loss of visual acuity -Thick, yellow toenails -decreased sensation in the feet

Which action would the nurse implement when a client is receiving total parenteral nutrition (TPN)? (select all that apply)

-Monitoring hydration -monitoring weight daily -monitoring vital signs every 4 hrs -discarding any solution after 24 hrs -checking the expiration date of the solution before administration

The regulation of type 1 diabetes in an 8 year old child is best attained with a combination of therapeutic modalities in addition to the administration of insulin. Which modalities would the nurse include in the teaching plan? (select all that apply)

-dietary control -regular exercise -blood glucose monitoring

The nurse is formulating a teaching plan for a client recently diagnosed with type 2 diabetes. Which interventions would the nurse include to decrease the risk of complications? (select all that apply)

-examine the feet daily -wear well-fitting shoes -perform regular exercise

The nurse plans to teach a 7 year old child with recently diagnosed type 1 diabetes how to give insulin injections. Which would be included in the first lesson? (select all that apply)

-explaining why insulin is important -providing a syringe for the child to practice manipulating -Seeking a return demonstration of how to give an injection to a doll

The nurse is caring for a client who is receiving total parenteral nutrition (TPN). which client complications may be cause by the TPN? (select all that apply)

-hyperglycemic -infection

The nurse mixes a short-acting and an intermediate-acting insulin in the same syringe. List the actions in the order the nurse will perform them.

1. Put air into the intermediate-acting insulin vial 2. Put air into the short-acting insulin vial 3. Withdraw the prescribed amount of short-acting insulin 4. Withdraw the prescribed amount of intermediate-acting insulin

An obese client must self-administer insulin at home. The nurse will teach the client to inject at which angle?

90 degree angle

The nurse is assessing several clients. Which client will require parenteral nutrition?

A client with severe malabsorption disorder

A client with type 1 diabetes receives Humulin R insulin in the morning. Shortly before lunch the nurse identifies that the client is diaphoretic and trembling. Which intervention is appropriate?

Assess the client's blood glucose level

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?

Administer teh insulin as prescribed

A client with malabsorption syndrome is started on total parenteral nutrition (TPN) sia subclavian catheter. Which instruction will the nurse teach the client to prevent the most common complication of TPN?

Avoid disturbing the dressing or getting it wet

A 9 year old child with type 1 diabetes is prone to having hypoglycemic episodes in the morning. Which intervention would be included in the school nurse's plan of care for this child?

Asking the child each day what was eaten for breakfast

A client with diabetes is being taught to self-administer a subcutaneous injection of insulin. Identify the preferred site for the self-administration of this medication.

C) abdomen

Which action would the nurse take when administering total parenteral nutrition (TPN)?

Change the TPN bag every 24 hrs, even if there is solution left in the bag

A client with type 2 diabetes has been receiving insulin in the hospital while being treated for sepsis. The client's infection is resolving and the primary health care provider writes a prescription to discontinue the 7:00am dose of insulin and to administer glyburide 5 mg twice daily. After administering the glyburide at 8:30 am, the nurse sees that the insulin had already been administered at 7:00 am. Which initial action would the nurse take?

Check the blood glucose for hypoglycemia

A client with type 1 diabetes has an above the knee amputation because of sever lower extremity arterial disease. Two dats after surgery, which intervention is appropriate when preparing the client to eat dinner?

Checking the client's serum glucose level

Which intervention would the nurse implement to relieve the symptoms associated with a hypoglycemic reaction?

Give 4 oz (120 mL) of fruit juice

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 dhortly 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?

Hypoglycemia

The nurse is caring for several clients with type 1 diabetes, and they each have a prescription for a specific type of insulin. Which insulin would the nurse conclude has the fastest onset of action?

Insulin Lispro

The laboratory findings of an obese hypertensive adolescent reveal hyperinsulinemia and dyslipidemia. Which condition is the adolescent likely to have?

Insulin resistance syndrome

The nurse is discussing insulin needs with an adolescent with recently diagnosed type 1 diabetes. Which information is important for the nurse to include concerning insulin administration?

Insulin will be required throughout life

The nurse educator is providing information about different insulin types. Which type of insulin can be safely mixed with regular human insulin in the same syringe?

Isophane insulin neutral protamine hagedorn (NPH)

A 15 year old adolescent is found to have type 1 diabetes. Which would the nurse include when teaching the adolescent about type 1 diabetes?

It has a more rapid onset than does type 2 diabetes

The nurse plans to teach a fifth-grader with type 1 diabetes how to self-administer lispro and glargine insulin. Which action would the nurse include in the teaching plan?

Learn to use the needle and syringe by practicing on a insulin pad first

The nurse is teaching an adolescent newly diagnosed with type 1 diabetes about self-care. Which is the primary long-term goal?

Maintaining normoglycemia

A child with type 1 diabetes has difficulty measuring the required insulin dose. the child frequently draws up 42 units of insulin instead of the prescribed 24 units. Which is the most appropriate intervention to ensure dosage safety?

Providing the child with a preset syringe that was developed for the visually impaired

A client who takes daily megadose of vitamins is hospitalized with joint pain, loss of hair, yellow pigmentation of the skin, and an enlarged liver due to vitamin toxicity. which type of toxicity would the nurse suspect?

Retinol (vitamin A)

Which nurse is using complex critical thinking skills when caring for a client?

Talks to the client to identify reasons for their behavior

An adolescent with diabetes had a 6:30 am fasting blood glucose level of 180 mg/dL (10.0 mmol/L). Which nursing action is a priority?

Tell the adolescent that the prescribed dose of rapid-acting insulin should be administered.

Which would the nurse conclude about a client when planning teaching strategies based on the results of a glycosylated hemoglobin measurement of 6%?`

The client has followed the treatment plan as prescribed

Which would the nurse emphasize when teaching insulin self-administration to a child with recently diagnosed diabetes?

The need to wash the hands before preparing the insulin injection

Which is the best nursing intervention to support a hospitalized child's nutrition who is apathetic towards eating?

asking the parents to visit at mealtimes

The nurse is preparing to teach a client about self-injection of insulin. Which action by the nurse will increase the effectiveness of the teaching session?

assess the client's barriers to learning self-injection techniques

When determining the main difference between type 1 and type 2 diabetes, the nurse recognizes which clinical presentation about type 1?

complications are not present at the time of diagnosis

Which action would the nurse take when a client with type 1 diabetes reports hunger, thirst, tiredness, and frequent urination?

determine the client's blood glucose level

One principle to be followed for children with type 1 diabetes is to provide for the variability of the child's activity. Which would the nurse teach the child about how to compensate for increased physical activity?

eat more food when planning to exercise more than usual

Which intervention would the nurse prioritize when planning a teaching program for a child who was recently diagnosed with type 1 diabetes?

exploring the child's feelings about diabetes

A client is scheduled to receive total parenteral nutrition (TPN). To administer TPN, which piece of equipment is important for the nurse to obtain?

infusion pump

A hospitalized child with type 1 diabetes becomes pale, diaphoretic, and shaky 2 hours after eating breakfast. Which action should the nurse take?

obtain a current blood glucose level

Which mechanism of action explains how glyburide decreases serum glucose levels?

stimulates the pancreas to produce insulin