Endocrine

Use the fingertip only for blood glucose checks.

A patient diagnosed with type 1 diabetes has had multiple episodes of hypoglycemia. What teaching by the nurse is indicated? a. Administer insulin in legs only. b. Check blood glucose every hour. c. Avoid the use of insulin aspart. d. Use the fingertip only for blood glucose checks.

Glycosylated hemoglobin (A1C) 7.0%

A patient diagnosed with type 2 diabetes is being seen for routine health screening. The patient has received nutritional education and begun regular exercise. What lab value indicates the patient may need to begin medication therapy? a. Triglyceride level of 130 mg/dL b. Premeal blood glucose level of 120 c. Glycosylated hemoglobin (A1C) 7.0% d. Peak after meal blood glucose level of 170

Alanine aminotransferase (ALT) level of 105

A patient diagnosed with type 2 diabetes is taking pioglitazone. What finding should be reported to the health care provider immediately? a. Blood glucose of 65 mg/dL b. Potassium level of 4.9 mEq c. Blood glucose of 180 mg/dL d. Alanine aminotransferase (ALT) level of 105

Inspect the back of the neck and the dressing for blood

A patient has undergone a total thyroidectomy. What postoperative care does the nurse provide? a. Provide oxygen to promote respiration. b. Inspect the back of the neck and the dressing for blood. c. Ask the patient to cough out any respiratory secretions. d. Monitor vital signs every 30 minutes until the patient is st

'Consume fewer calories to reduce your weight.'

A 5'8', 225-pound patient with metabolic syndrome has a blood pressure of 158/96 mm Hg, a high-density lipoprotein cholesterol level of 39 mg/dL, and a waist size of 44 inches. Which recommendation does the nurse make to this patient? a. 'Do not consume any concentrated sweets.' b. 'Consume fewer calories to reduce your weight.' c. 'Measure your abdominal circumference weekly.' d. 'Drink plenty of water to reduce your blood pressure.'

Metabolic syndrome

A patient being treated for cardiovascular disease has factors that increase the risk for developing type 2 diabetes mellitus. On which health problem should the nurse focus when assessing this patient? Hypoglycemia Gestational diabetes Metabolic syndrome Autonomic neuropathy

Patient checks urine for ketone bodies.

A patient diagnosed with diabetes plans to engage in strenuous exercise. The patient has a blood sugar level of 285 mg/dL. What action by the patient demonstrates an understanding of the teaching about diabetes? a. Patient administers bolus insulin. b. Patient checks urine for ketone bodies. c. Patient engages in strenuous exercise. d. Patient contacts the health care provider.

Avoid taking over-the-counter (OTC) drugs.

A patient diagnosed with hypothyroidism has been prescribed hormone replacement therapy. What does the nurse teach the patient about this therapy? Include fiber supplements in the diet. Take the prescribed therapy before bedtime. Avoid taking over-the-counter (OTC) drugs. Monitor urine frequency for therapy effectiveness.

The patient must take the drug exactly as prescribed.

A patient diagnosed with hypothyroidism is prescribed levothyroxine sodium. What instruction does the nurse provide to the patient about this treatment? a. The treatment lasts for a year. b. A fixed dose is maintained throughout the treatment. c. The patient must take the drug exactly as prescribed. d. The patient must be assessed for fever during the initiation of therapy.

Drink alcohol with meals. To avoid alcohol-induced hypoglycemia, the nurse should recommend that patients drink alcohol with meals or just after eating. It is not necessary to avoid alcohol. Blood glucose does not need to be checked after each drink. Larger doses of insulin are not indicated.

A patient is in an education class for diabetes care. What teaching should be provided to a patient regarding alcohol use and diabetes mellitus? a. Avoid alcohol use. b. Drink alcohol with meals. c. Check blood glucose after each drink. d. Prepare to administer larger doses than normal.

b. Use a separate toilet for at least 2 weeks after RAI therapy. c. Use a laxative on the second and third day after RAI therapy. a. Avoid fruits with a core and meat with bones.

A patient is prescribed radioactive iodine (RAI) therapy for hyperthyroidism. What safety precautions should the nurse teach the patient? Select all that apply. a. Avoid fruits with a core and meat with bones. b. Use a separate toilet for at least 2 weeks after RAI therapy. c. Use a laxative on the second and third day after RAI therapy. d. Discard disposable tissues in sealed plastic bags along with other garbage. e. Avoid using the family washing machine; hand-wash all clothes.

Graves disease The symptoms of palpitations and dysrhythmias, fatigue, and weight loss, along with the noted protrusion of the eyes, and dry, waxy swelling on the front surfaces of the lower legs are indicative of Graves disease. Diabetes, renal failure, and congenital heart failure do not manifest in this combination of signs and symptoms.

A patient presents with palpitations and dysrhythmias, fatigue, and weight loss. During the physical exam, the nurse notes abnormal protrusion of the eyes, and a dry, waxy swelling on the front surfaces of the lower legs. What does the nurse suspect the patient is experiencing? Diabetes Renal failure Graves disease Congestive heart failure

0900 A patient receiving insulin aspart should be assessed within 1 to 3 hours of administration when the medication peaks.

A patient received insulin aspart at 0700. At what time should the patient be assessed for signs of hypoglycemia? 0900 1100 1200 1400

While performing the test in the hospital

A patient recently admitted with new-onset type 2 diabetes will be discharged with a self-monitoring blood glucose machine. When is the best time for the nurse to explain to the patient the proper use of the machine? a. On admission b. Day of discharge c. When the patient states readiness d. While performing the test in the hospital

Increasing the medication dose

A patient who is receiving thyroid replacement therapy for hypothyroidism reports constipation and insomnia. What should be included in this patient's plan of care? a. Administering sedatives b. Increasing fiber in the diet c. Increasing the medication dose d. Discontinuing thyroid treatment

Give the insulin The insulin should be administered because this medication is for basal regulation and controls the baseline blood glucose.

A patient who is scheduled for surgery in the morning is placed on NPO status. The patient is scheduled to receive insulin glargine before bed. What action by the nurse should be taken? a. Give the insulin b. Hold the insulin c. Contact the healthcare provider d. Reduce the dose based on the blood glucose level

Metformin

A patient with chronic renal insufficiency was recently diagnosed with type 2 diabetes. The nurse should contact the health care provider and hold which medication? Acarbose Glipizide Metformin Pioglitazone

Patients with diabetes experience brain damage that would normally not cause damage in a patient without diabetes.

A patient with type 2 diabetes experiences a stroke and the nurse is caring for the patient in the intensive care unit (ICU). What factor puts this patient at greater risk for a poor clinical outcome? a. Patients with diabetes do not seek the care needed when having a stroke. b. Patient with diabetes experience increased vessel damage to the brain during a stroke due to elevated insulin levels. c. Patients with diabetes do not present the same way as other patients without diabetes who are having a stroke. d. Patients with diabetes experience brain damage that would normally not cause damage in a patient without diabetes.

proliferative diabetic retinopathy

A patient with type 2 diabetes mellitus is experiencing an eye hemorrhage and vision changes. What should the nurse suspect is occurring with this patient? a. Venous beading b. Optic nerve atrophy c. Closed-angle glaucoma d. Proliferative diabetic retinopathy

The level is higher than the recommended level and should be addressed by the health care provider.

A patient with type 2 diabetes, retinopathy, and complaints of painful 'pins and needles' sensations in the feet presents to the primary care clinic. The nurse notes the patient's low-density lipoprotein cholesterol (LDL) level is at 75 mg/dL. What can the nurse determine regarding the patient's LDL level? a. The level is higher than the recommended level and should be addressed by the health care provider. b. The level is lower than the recommended level and is considered to be in appropriate range for the patient. c. The level is higher than the recommended level but may still be within range for the patient's clinical presentation. d. The level is lower than the recommended level but may still need to be corrected due to the patient's clinical presentation.

1 tbsp of honey

Consuming which item is appropriate for the patient who becomes hypoglycemic at home? a. 1 tsp of sugar b. 1 tbsp of honey c. 1 oz of skim milk d. 1 cup of fruit juice

Dyspnea Dysphagia Hoarseness

The nurse expects what assessment findings in a patient with thyroid cancer? Select all that apply. Dyspnea Dysphagia Hoarseness Heat intolerance Muscle weakness

Increased financial resources

The nurse has provided education about factors responsible for increased rates of diabetes among minority groups. Which factor identified by the patient indicates a need for further teaching? Lifestyle issues Increased financial resources Mistrust of the health care system Lack of knowledge about glucose control and complications

Toenails Tinea pedis History of previous ulcer

The nurse is assessing a patient for diabetic foot problems. What should the nurse include in this assessment? Select all that apply. Toenails Tinea pedis Toe contractures History of previous ulcer Ankle joint range of motion

Muscle aches Difficulty in speech Intolerance to cold

The nurse is assessing a patient for hypothyroidism. What findings indicate the presence of hypothyroidism in the patient? Select all that apply. Insomnia Muscle aches Hyperactivity Difficulty in speech Intolerance to cold

'This results from lack of oxygen vessel swelling.'

The nurse is assessing an older adult patient with type 2 diabetes and notes that the patient has optic nerve atrophy. What statement will the nurse include when teaching the patient about this condition? a. 'This results from growth of new vessels. b. ''This results from lack of oxygen vessel swelling. c. ''This results from increased permeability of the vessels. d. ''This results from chronic over-production of insulin and stress hormones.'

Fruity odor on the breath The patient with metabolic acidosis exhales acetone, giving the breath a fruity odor. Hyperglycemia causes fluid and electrolyte imbalances, leading to polyuria and polyphagia. Polyuria is frequent and excessive urination resulting from osmotic diuresis. Polyphagia is excessive hunger caused by cell starvation from the lack of glucose. The patient with metabolic acidosis has an increased rate and depth of respiration to excrete more carbon dioxide and acid.

The nurse is aware that insulin deficiency leads to metabolic acidosis. Which manifestation is a result of metabolic acidosis? Frequent urination Excessive hunger Fruity odor on the breath Decreased respiration rate

'I am glad I'll be able to still eat some of my usual foods.'

The nurse is caring for a patient who has just developed a meal plan after being diagnosed with diabetes. Which statement by the patient reflects an accurate understanding of the teaching provided? a. 'I am glad I'll be able to still eat some of my usual foods. b. ''I will not need to monitor my blood glucose as frequently now.' c. 'Any meal adjustments will be based on my glucose monitoring.' d. 'Eating at different times a couple of days a week should not affect my blood glucose.'

Urine for albumin

The nurse is caring for a patient with diabetes mellitus who is being screened for nephropathy. What laboratory test will the nurse reference as the test used to screen for early nephropathy? a. Serum creatinine b. Urine for albumin c. Urine for ketones d. Blood urea nitrogen

11:00 AM Insulin aspart is a rapid-acting insulin with an onset of 15 minutes, a peak in 1 to 3 hours, and a duration of action of 3 to 5 hours. Episodes of hypoglycemia are more likely during the peak action of the medication. In this case, it would be at 11:00 AM.

The nurse is caring for a patient with diabetes mellitus who received insulin aspart at 8:00 AM. At which time does the nurse expect hypoglycemia most likely to occur in this patient? 8:30 AM 4:00 PM 8:30 PM 11:00 AM

'You are likely experiencing an episode of low blood sugar when this happens.'

The nurse is caring for a patient with diabetes mellitus who tells the nurse, 'I sometimes have episodes of seeing double. What causes that?' Which response would the nurse give? a. 'You are likely experiencing diabetic retinopathy. b. ' 'You are likely experiencing optic nerve atrophy.' c. 'You are likely experiencing an episode of low blood sugar when this happens.' d. 'You are likely experiencing an episode of high blood sugar when this happens.'

Skin cracks and fissures

The nurse is caring for a patient with diabetes who has autonomic neuropathy of the feet. What is the effect of this condition? a. Claw toe deformity b. Diabetic foot ulcer c. Reduced sensation d. Skin cracks and fissures

It triggers the release of glucose from cell storage sites.

The nurse is caring for a patient with diabetes. What distinguishing characteristic of glucagon must the nurse be aware of? a. It is secreted within 10 minutes of ingestion of food. b. It triggers the release of glucose from cell storage sites. c, It is secreted by the beta cells of the islets of Langerhans. d. It allows the body to take up, use, and store carbohydrates.

33-year-old female receiving treatment for thyroid storm

The nurse is caring for four patients with different health conditions. Which patient is most likely to develop psychotic behavior? a. 33-year-old female receiving treatment for thyroid storm b. 60-year-old male recovering from a hip replacement c. 53-year-old female receiving radiation therapy for breast cancer d. 48-year-old being treated with intravenous antibiotics for cellulitis

Oxygen Suction Calcium gluconate Emergency tracheotomy kit

The nurse is preparing the room for the patient returning from a thyroidectomy. Which items are important for the nurse to have available for this patient? Select all that apply. a.Oxygen b.Suction c. Furosemide d. Hypertonic saline e. Calcium gluconate f. Emergency tracheotomy kit

Irritability Irritability is a sign of hypoglycemia. Vomiting, positive ketones, and warm, moist skin are signs of hyperglycemia.

The nurse is providing education to a patient about the prevention of hypoglycemia. What signs and symptoms of this complication should be included in the teaching? a. Irritability b. Vomiting c. Positive ketones d. Warm, moist skin

Reduce modifiable risk factors

The nurse is providing education to a patient with diabetes mellitus who has manifestations of cardiovascular disease. What is the nurse's priority action? a. Reverse disease processes b. Reduce modifiable risk factors c. Determine the severity of disease d. Identify non-modifiable risk factors

Administer antithyroid drugs as prescribed. Place the patient on a continuous heart monitor. Maintain a patent airway and adequate ventilation.

The nurse is providing emergency care to a patient experiencing thyroid storm. What actions should the nurse take? Select all that apply. a. Reduce fluid intake. b. Provide a warm blanket for comfort. c. Administer antithyroid drugs as prescribed. d. Place the patient on a continuous heart monitor. e. Maintain a patent airway and adequate ventilation.

Fasting blood glucose of 127 mg/dL

The nurse is providing health screening. The nurse determines that the patient with which lab value should receive teaching related to diabetes? A 1c of 4.5% Fasting blood glucose of 127 mg/dL Random blood glucose of 198 mg/dL Two-hour glucose of 150 mg/dL during oral glucose tolerance test

Weightlifting Patients diagnosed with proliferative diabetic retinopathy should avoid weightlifting because the heavy lifting could cause complications. Walking, swimming, and arm exercises are not contraindicated.

The nurse is providing information for a patient diagnosed with proliferative diabetic retinopathy. What exercise should the nurse instruct the patient to avoid? Walking Swimming Weightlifting Arm exercises

Sulfonylureas should be discontinued one day before surgery. Sulfonylureas should be discontinued one day before surgery. Preoperative blood glucose should be less than 200 mg/dL. Patients do not normally have an increased length of stay; they do sometimes get admitted early. Opiate analgesics are not avoided after surgery.

The nurse is providing preoperative instructions to a patient with diabetes. What instructions should the nurse include? a. Sulfonylureas should be discontinued one day before surgery. b. Opioid analgesics are contraindicated in patients with diabetes. c. It is common to have an increased length of stay of 2 to 3 days. d. The goal is to keep preoperative blood glucose to less than 250 mg/dL.

'Sometimes it causes vomiting.' Vomiting is a sign of hyperglycemia, not hypoglycemia. Weakness, tachycardia, and feelings of anxiousness or nervousness are consistent with hypoglycemia.

The nurse is providing teaching about signs of hypoglycemia to a patient diagnosed with type 2 diabetes who is being discharged after an episode of hypoglycemia. Which statement by the patient indicates a need for further teaching? a. 'I may experience weakness.'' b. It can cause a fast heart rate.' c. 'Sometimes it causes vomiting.' d. 'I might feel anxious or nervous.'

Calorie restriction To avoid weight gain from insulin resistance, the patient should restrict calories rather than increase insulin. Increasing insulin and decreasing exercise will add to the weight gain. Sites of administration will not affect weight.

The nurse is providing teaching about weight gain secondary to insulin resistance to a patient with type 1 diabetes. What actions by the patient can minimize this complication? Calorie restriction Increasing insulin Decreasing exercise Changing administration sites

Socks or stockings should be fitted properly.

The nurse is providing teaching to a patient diagnosed with peripheral neuropathy secondary to diabetes. Which instructions regarding footwear should be included for the patient? a. Heels should be less than 1 inch high. b. All shoes should be fitted by a podiatrist. c. Socks or stockings should be fitted properly. d. Shoes should be 1 inch longer than the longest toe.

10 minutes Insulin lispro should be given 10 minutes before meals. If given 15 minutes, 30 minutes, or 2 hours before meal, the patient could experience hypoglycemia during the lag time.

The nurse is providing teaching to a patient prescribed insulin lispro. How long before a meal is the patient required to inject the insulin lispro? 2 hours 10 minutes 15 minutes 30 minutes

44-year-old healthy American Indian patient with a family history of type 2 diabetes

The nurse is reviewing the implications of culture on the development of diabetes. Which patient will the nurse determine has the greatest risk for developing type 2 diabetes mellitus? a. 44-year-old healthy American Indian patient with a family history of type 2 diabetes b. 60-year-old Asian American patient with an unknown family history of type 2 diabetes c. 55-year-old healthy non-Hispanic white patient with a family history of cardiovascular disease d. 22-year-old healthy Hispanic patient with an unknown family history of type 2 diabetes

The LDL cholesterol should be below 100 mg/dL for patients without signs of CVD. The ADA recommends that the LDL cholesterol be below 100 mg/dL (2.60 mmol/L) for patients without signs of CVD. The ADA also recommends that a patient's blood pressure be maintained below 140/80 mm Hg, and that the LDL cholesterol be below 70 mg/dL (1.8 mmol/L) for patients with signs of CVD. The ADA recommends that HDL cholesterol levels be below 35 mg/dL.

The nurse is teaching a group of nursing students about the American Diabetes Association (ADA) recommendations for patient care. Which recommendation made by a nursing student indicates understanding? a. The patient's blood pressure should be below 120/70 mm Hg. b. The patient's high-density lipoprotein (HDL) cholesterol level should be below 40 mg/dL. c. The low-density lipoprotein (LDL) cholesterol should be below 140 mg/dL for patients with signs of cardiovascular disease (CVD). d. The LDL cholesterol should be below 100 mg/dL for patients without signs of CVD.

Diarrhea

The nurse provides education about metformin to a patient with diabetes. What is a symptom of lactic acidosis, a common side effect of this medication? Diarrhea Restlessness Blurred vision Increased appetite

Formation of new retinal blood vessels

The patient with diabetes is at risk for eye and vision complications. What is the distinguishing characteristic of proliferative diabetic retinopathy? a. Hard, fatty deposits in the eye b. Formation of new retinal blood vessels c. Sausage-like appearance of retinal veins d. Dilation of the capillary wall in the retinal veins

Hypocalcemia Respiratory distress Laryngeal nerve damage.

What post-thyroidectomy complications does the nurse suspect in a patient who complains in a hoarse voice of difficulty breathing and a tingling sensation around the mouth? Select all that apply. Tetany Thyroid storm Hypocalcemia Respiratory distress Laryngeal nerve damage

Check urine for ketones. Patients should ensure there are no ketones in the urine. Patients can take medication for diarrhea or nausea. The patient should monitor the blood glucose every 4 hours, not 8 hours. Patients should have at least 8 to 12 ounces of sugar- free liquid every hour while awake.

What action is important for a patient with diabetes to take on sick days a. Check urine for ketones. b. Monitor blood glucose at least every 8 hours. c. Avoid taking medications for diarrhea or nausea. d. Drink 4 to 6 ounces of sugar-free liquid every hour while awake.

Hypomagnesemia Congenital dysgenesis Hypomagnesemia and congenital dysgenesis can cause hypoparathyroidism. Hypocalcemia, vitamin D deficiency, and congenital hyperplasia can lead to hyperparathyroidism, not hypoparathyroidism.

What are the causes of hypoparathyroidism? Select all that apply. a. Hypocalcemia b.Hypomagnesemia c. Vitamin D deficiency d. Congenital dysgenesis Congenital hyperplasia

Sole of the foot

What area of the patient's feet would the nurse identify as correct for assessing for plantar ulcers? Top of the foot Sole of the foot Side of the foot Between the toes

autoimmune disorder Type 1 diabetes mellitus (DM) is an autoimmune disorder in which beta cells are destroyed in a genetically susceptible person. Beta-cell failure and insulin resistance are characteristics of type 2 diabetes mellitus. Type 2 diabetes mellitus is a progressive disorder.

What best describes the etiology of type 1 diabetes mellitus?

Normal blood glucose levels

What can slow the progression of diabetic neuropathies? a. Daily exercise b. Avoiding high-fat foods c. Controlling blood pressure d. Normal blood glucose levels

a.Hypoglycemia Hypoglycemia is defined as a fasting blood glucose level lower than 74 mg/dL. Hyperglycemia is defined as a fasting blood glucose level greater than 106 mg/dL. These are universal guidelines that are not individualized, so more information is not necessary. The normal range for fasting blood glucose levels is 74 to 106 mg/dL.

What does a fasting blood glucose of 65 mg/dL indicate? a.Hypoglycemia b.Hyperglycemia c. More information needed d. Normal result in range for fasting

b. The basal metabolic rate decreases. c. Thyroid hormone secretion decreases. d. Body composition changes from muscular to fatty.

What does the nurse teach an older patient about the effect aging has on thyroid hormones? Select all that apply. a. The thyroid gland increases in size. b. The basal metabolic rate decreases. c. Thyroid hormone secretion decreases. d. Body composition changes from muscular to fatty. e.Higher doses of thyroid replacement hormone will be needed.

d. Check bath water temperature before stepping in the water. It is important to check bath water temperature prior to stepping into the water. Patients with diabetes should not soak their feet, they should not put moisturizing cream between their toes, and they should avoid wearing the same shoes two days in a row.

What information should be included when teaching a patient with diabetes about foot care? a. It is important to soak your feet once a week. b. It is important to wear the same shoes most days. c. Apply moisturizing cream between your toes and on your feet. d. Check bath water temperature before stepping in the water.

Hypokalemia The initial electrolyte imbalance that the nurse can anticipate for a patient experiencing hyperglycemia is hypokalemia. With the increased fluid loss from hyperglycemia, excessive potassium is excreted in the urine, leading to low serum potassium levels. Hyperkalemia may occur with acidosis because of the shift of the potassium from inside the cells of the blood. An imbalance in sodium is unrelated to the initial changes caused by hyperglycemia.

What initial electrolyte imbalance can the nurse anticipate in a patient experiencing hyperglycemia? Hypokalemia Hyperkalemia Hyponatremia Hypernatremia

The results are not altered by eating habits 24 hours before the test.

What is an important feature of the glycosylated hemoglobin A 1c (HbA 1c) test? a. The results are not altered by eating habits 24 hours before the test. b. The patient must drink a 75 g glucose load an hour before the test. c. It determines the average blood glucose levels of the previous 14 days. d. The patient must not have any caloric intake for at least 8 hours before the test.

Husky voice Thick tongue Mucinous edema

What manifestations does the nurse expect to find in a patient with hypothyroidism? Select all that apply. Oily hair Husky voice Thick tongue Pitting edema Mucinous edema

Provide 15 g of carbohydrate and cheese. When treating moderate hypoglycemia, the patient must be given 15 to 30 g of rapidly absorbed carbohydrate, followed by low-fat milk or cheese after 10 to 15 minutes. The patient with mild hypoglycemia usually has a blood glucose level of less than 60 mg/dL. It may be treated by offering the patient half a cup of fruit juice, or 4 cubes or teaspoons of sugar. In severe hypoglycemia, blood glucose is usually less than 20 mg/dL. The patient may be unconscious or unable to swallow; the patient should be administered 1 mg of glucagon as a subcutaneous or intramuscular injection.

What measure should the caregiver of a patient with diabetes take to treat moderate hypoglycemia? Provide half a cup of fruit juice. Offer 4 cubes, or teaspoons, of sugar. Subcutaneously inject 1 mg of glucagon. Provide 15 g of carbohydrate and cheese.

Osmotic diuresis

What mechanism causes electrolyte imbalances in the patient with diabetes who is experiencing extremely elevated blood glucose levels? a. Osmotic diuresis b. Cellular starvation c. Exhalation of acetone d. Free fatty acid release

Discard any unused insulin after 28 days.

What method must the patient with diabetes use with regard to insulin safety? a. Shake insulin well before administration. b. Discard any unused insulin after 28 days. c. Refrigerate unused insulin at 32° F (0° C). d. Store prefilled syringes in a horizontal position.

Retinopathy Nephropathy Retinopathy and nephropathy are microvascular complications that can occur with diabetes mellitus. Coronary heart disease, cerebral vascular disease, and peripheral vascular disease are macrovascular diseases that are complications of diabetes mellitus.

What microvascular complications of the blood vessel structure can occur in the patient with diabetes mellitus? Select all that apply. Retinopathy Nephropathy Coronary heart disease Cerebral vascular disease Peripheral vascular disease

The condition is usually resolved with antibiotic therapy.

What should the nurse be aware of when caring for a patient with acute thyroiditis? It is caused by a viral infection of the thyroid gland. It is usually triggered by a bacterial or viral infection. The condition is usually resolved with antibiotic therapy. The thyroid gland feels hard and enlarged on palpation.

Sick day rules Daily inspection of feet Reporting any vision changes

What teaching should be included for a patient with a new diagnosis of type 1 diabetes? Select all that apply. a. Sick day rules b. Avoidance of exercise c. Daily inspection of feet d. Reporting any vision changes e. Weekly blood work for the first year

Eat consistent amounts of food at consistent times. It is important to have consistent amounts of food at consistent times. Snacks are OK, calories should not be avoided when exercising, and carbohydrates should not be restricted to once a day.

When providing teaching about nutrition to a patient diagnosed with diabetes, what instruction should the nurse include? a. It is important to avoid snacks. b. Decrease calories when exercising. c. Carbohydrates should be restricted to once a day. d. Eat consistent amounts of food at consistent times.

Controlling hyperglycemia Controlling high triglycerides Ceasing smoking Controlling hypertension

Which are priority interventions for a diabetic patient to reduce modifiable risk factors associated with cardiovascular disease? Select all that apply. a. Ceasing smoking b. Reviewing family history c. Controlling hypertension d. Controlling hyperglycemia e. Controlling high triglycerides

Waist circumference of 40 inches or more

Which assessment finding is identified as a risk for type 2 diabetes mellitus (DM) and cardiovascular disease (CVD)? a. Blood pressure of 120/80 mm Hg b. Body mass index less than 25 kg/m 2 c. Fasting blood glucose level of 90 mg/dL d. Waist circumference of 40 inches or more

150 mg/dL A blood glucose level of 150 mg/dL is optimal. The Joint Commission's National Patient Safety Goals recommend a blood glucose level between 140 and 180 mg/dL. The values 90, 120, and 130 mg/dL are too low.

Which blood glucose level does the operating room nurse recognize as optimal during surgery to prevent hypoglycemia? 90 mg/dL 120 mg/dL 130 mg/dL 150 mg/dL

Neuropathy Retinopathy Nephropathy Neuropathy, retinopathy, and nephropathy are all chronic complications of diabetes. Hypoglycemia, diabetic ketoacidosis, and hyperglycemic-hyperosmolar state are acute complications that require emergency treatment.

Which complications of diabetes are considered chronic complications? Select all that apply. Neuropathy Retinopathy Nephropathy Hypoglycemia Diabetic ketoacidosis Hyperglycemic-hyperosmolar state

Those with type 2 diabetes make insulin, but in inadequate amounts.

Which explanation best assists a patient in differentiating type 1 diabetes from type 2 diabetes? a. People with type 1 diabetes are often obese. b. Most patients with type 1 diabetes are born with it. c. Those with type 2 diabetes make insulin, but in inadequate amounts. d. People with type 2 diabetes do not develop typical diabetic complications.

Obesity Sixty to eighty percent of patients with type 2 diabetes mellitus are obese. Hunger, weight loss, and increased urine output are symptoms associated with type 1 diabetes mellitus.

Which finding is seen in a patient with type 2 diabetes mellitus? Hunger Obesity Weight loss Increased urine output

A half cup of fruit juice A half cup of fruit juice is adequate for a patient to manage his or her hypoglycemia. For milk, 16 oz are too much; 8 oz is an adequate amount. For honey, 1 tbsp is enough; 4 tbsp are too much. Eight cubes of sugar are too much; four cubes are enough.

Which food will the nurse provide to a patient who has hypoglycemia and a blood glucose level of 60 mg/dL? a. 16 oz of milk b. 4 tbsp of honey c. Eight cubes of sugar d. A half cup of fruit juice

Glucagon

Which hormone is responsible for maintaining blood glucose levels during periods of fasting from food? Insulin Amylin Glucagon Proinsulin

Cortisol Glucagon Epinephrine Growth hormone

Which hormones raise blood glucose levels? Select all that apply. Insulin Cortisol Glucagon Epinephrine Growth hormone

Triglycerides 220 mg/dL One feature of metabolic syndrome is hyperlipidemia or a triglyceride level of 150 mg/dL or greater. In metabolic syndrome, the A1C level is between 5.5% and 6%. An A1C level of 5% is not consistent with metabolic syndrome. In metabolic syndrome the waist circumference for a female would be greater than 35 inches. A waist measurement of 33 inches in a female is not associated with metabolic syndrome. In metabolic syndrome blood pressure is greater than 130/85 mm Hg. A blood pressure of 128/86 is not associated with metabolic syndrome.

Which is a feature of metabolic syndrome? A1C 5.0% Triglycerides 220 mg/dL Waist 33 inches for a female Blood pressure 128/86 mm Hg

American Diabetes Association

Which is the best referral that the nurse can suggest to a patient who has been newly diagnosed with diabetes? Health care provider office Pharmaceutical representative American Diabetes Association Centers for Disease Control and Prevention

Papillary carcinoma Papillary carcinoma is the most common type of thyroid cancer in younger women and is characterized by slowly growing tumors

Which is the most common type of thyroid cancer in younger women? Papillary carcinoma Follicular carcinoma Medullary carcinoma Anaplastic carcinoma

Excessive urination Manifestations of hyperglycemia and diabetes include polydipsia (excessive thirst), polyuria (excessive urination), and polyphagia (excessive eating). Symptoms of hypoglycemia include diaphoresis, pallor, irritability, tremor, anxiety, confusion, hunger, and loss of consciousness.

Which manifestation is associated with hyperglycemia in a patient with diabetes mellitus? a. Pallor b. Irritability c. Diaphoresis d. Excessive urination

Lisinopril

Which medication taken by a patient with diabetes mellitus will protect the kidneys and help prevent diabetic nephropathy? Digoxin Lisinopril Propranolol Metoclopramide

Gluconeogenesis Gluconeogenesis is the conversion of proteins to glucose. Ketogenesis is the conversion of fats to acids. The production and storage of glycogen is known as glycogenesis, and proteolysis is the breakdown of protein.

Which of the following is the process of converting proteins to glucose? Proteolysis Ketogenesis Glycogenesis Gluconeogenesis

Dapagliflozin (Farxiga)

Which oral medication lowers blood glucose levels by preventing kidney reabsorption of glucose and sodium that was filtered from the blood into the urine, allowing for the filtered glucose to be excreted in the urine rather than moved back into the blood? Alogliptin (Nesina) Pramlintide (Symlin) Dapagliflozin (Farxiga) Exenatide (Byetta)

Patient who is receiving dialysis

Which patient taking metformin does the nurse consider at highest risk for lactic acidosis? Patient who is receiving dialysis. Patient who has hyperglycemia. Patient who is also taking warfarin. Patient who is also taking oral contraceptives.

'I should eat three graham crackers.' Eating three graham crackers is a correct management strategy for mild hypoglycemia. Water or resting does not remedy hypoglycemia. Glucagon should be administered only in cases of severe hypoglycemia.

Which response by the patient indicates a correct understanding of hypoglycemia management? a. 'I should sit down and rest.'' b. I should drink a glass of water.' c. 'I should eat three graham crackers.'' d. I should give myself 1 mg of glucagon.'

Maintain at least 3 ft of distance from infants.

Which safety precaution is appropriate for the patient receiving an unsealed radioactive isotope? Stand while urinating. Avoid the use of laxatives. Flush the toilet once after each use. Maintain at least 3 ft of distance from infants.

Tremors Headache

Which signs and symptoms of hypoglycemia will a nurse instruct a patient who is prescribed insulin therapy to report? Select all that apply. Polyuria Tremors Polydipsia Headache Polyphagia

It describes people at risk for type 2 diabetes who have a fasting glucose level of 100 to 125 mg/dL.

Which statement about pre-diabetes is correct? a. It describes an overweight person with insulin-dependent diabetes. b. It involves an inability to respond to insulin or make sufficient insulin in the pancreas. c. It is a form of type 1 diabetes that tends to occur in people over age 50 years who are slender. d. It describes people at risk for type 2 diabetes who have a fasting glucose level of 100 to 125 mg/dL.

Atonic bladder Dried, cracked skin Orthostatic hypotension Atonic bladder; dried, cracked skin; and orthostatic hypotension are all symptoms of autonomic neuropathy. Eye pain is a symptom of focal neuropathy (focal ischemia). Paresthesias and asymmetric weakness are symptoms of distal symmetric polyneuropathy.

Which symptoms indicate autonomic neuropathy? Select all that apply. Eye pain Paresthesias Atonic bladder Dried, cracked skin Asymmetric weakness Orthostatic hypotension

Subacute thyroiditis

Which type of thyroiditis does the nurse suspect in a patient who complains of cold, fever, chills, dysphagia, and muscle and joint pains? Acute thyroiditis Chronic thyroiditis Subacute thyroiditis Idiopathic thyroiditis

Abdomen Insulin absorption is fastest when it is injected in the abdomen, followed by the deltoid, thigh, and buttocks.

While teaching a patient about insulin injection technique, the nurse explains that injecting into which area will cause the insulin to be most rapidly absorbed? Thigh Deltoid Buttocks Abdomen

Metformin (Glucophage) Metformin (Glucophage) is a biguanide medication that lowers blood glucose levels by inhibiting liver glucose production, decreasing intestinal absorption of glucose, and increasing insulin sensitivity. Pioglitzone (Actos) is a thiazolidinedione that lowers blood glucose levels by decreasing liver glucose production and improving the sensitivity of insulin. Glipizide (Glucotrol) and glimepiride (Amaryl) are second- generation sulfonylurea agents that lower blood glucose levels by triggering the release of preformed insulin from beta cells.

hich medication lowers blood glucose levels by inhibiting liver glucose production, decreasing intestinal absorption of glucose, and increasing insulin sensitivity? Pioglitazine (Actos) Glipizide (Glucotrol Glimepiride (Amaryl) Metformin (Glucophage)

Reduce the room temperature. Change the bed linen whenever it becomes damp from diaphoresis. Ensure that the patient always has a fresh pitcher of ice water.

the nurse delegates the task of providing comfort to a patient with Graves' disease to an unlicensed assistive personnel (UAP). What instruction should the nurse give to the UAP? Select all that apply. a. Reduce the room temperature. b. Allow visitors to keep the patient company. c. Provide warm showers or a sponge bath at regular intervals. d. Ensure that the patient always has a fresh pitcher of ice water. e. Change the bed linen whenever it becomes damp from diaphoresis.