Glucose Regulation/Diabetes EAQ

A client newly diagnosed with type 2 diabetes is receiving glyburide and asks the nurse how this drug works. What mechanism of action does the nurse provide? A) Stimulates the pancreas to produce insulin B) Accelerates the liver's release of stored glycogen C) Increases glucose transport across the cell membrane D) Lowers blood glucose in the absence of pancreatic function

A

A nurse is caring for a client who has a 20-year history of type 2 diabetes. The nurse should assess for what physiologic changes associated with a long history of diabetes? A) Blurry, spotty, or hazy vision B) Arthritic changes in the hands C) Hyperactive knee and ankle jerk reflexes D) Dependent pallor of the feet and lower legs

A

While assessing the nails of a client with diabetes, the nurse finds that the skin on the client's hands and feet are dry due to infection. What could be the reason for this dryness? A) Applying moisturizing lotion between toes B) Cutting nails after soaking them for 10 minutes in warm water C) Cutting nails straight across and even with the tops of the fingers or toes D) Using sharp objects to poke or dig under the toenail or around the cuticle

B

A client with type 2 diabetes is admitted for elective surgery. The health care provider prescribes regular insulin even though oral antidiabetics were adequate before the client's hospitalization. What information does the nurse include when teaching the client about the addition of insulin? A) "You will need a higher serum glucose level while on bed rest." B) "The stress of surgery may cause uncontrollable periods of hypoglycemia." C) "With insulin, dosage can be adjusted to your changing needs during recovery from surgery." D) "The possibility of surgical complications is greater when a client takes oral hypoglycemics."

C

A nurse is teaching a young adolescent with type 2 diabetes about nutritional needs. Which statement demonstrates that the adolescent understands what was taught? A) "I can have low-fat, low-cal candy bars." B) "Regular soft drinks are better than diet ones." C) "It's okay for me to eat one slice of pizza at a party." D) "My fasting blood sugar should be no higher than 150 mg/dL (8.3 mmol/L)."

C

A 12-year-old child with type 2 diabetes is scheduled for abdominal surgery. Which factors are most important for the nurse to consider during the postoperative period? Select all that apply. A) Infection will likely occur at the surgical site. B) Ketoacidosis frequently occurs later in the postoperative period. C) The blood glucose level will increase because of the stress of surgery. D) Urine test results are the most useful gauge of diabetic control after surgery. E) Diabetic control is usually maintained with insulin after surgery.

C, E

When assessing the laboratory values of a client with type 2 diabetes, what would the nurse expect the results to reveal? A) Ketones in the blood but not in the urine B) Glucose in the urine but not in the blood C) Urine and blood positive for glucose and ketones D) Urine negative for ketones and positive glucose in the blood

D

A nurse teaches a client with type 2 diabetes how to provide self-care to prevent infections of the feet. Which statement made by the client shows that teaching was effective? A) "I should massage my feet and legs with oil or lotion." B) "I should apply heat intermittently to my feet and legs." C) "I should eat foods high in protein and carbohydrate kilocalories." D) "I should control my blood glucose with diet, exercise, and medication."

D

The clinical findings of a client with diabetes mellitus show decreased glucose tolerance. Which complication is anticipated in the client? A) Cystitis B) Thin and dry skin C) Decreased bone density D) Frequent yeast infections

D

An obese client with type 2 diabetes asks about the intake of alcohol or special "dietetic" food in the diet. What should the nurse include in teaching? A) Alcohol can be consumed, with its calories counted in the diet. B) Unlimited amounts of sugar substitutes can be used as desired. C) Alcohol should not be used in cooking because it adds too many calories. D) Special "dietetic" foods are needed because many regular foods cannot be used.

A

The nurse is caring for an older client admitted to the hospital with type 2 diabetes. What is important for the nurse to remember about older adults and type 2 diabetes? A) Older adults seldom develop ketoacidosis. B) Older adults secrete no endogenous insulin. C) Older adults have a lower risk of complications. D) Older adults develop a sudden onset of symptoms.

A

After assessing a client's condition, the nurse suspects that the client has diabetes mellitus. Which statement made by the client would be most appropriate in helping the nurse reach this conclusion? Select all that apply. A) "I am 55 years old." B) "I quite often feel thirsty." C) "I eat food every 2 hours." D) "I have excessive sweating." E) "I sometimes experience shortness of breath."

A, B, C

A 17-year-old adolescent was recently found to have type 2 diabetes mellitus. What information will the nurse include when providing education to the family? A) "Your teen will need insulin injections for the rest of her life." B) "The most important interventions are good nutrition and portion control." C) "This is a condition where the body produces antibodies against its own cells." D) "This condition causes weight loss and increased appetite, thirst, and urination."

B

An adolescent with a BMI of 30 reports fatigue, frequent urination, and a tingling sensation on the feet. The adolescent is then diagnosed with type 2 diabetes mellitus. Which nursing interventions would be appropriate? Select all that apply. A) Bariatric surgery B) Physical activities C) Dietary restrictions D) Dietary counseling E) Behavior modification

B, D, E

A client who is taking an oral hypoglycemic daily for type 2 diabetes develops the flu and is concerned about the need for special care. What should the nurse advise the client? Select all that apply. A) Avoid solid food. B) Take the oral medication. C) Drink fluids throughout the day. D) Monitor capillary glucose levels. E) Do not take medication until tolerating food.

B, C, D

A 67-year-old man with type 2 diabetes sadly confides in the nurse that he has been unable to have an erection for several years. What is the best response by the nurse? A) "At your age sex isn't that important." B) "Sex isn't everything it's cracked up to be." C) "You sound upset about not being able to have an erection." D) "Maybe it's time for you to speak to your primary healthcare provider about this."

C

A client with diabetes experiences tremors, pallor, and diaphoresis. What should the nurse consider is a possible cause of these clinical manifestations? A) Overeating B) Intestinal virus C) Aerobic exercise D) Missed insulin dose

C

A nurse is caring for two clients newly diagnosed with diabetes. One client has type 1 diabetes, and the other client has type 2 diabetes. When determining the main difference between type 1 and type 2 diabetes, the nurse recognizes what clinical presentation about type 1? A) Onset of the disease is slow. B) Excessive weight is a contributing factor. C) Complications are not present at the time of diagnosis. D) Treatment involves diet, exercise, and oral medications.

C

The health care provider prescribes an oral hypoglycemic for the client with type 2 diabetes. What will the nurse need to consider when developing the teaching plan? A) Oral hypoglycemics work by decreasing absorption of carbohydrates. B) Oral hypoglycemics work by stimulating the pancreas to produce insulin. C) Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control. D) Clients with type 2 diabetes do not need to be concerned about serious adverse effects from oral hypoglycemics.

C

A client is diagnosed as having type 2 diabetes. What is a priority teaching goal for the client? A) To perform foot care daily B) To administer insulin as prescribed C) To test urine for both sugar and acetone D) To identify pending hypoglycemia or hyperglycemia

D

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? A) "I will take the drug with food." B) "I must swallow my medication whole and not crush or chew it." C) "I will notify my doctor if I develop muscular or abdominal discomfort." D) "I will stop taking metformin for 24 hours before and after having a test involving dye."

D

A client with diabetes who is receiving long-term corticosteroid therapy is admitted to the hospital with leg ulcers. What increased risk does the nurse consider when assessing this client? A) Weight loss B) Hypoglycemia C) Decreased blood pressure D) Inadequate wound healing

D

A client with type 2 diabetes develops gout, and allopurinol is prescribed. The client is also taking metformin and an over-the-counter nonsteroidal antiinflammatory drug (NSAID). When teaching about the administration of allopurinol, what should the nurse instruct the client to do? A) Decrease the daily dose of NSAIDs. B) Limit fluid intake to one quart a day. C) Take the medication on an empty stomach. D) Monitor blood glucose levels more frequently.

D

A client with type 2 diabetes is taking one oral hypoglycemic tablet daily. The client asks whether an extra tablet should be taken before exercise. What is the best response by the nurse? A) "You will need to decrease your exercise." B) "An extra tablet will help your body use glucose correctly." C) "When taking medicine, your diet will not be affected by exercise." D) "No, but you should observe for signs of hypoglycemia while exercising."

D

A client with type 2 diabetes, who is taking an oral hypoglycemic agent, is to have a serum glucose test early in the morning. The client asks the nurse, "What do I have to do to prepare for this test?" Which statement by the nurse reflects accurate information? A) "Eat your usual breakfast." B) "Have clear liquids for breakfast." C) "Take your medication before the test." D) "Do not ingest anything before the test."

D

What is the priority nursing intervention for an older client with diabetes mellitus who presents with a large leg ulcer? A) Teaching techniques for dressing changes B) Informing the client about insurance companies C) Discussing community resources to obtain support D) Teaching how to transfer from a bed to chair in the least painful manner

D