NU 307 Diabetes Practice Questions

c. Check the blood glucose during the night

1. The health care provider suspects the Somogyi effect in a 50-year-old patient whose 6:00 AM blood glucose is 230 mg/dL. Which action will the nurse teach the patient to take? a. Avoid snacking at bedtime. b. Increase the rapid-acting insulin dose. c. Check the blood glucose during the night d. Administer a larger dose of long-acting insulin.

a. Thirst b. Ketonuria c. Dehydration d. Metabolic acidosis e. Kussmaul respirations f. Sweet, fruity breath odor

1. The nurse should observe the patient for symptoms of ketoacidosis when (select all that apply): a. Thirst b. Ketonuria c. Dehydration d. Metabolic acidosis e. Kussmaul respirations f. Sweet, fruity breath odor

c. Changes in diet and exercise may control blood glucose levels in type 2 diabetes.

1. Which statement by a nurse to a patient newly diagnosed with type 2 diabetes is correct? a. Insulin is not used to control blood glucose in patients with type 2 diabetes. b. Complications of type 2 diabetes are less serious than those of type 1 diabetes. c. Changes in diet and exercise may control blood glucose levels in type 2 diabetes. d. Type 2 diabetes is usually diagnosed when the patient is admitted with a hyperglycemic coma.

B. Insert a large-bore IV catheter

An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to: a. give a bolus of 50% dextrose. b. insert a large-bore IV catheter. c. initiate oxygen by nasal cannula. d. administer glargine (Lantus) insulin.

c. lifestyle changes to lower blood glucose.

A 48-year-old male patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about: a. self-monitoring of blood glucose. b. using low doses of regular insulin. c. lifestyle changes to lower blood glucose. d. effects of oral hypoglycemic medications.

b. It is more difficult to achieve strict glucose control than in younger patients.

A 72-year-old woman is diagnosed with diabetes. What does the nurse recognize about the management of diabetes in the older adult? a. It is more difficult to achieve strict glucose control than in younger patients. b. It usually is not treated unless the patient becomes severely hyperglycemic. c. It does not include treatment with insulin because of limited dexterity and vision. d. It usually requires that a younger family member be responsible for care of the patient.

d. Administer glucagon 1 mg intramuscularly (IM) or subcutaneously.

A diabetic patient is found unconscious at home and a family member calls the clinic. After determining that a glucometer is not available, what should the nurse advise the family member to do? a. Have the patient drink some orange juice. b. Administer 10 U of regular insulin subcutaneously. c. Call for an ambulance to transport the patient to a medical facility. d. Administer glucagon 1 mg intramuscularly (IM) or subcutaneously.

A. 10:00 AM

A patient receives aspart (NovoLog) insulin at 8:00 AM. Which time will it be most important for the nurse to monitor for symptoms of hypoglycemia? A. 10:00AM B. 12:00 AM C. 2:00 PM D. 4:00 PM

d. Impaired glucose tolerance.

The nurse determines that a patient with a 2-hour OGTT of 152 mg/dL has: a. Diabetes. b. Elevated A1C. c. Impaired fasting glucose. d. Impaired glucose tolerance.

d. "I'll know if I have sores or lesions on my feet because they will be painful."

Following the teaching of foot care to a diabetic patient, the nurse determines that additional instruction is needed when the patient makes which statement? a. "I should wash my feet daily with soap and warm water." b. "I should always wear shoes to protect my feet from injury." c. "If my feet are cold, I should wear socks instead of using a heating pad." d. "I'll know if I have sores or lesions on my feet because they will be painful."

A. Eat regular meals at regular times

Individualized nutrition therapy for patients using conventional, fixed insulin regimens should include teaching the patient to: A. Eat regular meals at regular times B. restrict calories to promote moderate weight loss C. Eliminate sucrose and other simple sugars from the diet D. Limit saturated fat intake to 30% of dietary calorie intake

A. "I can choose any foods, as long as I use enough insulin to cover the calories"

The nurse determines a need for additional instruction when the patient with newly diagnosed type 1 diabetes says which of the following? A. "I can have an occasional alcoholic drink if I include it in my meal plan." B. "I will need a bedtime snack because I take an evening dose of NPH insulin." C. "I can choose any foods, as long as I use enough insulin to cover the calories." D. "I will eat something at meal times to prevent hypoglycemia, even if I am not hungry."

b. chooses a puncture site in the center of the finger pad.

The nurse identifies a need for additional teaching when the patient who is self-monitoring blood glucose: a. washes the puncture site using warm water and soap. b. chooses a puncture site in the center of the finger pad. c. hangs the arm down for a minute before puncturing the site. d. says the result of 120 mg indicates good blood sugar control.

C. rapid respirations with deep inspiration

The nurse is assessing a newly admitted diabetic patient. Which observation the nurse should address as the priority? A. Bilateral numbness of both hands B. Stage II pressure ulcer on the right heel C. Rapid respirations with deep inspiration D. Areas of lumps and dents on the abdomen

A. Headache C. Abdominal cramps E. increase in urination F. weakness and fatigue

The patient with diabetes has a blood glucose level of 248 mg/dL. Which manifestations in the patient would the nurse understand as being related to this blood glucose level (select all that apply)? a. Headache b. Unsteady gait c. Abdominal cramps d. Emotional changes e. Increase in urination f. Weakness and fatigue

C. Hypoglycemia

The patient with newly diagnosed diabetes is displaying shakiness, confusion, irritability, and slurred speech. What would the nurse suspect is happening? a. DKA b. HHS c. Hypoglycemia d. Hyperglycemia

all of them

What characterizes type 2 diabetes (select all that apply)? A. B-cell exhaustion B. insulin resistance C. genetic predisposition D. altered production of adipokines E. inherited defect in insulin receptors F. inappropriate glucose production by the liver?

c. HHS requires greater fluid replacement to correct the dehydration.

What describes the primary difference in treatment for diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS)? a. DKA requires administration of bicarbonate to correct acidosis. b. Potassium replacement is not necessary in management of HHS. c. HHS requires greater fluid replacement to correct the dehydration. d. Administration of glucose is withheld in HHS until the blood glucose reaches a normal level.

D. fasting blood glucose result of 120 mg/dL

Which laboratory results would indicate that the patient has prediabetes? A. glucose tolerance result of 132 mg/dL B. glucose tolerance result of 240 mg/dL C. fasting blood glucose result of 80 mg/dL D. fasting blood glucose result of 120 mg/dL

C. A 34-year-old woman whose parents both have type 2 diabetes

Which patient should the nurse plan to teach how to prevent or delay the development of diabetes? A. An obese 50-year-old Hispanic woman B. A child whose father has type 1 diabetes C. A 34-year-old woman who parents both have type 2 diabetes D. A 12-year old boy whose father has maturity onset diabetes of the young (MODY)