PCC2 Exam 2 EAQ practice questions

Which components are associated with metabolic syndrome? Select all that apply. 1 Abdominal obesity 2 Elevated glucose levels 3 Elevated BP 4 Low levels of triglycerides 5 Increased levels of high-density lipoproteins (HDL)

1 2 3

Which statements are accurate when describing glargine? Select all that apply. 1 There is no pronounced peak action time. 2 It should be administered subcutaneously. 3 It should be administered orally with food and water each morning. 4 It should be diluted or mixed with other insulin or solutions in the same syringe. 5 If it does not achieve glycemic goals, the administration of a mealtime insulin may be required.

1 2 5

Which statements made by the nurse to a patient newly diagnosed with type 1 diabetes would be included in a teaching plan? Select all that apply. 1 "You should decrease your dietary sugar intake." 2 "I will teach you how to self-administer your insulin." 3 "It is important to consume a diet that is high in fats." 4 "It is important for you to reduce your physical activity." 5 "You should monitor your blood sugar as prescribed."

1 2 5

Which defining characteristics are associated with the Somogyi effect? Select all that apply. 1 Documented morning hyperglycemia 2 Caused by not rotating insulin injection sites 3 Avoided by consuming a bedtime snack 4 Treated with a lower dose of insulin in the evening 5 Documented hypoglycemia between 2:00 AM and 4:00 AM 6 Required adjustment of administration time of evening insulin

1 3 4 5

Which symptoms may be observed in patients with diabetic ketoacidosis (DKA)? Select all that apply. 1 Lethargy 2 Flushed, moist skin 3 Hypoventilation 4 Soft and sunken eyes 5 Sweet fruity odor of breath

1 4 5

What is the correct order of the events leading to ketoacidosis? 1. Insulin deficiency 2. Ketones accumulate 3. Breakdown of fat stores 4. Decreased glucose utilization

1. insulin deficiency 4. decreased glucose utilization 3. breakdown of fat stores 2. ketones accumulate

The nurse is teaching a patient with insulin-dependent diabetes about the effects of exercise on blood glucose level. When collaborating with the patient to develop a self-management plan, which examples of moderate activity would the nurse suggest? Select all that apply. 1 Fishing 2 Bowling 3 Dancing 4 Walking briskly 5 Aerobic exercises

2 3 4

Which findings are associated with type 1 diabetes mellitus? Select all that apply. 1 Fatigue 2 Excessive thirst 3 Frequent urination 4 Recurrent infections 5 Unexplained weight loss

2 3 5

A patient diagnosed with type 1 diabetes has had elevated blood sugar readings each morning for the past four days. Which intervention by the nurse would be performed initially? a. Check the patient's blood sugar at 3:00 AM. b. Provide the patient with an evening snack. c. Rotate insulin injection sites between the abdomen, thigh, and arm. d. Contact the health care provider to increase the evening insulin dose.

a

The nurse would encourage a patient newly diagnosed with type 2 diabetes to limit intake of which foods to help reduce the percent of fat in the diet? a. Cheese b. Broccoli c. Chicken d. Oranges

a

The nurse would instruct the patient with diabetes to fast for which period of time when scheduled for a fasting blood glucose level at 8:00 a.m.? a. At least eight hours b. 4:00 a.m. on the day of the test c. After dinner the evening before the test d. 7:00 a.m. on the day of the test

a

When evaluating the outcome of patient teaching regarding aspart insulin, which statement made by the patient demonstrates correct understanding of the teaching? a. "This insulin is used to treat the elevated sugar that occurs after meal intake." b. "I cannot mix this insulin in the same syringe with any other type of insulin." c. "I need to plan my meals well so I can inject my insulin 30 minutes before I begin to eat." d. "The best thing about this type of insulin is that I take it at bedtime and it works for 24 hours."

a

When teaching the patient with diabetes about repaglinide, which instruction regarding the timing of the medication would the nurse teach the patient? a. Immediately before meals b .When blood sugar levels are greater than 250 mg/dL c. Two hours after meals d. At bedtime

a

Which action would the nurse take first when teaching the patient with type 2 diabetes to become an active participant in his or her care? a. Assess the patient's understanding of the disease. b. Make a list of food restrictions for proper diabetes management. c. Refer the patient to a nutritionist. d. Set long-term goals to decrease the risk of complications.

a

Which complication can be monitored by annual screening using a monofilament? a. Diabetic neuropathy b. Diabetic retinopathy c. Diabetic dermopathy d. Diabetic nephropathy

a

Which complication of diabetes can be treated with hyperbaric oxygen? a. Diabetic foot ulcers b. Diabetic nephropathy c. Neuropathic arthropathy d. Peripheral vascular disease

a

Which complication of diabetes can cause hypoglycemic unawareness? a. Diabetic neuropathy b. Diabetic dermopathy c. Diabetic ketoacidosis d. Diabetic nephropathy

a

Which factor is the primary defect associated with type 1 diabetes mellitus? a. Absent or minimal insulin production b. Alteration in production of adipokines c. Decreased insulin production over time and insulin resistance d. Abnormal increase in insulin production by the pancreas over time

a

Which hormone regulates the normal blood glucose level in the body? a. Insulin b. Glucagon c. Epinephrine d. Growth hormone

a

Which medication is categorized as a starch blocker? a. Miglitol b. Alogliptin c. Nateglinide d. Glimepiride

a

Which range is the current recommendation of fiber for patients with diabetes? a. 25 to 30 g/day b. 20 to 25 g/day c. 40 to 50 g/day d. 10 to 20 g/day

a

Which risk factor is associated with macrovascular complications of diabetes mellitus? a. Obesity b. Low-fat diet c. Active lifestyle d. Hypotension

a

Which symptom reported by a patient with type 2 diabetes mellitus is considered one of the classic clinical manifestations of diabetes? a. Excessive thirst b. Gradual weight gain c. Overwhelming fatigue d. Recurrent blurred vision

a

A patient admitted with type 2 diabetes asks the nurse what "type 2" means. Which response by the nurse is accurate? a. "With type 2 diabetes, the body of the pancreas becomes inflamed." b. "With type 2 diabetes, insulin secretion is decreased and insulin resistance is increased." c. "With type 2 diabetes, the patient is totally dependent on an outside source of insulin." d. "With type 2 diabetes, the body produces autoantibodies that destroy β-cells in the pancreas."

b

A patient with type 1 diabetes reports feeling shaky and lightheaded and is pale and sweaty. The nurse would take which immediate action? a. Administering glucagon subcutaneously b. Providing the patient with a glucose tablet c. Administering supplemental regular insulin d. Offering the patient a complex carbohydrate snack

b

A patient's blood glucose level before breakfast is 324 mg/dL. The nurse reviews the electronic medical record and notes that the patient receives a high dose of insulin each evening at bedtime. The nurse suspects that the patient's hyperglycemia is most likely due to which problem with insulin therapy? a. Lipodystrophy b. Somogyi effect c. Allergic reaction d. Dawn phenomenon

b

After administering glucagon to an unconscious patient, the nurse would place the patient in which position? a. Supine b. Side-lying c. High-Fowler's d. Semi-Fowler's

b

Which complication of diabetes mellitus can be monitored by fundus photography? a. Neuropathy b. Retinopathy c. Nephropathy d. Dermatopathy

b

Which drug may result in weight gain as a side effect a. Biguanides b. Meglitinides c. Dopamine agonist d. Dipeptidyl peptidase-4 inhibitors

b

Which factor is associated with type 1 diabetes mellitus? a. Obesity b. Viral infection c. Sedentary lifestyle d. High-carbohydrate diet

b

Which question would the nurse ask a patient with polyuria, polydipsia, and polyphagia to rule out a false-negative glucose result? a. have you had any illness recently? b. "Have you recently taken acetaminophen?" c. "Have you been severely restricting your carbohydrate intake?" d. "Have you been lying around and resting a lot for the past few days?"

b

Which statement is characteristic of metformin? a. It causes weight gain. b. It decreases hepatic glucose production. c. It should not be given with sulfonylureas. d. It is inappropriate for initial management of type 2 diabetes.

b

Which statement made by the patient with type 1 diabetes indicates a need for further instruction? a. "I'll have a snack available when I exercise." b. "I'll check my blood sugar level after every meal." c. "I'll eat my meals and snacks at regular times every day." d. "I'll start learning how to make high-fiber, low-fat foods."

b

Which tissue has specific receptors for insulin and is considered an insulin-dependent tissue? a. Hepatic tissue b. Adipose tissue c. Nervous tissue d. Vascular tissue

b

Which treatment is useful in decreasing the serum ketone level in patients with diabetic ketoacidosis? a. Electrolytes b. Insulin therapy c. Sodium bicarbonate d. IV fluids

b

A college student, newly diagnosed with type 1 diabetes, has a headache, changes in vision, and is anxious, but does not have the portable blood glucose monitor with him or her. Which action would the campus nurse advise the patient to take? a. Eat a piece of pizza. b. Drink some diet soft drink. c. Eat 15 g of simple carbohydrates. d. Take an extra dose of rapid-acting insulin.

c

A newly diagnosed patient with type 2 diabetes has been prescribed metformin and asks the nurse how it works. Which explanation would the nurse give the patient? a. It increases insulin production from the pancreas. b. Metformin slows the absorption of carbohydrates in the small intestine. c. It decreases the rate of hepatic glucose production and augments glucose uptake by tissues, especially muscles. d. Metformin increases insulin release from the pancreas, inhibits glucagon secretion, and decreases gastric emptying.

c

A patient, admitted with type 1 diabetes, asks the nurse what "type 1" means. Which response by the nurse is accurate? a. "There is decreased insulin secretion, cellular resistance to insulin that is produced, or both." b. "An increased amount of adipose tissue has led to an insufficient amount of insulin being produced." c. "The body produces autoantibodies that destroy beta cells in the pancreas." d. "The insulin being made is not used by the tissues properly, leading to high blood sugar."

c

During which timeframe would the nurse monitor the patient for hypoglycemia after administering 10 units regular insulin subcutaneously at 8:30 p.m.? a. 8:40 p.m. to 9:00 p.m. b. 9:00 p.m. to 11:30 p.m. c. 10:30 p.m. to 1:30 a.m. d. 12:30 a.m. to 8:30 a.m.

c

Which assessment parameter would the nurse review to determine how well a patient's diabetes mellitus has been controlled over the past two to three months? a. Fasting blood glucose b. Oral glucose tolerance c. Glycosylated hemoglobin d. Random fingerstick blood glucose

c

Which complication of diabetes can be diagnosed by the ankle-brachial index? a. Diabetic neuropathy b. Diabetic nephropathy c. Peripheral arterial disease d. Hyperosmolar hyperglycemic syndrome

c

Which condition may be observed due to incorrect fluid replacement with hypotonic fluids in patients with diabetic ketoacidosis? a.Polyuria b. Hypokalemia c. Cerebral edema d. Metabolic acidosis

c

Which goal of the treatment plan for a patient with diabetic ketoacidosis (DKA) would be the initial focus? a.Treatment for hypokalemia b. Rapid reduction of elevated blood glucose c. Rehydration through IV fluid replacement d. Reduction of ketosis by encouraging oral nourishment

c

Which instruction would the nurse include in a teaching plan about diabetes and healthy eating? a. Avoid non-nutritive sweeteners. b. Consume a high-protein diet for weight loss. c. If ingesting alcohol, also consume carbohydrates. d. Include 50 to 60 g/day of dietary fiber.

c

Which instruction, in relation to mealtimes, would the nurse give to a patient who is prescribed lispro? a. Take on an empty stomach between meals. b. Take it simultaneously with a meal. c. Take it within 15 minutes of mealtime. d. Take it 30 to 45 minutes before a meal.

c

Which is an insulin-dependent tissue? a. Brain b. Kidney c. Skeletal muscle d. Red blood cells

c

Which pathologic change is the cause of microaneurysms in nonproliferative retinopathy? a. Retinal edema b. Neurovascularization c. Partial blood vessels occlusion d. Intraretinal hemorrhages

c

Which pathophysiologic cause of type 1 diabetes mellitus is correct? a. Insulin resistance of the body tissues b. Decreased mass count of pancreatic β-cells c. Autoimmune destruction of pancreatic β-cells d. Fatigued pancreatic β-cells due to overproduction of insulin

c

Which statement made by the patient indicates correct knowledge of the onset of action of the mealtime insulin aspart? a. "I will administer my aspart 30 minutes before mealtime." b. "I will administer my aspart 60 minutes before mealtime." c. "I will administer my aspart within 15 minutes of eating my meal." d. "I will administer my aspart 30 minutes after the conclusion of my meal."

c

A patient with type 2 diabetes who takes oral hypoglycemics at home is admitted to the hospital with an infection and asks why insulin injections have been prescribed. Which explanation would the nurse provide? a. Insulin acts synergistically with the antibiotic that was prescribed. b. Insulin should have been prescribed for the patient to take at home. c. Oral hypoglycemic medications are contraindicated in patients with infections d. The infection increases the glucose level, resulting in a need for more insulin.

d

After admitting a patient with diabetic ketoacidosis (DKA) to the emergency department, which nursing intervention is a priority? a. Administer IV insulin b. Administer oxygen c. Insert a Foley catheter d. Establish IV access

d

After discussing prevention of type 1 diabetes complications with the nurse, the patient is correct when making which statement? a. "I must limit fats in my diet to help prevent neuropathy." b. "I should use a hot water bottle on my feet when they feel cold." c. "I should have an eye examination at least once every two years for glaucoma screening." d. "It is important that I take my blood pressure medication to help prevent kidney damage."

d

Which foods would the nurse encourage a patient with diabetes mellitus and coronary artery disease to limit intake of to help reduce the percentage of saturated fat in their diet? a. Chicken and turkey b. Frozen and canned vegetables c. Enriched flour products d. Dairy products

d

Which intervention will be beneficial for a patient with a blood glucose level of 250 mg/dL who is receiving treatment for hyperosmolar hyperglycemic syndrome? a. Administering 0.9% NaCl b. Administering 0.1 unit/kg/hr of insulin c. Administering IM glucagon d. Administering IV fluids containing glucose

d

Which is a symptom of autonomic neuropathy? a. Aphasia b. Glaucoma c. Paresthesia d. Gastroparesis

d

Which is an insulin-dependent diabetes? a. Prediabetes b. Gestational diabetes c. Adult-onset diabetes d. Juvenile-onset diabetes

d

Which statement made by the patient with diabetes mellitus indicates that further education regarding exercise is required? a. "I should exercise about 30 minutes five days a week." b. "Because I take insulin daily, I should exercise about one hour after eating a meal." c. "Exercise will help me to lose weight, which will help my body to better use insulin." d. "It is especially important that I exercise if my blood sugar is above 250 mg/dL and my urine is positive for ketones."

d

Who can serve as a health care proxy? a. A blood relative b. A family member c. A domestic partner d. Anyone the patient chooses

d

When teaching the patient how to self-administer subcutaneous insulin, which instruction would the nurse include in the teaching plan? a. "At home, you must use an alcohol swab on the site before self-injection." b. "If you are planning on going jogging, you should use the thigh injection site to administer insulin." c. "You should use one site for insulin injections so you get used to the process of administering insulin." d. "Avoid injecting insulin intramuscularly because rapid and unpredictable absorption could result in hypoglycemia."

d apparently alcohol swab no longer recc.