Unit 2 Exam review (Diabetes) - Health and Illness I
The nurse is caring for a client with an episode of hypoglycemia. Which of the following requires correction by the charge nurse? 1.Assessing blood glucose level 2.Providing the client with 30 g of carbohydrates 3.The nurse teaches the client how to prevent hypoglycemia 4.The nurse withholds the scheduled insulin and notifies the health-care provider
. 2. Providing the client with 30 g of carbohydrates Only 15 g of carbohydrates should be given; then the blood glucose should be reassessed.
The nurse knows a patient with type 1 diabetes needs more education when a patient makes which of the following statements? 1. " I must take insulin pills for the rest of my life." 2. "I will count my carbohydrates at each meal and snack" 3. "I will monitor my feet carefully every day" 4. "I will try to keep my blood glucose between 70 and 130 mg/dL before meals.
1. "I must take insulin pills for the rest of my life" Insulin cannot be taken by mouth because it is a protein. Must inject insulin daily
Which statements by the patient with a new diagnosis of diabetes show understanding of instruction related to leading a healthy life and preventing complications? Select all that apply 1. "I should have a yearly eye examination." 2. "I must check my feet daily" 3. "I should aim to keep my premeal blood glucose readings under 130 mg/dL" 4." I will avoid all sweets and simple carbohydrates"
1. "I should have a yearly eye examination." Diabetes can caused blurred vision. 2. "I must check my feet daily" Diabetics are prone to foot complications 3. I should aim to keep my premeal blood glucose readings under 130 mg/dL" The ADA recommends that most patients maintain a preprandial (premeal) BG level of 80 to 130mg/dL
The nurse is teaching a client about self-administration of insulin. Which statement made by the client indicates an understanding of the teaching? 1. "I will rotate insulin injection sites every week." 2."I will space out injections 0.5 inches from the previous injection." 3."I will aspirate for blood with each injection." 4."I need to rub the site after injecting the insulin."
1. "I will rotate insulin injection sites every week."
The nurse is teaching a client about fast-acting sources of sugar. Which of the following should the nurse include in the teaching? Select all that apply. 1.4 oz orange juice 2.4 oz diet soda 3.8 oz whole milk 4.1 hard candy 5.Miniature box of raisins
1. 4 oz orange juice 4 oz of orange juice are a source of fast sugar. 5.Miniature box of raisins This is a source of fast sugar.
For which of the following blood glucose results would the nurse administer a "fast sugar"? 1. 48 2. 80 3. 126 4 .223
1. 48
A nursing home resident with a long history of diabetes requests a heating pad for cold, numb feet. What is the best response by the nurse? 1."Lets soak your feet in hot water instead, that might be safer." 2." Let's elevate your feet to promote circulation and provide more warmth." 3. "I will bring you a heating pad; it will help your circulation in your feet." 4. " A heating pad can cause burns, but I can bring you some extra socks."
4. " A heating pad can cause burns, but I can bring you some extra socks." Using anything hot on the skin can cause burns and can lead to infection.
A client with type 2 diabetes is undergoing surgery and is prescribed insulin while in the hospital. The client states that they do not take insulin and refuse the insulin. Which action by the nurse is best? 1.Explain why the insulin is being given at this time 2.Administer the insulin while the client is asleep 3.Change the insulin to an oral hypoglycemic agent 4.Withhold meals until the client takes the insulin
1. Explain why the insulin is being given at this time This action is best; if the nurse explains why the insulin is being given at this time, the client may agree to take it. A patient has the right to refuse medication.
The nurse is teaching a diabetic client about prevention of complications involving the eyes. Which of the following statements made by the client indicates an understanding of the teaching? 1."If I take my insulin like I am supposed to, it can reduce the risk of eye problems" 2."I should have an eye exam every other year." 3."High blood pressure can reduce the risk of eye disease." 4."There is no surgery available to improve my vision after a hemorrhage occurs."
1."If I take my insulin like I am supposed to, it can reduce the risk of eye problems" This statement is accurate; keeping blood glucose under control can reduce the risk of eye disease.
The nurse may find the following results of blood glucose testing during the peak action of insulin. Which of these results indicates a risk? 1.60 mg/dL 2.100 mg/dL 3.140 mg/dL 4.180 mg/dL
1.60 mg/dL The client is at risk for hypoglycemia during peak action times.
Which of the following orders would the nurse question in a client with type I diabetes? 1.Acarbose 2.Insulin lispro 3.Insulin regular 4.Insulin glargine
1.Acarbose Type I diabetics do not take oral antidiabetic agents.
A client with type 2 diabetes asks the nurse what long-term complications can occur. The nurse will include which of the following complications in the response? Select all that apply. 1.Diabetic retinopathy 2.Nephropathy 3.Hepatitis 4.Neuropathy 5.Foot problems
1.Diabetic retinopathy Diabetic retinopathy is caused by diseased small blood vessels; diabetes is a leading cause of blindness in diabetics. 2.Nephropathy Nephropathy is caused by damage to the tiny blood vessels in the kidneys; diabetes is the leading cause of end-stage renal disease. 5.Foot problems The combination of macrovascular disease, neuropathy, and risk for infection makes clients with diabetes prone to foot problems.
The nurse administers neutral protamine Hagedorn (NPH) insulin to a diabetic client. When should the nurse anticipate a hypoglycemic reaction to occur? 1.30-90 minutes 2.1-3 hours 3.2-5 hours 4.6-12 hours
2. 1-3 hours The nurse should anticipate a hypoglycemic reaction to occur during the peak time of 6-12 hours.
An obese adult patient is admitted to the hospital for shoulder repair. The nurse notes that the patient gets up four times during the night to urinate. Which action by the nurse is most important at this time? 1. Offer a bedside commode to the patient. 2. Request an order for a fasting blood glucose test. 3. Contact the dietitian for weight loss counseling. 4.Provide thorough perineal care after voiding
2. Request an order for a fasting blood glucose test. Constant urination (polyuria) is a sign/symptom of type 2 diabetes.
The nurse is teaching a client about oral hypoglycemic agents. Which statement made by the client indicates an understanding of the teaching? 1."I should take my insulin pill until the doctor tells me not to." 2."I should take my medicine before meals." 3."Since I'm taking this pill, I will never need insulin." 4."I should take only half a pill if my blood sugar is good."
2."I should take my medicine before meals." This statement is accurate; the medication should be taken before meals.
A client is discussing an insulin pump with the nurse. Which statement made by the client requires correction by the nurse? 1."The pump delivers insulin in small amounts through a catheter." 2."The catheter is placed in subcutaneous tissue and stays for 2 weeks." 3."I can add a bolus of insulin before meals or snacks." 4."I will insert the catheter in my abdomen."
2."The catheter is placed in subcutaneous tissue and stays for 2 weeks." This statement requires correction; the catheter stays for 2-3 days.
Diabetes is diagnosed when fasting blood glucose is greater than _________ mg/dL 1. 100 2. 200 3. 126 4. 180
3. 126
The nurse is caring for a client with hypoglycemia. Which clinical manifestations can the nurse expect to find? Select all that apply. 1.Dry skin 2.Irritability 3.Confusion 4.Seizures 5.Tremor
3. Confusion Clients with hypoglycemia are typically confused. 4. Tremor is a common finding in clients with hypoglycemia.
The nurse notes a fasting blood glucose (FBG) result of 160 mg/dL. Which condition does the nurse suspect? 1.Addison's disease 2.Hypothyroidism 3.Diabetes mellitus 4.Grave's disease
3. Diabetes mellitus An elevated FBG is indicative of diabetes.
The nurse is caring for a client with diabetes. Which of the following should the nurse report to the health-care provider? 1.Blood glucose of 110 mg/dL 2.Blood pressure of 112/72 3.Fever of 101.6° 4.Potassium level of 4.5 mEq/L
3. Fever of 101.6° The client has a fever, and diabetics are at high risk for infection.
The nurse is caring for a client with hyperosmolar hyperglycemic state (HHS). Which of the following interventions should the nurse implement? 1.Administer a glucose source 2.Restrict fluids 3.Administer 0.9% normal saline as ordered 4.Monitor blood glucose levels twice daily
3.Administer 0.9% normal saline as ordered Large amounts of IV fluid will be administered.
The nurse is caring for a client suspected of having diabetes mellitus. Which clinical manifestation is the nurse likely to find? 1.Hyperpigmentation of skin 2.Fat deposits on neck and shoulders 3.Dusky lower extremities with weak peripheral pulses 4.Exophthalmos
3.Dusky lower extremities with weak peripheral pulses This manifestation is indicative of diabetes mellitus (limited circulation).
The nurse is caring for a client who develops hypoglycemia. The client has dysphagia. Which of the following should the nurse administer? 1.4 oz orange juice 2.Glucose gel 3.Glucagon subcutaneously (SQ) 4.Miniature box of raisins
3.Glucagon subcutaneously (SQ) The nurse should administer glucagon SQ because the client has dysphagia. (difficulty swallowing)
The nurse is teaching a client about foot care. Which statement made by the client indicates the need for further education? 1."I will cut my toenail like the natural shape of the nail." 2."I should not go barefoot to avoid stepping on a nail." 3."I should not put lotion in between my toes." 4."I need to look at my feet once a week to see if I have sores."
4. "I need to look at my feet once a week to see if I have sores." Feet should be inspected daily for sores and red areas, not weekly.
The nurse is providing teaching for a client with type 2 diabetes. Which statement indicates an understanding by the client? 1."I should check my blood sugar 3 times daily like the doctor said." 2."I should eat a diet high in carbohydrates." 3."I should avoid exercise when possible." 4."If I feel like my blood sugar is high, I need to drink an orange juice."
4. "If I feel like my blood sugar is high, I need to drink an orange juice." This statement indicates an understanding that they are following the doctor's orders.
Which breakfast menu is most appropriate for a patient with diabetes? 1. Two eggs, two strips of bacon, orange juice, coffee 2. Oatmeal with artificial sweetener, whole-grain toast, tea 3. One half grapefruit, cranberry juice, bagel with sugar-free jelly 4. One slice whole grain toast with peanut butter, skim milk, orange juice.
4. One slice whole grain toast with peanut butter, skim milk, orange juice. The ADA recommends one quarter filled with starchy foods, such as whole grains, fruit, non or low-fat milk.
The nurse is administering an oral glucose tolerance test (OGTT). Which result indicates diabetes after 2 hours? 1.Blood glucose level of 100 mg/dL 2.Blood glucose level of 140 mg/dL 3.Blood glucose level of 180 mg/dL 4.Blood glucose level of 220 mg/dL
4.Blood glucose level of 220 mg/dL A blood glucose level of 200 mg/DL or higher in an OGTT is indicative of diabetes.
The nurse is caring for a client with symptoms of hyperglycemia. Which of the following interventions should the nurse implement first? 1.Administer 15 g of fast-acting carbohydrates 2.Administer glucagon subcutaneously as ordered 3.Encourage the client to skip a meal 4.Confirm hyperglycemia with a glucose meter
4.Confirm hyperglycemia with a glucose meter This is the first intervention the nurse should implement.
The nurse is administering lispro insulin to a client. When should the nurse administer the medication? 1. 1 hour before meals 2.30 minutes before meals 3.When trays arrive on the unit 4.When the client is eating
4.When the client is eating The nurse should wait until the client is eating before administering this insulin to prevent hypoglycemia.
