Chapter 21: Nutrition for Clients with Diabetes Mellitus

A client with diabetes mellitus has received instructions about sick-day management. Which client statement requires the nurse to intervene?

"I will increase the amount of carbohydrate intake."

A client who has been hospitalized with type 2 diabetes is to be discharged. Which teaching will the nurse provide for the client to be able to eat at restaurants?

"Select items that are baked or grilled."

Which nursing response is appropriate when a client reports wanting to use aspartame to sweeten tea?

"This product can be used in moderation."

A female client with type 1 diabetes has received diet teaching from the nurse. Which client statement requires further teaching by the nurse?

"I may consume two alcoholic drinks per day."

The nurse has taught a client about the signs and symptoms and treatment of hyperglycemia. Which statement by the client reflects an accurate understanding of this complication?

" I should attain and maintain a reasonable weight."

A client with type 2 diabetes is having a problem with hypoglycemia. The client asks the nurse which antidiabetic medications do not cause hypoglycemia. Which of the following responses by the nurse is best?

"Biguanides have the lowest risk of hypoglycemia when used as monotherapy."

A client with diabetes comes to the clinic, and the nurse is responsible for nutrition counseling. When the client says that she has eliminated all carbohydrates from her diet, the nurse should respond:

"Carbohydrate is the main nutrient influencing your blood sugar levels, but that doesn't mean that you should totally avoid carbohydrates."

A client reports enjoying vegetables and disliking most grains. Which suggestion will the nurse make to improve the client's nutrition intake?

"Choose starchy vegetables like potatos, corn, and peas to meet your grain requirement."

The nurse has just completed teaching a client with diabetes and chronic kidney disease about dietary restrictions. Which client statement demonstrates that teaching has been effective?

"Fruits and vegetables are healthy diet choices."

A client has chosen to undertake the exchange diet. If the client decided to choose 1/2 cup of unsweetened juice, which of the following statements by the nurse would be CORRECT?

"Half a cup of unsweetened juice provides 15 grams of carbohydrate."

A nurse is caring for a client who had hyperlipidemia as a result of low levels of high-density lipoproteins. What suggestion should the nurse offer to increase HDL level?

"Have a regular exercise routine."

The nurse is teaching a client with diabetes regarding hypoglycemia. Which statement by the client indicates the need for further instruction?

"I have a busy job and eat at unpredictable times every day."

A client asks the nurse how to proceed when their fasting glucose level prior to exercise is 72 mg/dL. How will the nurse respond?

"To avoid hypoglycemia, consume 15-30 grams of carbohydrates before exercise."

The nurse has finished teaching a client with diabetes about nutrition planning. Which meal, chosen by the client, indicates that further teaching is needed?

1 cup yogurt with fruit, 2 biscuits with 1 tablespoons butter, 2 scrambled eggs

The nurse has noted a client whose blood glucose is 62 mg/dL. Which intake will the nurse provide to the client per the "15-15 Rule"?

1/2 cup apple juice

A client receiving insulin is instructed by the nurse to monitor carbohydrate intake. Teaching has been effective when the client identifies which food choice as equivalent to one carbohydrate choice? Select all that apply.

1/2 cup unsweetened pears One cup of milk One small banana

The nurse educator starts a nutrition class by discussing the prevalence of diabetes among different races and ethnicies. Which individual does the nurse identify that would be most likely to be diagnosed with type 2 diabetes, based on evidence?

57-year-old African American

Which serum glucose laboratory report does the nurse interpret as indicative of hypoglycemia?

66 mg/dL

An adolescent with type 2 diabetes who is overweight will be placed on a lifestyle intervention program to lose approximately which percentage of body weight?

7-10%

The nurse is educating a client who has type 2 diabetes regarding carbohydrate counting. Which of the following statements should the nurse make?

All of the above are correct.

A nurse is caring for a client who wants to follow the 1800-calorie meal plan. Which food choice will the nurse recommend? Select all that apply.

Apple Tofu Spinach Whole wheat bread

A nurse is caring for a client with diabetes who is hospitalized for glucose stabilization. Which intervention will the nurse provide to support nutrition?

Assure consistent timing of meals and snacks

Discharge planning for a client with diabetic kidney disease will include which of the following dietary principles?

Avoid a high-protein diet.

Which of the following is CORRECT regarding nutrition recommendations for controlling diabetes complications?

Both A and B are correct.

The nurse is teaching a client with diabetes ways to eat better to reduce cardiovascular risk. Which recommendation will the nurse make?

Choose lean cuts of meat

A client with diabetes received lab results showing a total cholesterol level of 220 mg/dL, HDL 38 mg/dL, and LDL 140mg/dL. Which food choice will the nurse encourage the client to avoid as the priority?

Coconut oil

When caring for four clients, which client condition does the nurse identify as being at the highest risk for hyperosmolar hyperglycemic state (HHS)?

Dehydrated after mowing lawns for several days in the sun

A nurse is caring for a client with poorly controlled type 1 diabetes. The nurse will assess for which complication?

Diabetic ketoacidosis

A client newly diagnosed with type 2 diabetes reports enjoying hot tea that is sweet. Which sweetener will the nurse teach the client to avoid?

Fructose

The public health nurse is providing education at a community center about risk factors for type 2 diabetes. What predisposing factor for developing type 2 diabetes will the nurse discuss? Select all that apply.

History of gestational diabetes Previous diagnosis with prediabetes Hypertension Obesity

A nurse is assigned to care for a client with diabetes who has a diet high in saturated fats. What information should the nurse provide to the client about the detrimental effect of a high-fat diet?

It increases the risk of diabetic complications.

The nurse is caring for a client with type 1 diabetes. Which teaching will the nurse provide to help the client avoid hypoglycemia?

Keep a carbohydrate source on the nightstand in case hypoglycemia develops at night.

A 20-year-old client who has come to the clinic reports frequent excessive urination, excessive thirst, and an increased appetite that has taken place over the past few months. Which disorder does the nurse anticipate the client may have?

Type 1 diabetes

Which of the following statements is CORRECT about type 1 and type 2 diabetes?

Type 2 can occur at any age and accounts for 90% to 95% of diagnosed cases of diabetes.

A nurse is caring for a client with diabetic ketoacidosis. The nurse will monitor for which gastrointestinal symptom frequently caused by acidosis?

Vomiting

The nurse recognizes that management of diabetes involves keeping blood sugar levels as close to normal as possible without causing hypoglycemia. This can usually be accomplished with which of the following interventions?

a combination of medications, exercise and diet

Alcohol is more likely to cause hypoglycemia when consumed without food rather than with food. This statement is:

correct

Type 2 diabetes may go undiagnosed for years. This statement is:

correct.

A nurse should recognize which symptom as a cardinal sign of type 1 diabetes mellitus?

frequent urination

When developing a teaching plan for a client who is taking insulin, which of the following should the nurse suggest to counter mild hypoglycemia? Select all that apply.

glucose tablets glucose gel regular soft drink fruit juice

Risk factors for type 2 diabetes include all of the following EXCEPT:

greater than 35 years old

A client has recently been diagnosed with type 2 diabetes and asks the nurse for help formulating a nutrition plan. Which of the following would the nurse recommend to help the client manage his condition? Select all that apply.

nonnutritive sweeteners are safe when used within daily intake levels. Eat an adequate intake of fiber from a wide variety of sources. Limit your saturated fat to 7% of total calories.

A nurse is caring for a client who wants to consume monounsaturated fats in his diet. What should the nurse recommend the client include in the diet?

olive oil

A 44-year old client has type 2 diabetes with cardiovascular complications and must follow a special diet. Which food is allowed in this diet?

plant-based proteins

The nurse is educating a 65-year-old client before his discharge on how to prevent complications of diabetes. Which of the following factors that may accelerate the deleterious effects of diabetes should the nurse tell the client to avoid? Select all that apply.

saturated fat intake smoking obesity high blood pressure

The nurse is teaching a client about nutrition in diabetes management. What should be the target goal?

to keep blood glucose levels as near normal as possible

The nurse recognizes which type of diabetes is characterized by the absence of insulin secretion?

type 1 diabetes

The nurse is facilitating a nursing class regarding the difference between type 1 and type 2 diabetes. Which type of diabetes has the risk factors of family history, increasing age, obesity, physical inactivity, ethnicity, and a history of gestational diabetes?

type 2

The nurse explains that a client's condition can be controlled primarily through diet, exercise, and oral antidiabetic agents. This client is most likely has which of the following diagnoses?

type 2 diabetes.

The nurse recognizes that the type of diabetes that is controlled primarily through diet, exercise, and oral antidiabetic agents is which type?

type 2 diabetes.

A nurse is conducting a seminar on basic nutrition and is teaching about the different groups of carbohydrates. Which should the nurse identify as recommended sources of carbohydrates for managing diabetes?

whole grains, legumes, low-fat milk