Concepts 4 study questions

0820

A nurse administers pramlintide at 0800 to a client who has type 1 diabetes mellitus. At which of the following times should the nurse expect the drug to exert its peak action? -0820 -0900 -1030 -1100

0900

A nurse administers subcutaneous and PH Insulin at 0700 to a child who has diabetes. At which of the following times should the nurse observe for hypoglycemia caused by the onset of the medication? -0715 -0730 -0900 -1200

Hypotension

A nurse at a providers office is assessing a client who has been taking Hydrocortizone for adrenal insufficiency. The client reports fatigue and feeling overwhelmed by personal responsibilities. Which of the following findings should the nurse identify as an indication the provider might need to increase the clients dosage? -hypotension -hyperglycemia -Weight gain -fat redistribution

liver function tests

A nurse is caring for a client who has been taking acarbose for type 2 diabetes mellitus. Which of the following laboratory tests should the nurse plan to monitor? -WBC -Amylase -Platelet count -liver function tests

Tremors

A nurse is caring for a client who has capillary blood glucose 48 mg/dL. Which of the following findings should the nurse expect? -tremors -flushed skin -bradycardia -Decreased appetite

Beta blockers

A nurse is caring for a client who is about to begin insulin glargine therapy. The nurse should identify the need for additional precautions because the client also takes which of the following types of drugs? -oral contraceptives -calcium supplements -beta blockers -Iron supplements

1500

A nurse is caring for a client who is prescribed 15 units of NPH Insulin to be administered at 0700. Which which of the following times of day is most appropriate for the nurse plan to offer a snack? -0730 -0900 -1230 -1500

4 to 14 hr

A nurse is preparing to administer a clients for clothes and one at 0730. The nurse should expect this type of insulin to peak within which of the following time frames after administration? -30 min to 3 hours -1 to 5 hr -4 to 14 hr -2 to 6 hr

Urine output

A nurse is caring for a client who is taking desmopressin. The nurse should make which of the following assessments to evaluate the drugs effectiveness? -peripheral pulses -urine output -skin integrity -Blood glucose

lactic acidosis

A nurse is caring for a client who is taking metforman to treat type two diabetes mellitus and reports muscle pain. Which of the following adverse reactions should the nurse expect? -lactic acidosis -anticholinergic effects -Extrapyramidal effects -hypophosphatemia

Skip the dose

A nurse is caring for a client who takes repaglinide 15 to 30 min before each meal to treat type 2 diabetes mellitus. The client asks, " if I skip a meal, what should I do?" Which of the following responses should the nurse make? -double the dose before the next meal -take half the dose -skip the dose -take the usual dose

I will continue to check his blood sugar two times every day

A nurse is caring for a seven-year-old client who has an upper respiratory infection and a history of type 1 diabetes mellitus. Which of the following statements by the mother indicates a need for further instruction? -I will encourage him to drink a half a cup of water or sugar-free fluid every 30 minutes -I will report a change in breathing or signs of confusion -I will notify the doctor if his temperature is not controlled with acetaminophen -I will continue to check his blood sugar two times every day

Fasting blood glucose 155 mg/dL

A nurse is checking the laboratory results of a client who is at risk for diabetes mellitus. Which of the following laboratory results indicates to the nurse that the client is at risk for diabetes mellitus? -HbA1c 5.2% -2-hr blood glucose 132 mg/dL -fasting blood glucose 155 mg/dL -casual blood glucose 178 mg/dL

Regular

A nurse is collecting data from a client who has diabetes mellitus. The client is confused, flushed, and has an acetone odor on his breath. The nurse should anticipate a prescription for which of the following types of insulin to treat the client? -Detemir -Regular -Glargine -NPH

Inject insulin lispro 15 minutes before a meal

A nurse is preparing to administer insulin lispro to a client who has type 1 diabetes mellitus. Which of the following actions should the nurse plan to take? -check the client for hypoglycemia four hours after the Insulin lispro injection -inject insulin lispro 15 minutes before a meal -Monitor the client for polyuria after the insulin lispro injection -administer insulin lispro in the same syringe as a short acting insulin

Give the insulin 30 min before breakfast

A nurse is preparing to administer subcutaneous regular insulin to a client before he eats breakfast at 0800. Which of the following actions should the nurse take? -give the insulin at 0700 -give the insulin when the breakfast tray arrives -give the insulin 30 minutes after breakfast with other routine medications -give the insulin at 30 min before breakfast

I should not take my regular insulin when I am sick

A nurse is providing teaching to a school age child who has a new diagnosis of type one diabetes mellitus. Which of the following statements by the child indicates a need for additional teaching? -I will test my blood sugar before meals and at bedtime -I should eat a snack before I play soccer -I should not take my regular insulin when I am sick -I will rotate injection sites within my abdominal area

Carbohydrates should comprise 45 to 65% of daily caloric intake

A nurse is reinforcing discharge teaching about nutrition with a client who has a new diagnosis of diabetes mellitus. Which of the following statements should be included in the teaching? -carbohydrate intake should be limited to 110 g per day -protein intake has the greatest effect on after meal blood glucose levels -carbohydrates should comprise 45 to 65% of daily caloric intake -Proteins should comprise 10% of daily caloric intake

Headache

A nurse is reinforcing teaching about manifestations of hypoglycemia with an adolescent who has type 1 diabetes mellitus. Which of the following manifestations should the nurse include in the teaching? -headache -acetone breath -rapid respirations -Diminished reflexes

Eat more iron rich foods

A nurse is teaching a client about acarbose therapy to treat type 2 diabetes mellitus. Which of the following instructions should the nurse include? -eat more iron rich foods -avoid drinking grapefruit juice -increase fiber intake -Avoid drinking green tea

4 ounces of regular soda

A nurse is caring for a client who has type 1 diabetes mellitus and observes mild hand tremors. Which of the following snacks should the nurse offer the client after obtaining a glucometer reading of 60 mh/dL? -4 ounces of regular soda -1 to 2 oral glucose tablets -3 to 4 pieces of hard candy -6 ounces of milk

Non-nutritive sugar substitute

A nurse is caring for a client who has type one diabetes mellitus. Which of the following should the nurse recommend to the client as an appropriate sweetener? -corn syrup -natural honey -non-nutritive sugar substitute -Agave nectar

I can inject my insulin detemir in the evening before bedtime

A nurse is reinforcing teaching for a client who has diabetes mellitus and has a prescription for insulin detemir injections once daily. Which of the following statements by the clinical indicates an understanding of the teaching? -if my blood sugar is high, I can mix a dose of regular insulin with my insulin detemir -I should inject my insulin detemir 30 min before a meal to lower my blood sugar -I can inject my insulin detemir in the evening before bedtime -I don't have to worry about hypoglycemia while taking insulin detemir

Alcohol

A nurse is reinforcing teaching to a client who has diabetes mellitus and is to start taking chlorpropamide. The nurse should teach the client to avoid consumption of which of the following while taking this medication? -grapefruit -milk -alcohol -shellfish

I should drink a glass of milk when I am feeling irritable

A nurse is reinforcing teaching with a child who has type one diabetes mellitus about self-care. Which of the following statements by the child indicates understanding of the teaching? -I should skip breakfast when I am not hungry -I should increase my insulin with exercise -I should drink a glass of milk when I am feeling irritable -I should draw up the NPH insulin into the syringe before the regular insulin

Somnolence

A nurse is reinforcing teaching with a client who has a new prescription for Metformin. Which of the following findings should the nurse instruct the client to report as an adverse effect of Metformin? -Somnolence -Constipation -Fluid retention -Weight gain

Weight loss

A nurse is collecting data from a client who has type 1 diabetes mellitus. Which of the following findings should the nurse expect? -blurred vision -pruritus -Weight loss -Drowsiness

Prednisone

A nurse is collecting data from a client who takes Metformin for type 2 diabetes. Which of the following medications is contra indicated for this client do its effect on blood glucose levels? -Ranitidine -Cephalexin -prednisone -levothyroxine

The client refuses breakfast and requests to sleep

A nurse is discussing the care of a client who has type 1 diabetes mellitus with an assistive personnel (AP). Which of the following situations should the nurse instruct the AP to report immediately? -The client reports dizziness when standing -The client refuses breakfast and requests to sleep -The client asks the AP to trim his broken toenail -The client reports urine that is dark yellow in color

History of poor wound healing

A nurse is in a providers office collecting data from an older adult client who has type 2 diabetes Mellitus. Which of the following findings is a manifestation of hyperglycemia? -clammy skin -history of poor wound healing -Report of decreased urinary output -Random blood glucose 126 mg/dL

42 units

A nurse is prepared to administer morning insulin to a client who has a prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneous daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe? -14 units -28 units -32 units -42 units

Wrap the hand in a warm, moist cloth

A nurse attempting to collect a capillary blood specimen via fingerstick for blood glucose monitoring is unable to obtain an adequate drop of blood for the reagent strip. Which of the following actions should the nurse take first? -puncture another finger to obtain a capillary specimen -test the urine with a urine reagent strip -wrap the hand in a warm, moist cloth -perform a venipuncture to obtain a Venous sample

Weight gain

A nurse is caring for a client who is taking pioglitazone to treat type 2 diabetes mellitus. The nurse should monitor for which of the following findings? -joint pain -constipation -Weight gain -dilated pupils

polydipsia

A nurse is collecting data from a client who has diabetes mellitus. Which of the following findings indicates that the client is experiencing DKA? -polydipsia -clammy skin -confusion -Rapid pulse

My son might have nausea and vomiting with hypoglycemia

A nurse is reinforcing discharge teaching with a parent of a child who has a new diagnosis of diabetes mellitus. Which of the following statements by the parent requires a clarification of the teaching? -The onset of low blood glucose usually occurs rapidly -my son might complain of feeling shaky when he has a low blood glucose level -sweating can occur with hypoglycemia -My son might have nausea and vomiting with hypoglycemia

I will check blood glucose every four hours when I am sick

A nurse is reinforcing teaching about glucose monitoring with a client who has type one diabetes mellitus. Which of the following statements by the client indicates understanding of the teaching? -I will check my urine once a day for glucose -I will notify my provider if preprandial glucose is more than 120 mg/dL -I will check blood glucose every four hours when I am sick -I will check blood glucose 20 minutes after I treat a hypoglycemic episode

Rotate the injection site to keep insulin levels consistent

A nurse is reinforcing teaching about insulin injections with a client who is newly diagnosed with type 1 diabetes mellitus. Which of the following information should the nurse include about site selection? -rotate the injection site to keep insulin levels consistent -use cold insulin for injections to minimize site pain -insulin is absorbed most rapidly when injected in the thigh -Massage the site after injection to promote absorption

I will be sure my child aspirates before injecting the insulin

A nurse is reinforcing teaching about self administration of insulin with a parent have a school age child who has a new diagnosis of diabetes mellitus. Which of the following statements by the parent indicates a need for further teaching? -I will be sure my child aspirates before injecting the insulin -The insulin can be injected anywhere there is adipose tissue -I will be showing my child rotate sites after five injections in one area -The insulin should be injected at a 90° angle

I will be more thirsty than usual

A nurse is reinforcing teaching about the manifestation of hyperglycemia is a client who has diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching? -I might experience blurry vision at times -I will be more thirsty than usual -my breath may have a fruity odor -My appetite will be decreased

Glipizide stimulates to pancreas to release adequate Insulin

A nurse is reinforcing teaching for a client who has type 2 diabetes mellitus and is prescribed glipizide. The client should be taught that glipizide works in which of the following ways? -Glipizide promotes the breakdown of glycogen to glucose -Glipizide stimulates the pancreas to release adequate insulin -Glipizide blocks glucose production in the liver -Glipizide slows gastric emptying and decreases appetite

sedentary lifestyle

A nurse is reinforcing teaching of a female client who has a family history I have type 2 diabetes mellitus. The nurse should include which of the following risk factors for developing type two diabetes mellitus in the teaching? -recent viral infection -blood glucose of 98 mg/dL -triglyceride level of 100 mg/dL -Sedentary lifestyle

Inject pramlintide just before a meal, discard open vials after 28 days

A nurse is reinforcing teaching with a client who has a prescription for pramlintide for type one diabetes mellitus. Which of the following information should the nurse include? (Select all that apply) -take oral medications 30 minutes before injection -use of upper arms as a preferred injection sites -mix pramlintide with breakfast dose of insulin -inject pramlintide just before a meal -discard open vials after 28 days

I should eat more calories from complex carbohydrates than anything else

A nurse is reinforcing teaching with a client who has diabetes about which dietary source should provide The greatest percentage of her calories. Which of the following client statements indicates an understanding of the teaching? -most of my calories each day should be from fats -I should eat more calories from complex carbohydrates than anything else -simple sugars are needed more than other calorie sources -Proteins should be my main source of calories

It is best for you to drink an occasional glass of wine with a meal

A nurse is reinforcing teaching with a client who has diabetes mellitus And self administer insulin. The client reports drinking and occasional glass of wine. Which of the following is an appropriate response by the nurse? -wine is loaded with carbohydrates, so you should try to avoid it -you may have no more than three drinks a day -drinking plenty of water with your wine the lesson it's effects -It is best for you to drink and occasional glass of wine with a meal

I will feel shaky

A nurse is reinforcing teaching with a client who has diabetes mellitus I thought the manifestations of hypoglycemia. Which of the following statements by the client indicates an understanding of the teaching? -I will feel shaky -I will be more thirsty than usual -my skin will be warm and moist -My appetite will be decreased

Unopened vials of insulin should be kept in my refrigerator

A nurse is reinforcing teaching with a client who has diabetes mellitus and a new prescription for a lispro and Lantis insulin's. Which of the following statements by the client indicates an understanding of the teaching? -insulin injected into the thigh is the most rapidly absorb -unopened vials of insulin should be kept in my refrigerator -I should shake the bottle of insulin before withdrawing the medication -I will use Lantis Insulin immediately before each meal

Administer your usual daily dose of insulin

A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus about self-care during illness. Which of the following instructions should the nurse include in the teaching? -test your blood glucose level every six hours -administer your usual daily dose of insulin -Report a blood glucose level greater than 300 -Limit juices, soda, and gelatin

I should inject the insulin into my abdominal area

A nurse is reinforcing teaching with a client who has type one diabetes Mellitus. Which of the following statements from the client indicates to the nurse the teaching is effective? -I will shake the insulin vile vigorously to mix -I will freeze unopened insulin vials -I should increase my insulin when I exercise -I should inject the insulin into my abdominal area

I'll take this medicine 30 minutes before I eat

A nurse is reinforcing teaching with a client who has type two diabetes mellitus and is starting repaglinide. Which of the following statements by the client indicates understanding of the administration of this medication? -i'll take this medication after I eat -i'll take this medicine 30 minutes before I eat -i'll take this medicine just before I go to bed -i'll take this medication at least one hour before I eat

I will reduce my exercise schedule to three days a week

A nurse is reinforcing teaching with a client who is in her second trimester and has a new diagnosis of gestational diabetes. Which of the following statements by the client indicates a need for further teaching? -I should limit my carbohydrates to 50% of my daily caloric intake -I will reduce my exercise schedule to three days a week -I will take my glyburide with breakfast -I know I am at increased risk to develop type 2 diabetes

Take the medication with a meal

A nurse is reinforcing teaching with a client who is taking metforman XR for type 2 diabetes mellitus. Which of the following information should the nurse include in the teaching? -take the medication with a meal -you may crush or chew the medication -this medication can cause an increase in perspiration -this medication can turn your urine orange

Discard regular insulin if it appears cloudy

A nurse is reinforcing teaching with a client who is to self administer regular insulin and NPH Insulin from the same syringe. Which of the following instructions should the nurse provide? -draw up the NPH Insulin into the syringe first -inject air into the regular insulin first -shake the NPH insulin until it is well mixed -Discard regular insulin if it appears cloudy

You should give four to six injections in one area before switching sites

A nurse is reinforcing teaching with a school age child who has diabetes mellitus about insulin administration. Which of the following instructions should the nurse include? -you should inject a needle at a 30° angle -you should combine your glargine and regular insulin in the same syringe -you should aspirate for blood before injecting the insulin -you should give 4 to 6 injections in one area before switching sites

Test the urine for ketones

A nurse is reinforcing teaching with a school age child who has type 1 diabetes mellitus and his parents about illness management. Which of the following instructions should the nurse include? -withhold insulin dose if feeling nauseous -notify the provider if blood glucose levels are over 350 mg/dL -test the urine for Ketones -Limit fluid intake during meal time

Obtain an influenza vaccine annually

A nurse is reinforcing teaching with an adolescent who has type 1 diabetes mellitus. Which of the following instructions should the nurse include in the teaching? -administer glucagon for hyperglycemia -obtain an influenza vaccine annually -inject insulin in the deltoid muscle -Take glyburide with breakfast

Regular insulin

A nurse is reinforcing teaching with clients about the use of insulin to treat type one diabetes mellitus. For which of the following types of insulin should the nurse tell the clients to expect a peak effect 1 to 5 hr after administration? -Insulin glargine -NPH insulin -Regular insulin -insulin lispro

Reinforce instruction about insulin administration

A nurse is reviewing laboratory results from a client who is at 28 weeks of gestation and has gestational diabetes. The nurse notes that blood glucose levels taken one hour following a meal range from 145 mg/dL to 162 mg/dL over the past week. Which of the following actions should the nurse take? -obtain an HbA1c -schedule a three hour oral glucose tolerance test -reinforce instruction about insulin administration -Tell the client to increase carbohydrates to 65% of daily nutritional intake

Diuretics, corticosteroids, antipsychotics

A nurse is reviewing the medical record of a client who had a blood glucose of 260 mg/dL and no documented history of diabetes mellitus. Which of the following types of medications can cause hyperglycemia has an adverse effect? (Select all that apply) -diuretics -corticosteroids -oral anticoagulants -opioid analgesics -antipsychotics

Perform a fingerstick blood glucose check

A nurse is speaking with a client who is taking glipizide to treat type 2 diabetes mellitus aunt has called to report feeling shaky, hungry, and fatigued. Which of the following actions should the nurse instruct the client to take? -drink 16 ounces of water -perform a fingerstick blood glucose check -take another glipizide tablet -Lie down and rest

Lipohypertrophy

A nurse is teaching a client about self administering regular insulin. The nurse should instruct the client to rotate injection sites to prevent which of the following? -rapid absorption -Intradermal injection -injection pain -lipohypertrophy

Hold the test strip next to the blood on the fingertip

A nurse is teaching a client how to check blood glucose levels. The nurse should include which of the following instructions about transferring blood on to the reagent portion of the test strip? -smear the blood onto the strip -Squeeze the blood onto the strip -Touch the puncture to stimulate bleeding -Hold the test strip next to the blood on the fingertip

Avoid drinking alcohol

A nurse is teaching a client who has a prescription for glipizide therapy to treat type 2 diabetes mellitus. Which of the following instructions should the nurse include? -avoid drinking alcohol -sit or stand for 30 minutes after taking the drug -urinate every 4 hours -take the drug 2 hours after a meal

Administer pramlintide before meals

A nurse is teaching a client who has a prescription for pramlintide therapy to treat type one diabetes mellitus. Which of the following instructions should the nurse include? -mix pramlintide with insulin in the syringe -administer pramlintide before meals -take Pramlintide once daily at bedtime -Inject pramlintide into the upper arm

I can keep the current file of insulin in use stored at room temperature

A nurse is teaching a newly licensed nurse about insulin storage. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? -I will store unopened vials of insulin in the freezer -I will return any unused files of insulin to the pharmacy once they have been on the unit for one month -I will discard the current file of insulin after six doses have been withdrawn -I can keep the current file of insulin in use stored at room temperature

Hold the hand in a dependent position prior to the puncture, place the puncturing device perpendicular to the site, prick the outer edge of the fingertip for the blood sample

A nurse is teaching self monitoring of blood glucose (SMBG) to a client who has diabetes mellitus . Which of the following instructions should the nurse include? (Select all that apply) -perform SMBG once daily at bedtime -wipe the hand with an alcohol swab -hold the hand in a dependent position prior to the function -placed the puncturing device perpendicular to the site -Prick the outer edge of the fingertip for the blood sample

diaphoresis

A nurse is teaching the parents of a child who has diabetes mellitus about the manifestations of hypoglycemia. Which of the following manifestations should the nurse include in the teaching? -fruity breath odor -dry mucous membranes -polyuria -diaphoresis

Diaphoresis and tachycardia

A nurse mistakenly administers a dose of Metformin within 1 hour of the previous dose. Which of the following findings should alert the nurse that the client is experiencing an adverse effect from the medication error? -confusion and lethargy -rapid and deep respirations -diaphoresis and tachycardia -Nausea and abdominal cramping

renal impairment

A nurse should recognize that a provider will prescribe a lower dose of sitagliptin for a client who has type 2 diabetes mellitus and who also has which of the following? -thyroid disease -bronchitis -heart failure -Renal impairment

Your body doesn't process glucose well

And adult client newly diagnosed with type 2 diabetes mellitus asks the nurse to explain how he developed the condition. Which of the following responses should the nurse make? -your body's immune system has destroyed cells in your pancreas -your body doesn't process glucose well -your body will continue producing too much insulin without medicine to counteract it -your body's hemoglobin is not binding to the sugar you consume

Glucagon

Which of the following drugs shut the nurse have available for a client who is experiencing insulin toxicity? -naloxone -diphenhydramine -acetylcysteine -glucagon