Diabetes Compilation
17. When is a patient most susceptible to hypoglycemic symptoms after the administration of insulin? A. Onset B. Peak C. Duration D. Duration & Peak
B
2. Which of the following is NOT a typical finding in HHNS? A. Dehydration B. Blood pH <7.35 C. Mental status changes D. Osmotic diuresis
B
a nurse is providing teaching to a client who has type 2 DM and is starting replaglinide. which of the following statements by the client indicates understanding of the administration of this medication? a. I will take this after I eat b. I will take this medicine 30 min before I eat c. I will take this medicine just before I go to bed d. I will take this medication at least 1 hour before I eat
B replaglinide causes a rapid short lived release of insulin. the client should take this medication within 30 minutes before each meal so that insulin is available when food is digested
a nurse is caring for a client who is taking acarbose to treat type 2 DM. for which of the following adverse effects of this medication should the nurse monitor the client? a. insomnia b. diarrhea c. joint pain d. polycythemia
B the most common adverse effects of acarbose, an alpha glucosidase inhibitor are gastrointestinal. they include diarrhea. abdomnial distention and cramping and flatulence.
the client diagnosed with type 1 diabetes is reporting a dry mouth, extreme thirst, and increased urination. which interventions should the nurse implement? SATA a. admin one amp of IV 50% glucose b. prepare to admin IV regular insulin c. inject insulin isophane subq in the abdomen d. hang an IV infusion of D5W at a keep open rate e. check clients blood glucose level via glucometer
B,E the clients signs and symptoms indicate the client is experiencing DKA which is treated with IV regular insulin these are S/S of DKA therefore checking the glucose level is an appropriate intervention
1. A patient is diagnosed with pheochromocytoma. From your nursing knowledge, you know that the patient will present with hypertension, sweating, and palpations due to excessive catecholamine production from the? A. Adrenal Cortex B. Adrenal Zona Fasciculata C. Adrenal Medulla D. Adrenal Glomerulosa
C
8. Which of the following is NOT a medical treatment for DKA and HHNS? A. IV regular insulin B. Istonic C. Bicarbonate D. IV potassium Solution
C
a nurse is caring for a client who has a blood glucose of 52. the client is lethargic but arousable, which of the following actions should the nurse perform first? a. recheck BS in 15 min b. provide a carb and protein food c. provide 15g of simple carbohydrates d.report findings to provider
C (ex of this would be grape juice)
a nurse is teaching clients about the use of insulin to treat type 1 diabetes mellitus. for which of the following types of insulin should the nurse tell the clients to expect a peak effect 1 to 5 hours after administration? a. insulin glargine b. NPH insulin c. regular insulin d. insulin lispro
C regular insulin has a peak affect around 1 to 5 hr following administration
a nurse is teaching a client who has DM about a new prescription for pioglitazone. which of the following statements should the nurse include in the teaching? a. monitor for hypoglycemia 6 hours after taking the medication b. this med cannot be taken if you have a sulfa allergy c. this medication can be taken when using insulin d. this med is effective for people with type 1 DM
C the client can tke pioglitazone when using insulin because pioglitazone increases the cellular response to insulin, and insulin is needed in order for the medication to be effective
the school nurse is teaching a class about type 2 diabetes in children to elementary school teachers which infrmation is most important for the nurse to discuss w teachers? a. importance of not allowing students to eat candy in the classroom b.increase innumber of students devloping type 2 diabetes c.signs and symptoms of hypoglycemia and the immeadiate tx d. students need to run or walk for 20 min during recess period
C the most important info for teachers to know is how to treat potentially life threatening complications secondary to the medications used to treat type 2 diabetes. the school nurse should discuss issues that keep the students safe
3. A patient has excessive catecholamines in the urine. Which of the following signs and symptoms would the patient NOT exhibit? SELECT-ALL-THAT-APPLY: A. Tachycardia B. Anxiety C. Hypoglycemia D. Thermogenesis E. Decreased Basal Metabolic Rate
C, E
10. A patient has a blood glucose of 400. Which of the following medications could be the cause of this? A. Glyburide B. Atenolol C. Bactrim D. Prednisone
D
4. A patient has a blood glucose of 45 and is sweating, cold, and clammy. The patient is conscious. What is your next nursing intervention? A. Recheck the blood glucose in 5 minutes. B. Give the patient 15 grams of a complex carbohydrate. C. No intervention is needed because this is a normal blood glucose. D. Give the patient 15 grams of a simple carbohydrate.
D
7. In regards to question 6, you are also educating the patient about the post-opt care for a bilateral adrenalectomy. Which statement by the patient indicates they understood your instructions? A. "I will have to take mineralocorticoids daily for 2 years." B. "I will have to take glucocorticoids and mineralocorticoids daily for 2 years." C. "When I experience signs of stress I will have to take mineralocorticoids as needed." D. "I will have to take glucocorticoids and mineralocorticoids daily for life."
D
A nurse is providing teaching to a client who has a prescription for pramliintide for type 1 DM. which of the following should the nurse include in the teaching (SATA) ? a. take oral meds 30 min before injection b. use upper arms as preferred injection sites c. mix pramlintide with the breakfast dose of insulin d. inject pramlitntide just before a meal e. discard open vials after 28 days
D,E pramlitide can cause hypoglycemia, especially when the client also takes insulin's it is important to eat a meal after injecting this medication unused med in the open pramlitide vial should be discarded after 28 days
2. A patient is found to have a blood glucose of 375 mg/dL, positive ketones in the urine, and blood pH of 7.25. Which condition is this?
DKA
8. What statement or statements are INCORRECT regarding Diabetic Ketoacidosis? A. DKA occurs mainly in Type 1 diabetics. B. Ketones are present in the urine in DKA. C. Cheyne-stokes breathing will always present in DKA. D. Severe hypoglycemia is a hallmark sign in DKA. E. Options C & D
E
3. Which of the following statements are INCORRECT about exercise management for the diabetic patient? A. "I will check my blood glucose prior to exercise. If it is less than 200 I will eat a complex carb snack prior to exercising." B. "I plan on exercising for an extended period. So I will check my blood glucose prior, during, and after exercising." C. "My blood glucose is 268 and I have ketones in my urine. Therefore, I will avoid exercising today." D. All of the options are correct statements.
A
4. Which of the following statements are INCORRECT about Diabetic Ketoacidoisis? A. Extreme Hyperglycemia that presents with blood glucose >600 mg/dL B. Ketones are present in the urine. C. Metabolic acidosis is present with Kussmaul breathing. D. Potassium levels should be at least 3.3 or higher during treatment of DKA with insulin therapy.
A
5. . Which statement is NOT correct about pheochromocytoma? A. This condition can be trigger by eating foods high in Tyramine such as hamburger meat and spinach. B. Monoamine oxidase inhibitors can trigger signs and symptoms of pheochromocytoma. C. An adrenalectomy is the only surgical treatment for pheochromocytoma. D. Patients with pheochromocytoma are at risk for hypertensive crisis.
A
6. A 36-year-old male is newly diagnosed with Type 2 diabetes. Which of the following treatments do you expect the patient to be started on initially? A. Diet and exercise regime B. Metformin BID by mouth C. Regular insulin subcutaneous D. None, monitoring at this time is sufficient enough
A
6. Which patient population is most at risk for DKA? A. Newly diagnosed diabetes B. Middle-aged adults who are obese C. Older-adults with Type 2 diabetes D. None of the options
A
7. A patient is scheduled to take 10 units of Humulin N at 1100. When is the patient most susceptible for hypoglycemia? A. 1900 B. 1300 C. 1130 D. 1500
A
8. You administered 5 units of Humalog at 0800. What is the ONSET and DURATION of this medication? A. Onset: 15 minutes, Duration: 3 hours B. Onset: 2 hours, Duration: 16 hours C. Onset: 30 minutes, Duration: 1 hour D. Onset: 2 hours, Duration: 24 hours
A
9. A patient taking the medication Precose asks when it is the best time to take this medication. Your response is: A. With the first bite of food B. 1 hour prior to eating C. 1 hour after eating D. At bedtime
A
which clinical manifestation of type 2 diabetes occurs if glucose levels are very high? a. blurred vision b. hyperactivity c. oliguria d. increased energy
A
A nurse is teaching a newly licensed nurse about caring for a client who is scheduled for an esophogastric ballon tamponade tube to treat bleeding esophageal varices. which of the following pieces of information should the nurse include in the teaching? a. the client will be placed on mechanical ventiallation prior to this procedure b.the tube will be inserted into the clients trachea c. the client will recieve a bowel prep with cathartics prior to procedure d.the tube allows the application of ligation band to the bleeding varices
A -the client will require intubation and mechanical ventiallation prior to procedure to protect the airway
the client with type 1 diabetes is diagnosed with DKA. the HCP prescribes IV regular insulin by continuous IV infusion . which intervention should the nurse implement when administering the medication? A. flush tubing with 50mL of insulin drip before admin to client B.monitor clients serum glucose level every hour and document it on MAR C. draw the clients ABG results daily and document them in the chart D. admin the clients regular insulin drip via gravity at prescribed rat
A regular insulin adheres to the lining of the plastic IV tubing: therefore the nurse should flush the tubing with at least 50mL of the insulin solution so that the insulin will adhere to the tubing before the prescribed dosage is admin to the client. if this is not done the client will not receive the correct dose of insulin during the first few hours of admin.
a nurse is providing teaching for 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 this medication? a. somnolence b. constipation c. fluid retention d. weight gain
A somnolence can indicate lactic acidosis, which is manifested by extreme drowsiness, hyperventilation and muscle pain. it is a rare but serious adverse effect caused by metformin and should be reported to the provider.
a nurse is teaching a client who haas type 1 DM about a new subcutaneous insulin infusion pump . which of the following pieces of information should the nurse include in the teaching? a.plan to use a type of short duration insulin in the infusion pump b. replace the infusion pump set every 4 days c. turn off the infusion pump for at least 3 hours each day d. move the infusion pump catheter 1.27cm (0.5in) away from the old site
A the client should plan to use short duration insulin such as regular, lispro, aspart, or glulisine insulin in the infusion pump to deliver a baseline infusion of insulin. the client should also administer bolus doses of insulin before each meal
the client newly diagnosed with type 1 diabetes asks the nurse why should i get an external portable insulin pump. which statement is the nurses best response? a. it will cause you to have fewer hypoglycemimc reactions and it will control blood glucose levels better b.insulin pumps provide an automatic memory of the data and time of the last 24 boluses c.pump injects intermediate acting insulin automatically into the vein to maintain a normal blood glucose level d. the portable pump is the easiest way to administer insulin to someone whith type 1 diabetes and is highly reccomended
A a portable insulin pump is a battery operated device that uses rapid acting insulin-Lispro, humalog, or novolog. it delivers both basal insulin infusion (continuous release of a small amount of insulin) and bolus doses with meals. this provides fewer hypoglycemic reactions and better blood glucose levels.
a nurse is caring for a client with DKA who has a prescription for an IV infusion of insulin. the nurse should document that which of the following types of insulin was administered intravenously to treat ketoacidosis? a. regular insulin b. insulin lispro c. insulin aspart d. insulin glargine
A treatment for DKA is directed at correcting hyperglycemia and acidosis.l therefore the clients insulin levels are restored with an initial IV bolus of regular insulin followed by continuous infusion
13. A patient with diabetes is experiencing a blood glucose of 275 when waking. What is a typical treatment for this phenomenon? A. None, this is a normal blood glucose reading. B. The patient may need a night time dose of an intermediate-acting insulin to counteract the morning hyperglycemia. C. A bedtime snack may prevent this phenomenon. D. This is known as the Somogyi effect and requires decreasing the bedtime dose of insulin.
B
2. A patient is admitted with Diabetic Ketoacidosis. The physician orders intravenous fluids of 0.9% Normal Saline and 10 units of intravenous regular insulin IV bolus and then to start an insulin drip per protocol. The patient's labs are the following: pH 7.25, Glucose 455, potassium 2.5. Which of the following is the most appropriate nursing intervention to perform next? A. Start the IV fluids and administer the insulin bolus and drip as ordered B. Hold the insulin and notify the doctor of the potassium level of 2.5 C. Hold IV fluids and administer insulin as ordered D. Recheck the glucose level
B
3. A patient with diabetes has a morning glucose of 50. The patient is sweaty, cold, and clammy. Which of the following nursing interventions is the MOST important? A. Recheck the glucose level B. Give the patient ½ cup (4 oz) of fruit juice C. Call the doctor D. Keep the patient nothing by mouth
B
3. Which patient is MOST likely to develop Diabetic Ketoacidosis? A. A 25 year old female newly diagnosed with Cushing's Disease taking glucocorticoids. B. A 36 year old male with diabetes mellitus who has been unable to eat the past 2 days due to a gastrointestinal illness and has not been taking insulin. C. A 35 year old female newly diagnosed with Type 2 diabetes. D. None of the options are correct.
B
5. A patient has an infection and reports not checking their blood glucose or regularly taking Metformin. What condition is this patient MOST at risk for? A. DKA B. HHNS C. Metabolic alkalosis D. Metabolic acidosis
B
5. A patient with Type 2 Diabetes is started on the medication Glyburide. Which of the following statements by the patient causes concern? A. "I will monitor my blood glucose regularly because I know this medication can cause a low blood sugar." B. "I will consume no more than 8 oz. of alcohol per week." C. "I will continue monitoring my diet and participating in exercise while taking this medication." D. "This medication works by stimulating the beta cells in the pancreas to make insulin."
B
6. A patient is scheduled to take a morning dose of Metformin. The patient is scheduled for surgery tomorrow. Which of the following nursing interventions are correct? A. Administer the medication as ordered. B. Hold the dose and notify the doctor for further orders. C. Administer the medication as ordered but hold tomorrows morning's dose. D. Check the patient's blood glucose prior to administering the medication.
B
7. Which of the following statements are true regarding Type 2 diabetes treatment? A. Insulin and oral diabetic medications are administered routinely in the treatment of Type 2 diabetes. B. Insulin may be needed during times of surgery or illness. C. Insulin is never taken by the Type 2 diabetic. D. Oral medications are the first line of treatment for newly diagnosed Type 2 diabetics.
B
8. A patient undergoing treatment for Hyperglycemic Hyperosmolar Nonketotic Syndrome has a blood glucose of 799. The doctor has ordered intravenous fluids and intravenous Regular insulin therapy. Which of the following findings causes concern before starting insulin therapy? A. Regular insulin cannot be given intravenously; therefore, the nurse needs to clarify the doctor's order. B. The patient's potassium level is 3.1. C. The patient is complaining of severe thirst and has dry mucous membranes. D. The patient is confused and drowsy.
B
9. Which of the following is not a sign or symptom of Diabetic Ketoacidosis? A. Positive Ketones in the urine B. Oliguria C. Polydipsia D. Abdominal Pain
B
a nurse is caring for a client who has type 2 DM and is displaying manifestations of hyperglycemia. which of the following findings indicates the client has hypeglycemia? a. hunger b. increased urination c. cold, clammy skin d. tremors
B
a nurse is planning dietary teaching for a client who has DM. which of the following actions should the nurse plan to take first? a. obtain sample mensus from the dietician to give to the client b. ask the client to identify the types of food she prefers c. identiy the recommended range of the clients blood glucose level d. discuss long term complications that can result from non- adherence to the dietary
B
a nurse is caring for a client who has been taking metformin for 6 months. which of the following findings should the nurse identify as an expected therapeutic effect of the medication? a. decreased vitamin B12 levels b. decreased blood glucose level c. abdominal bloating and diarrhea d. decreased LDL level
B a client who has been taking metformin for 6 months should experience the expected therapeutic effect of a decrease in blood glucose levels. metformin is a non insulin medication for clients who have type 2 DM
a nurse is admin insulin glulisine 10 unites subq at 0730 to an adolescent client who has type 1 DM. the nurse should anticipate the onset of action of the insulin at which of the following times? a. 0800 b. 0745 c.0900 d. 1030
B insulin glulisine has a very short onset of action of 15 min the nurse should expect the onset of action around 0745 and ensure the client eats breakfast immeadiatly following admin of insulin
a nurse is providing teaching to a client who has type 2 DM and a new prescription for metformin. which of the following adverse effects of metformin should the nurse instruct the client to watch for and report to the provider? a. weight gian b. myalgia c. hypoglycemia d. severe constipation
B myalgia, malaise, somnolence, and hyperventilation are manifestations of lactic acidosis which rarely occur while taking metformin due to the blockage of lactic acid oxidation. the nurse should instruct the client to report these findings promptly to the provider.
the nurse admin 25 units of insulin isophane (NPH) to a client with type 1 diabetes at 1600. which intervention should the nurse implement? a. assess the client for hypoglycemia arodun 1800 b. ensure the client eats a nighttime snack c. check serum blood glucose level d. give client the supper tray
B the nurse needs to ensure the client eats the nighttime snack to help prevent nighttime hypoglycemia
1. Which of the following patients is MOST LIKELY experiencing Hyperglycemic Hyperosmolar Nonketotic Syndrome based on their symptoms? A. A 72 year old with a health history of diabetes who has a blood glucose of 300 mg/dL and is complaining of thirst and frequent urination. B. A 66 year old with type I diabetes that has ketones present in their urine. C. A 69 year old admitted with an infection of the right foot with a health history of diabetes that reports missing several doses of Metformin and has a blood glucose of 600 mg/dL. D. A 6 year old that is presenting with polyuria, polydipsia, abdominal pain, and vomiting.
C
1. Which of the following symptoms do NOT present in hyperglycemia? A. Extreme thirst B. Hunger C. Blood glucose <60 mg/dL D. Glycosuria
C
15. Which of the following insulins has no peak but a duration of 24 hours? A. NPH B. Novolog C. Lantus D. Humulin N
C
16. A patient is scheduled to take 7 units of Humulin R at 0830. You administer Humulin R at 0900 in the right thigh. When do you expect this medication to peak? A. 1300 B. 0930 C. 1100 D. 1700
C
18. Which of the following insulins can be administered intravenously? A. NPH B. Lantus C. Humulin R D. Novolog
C
2. A patient with diabetes asks you about what type of exercise they should perform throughout the week. The best response is: A. Lifting weights B. Sprinting C. Swimming D. Jumping
C
4. A patient is admitted with uncontrolled hypertension and the doctor suspects pheochromoctyoma. On assessment, you note the blood pressure to be 196/120 and HR 130. The patient reports feeling very anxious, sweaty, and having palpations. What do you expect the doctor will order to confirm a diagnosis of pheochromocytoma? A. Urinalysis B. Urine culture C. 24-hour urine D. 8-hour urine
C
6. A patient is scheduled for a bilateral adrenalectomy. Preoperatively, the patient is ordered by the doctor to take an alpha-adrenergic blocker. After administering a dose of this medication, what type of side effect will you monitor the patient for? A. Bradypnea B. Hyperglycemia C. Reflex tachycardia D. Hypertension
C
Å7. Which of the following statements is INCORRECT about Hyperglycemic Hyperosmolar Nonketotic Syndrome? A. HHNS occurs mainly in type 2 diabetics. B. This condition presents without ketones in the urine. C. Metabolic alkalosis presents in severe HHNS. D. Intravenous Regular insulin is used to treat hyperglycemia.
C
The nurse enters the patient's room to complete the discharge process and finds the patient to be lying in bed unresponsive and breathing. The patient has a blood glucose reading of 48 mg/dL. What is the most appropriate response by the nurse? A.Place a packet of table sugar in the patient's mouth. B.Start CPR. C.Roll the patient to the side and administer the ordered glucagon. D.Have the patient drink orange juice.
C Glucagon, a natural hormone secreted by the pancreas, is available as a subcutaneous injection to be given when a quick response to severe hypoglycemia is needed. Because glucagon injection may induce vomiting, roll an unconscious patient onto his or her side before injection. Glucagon is useful in the unconscious hypoglycemic patient without established intravenous access. The patient is at risk for aspiration so nothing should be administered by mouth. CPR is not indicated.
a nurse is teaching a client who has type 2 DM about a prescription for insulin lispro. which of the following statements should the nurse include in the teaching? a. the effects of the insulin lispro can last for 8 to 12 hours b. administer insulin lispro 30 to 60 minutes before eating c. insulin lispro has an onset of about 15 minutes d. this insulin can be given as a continuous IV bolus
C insulin lispro is a rapid acting insulin and has an onset of 15 to 30 minutes
a nurse is caring for a client who takes repaglinide 15 to 30 min before each meal to treat type 2 DM. client asks if i skip a meal what should i do? which of the following responses should the nurse make? A. double the dose before next meal B.take half the dose C. skip the dose take the usual dose
C to avoid a sudden and serious drop in blood glucose, the client should skip the dose of repaglinde, a meglitinide, whenever skipping a meal. the nurse should also instruct the client to try and avoid skipping meals.
a nurse is teaching self administration of NPH insulin to a client who has type 2 DM. which of the following instructions should the nurse include? a. alternate injecting doses between the abdomen and the thigh b. shake the vial before withdrawing the dosage c. rotate injection sites within the same area d. discard the vial if the insulin is cloudy
C to prevent lipodystrophy the client should rotate injection sites and keep them about 2.5cm (1in) apart within the same anatomical area
7. What type of insulin do you expect the doctor to order for treatment of DKA? A. IV NPH B. IV Novolog C. IV Levemir D. IV Regular Insulin
D
8. A patient is receiving treatment for pheochromocytoma. What type of diet is best for this patient? A. Low sodium and high potassium diet B. 2 L fluid restriction diet C. Low calorie and high fiber diet D. High calorie diet
D
a client newly diagonsed with type 1 diabetes has an unusual increase in blood glucose from bedtime to morning. the physician suspects the client is experiencing insulin waning. based on the diagnosis, the nurse expects which change to the clients medication regimen? a. decrease evening bedtime dose of intermediate acting insulin and admin a bedtime snack b. changing the time of evening injection of intermediate acting insulin from dinnertime to bedtime c. increasing morning dose of long acting insulin d. admin a dose of intermediate acting insulin before the evening meal
D
once digested, what percentage of carbohydrates is converted to glucose? a. 90 b. 80 c. 70 d. 100
D
The patient is being discharged home with insulin aspart (NovoLog) and insulin isophane suspension (NPH). Which information does the nurse include when providing discharge teaching to the patient? A.Store the insulins in the refrigerator B.Shake the insulins for 1 full minute before use. C.Administer the injection at a 30-degree angle to your skin. D.Draw up the insulin aspart (NovoLog) first, then the insulin isophane suspension (NPH) into the same syringe.
D Rationale: The rapid-acting (clear) then the intermediate-acting (cloudy) insulins should be mixed in the syringe after the appropriate amount of air has been injected. Insulin is stored at room temperature when it will be used within the month. The injection should be administered at a 90-degree angle for patients who have adequate body fat and at a 45-degree angle for patients who are very thin. Insulins should be rolled prior to administration and not shaken.
When teaching a patient who is starting metformin (Glucophage), which instruction by the nurse is correct? a."Take metformin if your blood glucose level is above 150 mg/dL. "b."Take this 60 minutes after breakfast." c."Take the medication on an empty stomach 1 hour before meals." d."Take the medication with food to reduce gastrointestinal (GI) effects."
D The GI adverse effects of metformin can be reduced by administering it with meals. The other options are incorrect
a nurse is caring for a client who has been taking acarbose for type 2 DM. which of the following laboratory tests should the nurse plan to monitor? a. WBC b. amylase c. platelet count d. liver function tests
D acarbose can cause liver toxicity when taken long term. ensure the clients liver function is monitored while taking this medication
which statement best decribes the pharmacodynamics of insulin? a. insulin causes the pancreas to secrete glucose into the bloodstream b.insulin is metabolized by the lever and muscle and excreted in the urine c.insulin is needed tomaintain collodial osmotic pressure in blood stream d. insulin lowers blood glucose by promoting use of glucose in the body cells
D ovetime, elevated glucose levels in the bloodstream can cause long term complications including neuropathy, retinopathy, and nephropathy. insulin lowers blood glucose by promoting the use of glucose in body cells
5. True or False: DKA and HHNS mainly occur in type 2 diabetics.
F
6. True or False: Hypertonic fluids, such as 3% saline, are the first line of treatment to correct dehydration in HHNS.
F
14. True or False: The Somogyi effect causes the patient to experience an increase in their blood glucose during the hours of 2-3 am.
False
-
-
2. Type 1 diabetics typically have the following clinical characteristics: A. Thin, young with ketones present in the urine B. Overweight, young with no ketones present in the urine C. Thin, older adult with glycosuria D. Overweight, adult-aged with ketones present in the urine
A
2. What cells are responsible for secreting catecholamines? A. Chromaffin B. Langerhans C. Enkephalin D. Parietal
A
A nurse is providing discharge teaching to a client who had DKA. which of the following information should the nurse include in the teaching about DKA? a. drink 2L fluids daily b. monitor blood glucose every 4hr when ill c. admin insulin as prescribed when ill d. notify provider when blood glucose is 200 e. report ketones in urine after 24hr of illness
A,B,C,E
A client is receiving metformin (Glucophage). The nurse suspects that the client is developing lactic acidosis based on assessment of which of the following? Select all that apply. A) Malaise C) Tachypnea D) Abdominal pain E) Muscular pain
A,C,DE
10. You are providing care to a patient experiencing diabetic ketoacidosis. The patient is on an insulin drip and their current glucose level is 300. In addition, to the insulin drip the patient also has 5% Dextrose 0.45% NS infusing in the right antecubital vein. Which of the following patient signs/symptoms causes concern? A. Patient has a potassium level of 2.3 B. Patient complains of thirst. C. Patient is nauseous. D. Patient's skin and mucous membranes are dry.
A
12. A patient newly diagnosed with diabetes is about to be discharged home. You are watching the patient administer insulin. Which of the following actions causes you to re-educate them? A. They massaged the site after administering the insulin. B. They injected into the fat of their thighs. C. They used an opposite side for injection compared to the last insulin injection. D. They engaged the safety after administering the medication.
A
The client with type 2 diabetes is admitted into the medical department with a wound on the left leg that will not heal. The HCP prescribes sliding-scale insulin. The client tells the nurse, "I don't want to have to take shots. I take pills at home." Which statement is the nurse's best response? 1. "If you can't keep your glucose under control with pills, you must take insulin." 2. "You should discuss the insulin order with your HCP because you don't want to take it." 3. "You are worried about having to take insulin. I will sit down and we can talk." 4. "During illness you may need to take insulin to keep your blood glucose level down."
4 . Blood glucose levels elevate during times of stress, surgery, or serious infection. The client with type 2 diabetes may need to be given insulin temporarily to help keep the blood glucose level within normal limits.
11. A patient is scheduled to take 5 units of Humulin R and 10 units of NPH. What is the proper way of mixing these insulins? A. These insulins cannot be mixed, therefore, should be drawn up in different syringes. B. Draw-up the Humulin R insulin first and then the NPH insulin. C. Draw-up 2.5 units of NPH, then 10 units of Humulin R, and then finish drawing up 2.5 units of NPH. D. Draw-up the NPH insulin first and then the Humulin R insulin.
B
1. Which of the following patient statements about the diabetic diet regime is correct? A. "I'll try to consume about 20% carbs and 40% fats on a daily basis." B. "Foods that are high in mono and poly fats are avocadoes, olives, and nuts." C. "Meats increase the glycemic index; therefore, I should only consume 5% of them on a daily basis." D. "I should completely avoid starchy vegetables like potatoes and corn."
B
10. A Type 2 diabetic may have all the following signs or symptoms EXCEPT: A. Blurry vision B. Ketones present in the urine C. Glycosuria D. Poor wound healing
B
1. This complication is found mainly in Type 2 diabetics?
HHNS
4. This condition happens gradually and is more likely to affect older adults?
HHNS
11. A patient is being discharged home after recovering from HHNS. Which statement by the patient requires patient re-education about this condition? A. "I will monitor my blood glucose levels regularly." B. "This condition happens suddenly without any warning signs." C. "If I become sick I will monitor my blood glucose more frequently and drink lots of fluids." D. "It is important I take my medication as prescribed."
B
A nurse is assessing a client who has DKA and ketones in the urine. the nurse should expect which of the following findings? a. weight gain b. fruity odor of breath c. abdominal pain d. Kussmaul resp e. metabolic acidosis
B,C,D,E
8. A patient diagnosed with diabetes mellitus is being discharged home and you are teaching them about preventing DKA. What statement by the patient demonstrates they understood your teaching about this condition? A. "I will hold off taking my insulin while I'm sick." B. "It is normal for my blood sugar to be 250-350 mg/dL while I'm sick." C. "It is important I check my blood glucose every 3-4 hours when I'm sick and consume liquids." D. "I should not be alarmed if ketones are present in my urine because this is expected during illness."
C
. Hyperglycemic Hyperosmolar Nonketotic Syndrome would have all of the following signs and symptoms EXPECT? A. Dry mucous membranes B. Polyuria C. Blood glucose >600 mg/dL D. Kussmaul breathing
D
3. True or False: Treatment of Hyperglycemic Hyperosmolar Nonketotic Syndrome is similar to the treatment of Diabetic Ketoacidosis.
T
9. A patient who has diabetes is nothing by mouth as prep for surgery. The patient states they feel like their blood sugar is low. You check the glucose and find it to be 52. The next nursing intervention would be to: A. Administer Dextrose 50% IV per protocol B. Continue to monitor the glucose C. Give the patient 4 oz of fruit juice D. None, this is a normal blood glucose reading
The answer is A. This question requires critical thinking because the patient is NPO for surgery and can NOT eat but is experiencing hypoglycemia. Normally, you could give the patient 15 grams of a simple carbohydrate like 4 oz of fruit juice or soda, glucose tablets, gel etc. per hypoglycemia protocol However, the patient can NOT eat due to surgery prep. Therefore the nurse would need to administer Dextrose 50% IV per protocol to help increase the blood glucose and recheck the glucose level.
4. Which of the following patients is at most risk for Type 2 diabetes? A. A 6 year old girl recovering from a viral infection with a family history of diabetes. B. A 28 year old male with a BMI of 49. C. A 76 year old female with a history of cardiac disease. D. None of the options provided.
The answer is B. Remember Type 2 diabetes risk factors are related to lifestyle....being obese is a risk factor (BMI >30 in males is considered obese). So, the 28 year old male with a BMI of 49 is most at risk for Type 2.
5. The _____ ______ secrete insulin which are located in the _______. A. Alpha cells, liver B. Alpha cells, pancreas C. Beta cells, liver D. Beta cells, pancreas
The answer is D.
5. True or False: When priming the tubing for an Insulin infusion it is best practice to waste 50cc to 100cc of insulin prior to starting the infusion because insulin absorbs into the plastic lining of the tubing.
True
7. True or False: Osmotic diuresis is present in HHNS and DKA due to the kidney's inability to reabsorb the excessive glucose which causes glucose to leak into the urine which in turn causes extra water and electrolytes to be excreted.
True
A client is receiving glipizide at a health care facility. The client is also prescribed an anticoagulant. The nurse would be alert for which of the following related to the interaction of these two drugs?
increased hypoglycemic effect
a nurse is caring for a client who had a gastric resection to treat adenocarcinoma of the stomach. the client tells then nurse in the PACU that he does not remember why the surgeon said he had to have a tube in his nose. the nurse should explain that the NG tube serves which of the following purposes?
prevents excessive pressure on suture lines
