diabetes/hyperglycemia nclex questions
When does regular insulin generally have peak action after application? Answers: A. 30-45 minutes B. 45-60 minutes C. 1-2 hours D. 2-3 hours
D 1-2 hours The exact details depend on various factors, but 2-3 hours for peak action of regular insulin is an accepted range.
What insulin type can be given by IV? Select all that apply: Answers: A. Glipizide (Glucotrol) B. Lispro (Humalog) C. NPH insulin D. Glargine (Lantus) E. Regular insulin
E Regular insulin The only insulin that can be given by IV is regular insulin.
When the nurse is caring for a patient with type 1 diabetes, what clinical manifestation would be a priority to closely monitor? Hypoglycemia Hyponatremia Ketonuria Polyphagia
Hypoglycemia Key word: Caring....drugs for diabetes have a risk for hypoglycemia
A client newly diagnosed with diabetes mellitus asks why he needs ketone testing when the disease affects his blood glucose levels. How should the nurse respond? "The spleen releases ketones when your body can't use glucose." "Ketones will tell us if your body is using other tissues for energy." "Ketones can damage your kidneys and eyes." "Ketones help the physician determine how serious your diabetes is."
"Ketones will tell us if your body is using other tissues for energy."
A 16-year-old client newly diagnosed with type 1 diabetes has a very low body weight despite eating regular meals. The client is upset because friends frequently state, "You look anorexic." Which statement by the nurse would be the best response to help this client understand the cause of weight loss due to this condition? "I will refer you to a dietician who can help you with your weight." "You may be having undiagnosed infections, causing you to lose extra weight." "Your body is using protein and fat for energy instead of glucose." "Don't worry about what your friends think; the carbohydrates you eat are being quickly digested, increasing your metabolism."
"Your body is using protein and fat for energy instead of glucose."
What is the duration of regular insulin? 4 to 6 hours 3 to 5 hours 12 to 16 hours 24 hours
4 to 6 hours The DURATION for regular (short) insulin is 4-6 hrs
A client is receiving insulin lispro at 7:30 AM. The nurse ensures that the client has breakfast by which time? 7:45 AM 8:00 AM 8:15 AM 8:30 AM
7:45 AM EAT BY ONSET! The onset for lispro is 15-30 mins
The client who is managing diabetes through diet and insulin control asks the nurse why exercise is important. Which is the best response by the nurse to support adding exercise to the daily routine? Increases ability for glucose to get into the cell and lowers blood sugar Creates an overall feeling of well-being and lowers risk of depression Decreases need for pancreas to produce more cells Decreases risk of developing insulin resistance and hyperglycemia
Increases ability for glucose to get into the cell and lowers blood sugar
A nurse is preparing a continuous insulin infusion for a child with diabetic ketoacidosis and a blood glucose level of 800 mg/dl. Which solution is the most appropriate at the beginning of therapy? 100 units of regular insulin in normal saline solution 100 units of neutral protamine Hagedorn (NPH) insulin in normal saline solution 100 units of regular insulin in dextrose 5% in water 100 units of NPH insulin in dextrose 5% in wate
100 units of regular insulin in normal saline solution
In educating a client about Type II Diabetes, what would be a proper explanation for poor wound healing? Answers: A. High blood glucose damages capillaries B. Swings in blood sugar prevent proper clotting C. The pancreas fails to secrete the proper chemicals D. Ketosis prevents proper healing
A High blood glucose damages capillaries High blood glucose damages capillaries which prevent proper healing.
A nurse is caring for a diabetic patient with a diagnosis of nephropathy. What would the nurse expect the urinalysis report to indicate? Albumin Bacteria Red blood cells White blood cells
Albumin Albumin is most reliable! Albumin is in kidneys
A client newly diagnosed with type 1 diabetes asks the nurse why injection site rotation is important. What is the nurse's best response? Avoid infection. Promote absorption. Minimize discomfort. Prevent muscle destruction.
Promote absorption.
The nurse is caring for a client who has normal glucose levels at bedtime, hypoglycemia at 2am and hyperglycemia in the morning. What is this client likely experiencing? Answers: A. Dawn phenomenon B. Somogyi effect C. An insulin spike D. Excessive corticosteroids
. B, Somogyi effect The Somogyi effect is when blood sugar drops too low in the morning causing rebound hyperglycemia in the morning. The hypoglycemia at 2am is highly indicative. The Dawn phenomenon is similar but would not have the hypoglycemia at 2am.
What is the duration of regular insulin? 4 to 6 hours 3 to 5 hours 12 to 16 hours 24 hours
4 to 6 hours
A patient is diagnosed with type 1 diabetes. What clinical characteristics does the nurse expect to see in this patient? Select all that apply. Ketosis-prone Little or no endogenous insulin Obesity at diagnoses Younger than 30 years of age Older than 65 years of age
Ketosis-prone Younger than 30 years of age Little or no endogenous insulin
A client with a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNS) has a history of type 2 diabetes that is being controlled with an oral diabetic agent, tolazamide. Which laboratory test is the most important for confirming this disorder? Serum potassium level Serum sodium level Arterial blood gas (ABG) values Serum osmolarity
Serum osmolarity
A client with status asthmaticus requires endotracheal intubation and mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose levels hourly and watch for which early signs and symptoms associated with HYPOGLYCEMIA? Sweating, tremors, and tachycardia Dry skin, bradycardia, and somnolence Bradycardia, thirst, and anxiety Polyuria, polydipsia, and polyphagia
Sweating, tremors, and tachycardia
Glycosylated hemoglobin reflects blood glucose concentrations over which period of time? 1 month 3 months 6 months 9 months
3 months This was on ppt
While working in the diabetes clinic, you obtain this information about an 8-year-old with type 1 diabetes. Which finding is most important to address when planning child and parent education? 1) Most recent hemoglobin A1c level of 7.8%. 2) Many questions about diet choices from the parents. 3) Child's participation in soccer practice after school 2 days a week. 4) Morning preprandial glucose range of 55 to 70 mg/dL.
4. That is an EXTREMELY LOW blood glucose, that is most important to mention
Insulin lipodystrophy should be treated in part by: Answers: A. B. Balancing diet and snack routine C. Reduction of insulin dose D. Adding an oral glycemic medication
A Alternating insulin injection sites Alternating insulin injection sites helps avoid lipodystrophy, which is a lump or dent in the skin that can be caused by using the same site for injections.
A client with type II diabetes is being educated about what to do if he catches the flu or a cold. What is something he should be informed of? Answers: A. Discontinue Metformin (glucophage) B. Expect hyperglycemia C. Add 2-3 more snacks to diet D. Come into the hospital for monitoring
B Expect hyperglycemia The body's natural reaction to illness is to release glucose. As such, diabetics can expect to face increased hyperglycemia in addition to their illness.
A client with diabetes and coronary heart disease is being evaluated for treatment. In light of the heart condition, which medication option is more likely to be an issue? Answers: A. Metformin (Glucophage) B. Pioglitazone (Actos) C. Insulin D. Sitagliptin (Januvia)
B Pioglitazone (Actos) Cardiac safety of diabetes meds is a very complex subject. That said, pioglitazone is known to possibly have issues.
The nurse is caring for a patient whose blood glucose level is 55mg/dL. What is the likely nursing response? Answers: A. Administer a glucagon injection B. Give a small meal C. Administer 10-15 grams of a carbohydrate D. Give a small snack of high protein food
C Administer 10-15 grams of a carbohydrate The client has low hypoglycemia. This is generally treated with a small snack.
In educating a client with diabetes, what response would reveal need for further education? Answers: A. I should avoid tights B. I should take good care of my toe nails C. I should not go more than 3 days without washing my feet D. I should avoid going barefoot and should wear clean socks
C I should not go more than 3 days without washing my feet The recommended self-care routine is to wash feet on a daily basis without soaking and carefully cleaning.
What is NOT true of hyperglycemic hyperosmolar nonketotic syndrome (HHNS) compared to diabetic ketoacidosis (DKA)? Answers: A. HHNS is found mainly in Type II Diabetes B. Both have high levels of hyperglycemia C. Both typically are treated with insulin D. In HHNS, blood pH tends to drop
D In HHNS, blood pH tends to drop In HHNS, you tend to avoid the decrease in pH and ketosis (hence nonketotic) that often occurs in diabetic ketoacidosis. Remember that the two are very similar otherwise.
Which assessment finding is most important in determining nursing care for a client with diabetes mellitus? Respirations of 12 breaths/minute Cloudy urine Blood sugar 170 mg/dL Fruity breath
Fruity breath
A 60-year-old client comes to the ED reporting weakness, vision problems, increased thirst, increased urination, and frequent infections that do not seem to heal easily. The physician suspects that the client has diabetes. Which classic symptom should the nurse watch for to confirm the diagnosis of diabetes? Numbness Increased hunger Fatigue Dizziness
Increased hunger (polyphagia)
For a client with hyperglycemia, which assessment finding best supports a nursing diagnosis of Deficient fluid volume? Cool, clammy skin Jugular vein distention Increased urine osmolarity Decreased serum sodium level
Increased urine osmolarity (concentration)
A group of students are reviewing the various types of drugs that are used to treat diabetes mellitus. The students demonstrate understanding of the material when they identify which of the following as an example of an alpha-glucosidase inhibitor? Metformin Glyburide Miglitol Rosiglitazone
Miglitol
Which clinical characteristic is associated with type 1 diabetes (previously referred to as insulin-dependent diabetes mellitus)? Presence of islet cell antibodies Obesity Rare ketosis Requirement for oral hypoglycemic agents
Presence of islet cell antibodies
A client who was diagnosed with type 1 diabetes 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blood glucose level? Cool, moist skin Rapid, thready pulse Arm and leg trembling Slow, shallow respirations
Rapid, thready pulse (hyperglycemia) Even tho hypoglycemia causes tachycardia too
