Metabolism PrepU

A pregnant client has been diagnosed with gestational diabetes. Which are risk factors for developing gestational diabetes? Select all that apply. A. maternal age less than 18 years B. genitourinary tract abnormalities C. obesity D. hypertension E. previous large for gestational age (LGA) infant

C D E

A nurse is caring for a pregnant client whose fetus has been diagnosed with macrosomia. When reviewing the client's history, which information would the nurse expect to find? A. preterm pregnancy B. small body size of mother C. maternal rickets D. gestational diabetes

D

A 29-year-old client has gestational diabetes. The nurse is teaching her about managing her glucose levels. Which therapy would be most appropriate for this client? A. diet B. long-acting insulin C. oral hypoglycemic drugs D. glucagon

A

A nurse is providing education to a woman at 28 weeks' gestation who has tested positive for gestational diabetes mellitus (GDM). What would be important for the nurse to include in the client teaching? A. She is at increased risk for type 2 diabetes mellitus after her baby is born. B. Her baby is at increased risk for neonatal diabetes mellitus. C. Her baby is at increased risk for type 1 diabetes mellitus. D. She is at increased risk for type 1 diabetes mellitus after her baby is born.

A

Insulin is secreted by which of the following types of cells? A. Beta cells B. Melanocytes C. Neural cells D. Basal cells

A

The greatest percentage of people have which type of diabetes? A. Type 2 B. Type 1 C. Gestational D. Impaired glucose tolerance

A

What is the only insulin that can be given intravenously? A. Regular B. NPH C. Lantus D. Ultralente

A

Which of the following is an age-related change that may affect diabetes and its management? A. Hypotension B. Decreased renal function C. Increased bowel motility D. Increased thirst

B

A client newly diagnosed with type 1 diabetes asks the nurse, "Why do I have to take two shots of insulin? One shot is not enough?" The nurse should tell the client: A. "A single shot of long-acting insulin would be preferable." B. "You might be able to change to oral medications soon." C. "Two shots will give you better control and decrease complications." D. "I will ask the health care provider to change your insulin schedule."

C

A nurse is teaching a client about type 2 diabetes mellitus. What information would reduce a client's risk of developing this disease? A. "You should stop cigarette smoking." B. "Follow a high-protein diet including meat, dairy, and eggs." C. "Maintain weight within normal limits for your body size and muscle mass." D. "Prevent developing hypertension by reducing stress and limiting salt intake."

C

In a child with diabetes insipidus, which characteristic would most likely be present in the child's health history? A. Delayed closure of the fontanels, coarse hair, and hypoglycemia in the morning B. Gradual onset of personality changes, lethargy, and blurred vision C. Vomiting early in the morning, headache, and decreased thirst D. Abrupt onset of polyuria, nocturia, and polydipsia

D

An elementary school child takes metformin (Glucophage) three times each day. Which of the following disorders would the school nurse expect the child to have? A. Type 1 DM B. Gastrointestinal reflux C. Inflammatory bowel disorder D. Type 2 DM

D

The nurse has told the 14-year-old diabetic that the doctor would like them to have their hemoglobin A1C test performed. Which comment by the client indicates that she understands what this test is for? A. "That is the test that I take after I have fasted for at least 8 hours." B. "The normal level for my hemoglobin A1C is between 60 to 100 mg/dL." C. "I monitor my own blood glucose every day at home. I don't see why the doctor would want this done." D. "This will tell my doctor what my average blood glucose level has been over the last 2 to 3 months."

D

Which of the following should be included in the teaching plan for a patient receiving glargine (Lantus),"peakless" basal insulin? A. Administer the total daily dosage in 2 doses B. Draw up the drug first, then add regular insulin C. Is rapidly absorbed, has a fast onset of action D. Do not mix with other insulins

D

A 16-year-old adolescent is at the office for a checkup. The parent states, "My child keeps forgetting to take insulin. What can we do to make sure my child takes it?" Which is the best response by the nurse? A. "You can set a medication time that allows your child to have a normal routine that does not interrupt school or sleep." B. "You can offer your child prizes for taking the medication." C. "You can make sure that you are the only one who understands and is able to administer the medication." D. "You can remind your child that the medication is in the cabinet, and that the child should take it when needed."

A

A 17-year-old adolescent is found wandering around. The adolescent is confused, sweaty, and pale. Which test would the nurse expect to be performed first? A. Blood glucose level B. CT scan C. Arterial blood gases D. Blood cultures

A

A 9-year-old was just diagnosed with type 1 diabetes mellitus (DM). The parents state, "We hope our child won't have to take insulin injections." How should the nurse respond? A. "The pancreas doesn't produce insulin in Type 1 diabetes, so it is likely that insulin injections will be necessary." B. "It is very early in the diagnosis process. Let's wait to see if insulin will be necessary." C. "Sometimes oral hypoglycemic agents are all that is necessary. Hopefully that will be the case with your child." D. "You will have to trust whatever the doctor decides to order."

A

A diabetic educator is discussing "sick day rules" with a newly diagnosed type 1 diabetic. The educator is aware that the patient will require further teaching when the patient states what? A. "I will not take my insulin on the days when I am sick, but I will certainly check my blood sugar every 2 hours." B. "If I cannot eat a meal, I will eat a soft food such as soup, gelatin, or pudding six to eight times a day." C. "I will call the doctor if I am not able to keep liquids in my body due to vomiting or diarrhea." D. "I will call the doctor if my blood sugar is over 300 mg/dL or if I have ketones in my urine."

A

A group of students are reviewing information about oral diabetic agents. The students demonstrate understanding of these agents when they identify which agent as reducing glucose production from the liver? A. Metformin B. Glipizide C. Glyburide D. Nateglinide

A

The nurse is caring for a child with type 1 diabetes mellitus. The nurse notes that the child is drowsy, has flushed cheeks and red lips, a fruity smell to the breath, and there has been an increase in the rate and depth of the child's respirations. The nurse recognizes that these symptoms indicate the child has: A. diabetic ketoacidosis B. polyphagia C. insulin reaction D. Cheyne-Stokes respirations

A

NPH is an example of which type of insulin? A. Rapid-acting B. Short-acting C. Intermediate-acting D. Long-acting

C

When referred to a podiatrist, a client newly diagnosed with diabetes mellitus asks, "Why do you need to check my feet when I'm having a problem with my blood sugar?" The nurse's most helpful response to this statement is: A. "The physician wants to be sure your shoes fit properly so you won't develop pressure sores." B. "The circulation in your feet can help us determine how severe your diabetes is." C. "Diabetes can affect sensation in your feet and you can hurt yourself without realizing it." D. "It's easier to get foot infections if you have diabetes."

C

Which of the following statements is true regarding gestational diabetes? A. It occurs in most pregnancies. B. Its onset is usually in the first trimester. C. A glucose challenge test should be performed between 24 and 28 weeks. D. There is a low risk for perinatal complications.

C

A woman develops gestational diabetes. Which assessment should she make daily? A. Test her urine for protein with a chemical reagent strip. B. Measure her abdominal diameter with a tape measure. C. Measure her uterine height by hand-span distance. D. Measure serum for glucose level by a finger prick.

D

The nurse is interviewing the caregivers of a child admitted with a diagnosis of type 1 diabetes mellitus. The caregiver states, "The teacher tells us that our child has to use the restroom many more times a day than other students do." The caregiver's statement indicates the child most likely has: A. Polyuria B. Pica C. Polyphagia D. Polydipsia

A

The nurse is speaking to the mother of an adolescent recently diagnosed with type 1 diabetes mellitus. The mother asks the nurse how her son's basketball training will affect his blood sugar. Which is the best response by the nurse? A. "When exercising, your son should add an extra snack containing 15 to 30 g of carbohydrates for each 45 to 60 minutes of exercise." B. "Exercising will increase your son's blood sugar. He will need to check his blood sugar every 15 minutes during his training." C. "Your son will need to check his blood sugar prior to his training. If it's over 300 then he will be fine to exercise." D. "Your son will need to make sure his blood sugar is under control for at least 6 months prior to resuming his training."

A

The nurse is teaching the client about home blood glucose monitoring. Which blood glucose measurement indicates hypoglycemia? A. 59 mg/dL (3.3 mmol/L) B. 75 mg/dL (4.2 mmol/L) C. 108 mg/dL (6.0 mmol/L) D. 119 mg/dL (6.6 mmol/L)

A

When teaching the diabetic client about foot care, the nurse should instruct the client to: A. avoid going barefoot. B. buy shoes a half size larger. C. cut toenails at angles. D. use heating pads for sore feet.

A

Which of the following are byproducts of fat breakdown, which accumulate in the blood and urine? A. Ketones B. Creatinine C. Hemoglobin D. Cholesterol

A

Which of the following would be included in the teaching plan for a patient diagnosed with diabetes mellitus? A. Elevated blood glucose levels contribute to complications of diabetes, such as diminished vision. B. Sugar is found only in dessert foods. C. The only diet change needed in the treatment of diabetes is to stop eating sugar. D. Once insulin injections are started in the treatment of type 2 diabetes, they can never be discontinued.

A