Quiz 2

Which of the following physiologic processes characterize type 2 diabetes? (SATA) a) insulin resistance b) b cell exhaustion c) altered production of hormones and cytokines d) t cell exhuastion e) acinar cell dysfunction

a) b) c)

Which of the following are manifestations of diabetic ketoacidosis? (SATA) a) thirst b) sweat, fruity breath odor c) hypokalemia d) fluid overload e) ketonuria

a) b) e)

A 27-year-old patient admitted with diabetic ketoacidosis (DKA) has a serum glucose level of 732 mg/dL and serum potassium of 2.7 mEq/L. Which action prescribed by the health care provider should the nurse take first? a) place patient on a cardiac monitor b) start an insulin infusion of 0.1 units/kg/hr c) obtain urine glucose and ketone levels d) administer IV potassium supplements

a)

A patient who was admitted with diabetic ketoacidosis secondary to a urinary tract infection has been weaned off an insulin drip 30 minutes ago. The patient reports feeling lightheaded and sweaty. Which action should the nurse take first? a) obtain a glucose reading using a finger stick b) infuse dextrose 50% by slow IV push c) have the patient drink 4 oz of orange juice d) administer 1 mg glucagon subcutaneously

a)

The patient with diabetes is brought to the emergency department by his family members, who say that he is not acting like himself and he is more tired than usual. Which is the first nursing priority? a) obtain vital signs and clarify the family's statement regarding "not acting like himself" b) establish IV access c) check blood glucose d) begin continuous regular insulin drip

a)

Which laboratory results would indicate that the patient has prediabetes? a) fasting glucose of 130 mg/dL b) a white count of 43,000 c) HbA1C of 4-5% d) glucose tolerance result of 132 mg/dl

a)

Which patient meets the diagnostic criteria for diabetes mellitus type II? a) a 48 yo woman with a Hgb A1C of 8.4% b) a 68 yo woman with a random plasma glucose of 190 mg/dL c) a 78 yo man with a 2 hr glucose tolerance plasma gluocose of 184 mg/dL d) a 58 yo man with a fasting blood glucose of 111 mg/dL

a)

Which classic symptom is caused by the osmotic effect of glucose in type 1 diabetes? a) recurrent infections b) polydipsia c) fatigue d) polyphagia

b)

Which of the following scenarios would lead the nurse to assess the diabetic patient for symptoms of ketoacidosis? a) the patient who skips meals after taking insulin, leading to rapid metabolism of glucose and breakdown of fats for energy b) an insulin deficit that causes the body to metabolize large amounts of fatty acids rather than glucose for energy c) glucose levels become so high that osmotic diuresis promotes fluid and electrolyte loss d) illnesses causing nausea and vomiting lead to bicarbonate loss with body fluids

b)

An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to a. give a bolus of 50% dextrose. b. insert a large-bore IV catheter. c. initiate oxygen by nasal cannula. d. administer glargine (Lantus) insulin. e. administer a bolus of IV fluids as prescribed by the provider

b) c) e)

After change-of-shift report, which patient will the nurse assess first? a. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon b. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL c. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa d. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain

c)

What describes the primary differences in treatment for DKA and HHS? a) potassium replacement is not necessary in management of HHS b) administration of glucose is withheld in HHS until the blood glucose reaches a normal level c) HHS requires greater fluid replacement to correct the dehydration e) DKA requires administration of bicarbonate to correct acidosis

c)

What should the goals of nutrition therapy for the patient with Type II diabetes include? a) maintaining a special diabetic diet using dietetic food b) ideal body weight c) normal serum glucose and lipid levels d) five small meals per day with a bedtime snack

c)

Which instruction should the nurse include when teaching a diabetic patient about insulin administration? a) inject air into skin prior to injecting the insulin b) clean the skin after each injection with alcohol c) consistently use the same size of insulin syringe to avoid dosing errors d) pull back on the plunger after inserting the needle to check for blood

c)

Which intervention can the nurse delegate to the unlicensed assistive personnel (UAP) when caring for a diabetic patient? a) check the patient's technique for drawing up insulin b) teach the patient to use a meter for self-monitoring of blood gluocse c) check that the bath water is not too hot d) discuss the complication of diabetes

c)

Which statement made by a diabetic indicates that teaching has been successful regarding prevention of diabetic neuropathy? a) "I should have yearly dilated eye examinations by an opthalmologist" b) "smokeless tobacco products decrease the risk of kidney damage" c) "I can help by controlling my blood sugar" d) "I will avoid hypoglycemia by keeping my blood sugar above 180 mg/dL"

c)

Which statement made by a patient with diabetes mellitus indicates that teaching was successful regarding a healthy eating plan? a) "If I use an insulin pump, I will not need to limit the amount of saturated fat in my diet" b) "I plan to lose 25 pounds this year by following a high-protein diet" c) "I may have a hypoglycemic reaction if I drink alcohol on an empty stomach" d) " I should include more fiber in my diet than a person who does not have diabetes"

c)

A patient is admitted with diabetic ketoacidosis. Which admission order should the nurse implement first? a) start a regular insulin infusion at 0.1 units/kg/hr b) administer regular insulin 10 U by IV push c) give sodium bicarbonate 50 mEq IV push d) Infuse 1 liter of normal saline per hour

d)

The patient with newly diagnosed diabetes is displaying shakiness, confusion, irritability, and slurred speech. What should the nurse suspect is happening? a) DKA b) HHS c) hyperglycemia d) hypoglycemia

d)

Which statement by the patient recently diagnosed with type 1 diabetes mellitus regarding insulin administration requires an intervention by the nurse? a) "the best injection site for insulin administration is in my abdomen" b) "i may keep my insulin at room temperature for up to a month" c) I can wash the site with soap and water before insulin administration" d) "I will discard any insulin bottle that is cloudy in appearance"

d)