Adaptive Quiz Week 2 Questions

4. A nurse is caring for a patient who has a 20 year history of type 2 diabetes. The nurse should assess for what physiologic changes associated with a long history of diabetes? A: Blurry, spotty, or hazy vision B: Arthritic changes in the hands C: Hyperactive knee and ankle jerk reflexes D: Dependent pallor of the feet and lower legs

A: Blurry, Spotty, or Hazy vision.

12. The nurse is educating the patient newly dx with type 2 diabetes on oral antidiabetic medications. What should the nurse include in the teaching plan? SATA A: The client should obtain a finger stick blood glucose reading before each meal B: The client does not need to follow a specific diet until insulin is required C: The teaching plan should include signs and symptoms of hypoglycemia D: The teaching plan does not need to include signs and symptoms of hypoglycemia, as the client is not on insulin E: The teaching plan should include sick day rules

A: Patient should obtain a finger stick glucose reading before each meal C: Plan should include signs and symptoms of hypoglycemia E: Sick day rules

11. While obtaining the patient's health history, which factor does the nurse identify that predisposes the patient to type 2 diabetes? A: Having diabetes insipidus B: Eating low cholesterol foods C: Being 20 pounds (9 kilograms) overweight D: Drinking a daily alcoholic beverage

C: Being 20 pounds overweight.

6. A 9 year old child with type 1 diabetes is prone to have hypoglycemic episodes in the morning. Which intervention would be included in the school nurse's plan of care for this child? A: Limiting fluid intake during school hours B: Asking the child each day what was eaten for breakfast C: Considering the presence of diabetes but treating the child the same as the other children D: Checking several times a day for injures because of participation in the physical education program

B: Asking the child each day what was eaten for breakfast.

13. An adolescent is found to have type 1 diabetes. The nurse plans to teach the adolescent that dietary control and exercise can help regulate the disorder. What additional information should the nurse include in the teaching plan? SATA A: Insulin Therapy B: Prophylactic antibiotics C: Blood glucose monitoring D: Oral hypoglycemic agents E: Adherence to the treatment regimen

A: Insulin Therapy C: Blood Glucose Monitoring E: Adherence to the treatment regimen

9. Which nursing assessment is most important for a large-for-gestational age infant of a diabetic mother? A: Temperature less than 98F (36.6C) B: Heart rate of 110 beats/min C: Blood glucose level less than 40mg/dL (2.2 mol/L) D: Increasing bilirubin during the first 24 hours

C: Blood glucose level of less than 40

21. Some patient self-prescribe OTC glucosamine to help relieve joint pain and stiffness. Which condition should the nurse identify as a reason for the patient not to take this supplement? A: Osteoarthrits B: Heart disease C: Hyperthyroidism D: Diabetes mellitus

D: Diabetes Mellitus

14. The nurse is caring for a patient newly dx with diabetes. When preparing the teaching plan about the importance of yearly eye examinations, the nurse should instruct the patient on which eye problem MOST associated with diabetes A: Cataracts B: Glaucoma C: Retinopathy D: Astigmatism

C: Retinopathy

8. The nurse is explaining insulin needs to a patient with gestational diabetes who is in her second trimester of pregnancy. Which information should the nurse give to this patient? A: Insulin needs will increase during the second trimester B: Insulin needs will decrease during the second trimester C: Insulin needs will not change during the second trimester D: Insulin needs will be switched to an oral antidiabetic medication during the second trimester

A: Insulin needs will increase during the second trimester.

3. A nurse is caring for an older patient who had non-insulin dependent diabetes for 15 years that progressed to insulin-dependent diabetes 2 years ago. What common complications of diabetes should the nurse assess for when examining this patient? SATA A: Leg ulcers B: Loss of visual acuity C: Increased creatinine clearance D: Prolonged capillary refill in the toes E: Decreased sensation in the lower extremities

A: Leg Ulcers- B: Loss of visual acuity- D: Prolonged capillary refill in the toes- E: Decreased sensation in the lower extremities.

15. The nurse is caring for an older client admitted to the hospital with type 2 diabetes. What is important for the nurse to remember about older adults and type 2 diabetes? A: Older adults seldom develop ketoacidosis B: Older adults secrete no endogenous insulin C: Older adults have a lower risk of complications D: Older adults develop a sudden onset of symptoms

A: Older adults seldom develop ketoacidosis.

16.A patient with type 1 comes to the clinic because of concerns regarding erratic control of blood glucose with the prescribed insulin therapy. The patient has been experiencing a sudden fall in the blood glucose level, followed by a sudden episode of hyperglycemia. Which complication of insulin therapy should the nurse conclude that the patient is experiencing? A: Somogyi Effect B: Dawn Phenomenon C: Diabetic ketoacidosis D: Hyperosmolar nonketotic syndrome

A: Somogyi Effect

10. A 12 year old child with type 2 diabetes is scheduled for abdominal surgery. Which factors are MOST important for the nurse to consider during the postoperative period? SATA A: Infection will likely occur at the surgical site B: Ketoacidosis frequently occurs later in the postoperative period C: The blood glucose level will increase because of the stress of surgery D: Urine test results are the most useful gauge of diabetic control after surgery E: Diabetic control is usually maintained with insulin after surgery.

C: Blood glucose level will increase because of the stress of surgery. E: Diabetic control is usually maintained with insulin after surgery.

19. A patient with type 2 diabetes has been receiving insulin in the hospital while being treated for sepsis. The patient's infection is resolving and the pcp writes a Rx to d/c the 7 AM dose of insulin and administer glyburide 5 mg BID. The nurse on day shift administers the glyburide at 0830. When recording the administration in the patients chart, the nurse sees that the insulin had already been given at 0700. What INITIAL action should the nurse take? A: Measure the vital signs B: Notify the primary healthcare provider C: Assess for signs of ketoacidosis D: Check blood glucose for hypoglycemia

D: Check blood glucose for hypoglycemia.

5. What is the safest and MOST reliable birth control method for the nurse to recommend to a patient with type 1 diabetes? A: Vaginal sponge B: Oral contraceptive C: Rhythm method with a condom D: Diaphragm with a spermicidal gel

D: Diaphragm with a spermicidal gel

22. A patient with type 2 is take on glyburide tablet daily. The patient asks whether an extra pill should be taken before exercise. What is the nurse's best response? A: You will need to decrease how much you are exercising B: An extra pill will help your body use glucose when exercising C: The amount of medication you need to take is not related to exercising D: Do not take an extra pill because you may become hypoglycemic when exercising.

D: Do NOT take an extra pill because you may become hypoglycemic while exercising.

20. A patient newly diagnosed with Type 2 diabetes is receiving glyburide and asks the nurse how this drug works. What mechanism of action should the nurse provide? A: Stimulates the pancreas to produce insulin B: Accelerates the liver's release of stored glycogen C: Increases glucose transport across the cell membranes D: Lowers blood glucose in the absence of pancreatic function

A: Stimulates the pancreas to produce insulin.

18. A patient with Type 2 diabetes is admitted for elective surgery. The health care provider prescribes regular insulin even though oral antidiabetics were adequate before the hospitalization. What information does the nurse include when teaching the patient about the addition of insulin? A: You will need a higher serum glucose level while on bed rest B: The tress of surgery may cause uncontrollable periods of hypoglycemia C: With insulin, dosage can be adjusted to your changing needs during recovery from surgery D: The possibility of surgical complications is greater then a client takes oral hypoglycemics.

C: "With insulin, dosage can be adjusted to your changing needs during recovery from surgery."

2. A nurse caring for 2 patients newly dx with diabetes. 1 has type 1 and the other has type 2. When determining the main difference between type 1 and type 2, the nurse recognizes what clinical presentation? A: Onset of the disease is slow B: Excessive weight is a contributing factor C: Complications are not present at the time of diagnosis D: Treatment involves diet, exercise, and oral medications

C: Complications are not present at time of dx.

17. Which clinical indicator should the nurse identify as expected for a patient with type 2 diabetes? A: Ketones in the blood but not in the urine B: Glucose in the urine but not hyperglycemia C: Hyperglycemia and urine negative for ketones D: Blood and urine positive for both glucose and ketones

C: Hyperglycemia and urine negative for ketones.

1. Which instructions will be MOST beneficial for a diabetic client with renal disease? SATA A: Recommend the client drink boiled water B: Suggest the client to go for a morning walk C: Instruct the client to check blood pressure regularly D: Contact the primary healthcare provider before taking ibuprofen E:Encourage the client to undergo a microalbuminuria test yearly

C: Instruct the client to check blood pressure regularly D: Contact PCP before taking ibuprofen E: Encourage the client to undergo a microalbuminuria test.

7. The healthcare provider prescribes one tube of glucose gel for the patient with type 1 diabetes. The nurse recognizes that this is for treatment of which diabetes complication? A: Diabetic acidosis B: Hyperinsulin secretion C: Insulin-induced hypoglycemia D: Idiosyncratic reactions to insulin

C: Insulin-induced hypoglycemia