Chapter 48 Online questions
The nurse is teaching a patient with type 2 diabetes mellitus how to prevent diabetic nephropathy. Which statement made by the patient indicates that teaching has been successful?
"I can help control my blood pressure by avoiding foods high in salt."
The nurse instructs a patient with diabetes mellitus about a healthy eating plan. Which statement made by the patient indicates that teaching was successful?
"I may have a hypoglycemic reaction if I drink alcohol on an empty stomach."
The nurse has taught a patient admitted with diabetes principles of foot care. The nurse evaluates that the patient understands the principles of foot care if the patient makes what statement?
"I should look at the condition of my feet every day."
The nurse teaches a patient recently diagnosed with type 1 diabetes mellitus about insulin administration. Which statement by the patient requires an intervention by the nurse?
"I will discard any insulin bottle that is cloudy in appearance."
The nurse is teaching a patient with type 2 diabetes mellitus about exercise to help control blood glucose. The nurse knows the patient understands when the patient elicits which exercise plan?
"I will take a brisk 30-minute walk 5 days per week and do resistance training three times a week."
A patient admitted with type 2 diabetes asks the nurse what "type 2" means. What is the most appropriate response by the nurse?
"With type 2 diabetes, insulin secretion is decreased, and insulin resistance is increased."
The patient received regular insulin 10 units subcutaneously at 8:30 PM for a blood glucose level of 253 mg/dL. The nurse plans to monitor this patient for signs of hypoglycemia at which time related to the insulin's peak action?
10:30 PM to 1:30 AM
The nurse is reviewing laboratory results for the clinic patients to be seen today. Which patient meets the diagnostic criteria for diabetes mellitus?
A 48-yr-old woman with a hemoglobin A1C of 8.4%
Which patient with type 1 diabetes mellitus would be at the highest risk for developing hypoglycemic unawareness?
A 73-yr-old patient who takes propranolol (Inderal)
The nurse is assigned to the care of a patient diagnosed with type 2 diabetes. In formulating a teaching plan that encourages the patient to actively participate in management of the diabetes, what should be the nurse's initial intervention?
Assess patient's perception of what it means to have diabetes.
The patient with type 1 diabetes mellitus eats a large meal but does not take his insulin as prescribed. In what order do the following physiologic events occur in the development of a hyperglycemic emergency? (Answer with a letter followed by a comma and a space (e.g. A, B, C, D).) __ a. Fat metabolism leads to ketonemia. b. Insufficient insulin in the blood stream c. Fat is mobilized for energy from the adipose tissue. d. Potassium and water are excreted with H+ and ketones in the urine. e. Organic acid accumulation in the blood causes metabolic acidosis.
B, C, A, E, D
A patient with type 2 diabetes has a urinary tract infection (UTI), is difficult to arouse, and has a blood glucose of 642 mg/dL. When the nurse assesses the urine, there are no ketones present. What nursing action is appropriate at this time?
Cardiac monitoring to detect potassium changes
The nurse is assisting a patient with newly diagnosed type 2 diabetes to learn dietary planning as part of the initial management of diabetes. The nurse would encourage the patient to limit intake of which foods to help reduce the percent of fat in the diet?
Cheese
The nurse has been teaching a patient with diabetes mellitus how to perform self-monitoring of blood glucose (SMBG). During evaluation of the patient's technique, the nurse identifies a need for additional teaching when the patient does what?
Chooses a puncture site in the center of the finger pad
A patient is newly diagnosed with type 1 diabetes and reports a headache, changes in vision, and being anxious but does not have a portable blood glucose monitor present. Which action should the nurse advise her to take?
Eat 15 g of simple carbohydrates.
The nurse is evaluating a patient diagnosed with type 2 diabetes mellitus. Which symptom reported by the patient correlates with the diagnosis?
Excessive thirst
The nurse caring for a patient hospitalized with diabetes mellitus would look for which laboratory test result to obtain information on the patient's past glucose control?
Glycosylated hemoglobin level
The nurse is reviewing laboratory results for a patient with a 15-year history of type 2 diabetes. Which result reflects the expected pattern accompanying macrovascular disease as a complication of diabetes?
Increased triglyceride levels
A patient, admitted with diabetes mellitus, has a glucose level of 380 mg/dL and a moderate level of ketones in the urine. As the nurse assesses for signs of ketoacidosis, which respiratory pattern would the nurse expect to find?
Kussmaul respirations
The nurse is teaching a patient who has diabetes about vascular complications of diabetes. What information is appropriate for the nurse to include?
Microangiopathy is specific to diabetes and most commonly affects the capillary membranes of the eyes, kidneys, and skin.
A patient with diabetes mellitus is scheduled for a fasting blood glucose level at 8:00 AM. The nurse instructs the patient to only drink water after what time?
Midnight before the test
A patient with diabetes mellitus who has multiple infections every year needs a mitral valve replacement. What is the most important preoperative teaching the nurse should provide to prevent a cardiac infection postoperatively?
Obtain comprehensive dental care.
The newly diagnosed patient with type 2 diabetes has been prescribed metformin. What should the nurse teach the patient to best explain how this medication works?
Reduces glucose production by the liver and enhances insulin sensitivity
A patient is admitted with diabetes mellitus, malnutrition cellulitis, and a potassium level of 5.6 mEq/L. The nurse understands that what could be contributing factors for this laboratory result (select all that apply.)?
The level may be increased as a result of dehydration that accompanies hyperglycemia. The level may be raised as a result of metabolic ketoacidosis caused by hyperglycemia. The level is consistent with renal insufficiency that can develop with renal nephropathy.
