Chapter 51: Diabetes Med/Surg 2

A client with diabetes mellitus has a blood glucose level of 40 mg/dL. Which rapidly absorbed carbohydrate would be most effective? A. 1/2 cup fruit juice or regular soft drink B. 4 oz of skim milk C. 1/2 tbsp honey or syrup D. three to six LifeSavers candies

A. 1/2 cup fruit juice or regular soft drink

The nurse is administering lispro insulin. Based on the onset of action, how long before breakfast should the nurse administer the injection? A. 10 to 15 minutes B. 30 to 40 minutes C. 1 to 2 hours D. 3 hours

A. 10 to 15 minutes

A client with diabetes comes to the clinic for a follow-up visit. The nurse reviews the client's glycosylated hemoglobin test results. Which result would indicate to the nurse that the client's blood glucose level has been well controlled? A.6.5% B.7.5% C.8.0% D.8.5%

A. 6.5%

A health care provider prescribes short-acting insulin for a patient, instructing the patient to take the insulin 20 to 30 minutes before a meal. The nurse explains to the patient that Humulin-R taken at 6:30 AM will reach peak effectiveness by: A. 8:30 AM. B. 10:30 AM. C. 12:30 PM. D. 2:30 PM.

A. 8:30 AM

A nurse is caring for a diabetic patient with a diagnosis of nephropathy. What would the nurse expect the urinalysis report to indicate? A. Albumin B. Bacteria C. Red blood cells D. White blood cells

A. Albumin

When the nurse is caring for a patient with type 1 diabetes, what clinical manifestation would be priority to closely monitor? A. Hypoglycemia B. Hyponatremia C. Ketonuria D. Polyphagia

A. Hypoglycemia

A nurse is providing education to a client who is newly diagnosed with diabetes mellitus. What are classic symptoms associated with diabetes? A. Increased thirst, Hunger, and urination B. Increased weight loss, dehydration, and fatigue C. Loss of appetite, increased urination, and dehydration D. Increased weight gain, appetite, and thirst.

A. Increased Thirst, Hunger, and urination

A nurse is caring for a client with an abnormally low blood glucose concentration. What glucose level should the nurse observe when assessing laboratory results? A. Less than 70 mg/dL (3.7 mmol/L) B. Between 70 and 75 mg/dL (3.9 to 4.16 mmol/L) C. Between 75 and 90 mg/dL (4.16 to 5.00 mmol/L) D. 95 mg/dL (5.27 mmol/L)

A. Less than 70 mg/dl (3.7 mmol/L)

A client with diabetes is receiving an oral antidiabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer? A. Metformin B. Glyburide C. Repaglinide D. Glipizide

A. Metformin

Glycosylated hemoglobin reflects blood glucose concentrations over which period of time? A. 1 month B. 3 months C. 6 months D. 9 months

B. 3 months

When administering insulin to a client with type 1 diabetes, which of the following would be most important for the nurse to keep in mind? A. Duration of the insulin B. Accuracy of the dosage C. Area for insulin injection D. Technique for injecting

B. Accuracy of the dosage

A nurse is preparing a client with type 1 diabetes for discharge. The client can care for himself; however, he's had a problem with unstable blood glucose levels in the past. Based on the client's history, he should be referred to which health care worker? A. Home health nurse B. Dietitian C. Psychiatrist D. Social worker

B. Dietician

A nurse is preparing a client with type 1 diabetes for discharge. The client can care for himself; however, he's had a problem with unstable blood glucose levels in the past. Based on the client's history, he should be referred to which health care worker? A.Home health nurse B. Dietician C. Psychiatrist D.Social worker

B. Dietician

A client with diabetes mellitus is receiving an oral anti diabetic agent. The nurse observes for which symptom when caring for this client? A. Polyuria B. Hypoglycemia C. Blurred vision D. Polydipsia

B. Hypoglycemia

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? A. Numbness B. Increased hunger C. Fatigue D. Dizziness

B. Increased hunger

The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which of the following would the nurse include as associated with type 2 diabetes? A. Onset most common during adolescence B. Insufficient insulin production C. Less common than type 1 diabetes D. Little relation to pre-diabetes

B. Insufficient insulin production

The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which of the following would the nurse include as associated with type 2 diabetes? A. Onset most common during adolescence. B. Insufficient insulin production C. Less common than type 1 D. Little relation to prediabetes

B. Insufficient insulin production

Which statement is correct regarding glargline insulin? A. Its peak action occurs in 2 to 3 hours B. It cannot be mixed with any other type of insulin. C. It is absorbed rapidly. D. It is given twice daily

B. It cannot be mixed with any other type of insulin.

Which is the primary reason for encouraging injection site rotation in an insulin dependent diabetic? A. Avoid infection B. Promote absorption C. Minimize discomfort D. Prevent muscle destruction

B. Promote absorption

A client with diabetes mellitus has a prescription for 5 units of U-100 regular insulin and 25 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. At about 4:30 p.m., the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms? A. Serum Glucose level of 450 mg/dl B. Serum Glucose level of 52 mg/dl C. Serum calcium level of 8.9 mg/dl D. Serum Calcium level of 10.2 mg/dl

B. Serum Glucose level of 52 mg/dl

A client with type 1 diabetes presents with a decreased level of consciousness and a fingerstick glucose level of 39 mg/dl. His family reports that he has been skipping meals in an effort to lose weight. Which nursing intervention is most appropriate? A. Inserting a feeding tube and providing tube feedings B. Administering a 500-ml bolus of normal saline solution C. Administering 1 ampule of 50% dextrose solution, per physician's order D. Observing the client for 1 hour, then rechecking the finger stick glucose level.

C. Administering 1 ampule of 50% dextrose solution, per physician's order

During a follow-up visit 3 months after a new diagnosis of type 2 diabetes, a client reports exercising and following a reduced-calorie diet. Assessment reveals that the client has only lost 1 pound and did not bring the glucose-monitoring record. Which value should the nurse measure? A. Fasting blood glucose level B. Glucose via a urine dipstick test C. Glycosylated hemoglobin level D. Glucose via an oral glucose tolerance test.

C. Glycosylated hemoglobin level

A patient who is diagnosed with type 1 diabetes would be expected to: A. Be restricted to an American Diabetic Association Diet B. Have no damage to the islet cells of the pancreas C. Need exogenous insulin D. Receive daily doses of hypoglycemic agent.

C. Need exogenous insulin

The nurse is teaching a client about self-administration of insulin and about mixing regular and neutral protamine Hagedorn (NPH) insulin. Which information is important to include in the teaching plan? A. If two different types of insulin are ordered, they need to be given in separate injections. B. When mixing insulin, the NPH insulin is drawn up into the syringe first. C. When mixing insulin, the regular insulin is drawn up into the syringe first. D. There is no need to inject air into the bottle of insulin before withdrawing the insulin.

C. when mixing insulin, the regular insulin is drawn up into the syringe first.

A patient who is 6 months' pregnant was evaluated for gestational diabetes mellitus. The doctor considered prescribing insulin based on the serum glucose result of: A. 90 mg/dL before meals. B. 120 mg/dL, 1 hour postprandial. C. 80 mg/dL, 1 hour postprandial. D. 138 mg/dL, 2 hours postprandial.

D. 138 mg/dl, 2 hours postprandial

Which information should be included in the teaching plan for a client receiving glargine "peak less" basal insulin? A. Administer the total daily dosage in two doses. B. Draw up the drug first, then add regular insulin. C. It is rapidly absorbed and has a fast onset of action. D. Do not mix with other insulins.

D. Do not mix with other insulins.

The nurse is explaining glycosylated hemoglobin testing to a diabetic client. Which of the following provides the best reason for this order? A. Provides best information on the body's ability to maintain normal blood functioning B. Best indicator for the nutritional state of the client C. Is less costly than performing daily blood sugar test D. Reflects the amount of glucose stored in hemoglobin over past several months.

D. Reflects the amount of glucose stored in hemoglobin over past several months.

A client with diabetes is receiving an oral anti diabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer? A. Metformin B. Glyburide C. Repaglinide D. Glipizide

A. Metformin

A nurse is teaching a diabetic support group about the causes of type 1 diabetes. The teaching is determined to be effective when the group is able to attribute which factor as a cause of type 1 diabetes? A. Presence of Autoantibodies against islet cells B. Obesity C. Rare Ketosis D. Altered glucose metabolism

A. Presence of Autoantibodies against islet cells

After being sick for 3 days, a client with a history of diabetes mellitus is admitted to the hospital with diabetic ketoacidosis (DKA). The nurse should evaluate which diagnostic test results to prevent dysrhythmias? A.Serum potassium level B. Serum calcium level C. Serum sodium level D. Serum chloride level

A. Serum potassium level

A client with a history of type 1 diabetes is demonstrating fast, deep, labored breathing and has fruity odored breath. What could be the cause of the client's current serious condition? A. Ketoacidosis B. Hyperosmolar Hyperglycemic non ketotic syndrome C. Hepatic disorder D. All options are correct

A. Ketoacidosis

A male client, aged 42 years, is diagnosed with diabetes mellitus. He visits the gym regularly and is a vegetarian. Which of the following factors is important when assessing the client? A. the client's consumption of carbohydrates B. History of radiographic contrast studies that used iodine C. The client's mental and emotional status D. The client's exercise routine

A. the Client's consumption of carbohydrates

Which type of insulin acts MOST quickly? A. Regular B. NPH C. Lispro D. Glargine

C. Lispro

A patient has been newly diagnosed with type 2 diabetes, and the nurse is assisting with the development of a meal plan. What step should be taken into consideration prior to making the meal plan? A. Making sure that the patient is aware that quantity of foods will be limited B. Ensuring that the patient understands that some favorite foods may not be allowed on the meal plan and substitutes will need to be found C. Determining whether the patient is on insulin or taking oral anti-diabetic medication D. Reviewing the patient's diet history to identify eating habits and lifestyle and cultural eating patterns

D. Reviewing the patient's diet history to identify eating habits and lifestyle and cultural eating patterns.

Which of the following factors would a nurse identify as a most likely cause of diabetic keto acidosis (DKA) in a client with diabetes? A. The client continues medication therapy despite adequate food intake. B. The client has not consumed sufficient calories. C. The client has been exercising more than usual. D. The client has eaten and has not taken or received insulin.

D. The client has eaten and has not taken or received insulin.