chapter 51 exam 3 questions

which type of insulin acts most quickly? a. Lispro b. Glargine c. NPH d. Regular

a. Lispro

which would be included in the teaching plan for a client diagnosed with diabetes mellitus? a. an elevated blood glucose concentration contributes to complications of diabetes, such as diminished vision b. sugar is found only in dessert foods c. the 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. an elevated blood glucose concentration contributes to complications of diabetes, such as diminished vision

a client is admitted with diabetic ketoacidosis (DKA). which order from the physician should the nurse implement first? a. infuse 0.9% normal saline solution 1L/hr for 2 hours b. start an infusion of regular insulin at 50U/hr c. administer sodium bicarbonate 50 mEq IV push d. administer regular insulin 30U IV push

a. infuse 0.9% normal saline solution 1L/hr for 2 hours need to correct the dehydration/electrolyte loss and acidosis BEFORE the hyperglycemia

a client with type 1 diabetes is experiencing polyphagia. the nurse knows to assess for which additional clinical manifestation(s) associated with this classic symptom? a. muscle wasting and tissue loss b. altered mental state c. weight gain d. dehydration

a. muscle wasting and tissue loss

which factor is the focus of nutrition intervention for clients with type 2 diabetes? a. weight loss b. blood glucose level c. protein metabolism d. carbohydrate intake

a. weight loss

which clinical manifestation of type 2 diabetes occurs if glucose levels are very high? a. oliguria b. blurred vision c. increased energy d. hyperactivity

b. blurred vision

a client wit type 1 diabetes reports waking up in the middle of the night feeling nervous and confused, with tremors, sweating, and a feeling of hunger. morning fasting blood glucose readings have been 110-140 mg/dL. the client admits to exercising excessively and skipping meals over the past several weeks. based on these symptoms, the nurse plans to instruct the client to a. eat a complex carbohydrate snack in the evening before bed b. check blood glucose at 3am c. skip the evening neutral protamine hagedorn insulin on days when exercising and skipping meals d. administer an increased dose of neutral protamine hagedorn insulin in the evening

b. check blood glucose at 3am

which information should be included in the teaching plan for a client receiving glargine, which is "peakless" basal insulin? a. glargine is rapidly absorbed and has a fast onset of action b. do not mix with other insulins c. draw up the drug first, then add regular insulin d. administer the total daily dosage in 2 doses

b. do not mix with other insulins

a 1200-calorie diet and exercise are prescribed for a client with newly diagnosed type 2 diabetes. the nurse is teaching the client about meal planning using exchange lists. the teaching is determined to be effective based on which statement by the client? a. for dinner i ate 2 ounces of sliced turkey, 1 cup mashed sweet potatoes, half a cup of carrots, half a cup of peas, a 3-ounce dinner roll, 1 medium banana, and a diet soda b. for dinner i ate a 3-ounce hamburger on a bun, with ketchup, pickle, and onion, a green salad with 1 teaspoon italian dressing, 1 cup of watermelon soda, and a diet soda c. for dinner i ate 2 cups of cooked pasta with 3-ounces of boiled shrimp, 1 cup plum tomatoes, half a cup of peas in a garlic wine sauce, 2 cups of fresh strawberries, and ice water with lemon d. for dinner i ate 4 ounces of sliced roast beef on a bagel with lettuce, tomato, and onion, 1 ounce low-fat cheese, 1 tablespoon mayonnaise, 1 cup fresh strawberry shortcake, and unsweetened iced tea

b. for dinner i ate a 3-ounce hamburger on a bun, with ketchup, pickle, and onion, a green salad with 1 teaspoon italian dressing, 1 cup of watermelon soda, and a diet soda

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. glucose via an oral glucose tolerance test b. glycosylated hemoglobin level c. fasting blood glucose level d. glucose via a urine dipstick test

b. glycosylated hemoglobin level

a client with diabetes mellitus is receiving an oral antidiabetic agent. the nurse observes for which symptom when caring for this client? a. blurred vision b. hypoglycemia c. polyuria d. polydipsia

b. hypoglycemia

a client with type 2 diabetes has recently been prescribed acarbose, and the nurse is explaining how to take this medication. the teaching is determined to be effective based on which statement by the client? a. i will take this medication in the morning, 15 minutes before breakfast b. i will take this medication in the morning, with my first bite of breakfast c. this medication needs to be taken after the midday meal d. it does not matter what time of day i take this medication

b. i will take this medication in the morning, with my first bite of breakfast

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 regular insulin is drawn up into the syringe first c. there is no need to inject air into the bottle of insulin before withdrawing the insulin d. when mixing insulin, the NPH insulin is drawn up into the syringe first

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

the nurse is administering lispro insulin. based on the onset of actions, how long before breakfast should the nurse administer the injection? a. 1-2 hours b. 30-40 minutes c. 10-15 minutes d. 3 hours

c. 10-15 minutes

which statement is true regarding gestational diabetes? a. onset usually occurs in the first trimester b. there is a low risk for perinatal complications c. a glucose challenge test should be performed between 24-28 weeks d. it occurs in the majority of pregnancies

c. a glucose challenge test should be performed between 24-28 weeks

a client newly diagnosed with type 1 diabetes has an unusual increase in blood glucose from bedtime to morning. the physician suspects the client is experiencing insulin waning. based on this diagnosis, the nurse expects which change to the clients medication regemin? a. changing the time of evening injection of intermediate-acting insulin from dinnertime to bedtime b. decreasing evening bedtime dose of intermediate-acting insulin and administering a bedtime snack c. administering a dose of intermediate-acting insulin before the evening meal d. increasing morning dose of long-acting insulin

c. administering a dose of intermediate-acting insulin before the evening meal

a client is admitted to the health care center with abdominal pain, nausea, and vomiting. the medical reports indicate a history of type 1 diabetes. the nurse suspects the client's symptoms to be those of diabetic ketoacidosis (DKA). which action will help the nurse confirm the diagnosis? a. assess the clients ability to move all extremities b. assess the clients ability to take a deep breath c. assess the clients breath odor d. assess for excessive sweating

c. assess the clients breath odor

a nurse is preparing to discharge a client with coronary artery disease and hypertension who is at risk for type 2 diabetes. which information is important to include in the discharge teaching? a. how to self-inject insulin b. how to monitor ketones daily c. how to control blood glucose through lifestyle modification with diet and exercise d. how to organize signs of diabetic ketoacidosis

c. how to control blood glucose through lifestyle modification with diet and exercise

NPH is an example of which type of insulin? a. rapid-acting b. long-acting c. intermediate-acting d. short-acting

c. intermediate-acting

which statement is correct regarding glargine insulin? a. it is absorbed rapidly b. it is given twice daily c. it cannot be mixed with any other type of insulin d. its peak action occurs in 2-3 hours

c. it cannot be mixed with any other type of insulin

which is a by-product of fat breakdown in the absence of insulin and accumulates in the blood and urine? a. creatinine b. hemoglobin c. ketones d. cholesterol

c. ketones

a nurse is teaching a client recovering from DKA about management of "sick days". the client asks the nurse why it is important to monitor the urine for ketones. which statement is the nurse's best response? a. when the body does not have enough insulin, hyperglycemia occurs. excess glucose is broken down by the liver, causing acidic by-products to be released b. ketones are formed when insufficient insulin leads to cellular starvation. as cells rupture, they release these acids into the blood c. ketones accumulate in the blood and urine when fat breaks down in the absence of insulin. ketones signal an insulin deficiency that will cause the body to start breaking down stored fat for energy d. excess glucose in the blood is metabolized by the liver and turned into ketones, which are an acid

c. ketones accumulate in the blood and urine when fat breaks down in the absence of insulin. ketones signal an insulin deficiency that will cause the body to start breaking down stored fat for energy

a client with diabetes mellitus is prescribed to switch from animal to synthesized human insulin. which factor should the nurse monitor when caring for the client? a. polyuria b. hypertonicity c. low blood glucose concentration d. allergic reactions

c. low blood glucose concentration

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 contribute which factor as a cause of type 1 diabetes? a. obesity b. rare ketosis c. presence of autoantibodies against islet cells d. altered glucose metabolism

c. presence of autoantibodies against islet cells

which clinical characteristic is associated with type 1 diabetes (previously referred to as insulin-dependent diabetes mellitus? a. requirement for oral hypoglycemic agents b. rare ketosis c. presence of islet cell antibodies d. obesity

c. presence of islet cell antibodies

which category of oral antidiabetic exerts the primary action by directly stimulating the pancreas to secrete insulin? a. biguanides b. alpha-glucosidase inhibitors c. sulfonylureas d. thiazolidinediones

c. sulfonylureas

a client receives a daily injection of glargine insulin at 7am. when should the nurse monitor this client for a hypoglycemic reaction? a. between 8-10am b. between 4-6pm c. this insulin has no peak action and does not cause a hypoglycemic reaction d. between 7-9pm

c. this insulin has no peak action and does not cause a hypoglycemic reaction

a client with type 1 diabetes mellitus is being taught about self-injection of insulin. which fact about site rotation should the nurse include in the teaching? a. choose a different site at random for each injection b. avoid the abdomen because absorption there is irregular c. use all available injection sites within one area d. rotate sites from area to area every other day

c. use all available injection sites within one area

once digested, what percentage of carbohydrates is converted to glucose? a. 80 b. 70 c. 90 d. 100

d. 100

glycosated hemoglobin reflects blood glucose concentrations over which period of time? a. 1 month b. 9 months c. 6 months d. 3 months

d. 3 months

which clinical characteristic is associated with type 2 diabetes (previously referred to as non-insulin-dependent diabetes mellitus? a. clients demonstrate islet cell antibodies b. client is prone to ketosis c. client is usually thin at diagnosis d. blood glucose can be controlled through diet and exercise

d. blood glucose can be controlled through diet and exercise

which age-related change may affect diabetes and its management? a. increased thirst b. hypotension c. increased bowel motility d. decreased renal function

d. decreased renal function

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. dizziness c. fatigue d. increased hunger

d. increased hunger

which term refers to the progressive increase in blood glucose from bedtime to morning? a. diabetic ketoacidosis (DKA) b. Somogyi effect c. Dawn phenomenon d. insulin waning

d. insulin waning

which may be potential cause of hypoglycemia in the client diagnosed with diabetes mellitus? a.the client has not been exercising b. the client has not complied with the prescribed treatment regimen c. the client has eaten but has not taken or received insulin d. the client has not eaten but continues to take insulin or oral antidiabetic medications

d. the client has not eaten but continues to take insulin or oral antidiabetic medications

a 16-year old client newly diagnosed with type 1 diabetes has a very low body-weight despite regular meals. the client is upset because friends frequently state "you look anorexic". which statement by the nurse would be the best response to help this client understand the cause of weight loss due to this condition? a. dont worry about what your friends think, the carbohydrates you eat are being quickly digested, increasing your metabolism b. you may be having undiagnosed infections, causing you to lose extra weight c. i will refer you to a dietician who can help you with your weight d. your body is using protein and fat for energy instead of glucose

d. your body is using protein and fat for energy instead of glucose