Diabetes #10
The nurse concludes that a client with type 1 diabetes is experiencing hypoglycemia. Which responses support this conclusion? Select all that apply. Vomiting Headache Tachycardia Cool, clammy skin Increased respirations
Headache Tachycardia Cool, clammy skin
A nurse is caring for several clients with type 1 diabetes, and they each have a prescription for a specific type of insulin. Which insulin does the nurse conclude has the fastest onset of action? NPH insulin Insulin lispro Regular insulin Insulin glargine
Insulin lispro
An adolescent with type 1 diabetes who has a history of inadequate adherence to therapy is admitted to the hospital with a blood glucose level of 700 mg/dL (38.9 mmol/L). A continuous insulin infusion is started. What complication should the nurse make a priority of detecting while the adolescent is receiving the infusion? Hypovolemia Hypokalemia Hypernatremia Hypercalcemia
hypokalemia
A nurse is caring for a client newly diagnosed with type 1 diabetes. When the primary healthcare provider tries to regulate this client's insulin regimen, the client experiences episodes of hypoglycemia and hyperglycemia, and 15 g of a simple sugar is prescribed. What is the reason this is administered when a client experiences hypoglycemia? Inhibits glycogenesis Stimulates release of insulin Increases blood glucose levels Provides more storage of glucose
increases blood glucose levels
The nurse is caring for a client with diabetes mellitus who is scheduled to receive an intravenous (IV) administration of 25 units of insulin in 250 mL normal saline. What does the nurse recognize as the only type of insulin that is compatible with intravenous solutions? NPH insulin Insulin lispro Regular insulin Insulin glargine
regular insulin
What treatment should the nurse suggest to an adolescent with type 1 diabetes if an insulin reaction is experienced while the adolescent is at a basketball game? Call your parents immediately." "Buy a soda and hamburger to eat." "Administer insulin as soon as possible." "Leave the arena and rest until the symptoms subside."
"Buy a soda and hamburger to eat
While obtaining the client's health history, which factor does the nurse identify that predisposes the client to type 2 diabetes? Having diabetes insipidus Eating low-cholesterol foods Being 20 pounds (9 kilograms) overweight Drinking a daily alcoholic beverage
Being 20 pounds (9 kilograms) overweight
A client is diagnosed as having type 2 diabetes. What is a priority teaching goal for the client? To perform foot care daily To administer insulin as prescribed To test urine for both sugar and acetone To identify pending hypoglycemia or hyperglycemia
To identify pending hypoglycemia or hyperglycemia
The nurse is teaching an adolescent with type 1 diabetes who is prescribed a combination of regular insulin and an intermediate-acting insulin to be administered in the morning and throughout the day. The nurse asks the adolescent at what time of day the second dose of NPH insulin should be administered. Which response by the adolescent demonstrates the teaching has been effective? At lunch At dinnertime 1 hour after lunch 1 hour after dinner
at dinner time
A nurse is formulating a teaching plan for a client recently diagnosed with type 2 diabetes. What interventions should the nurse include to decrease the risk of complications? Select all that apply Examine the feet daily Wear well-fitting shoes Perform regular exercise Powder the feet after showering Visit the primary healthcare provider weekly Test bathwater with the toes before bathing
examine the feet daily wear well fitting shoes perform regular exercise
The nurse is preparing a client who is on metformin therapy and is scheduled to undergo renal computed tomography with contrast dye. What does the nurse anticipate the primary healthcare provider to inform the client regarding the procedure? "Discontinue metformin 1 day prior to procedure." "Discontinue metformin a half-day prior to procedure." "Discontinue metformin 3 days following the procedure." "Discontinue metformin 7 days following the procedure." "Discontinue metformin 7 days following the procedure
"Discontinue metformin 1 day prior to procedure."
A school nurse is teaching a 12-year-old child with recently diagnosed type 1 diabetes about the action of insulin injections. What statement indicates that the child understands how insulin works in the body? "Glucose is released as fats break down." "It keeps glucose from being stored in the liver." "Glucose is carried into cells, where it is used for energy." "It stops wasting of blood glucose by converting it to glycogen."
"Glucose is carried into cells, where it is used for energy."
A nurse teaches a client with type 2 diabetes how to provide self-care to prevent infections of the feet. Which statement made by the client shows that teaching was effective? "I should massage my feet and legs with oil or lotion." "I should apply heat intermittently to my feet and legs." "I should eat foods high in protein and carbohydrate kilocalories." "I should control my blood glucose with diet, exercise, and medication."
"I should control my blood glucose with diet, exercise, and medication."
A client with a new diagnosis of type 1 diabetes is told that lifelong insulin will be needed. The client becomes agitated and says, "I am scared of shots. If that is my only option, I'll just have to go into a coma and die!" What is the nurse's best response? "Injections are not the only option available for insulin." "It won't be so bad; you will get used to it if you will only try. "This is one of those times when you need to act like an adult." "Clients have the right to refuse treatment, but I need you to sign this form that removes us from liability for your decision."
"Injections are not the only option available for insulin."
A nurse is monitoring a client's laboratory results for a fasting plasma glucose level. Within which range of a fasting plasma glucose level does the nurse conclude that a client is considered to be diabetic? 40 to 60 mg/dL (2.2 to 3.3 mmol/L) 80 to 99 mg/dL (4.5 to 5.5 mmol/L) 100 to 125 mg/dL (5.6 to 6.9 mmol/L) 126 to 140 mg/dL (7.0 to 7.8 mmol/L)
126 to 140 mg/dL (7.0 to 7.8 mmol/L)
A client who is 60 pounds (27.2 kilograms) more than the ideal body weight is admitted to the hospital with a diagnosis of type 1 diabetes. Which concept should the nurse include in teaching about diabetes when discussing strategies to lose weight? Obesity leads to insulin resistance. Surplus fat causes excretion of insulin. Fat cells absorb insulin and prevent its circulation to other cells. Lipids accumulate in the pancreas and interfere with insulin production
Obesity leads to insulin resistance.
When obtaining a health history from a client recently diagnosed with type 1 diabetes, the nurse expects the client to report what clinical manifestations? Irritability, polydipsia, and polyuria Polyuria, polydipsia, and polyphagia Nocturia, weight loss, and polydipsia Polyphagia, polyuria, and diaphoresis
Polyuria, polydipsia, and polyphagia
A 16-year-old adolescent with recently diagnosed type 1 diabetes will receive NPH insulin subcutaneously. The nurse teaches the adolescent about peak action of the drug and the risk for hypoglycemia. How many hours after NPH insulin administration does the insulin peak? 1 to 2 hours 2 to 4 hours 5 to 10 hours 4 to 12 hours
4 to 12 hours
The nurse is teaching a client newly diagnosed with diabetes about the importance of glucose monitoring. Which blood glucose levels should the nurse identify as hypoglycemia? 68 mg/dL (3.8 mmol/L) 78 mg/dL (4.3 mmol/L) 88 mg/dL (4.9 mmol/L) 98 mg/dL (5.4 mmol/L)
68 mg/dL (3.8 mmol/L)
When teaching an adolescent with type 1 diabetes about dietary management, what instruction should the nurse include? Meals should be eaten at home. Foods should be weighed on a gram scale. A ready source of glucose should be available. Specific foods should be cooked for the adolescent.
A ready source of glucose should be available.
A nurse is caring for an older client 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 client? Select all that apply. Leg ulcers Loss of visual acuity Increased creatinine clearance Prolonged capillary refill in the toes Decreased sensation in the lower extremities
Leg ulcers Loss of visual acuity Prolonged capillary refill in the bones Decreased sensation in the lower extremities
The nurse is caring for a client newly diagnosed with diabetes. What symptom of hypoglycemia is most common and should be taught to the client? Kussmaul respirations Tachycardia Confusion Anorexia
confusion
A nurse explains to a client with diabetes that self-monitoring of blood glucose is preferred to urine glucose testing. Why is blood glucose monitoring preferred? Blood glucose monitoring is more accurate. Blood glucose monitoring is easier to perform. Blood glucose monitoring is done by the client Blood glucose monitoring is not influenced by drugs.
Blood glucose monitoring is more accurate.
A nurse is caring for a client 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? Blurry, spotty, or hazy vision Arthritic changes in the hands Hyperactive knee and ankle jerk reflexes Dependent pallor of the feet and lower legs
Blurry, spotty, or hazy vision
A nurse is caring for a client who has had type 1 diabetes for 25 years. The client states, "I have been really bad for the last 15 years. I have not paid attention to my diet and have done little to control my diabetes." What common complications of diabetes might the nurse expect to identify when assessing this client? Select all that apply. Leg ulcers Loss of visual acuity Thick, yellow toenails Increased growth of body hair Decreased sensation in the feet
Leg ulcers Loss of visual acuity Thick, yellow toenails Decreased sensation in the feet
A client feeling increasingly tired seeks medical care. Type 1 diabetes is diagnosed. What causes increased fatigue with type 1 diabetes? Increased metabolism at the cellular level Increased glucose absorption from the intestine Decreased production of insulin by the pancreas Decreased glucose secretion into the renal tubules
Decreased production of insulin by the pancreas
A client with type 1 diabetes complains of hunger, thirst, tiredness, and frequent urination. Based on these findings, the nurse should take what action? Notify the physician immediately about the client's symptoms. Determine the client's blood glucose level. Administer the client's prescribed insulin. Give the client a peanut butter and graham cracker snack.
Determine the client's blood glucose level
A nurse is caring for a school-aged child with type 1 diabetes and determines that the child is experiencing an episode of hyperglycemia. What assessments led the nurse to this conclusion? Select all that apply. Irritability Dry skin Diaphoresis Increased thirst Deep, rapid breathing
Dry skin Diaphoresis Increased thirst Deep, rapid breathing
Four hours after surgery, the blood glucose level of a client who has type 1 diabetes is elevated. What intervention should the nurse implement? Administer an oral hypoglycemic Institute urine glucose monitoring Give supplemental doses of regular insulin Decrease the rate of the intravenous infusion
Give supplemental doses of regular insulin
A nurse is caring for a client with type 1 diabetes who developed ketoacidosis. Which laboratory value supports the presence of diabetic ketoacidosis? Decreased serum glucose levels Decreased serum calcium levels Increased blood urea nitrogen levels Increased serum bicarbonate levels
Increased blood urea nitrogen levels
A 15-year-old adolescent is found to have type 1 diabetes. What should the nurse include when teaching the adolescent about type 1 diabetes? It does not always require insulin. It involves early vascular changes. It occurs more often in obese adolescents. It has a more rapid onset than does type 2 diabetes.
It has a more rapid onset than does type 2 diabetes.
A nurse plans to teach a school-aged child with type 1 diabetes who is receiving both intermediate-acting insulin (Novolin N) and regular insulin (Novolin R) daily how to self-administer the insulin before discharge. What should the nurse teach the child? Practice using the nonmedicated insulin pen first. Alternate sites until the best one to use is found. Draw up the Novolin N first and then draw up the regular insulin. Self-inject the insulin immediately after being taught the technique.
Practice using the nonmedicated insulin pen first.
The nurse is caring for a client newly diagnosed with diabetes. When preparing the teaching plan about the importance of yearly eye examinations, the nurse should instruct the client on which eye problem most associated with diabetes? Cataracts Glaucoma Retinopathy Astigmatism
Retinopathy
While hospitalized, a client with diabetes is observed picking at calluses on the feet. Which intervention should the nurse implement immediately? Warn the client of the danger of infection Suggest that the client wear white cotton socks Teach the client the importance of effective foot care Check the client's shoes for their fit in the area of the calluses
Teach the client the importance of effective foot care
At 7:00 AM a nurse learns that an adolescent with diabetes had a 6:30 AM fasting blood glucose level of 180 mg/dL (10.0 mmol/L). What is the priority nursing action at this time? Encouraging the adolescent to start exercising Asking the adolescent to obtain an immediate glucometer reading Informing the adolescent that a complex carbohydrate such as cheese should be eaten Telling the adolescent that the prescribed dose of rapid-acting insulin should be administered
Telling the adolescent that the prescribed dose of rapid-acting insulin should be administered
The nurse provides education related to manifestations of hyperglycemia to a client with type 1 diabetes. Which signs and symptoms identified by the client indicate that the teaching was effective? Select all that apply. Thirst Headache Nervousness Fruity breath odor Excessive urination
Thirst Fruity odor breath Excessive urination
When assessing the laboratory values of a client with type 2 diabetes, what would the nurse expect the results to reveal? Ketones in the blood but not in the urine Glucose in the urine but not in the blood Urine and blood positive for glucose and ketones Urine negative for ketones and positive glucose in the blood
Urine negative for ketones and positive glucose in the blood
A 17-year-old student with type 1 diabetes asks the nurse which hormone causes the blood glucose level to rise. When responding, the nurse should explain in language that the client can understand that liver glycogenolysis is stimulated by a hormone secreted by the islets of Langerhans. Which hormone is this? Adrenocorticotropic hormone (ACTH) Insulin Glucagon Epinephrine
glucagon
While a nurse is teaching a client with diabetes about food choices, the client states, "I do not like broccoli." Which food should the nurse suggest to substitute for broccoli? Peas Corn Green beans Mashed potato
green beans
The nurse is counseling a client with type 1 diabetes about the client's favorite foods that are lowest in carbohydrates (CHO). Which food choice picked by the client determines that teaching was effective? Skim milk Apple juice Nonfat yogurt Fresh orange juice
skim milk
A client newly diagnosed with type 1 diabetes is taught to exercise on a regular basis. What is the primary reason for instruction on exercise? To decrease insulin sensitivity To stimulate glucagon production To improve the cellular uptake of glucose To reduce metabolic requirements for glucose
to improve the cellular uptake of glucose
The nurse is providing instructions about foot care for a client with diabetes mellitus. What should the nurse include in the instructions? Select all that apply. Wear shoes when out of bed. Soak the feet in warm water daily. Dry between the toes after bathing. Remove corns as soon as they appear. Use a heating pad when the feet feel cold.
wear shoes when out of bed dry between the toes after bathing
When obtaining the history of a client recently diagnosed with type 1 diabetes, what will the nurse expect to discover? Edema Anorexia Weight loss Hypoglycemic episodes
weight loss
