diabetes

7.A nurse assesses clients who are at risk for diabetes mellitus. Which client is at greatest risk? A 29-year-old Caucasian A 32-year-old African- American A 44-year-old Asian A 48-year-old American Indian

A 48-year-old American Indian

12.A nurse cares for a client with diabetes mellitus who asks, Why do I need to administer more than one injection of insulin each day? How should the nurse respond? You need to start with multiple injections until you become more proficient at self-injection. A single dose of insulin each day would not match your blood insulin levels and your food intake patterns. A regimen of a single dose of insulin injected each day would require that you eat fewer carbohydrates. A single dose of insulin would be too large to be absorbed, predictably putting you at risk for insulin shock.

A single dose of insulin each day would not match your blood insulin levels and your food intake patterns.

4.A nurse provides diabetic education at a public health fair. Which disorders should the nurse include as complications of diabetes mellitus? (Select all that apply.) a. Stroke b. Kidney failure c. Blindness d. Respiratory failure e. Cirrhosis

A, B, C

5.A nurse collaborates with the interdisciplinary team to develop a plan of care for a client who is newly diagnosed with diabetes mellitus. Which team members should the nurse include in this interdisciplinary team meeting? (Select all that apply.) a. Registered dietitian b. Clinical pharmacist c. Occupational therapist d. Health care provider e. Speech-language pathologist

A, B, D

3.A nurse teaches a client with diabetes mellitus about foot care. Which statements should the nurse include in this clients teaching? (Select all that apply.) a. Do not walk around barefoot. b. Soak your feet in a tub each evening. c. Trim toenails straight across with a nail clipper. d. Treat any blisters or sores with Epsom salts. e. Wash your feet every other day.

A, C

2.A nurse assesses a client who is experiencing diabetic ketoacidosis (DKA). For which manifestations should the nurse monitor the client? (Select all that apply.) a. Deep and fast respirations b. Decreased urine output c. Tachycardia d. Dependent pulmonary crackles e. Orthostatic hypotension

A, C, E

1.A nurse assesses clients at a health fair. Which clients should the nurse counsel to be tested for diabetes? (Select all that apply.) a. 56-year-old African-American male b.Female with a 30-pound weight gain during pregnancy c.Male with a history of pancreatic trauma d. 48-year-old woman with a sedentary lifestyle e. Male with a body mass index greater than 25 kg/m2 f. 28-year-old female who gave birth to a baby weighing 9.2 pounds

A, D, E, F

14.A nurse assesses a client with diabetes mellitus and notes the client only responds to a sternal rub by moaning, has capillary blood glucose of 33 g/dL, and has an intravenous line that is infiltrated with 0.45% normal saline. Which action should the nurse take first? Administer 1 mg of intramuscular glucagon. Encourage the client to drink orange juice. Insert a new intravenous access line. Administer 25 mL dextrose 50% (D50) IV push.

Administer 1 mg of intramuscular glucagon.

31.A nurse assesses a client who has diabetes mellitus and notes the client is awake and alert, but shaky, diaphoretic, and weak. Five minutes after administering a half-cup of orange juice, the clients clinical manifestations have not changed. Which action should the nurse take next? Administer another half-cup of orange juice. Administer a half-ampule of dextrose 50% intravenously. Administer 10 units of regular insulin subcutaneously. Administer 1 mg of glucagon intramuscularly.

Administer another half-cup of orange juice.

45.At 4:45 p.m., a nurse assesses a client with diabetes mellitus who is recovering from an abdominal hysterectomy 2 days ago. The nurse notes that the client is confused and diaphoretic. The nurse reviews the assessment data provided in the chart below: After reviewing the clients assessment data, which action is appropriate at this time? Assess the clients oxygen saturation level and administer oxygen. Reorient the client and apply a cool washcloth to the clients forehead. Administer dextrose 50% intravenously and reassess the client. Provide a glass of orange juice and encourage the client to eat dinner.

Administer dextrose 50% intravenously and reassess the client.

20.A nurse cares for a client experiencing diabetic ketoacidosis who presents with Kussmaul respirations. Which action should the nurse take? Administration of oxygen via face mask Intravenous administration of 10% glucose Implementation of seizure precautions Administration of intravenous insulin

Administration of intravenous insulin

9.A nurse teaches a client with type 2 diabetes mellitus who is prescribed glipizide (Glucotrol). Which statement should the nurse include in this clients teaching? Change positions slowly when you get out of bed. Avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs). If you miss a dose of this drug, you can double the next dose. Discontinue the medication if you develop a urinary infection.

Avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs).

16.A nurse teaches a client who is prescribed an insulin pump. Which statement should the nurse include in this clients discharge education? Test your urine daily for ketones. Use only buffered insulin in your pump. Store the insulin in the freezer until you need it. Change the needle every 3 days.

Change the needle every 3 days.

25.A nurse assesses a client with diabetes mellitus 3 hours after a surgical procedure and notes the clients breath has a fruity odor. Which action should the nurse take? Encourage the client to use an incentive spirometer. Increase the clients intravenous fluid flow rate. Consult the provider to test for ketoacidosis. Perform meticulous pulmonary hygiene care.

Consult the provider to test for ketoacidosis.

26.A preoperative nurse assesses a client who has type 1 diabetes mellitus prior to a surgical procedure. The clients blood glucose level is 160 mg/dL. Which action should the nurse take? Document the finding in the clients chart. Administer a bolus of regular insulin IV. Call the surgeon to cancel the procedure. Draw blood gases to assess the metabolic state.

Document the finding in the clients chart.

42.A nurse prepares to administer insulin to a client at 1800. The clients medication administration record contains the following information: Insulin glargine: 12 units daily at 1800 Regular insulin: 6 units QID at 0600, 1200, 1800, 2400 Based on the clients medication administration record, which action should the nurse take? Draw up and inject the insulin glargine first, and then draw up and inject the regular insulin. Draw up and inject the insulin glargine first, wait 20 minutes, and then draw up and inject the regular insulin. First draw up the dose of regular insulin, then draw up the dose of insulin glargine in the same syringe, mix, and inject the two insulins together. First draw up the dose of insulin glargine, then draw up the dose of regular insulin in the same syringe, mix, and inject the two insulins together.

Draw up and inject the insulin glargine first, and then draw up and inject the regular insulin.

4.A nurse assesses a client who has a 15-year history of diabetes and notes decreased tactile sensation in both feet. Which action should the nurse take first? Document the finding in the clients chart. Assess tactile sensation in the clients hands. Examine the clients feet for signs of injury. Notify the health care provider.

Examine the clients feet for signs of injury.

34.A nurse assesses a client who is being treated for hyperglycemic-hyperosmolar state (HHS). Which clinical manifestation indicates to the nurse that the therapy needs to be adjusted? Serum potassium level has increased. Blood osmolarity has decreased. Glasgow Coma Scale score is unchanged. Urine remains negative for ketone bodies.

Glasgow Coma Scale score is unchanged.

41.A nurse reviews laboratory results for a client with diabetes mellitus who is prescribed an intensified insulin regimen: Fasting blood glucose: 75 mg/dL Postprandial blood glucose: 200 mg/dL Hemoglobin A1c level: 5.5% How should the nurse interpret these laboratory findings? Increased risk for developing ketoacidosis Good control of blood glucose Increased risk for developing hyperglycemia Signs of insulin resistance

Good control of blood glucose

40.After teaching a client who is newly diagnosed with type 2 diabetes mellitus, the nurse assesses the clients understanding. Which statement made by the client indicates a need for additional teaching? I should increase my intake of vegetables with higher amounts of dietary fiber. My intake of saturated fats should be no more than 10% of my total calorie intake. I should decrease my intake of protein and eliminate carbohydrates from my diet. My intake of water is not restricted by my treatment plan or medication regimen.

I should decrease my intake of protein and eliminate carbohydrates from my diet.

17.After teaching a client who has diabetes mellitus and proliferative retinopathy, nephropathy, and peripheral neuropathy, the nurse assesses the clients understanding. Which statement made by the client indicates a correct understanding of the teaching? I have so many complications; exercising is not recommended. I will exercise more frequently because I have so many complications. I used to run for exercise; I will start training for a marathon. I should look into swimming or water aerobics to get my exercise.

I should look into swimming or water aerobics to get my exercise.

10.After teaching a client with type 2 diabetes mellitus who is prescribed nateglinide (Starlix), the nurse assesses the clients understanding. Which statement made by the client indicates a correct understanding of the prescribed therapy? Ill take this medicine during each of my meals. I must take this medicine in the morning when I wake. I will take this medicine before I go to bed. I will take this medicine immediately before I eat.

I will take this medicine immediately before I eat.

24.After teaching a client who is recovering from pancreas transplantation, the nurse assesses the clients understanding. Which statement made by the client indicates a need for additional education? If I develop an infection, I should stop taking my corticosteroid. If I have pain over the transplant site, I will call the surgeon immediately. I should avoid people who are ill or who have an infection. I should take my cyclosporine exactly the way I was taught.

If I develop an infection, I should stop taking my corticosteroid.

44.A nurse reviews the chart and new prescriptions for a client with diabetic ketoacidosis: Which action should the nurse take? Laboratory Results Serum potassium: 2.6 mEq/L Medications Potassium chloride 40 mEq IV bolus STAT Increase IV fluid to 100 mL/hr Administer the potassium and then consult with the provider about the fluid order. Increase the intravenous rate and then consult with the provider about the potassium prescription. Administer the potassium first before increasing the infusion flow rate. Increase the intravenous flow rate before administering the potassium.

Increase the intravenous rate and then consult with the provider about the potassium prescription.

18.An emergency department nurse assesses a client with ketoacidosis. Which clinical manifestation should the nurse correlate with this condition? Increased rate and depth of respiration Extremity tremors followed by seizure activity Oral temperature of 102 F (38.9 C) Severe orthostatic hypotension

Increased rate and depth of respiration

38.A nurse assesses a client with diabetes mellitus who self-administers subcutaneous insulin. The nurse notes a spongy, swelling area at the site the client uses most frequently for insulin injection. Which action should the nurse take? Apply ice to the site to reduce inflammation. Consult the provider for a new administration route. Assess the client for other signs of cellulitis. Instruct the client to rotate sites for insulin injection.

Instruct the client to rotate sites for insulin injection.

28.A nurse reviews the medication list of a client with a 20-year history of diabetes mellitus. The client holds up the bottle of prescribed duloxetine (Cymbalta) and states, My cousin has depression and is taking this drug. Do you think Im depressed? How should the nurse respond? Many people with long-term diabetes become depressed after a while. Its for peripheral neuropathy. Do you have burning pain in your feet or hands? This antidepressant also has anti-inflammatory properties for diabetic pain. No. Many medications can be used for several different disorders.

Its for peripheral neuropathy. Do you have burning pain in your feet or hands?

6.A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement should the nurse include in this clients plan of care to delay the onset of microvascular and macrovascular complications? Maintain tight glycemic control and prevent hyperglycemia. Restrict your fluid intake to no more than 2 liters a day. Prevent hypoglycemia by eating a bedtime snack. Limit your intake of protein to prevent ketoacidosis.

Maintain tight glycemic control and prevent hyperglycemia.

39.A nurse reviews the medication list of a client recovering from a computed tomography (CT) scan with IV contrast to rule out small bowel obstruction. Which medication should alert the nurse to contact the provider and withhold the prescribed dose? Pioglitazone (Actos) Glimepiride (Amaryl) Glipizide (Glucotrol) Metformin (Glucophage)

Metformin (Glucophage)

33.A nurse teaches a client with diabetes mellitus about sick day management. Which statement should the nurse include in this clients teaching? When ill, avoid eating or drinking to reduce vomiting and diarrhea. Monitor your blood glucose levels at least every 4 hours while sick. If vomiting, do not use insulin or take your oral antidiabetic agent. Try to continue your prescribed exercise regimen even if you are sick.

Monitor your blood glucose levels at least every 4 hours while sick.

23.A nurse cares for a client who is diagnosed with acute rejection 2 months after receiving a simultaneous pancreas-kidney transplant. The client states, I was doing so well with my new organs, and the thought of having to go back to living on hemodialysis and taking insulin is so depressing. How should the nurse respond? Following the drug regimen more closely would have prevented this. One acute rejection episode does not mean that you will lose the new organs. Dialysis is a viable treatment option for you and may save your life. Since you are on the national registry, you can receive a second transplantation.

One acute rejection episode does not mean that you will lose the new organs.

21.A nurse cares for a client who has type 1 diabetes mellitus. The client asks, Is it okay for me to have an occasional glass of wine? How should the nurse respond? Drinking any wine or alcohol will increase your insulin requirements. Because of poor kidney function, people with diabetes should avoid alcohol. You should not drink alcohol because it will make you hungry and overeat. One glass of wine is okay with a meal and is counted as two fat exchanges.

One glass of wine is okay with a meal and is counted as two fat exchanges.

29.A nurse assesses a client with diabetes mellitus. Which clinical manifestation should alert the nurse to decreased kidney function in this client? Urine specific gravity of 1.033 Presence of protein in the urine Elevated capillary blood glucose level Presence of ketone bodies in the urine

Presence of protein in the urine

11.A nurse cares for a client who is prescribed pioglitazone (Actos). After 6 months of therapy, the client reports that his urine has become darker since starting the medication. Which action should the nurse take? Assess for pain or burning with urination. Review the clients liver function study results. Instruct the client to increase water intake. Test a sample of urine for occult blood.

Review the clients liver function study results.

2.A nurse reviews laboratory results for a client with diabetes mellitus who presents with polyuria, lethargy, and a blood glucose of 560 mg/dL. Which laboratory result should the nurse correlate with the clients polyuria? Serum sodium: 163 mEq/L Serum creatinine: 1.6 mg/dL Presence of urine ketone bodies Serum osmolarity: 375 mOsm/kg

Serum osmolarity: 375 mOsm/kg

32.A nurse reviews the laboratory results of a client who is receiving intravenous insulin. Which should alert the nurse to intervene immediately? Serum chloride level of 98 mmol/L Serum calcium level of 8.8 mg/dL Serum sodium level of 132 mmol/L Serum potassium level of 2.5 mmol/L

Serum potassium level of 2.5 mmol/L

36.After teaching a client with type 2 diabetes mellitus, the nurse assesses the clients understanding. Which statement made by the client indicates a need for additional teaching? I need to have an annual appointment even if my glucose levels are in good control. Since my diabetes is controlled with diet and exercise, I must be seen only if I am sick. I can still develop complications even though I do not have to take insulin at this time. If I have surgery or get very ill, I may have to receive insulin injections for a short time.

Since my diabetes is controlled with diet and exercise, I must be seen only if I am sick.

After teaching a client with diabetes mellitus to inject insulin, the nurse assesses the clients understanding. Which statement made by the client indicates a need for additional teaching? The lower abdomen is the best location because it is closest to the pancreas. I can reach my thigh the best, so I will use the different areas of my thighs. By rotating the sites in one area, my chance of having a reaction is decreased. Changing injection sites from the thigh to the arm will change absorption rates.

The lower abdomen is the best location because it is closest to the pancreas.

27.A nurse teaches a client with diabetes mellitus who is experiencing numbness and reduced sensation. Which statement should the nurse include in this clients teaching to prevent injury? Examine your feet using a mirror every day. Rotate your insulin injection sites every week. Check your blood glucose level before each meal. Use a bath thermometer to test the water temperature

Use a bath thermometer to test the water temperature.

22.A nurse teaches a client with type 1 diabetes mellitus. Which statement should the nurse include in this clients teaching to decrease the clients insulin needs? Limit your fluid intake to 2 liters a day. Animal organ meat is high in insulin. Limit your carbohydrate intake to 80 grams a day. Walk at a moderate pace for 1 mile daily.

Walk at a moderate pace for 1 mile daily.

15.A nurse cares for a client with diabetes mellitus who is visually impaired. The client asks, Can I ask my niece to prefill my syringes and then store them for later use when I need them? How should the nurse respond? Yes. Prefilled syringes can be stored for 3 weeks in the refrigerator in a vertical position with the needle pointing up. Yes. Syringes can be filled with insulin and stored for a month in a location that is protected from light. Insulin reacts with plastic, so prefilled syringes are okay, but you will need to use glass syringes. No. Insulin syringes cannot be prefilled and stored for any length of time outside of the container.

Yes. Prefilled syringes can be stored for 3 weeks in the refrigerator in a vertical position with the needle pointing up.

1.A nurse is teaching a client with diabetes mellitus who asks, Why is it necessary to maintain my blood glucose levels no lower than about 60 mg/dL? How should the nurse respond? Glucose is the only fuel used by the body to produce the energy that it needs. Your brain needs a constant supply of glucose because it cannot store it. Without a minimum level of glucose, your body does not make red blood cells. Glucose in the blood prevents the formation of lactic acid and prevents acidosis.

Your brain needs a constant supply of glucose because it cannot store it.

5.A nurse cares for a client who has a family history of diabetes mellitus. The client states, My father has type 1 diabetes mellitus. Will I develop this disease as well? How should the nurse respond? Your risk of diabetes is higher than the general population, but it may not occur. No genetic risk is associated with the development of type 1 diabetes mellitus. The risk for becoming a diabetic is 50% because of how it is inherited. Female children do not inherit diabetes mellitus, but male children will.

Your risk of diabetes is higher than the general population, but it may not occur.

9. A patient is ordered to receive insulin lispro at mealtimes. The nurse will instruct this patient to administer the medication at which time? a. 5 minutes before eating b. 15 minutes after eating c. 30 minutes before eating d. 10 minutes after eating

a. 5 minutes before eating

12. A patient who has type 1 diabetes mellitus asks the nurse about using a combination insulin product such as Humalog 75/25. The nurse will tell the patient that use of this product a. depends on individual insulin needs. b. is useful for patient with insulin resistance. c. means less rotation of injection sites. d. requires refrigeration at all times.

a. depends on individual insulin needs.

17. A patient who has type 2 diabetes mellitus asks the nurse why the provider has changed the oral antidiabetic agent from tolbutamide (Orinase) to glipizide (Glucotrol). The nurse will explain that glipizide a. has a longer duration of action. b. has fewer gastrointestinal side effects. c. may be taken on an as-needed basis. d. results in less hypoglycemic potential.

a. has a longer duration of action.

18. A patient who has been taking a sulfonylurea antidiabetic medication will begin taking metformin (Glucophage). The nurse understands that this patient is at increased risk for which condition? a. Hypoglycemia b. Hyperglycemia c. Renal failure d. Respiratory distress

c. Renal failure

35.A nurse cares for a client who has diabetes mellitus. The nurse administers 6 units of regular insulin and 10 units of NPH insulin at 0700. At which time should the nurse assess the client for potential problems related to the NPH insulin? a. 0800 b. 1600 c. 2000 d. 2300

b. 1600 Neutral protamine Hagedorn (NPH) is an intermediate-acting insulin with an onset of 1.5 hours, peak of 4 to 12 hours, and duration of action of 22 hours.

43.A nurse prepares to administer prescribed regular and NPH insulin. Place the nurses actions in the correct order to administer these medications. 1.Inspect bottles for expiration dates. 2.Gently roll the bottle of NPH between the hands. 3.Wash your hands. 4.Inject air into the regular insulin. 5.Withdraw the NPH insulin. 6.Withdraw the regular insulin. 7.Inject air into the NPH bottle. 8.Clean rubber stoppers with an alcohol swab. a. 1, 3, 8, 2, 4, 6, 7, 5 b. 3, 1, 2, 8, 7, 4, 6, 5 c. 8, 1, 3, 2, 4, 6, 7, 5 d. 2, 3, 1, 8, 7, 5, 4, 6

b. 3, 1, 2, 8, 7, 4, 6, 5

6. The nurse receives the following order for insulin: IV NPH (Humulin NPH) 10 units. The nurse will perform which action? a. Administer the dose as ordered. b. Clarify the insulin type and route. c. Give the drug subcutaneously. d. Question the insulin dose.

b. Clarify the insulin type and route.

8.A nurse teaches a client about self-monitoring of blood glucose levels. Which statement should the nurse include in this clients teaching to prevent bloodborne infections? a. Wash your hands after completing each test. b. Do not share your monitoring equipment. c. Blot excess blood from the strip with a cotton ball.

b. Do not share your monitoring equipment.

11. A patient has administered regular insulin 30 minutes prior but has not received a breakfast tray. The patient is experiencing nervousness and tremors. What is the nurses first action? a. Administer glucagon. b. Give the patient orange juice. c. Notify the kitchen to deliver the tray. d. Perform bedside glucose testing.

b. Give the patient orange juice.

30.A nurse develops a dietary plan for a client with diabetes mellitus and new-onset microalbuminuria. Which component of the clients diet should the nurse decrease? a. Carbohydrates b. Proteins c. Fats d. Total calories

b. Proteins

1. The nurse is teaching a group of nursing students about diabetes. The nurse explains that which type of diabetes is the most common? a. Type 1 diabetes mellitus b. Type 2 diabetes mellitus c. Diabetes insipidus d. Secondary diabetes

b. Type 2 diabetes mellitus

16. A patient who is unconscious and has a pulse is brought to the emergency department. The patient is wearing a Medic-Alert bracelet indicating type 1 diabetes mellitus. The nurse will anticipate an order to administer a. cardiopulmonary resuscitation (CPR). b. glucagon. c. insulin. d. orange juice.

b. glucagon.

19.A nurse assesses a client who has diabetes mellitus. Which arterial blood gas values should the nurse identify as potential ketoacidosis in this client? a. pH 7.38, HCO3 22 mEq/L, PCO2 38 mm Hg, PO2 98 mm Hg b. pH 7.28, HCO3 18 mEq/L, PCO2 28 mm Hg, PO2 98 mm Hg c. pH 7.48, HCO3 28 mEq/L, PCO2 38 mm Hg, PO2 98 mm Hg d. pH 7.32, HCO3 22 mEq/L, PCO2 58 mm Hg, PO2 88 mm Hg

b. pH 7.28, HCO3 18 mEq/L, PCO2 28 mm Hg, PO2 98 mm Hg

8. The nurse is teaching a patient about home administration of insulin. The patient will receive regular (Humulin R) and NPH (Humulin NPH) insulin at 0700 every day. What is important to teach this patient? a. Draw up the medications in separate syringes. b. Draw up the NPH insulin first. c. Draw up the regular insulin first. d. Draw up the medications after mixing them in a vial.

c. Draw up the regular insulin first.

4. The nurse is teaching a patient who is newly diagnosed with type 1 diabetes mellitus about insulin administration. Which statement by the patient indicates a need for further teaching? a. I may use a chosen site daily for up to a week. b. I should give each injection a knuckle length away from a previous injection. c. I will not be concerned about a raised knot under my skin from injecting insulin. d. Insulin is absorbed better from subcutaneous sites on my abdomen.

c. I will not be concerned about a raised knot under my skin from injecting insulin.

2. A patient develops type 2 diabetes mellitus. The nurse will explain that this type of diabetes a. is generally triggered by medications. b. is not as common as type 1 diabetes. c. is often related to heredity and obesity. d. will not require insulin therapy.

c. is often related to heredity and obesity.

19. A 45-year-old patient who is overweight has had a diagnosis of type 2 diabetes for 2 years. The patient uses 20 units of insulin per day. The patients fasting blood glucose (FBG) is 190 mg/dL. The patient asks the nurse about using an oral antidiabetic agent. The nurse understands that oral antidiabetic agents a. cannot be used if the patient is overweight. b. cannot be used once a patient requires insulin. c. may be used since this patient meets criteria. d. may not be used since this patients fasting blood glucose is too high.

c. may be used since this patient meets criteria.

5. The nurse is teaching a patient how to administer insulin. The patient is thin with very little body fat. The nurse will suggest injecting insulin a. by pinching up the skin and injecting straight down. b. in the abdomen only with the needle at a 90-degree angle. c. subcutaneously with the needle at a 45- to 60-degree angle. d. using the thigh and buttocks areas exclusively.

c. subcutaneously with the needle at a 45- to 60-degree angle.

3.After teaching a young adult client who is newly diagnosed with type 1 diabetes mellitus, the nurse assesses the clients understanding. Which statement made by the client indicates a correct understanding of the need for eye examinations? a. At my age, I should continue seeing the ophthalmologist as I usually do.b. I will see the eye doctor when I have a vision problem and yearly after age c. My vision will change quickly. I should see the ophthalmologist twice a year. d. Diabetes can cause blindness, so I should see the ophthalmologist yearly.

d. Diabetes can cause blindness, so I should see the ophthalmologist yearly.

15. Which statement by a patient who will begin using an external insulin pump indicates understanding of this device? a. I will have an increased risk for hypoglycemia. b. I will leave this on when bathing or swimming. c. I will not need to count carbohydrates anymore. d. I will still need to monitor serum glucose.

d. I will still need to monitor serum glucose.

3. A patient who is overweight is being evaluated for diabetes. The patient has a blood glucose level of 160 mg/dL and a hemoglobin A1c of 5.8%. The nurse understands that this patient has which condition? a. Diabetes mellitus b. Hypoglycemia c. Normal blood levels d. Prediabetes

d. Prediabetes

13. The patient asks the nurse about storing insulin. Which response by the nurse is correct? a. All insulin vials must be refrigerated. b. Insulin will last longer if kept in the freezer. c. Opened vials of insulin must be discarded. d. Some combination pens do not require refrigeration.

d. Some combination pens do not require refrigeration.

7. The nurse will administer parenteral insulin to a patient who will receive a mixture of NPH (Humulin NPH) and regular (Humulin R). The nurse will give this medication via which route? a. Intradermal b. Intramuscular c. Intravenous d. Subcutaneous

d. Subcutaneous

37.When teaching a client recently diagnosed with type 1 diabetes mellitus, the client states, I will never be able to stick myself with a needle. How should the nurse respond? a. I can give your injections to you while you are here in the hospital. b. Everyone gets used to giving themselves injections. It really does not hurt. c. Your disease will not be managed properly if you refuse to administer the shots. d. Tell me what it is about the injections that are concerning you.

d. Tell me what it is about the injections that are concerning you.

14. A patient who has insulin-dependent diabetes mellitus must take a glucocorticoid medication for osteoarthritis. When teaching this patient, the nurse will explain that there may be a need to a. decrease the glucocorticoid dose. b. decrease the insulin dose. c. increase the glucocorticoid dose. d. increase the insulin dose.

d. increase the insulin dose.

10. The parent of a junior high-school child who has type 1 diabetes asks the nurse if the child can participate in sports. The nurse will tell the parent a. that strenuous exercise is not recommended for children with diabetes. b. that the child must be monitored for hyperglycemia while exercising. c. to administer an extra dose of regular insulin prior to exercise. d. to send a snack with the child to eat just prior to exercise.

d. to send a snack with the child to eat just prior to exercise.