Diabetes Sherpath Quiz 1
Which statement by a nurse to a patient newly diagnosed with type 2 diabetes is correct?
Changes in diet and exercise may control blood glucose levels in type 2 diabetes. - For some patients with type 2 diabetes, changes in lifestyle are sufficient to achieve blood glucose control.
Which information will the nurse include when teaching a patient who has type 2 diabetes about glyburide ?
Glyburide stimulates insulin production and release from the pancreas.
The nurse is interviewing a new patient with diabetes who takes rosiglitazone (Avandia). Which information would the nurse anticipate resulting in the health care provider discontinuing the medication?
The patient has chest pressure when walking.
A patient who has type 2 diabetes is being prepared for an elective coronary angiogram. Which information would the nurse anticipate might lead to rescheduling the test?
The patient took the prescribed metformin today.
A patient with diabetes rides a bicycle to and from work every day. Which site should the nurse teach the patient to use to administer the morning insulin?
abdomen - Patients should be taught not to administer insulin into a site that will be exercised because exercise will increase the rate of absorption. The thigh, buttock, and arm are all exercised by riding a bicycle
A patient who has type 1 diabetes plans to swim laps for an hour daily at 1:00 PM. The clinic nurse will plan to teach the patient to
check glucose level before, during, and after swimming.
The nurse identifies a need for additional teaching when the patient who is self-monitoring blood glucose
chooses a puncture site in the center of the finger pad.
A hospitalized diabetic patient received 38 U of NPH insulin at 7:00 AM. At 1:00 PM, the patient has been away from the nursing unit for 2 hours, missing the lunch delivery while awaiting a chest x-ray. To prevent hypoglycemia, the best action by the nurse is to
request that if testing is further delayed, the patient be returned to the unit to eat.
The nurse is assessing a 22-yr-old patient experiencing the onset of symptoms of type 1 diabetes. To which question would the nurse anticipate a positive response?
"Have you lost weight lately?"
The nurse determines a need for additional instruction when the patient with newly diagnosed type 1 diabetes says which of the following?
"I can choose any foods, as long as I use enough insulin to cover the calories."
Which statement by the patient indicates a need for additional instruction in administering insulin?
"I need to rotate injection sites among my arms, legs, and abdomen each day."
The nurse has been teaching a patient with type 2 diabetes about managing blood glucose levels and taking glipizide (Glucotrol). Which patient statement indicates a need for additional teaching?
"My diabetes won't cause complications because I don't need insulin."
After change-of-shift report, which patient will the nurse assess first?
60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
After change-of-shift report, which patient should the nurse assess first?
A 19-yr-old patient with type 1 diabetes who has a hemoglobin A1C of 12%
When a patient with type 2 diabetes is admitted for a cholecystectomy, which nursing action can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?
Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.
The nurse is preparing to teach a 43-yr-old man who is newly diagnosed with type 2 diabetes about home management of the disease. Which action should the nurse take first?
Assess the patient's perception of what it means to have diabetes mellitus.
An active 32-yr-old male who has type 1 diabetes is being seen in the endocrine clinic. Which finding indicates a need for the nurse to discuss a possible a change in therapy with the health care provider?
Blood pressure 140/88 mmHg
To monitor for complications in a patient with type 2 diabetes, which tests will the nurse in the diabetic clinic schedule at least annually (select all that apply)?
Blood pressure, Serum creatinine, Urine for microalbuminuria, Monofilament testing of the foot
The health care provider suspects the Somogyi effect in a 50-yr-old patient whose 6:00 AM blood glucose is 230 mg/dL. Which action will the nurse teach the patient to take?
Check the blood glucose during the night - If the Somogyi effect is causing the patient's increased morning glucose level, the patient will experience hypoglycemia between 2:00 and 4:00 AM.
Which information will the nurse include in teaching a female patient who has peripheral arterial disease, type 2 diabetes, and sensory neuropathy of the feet and legs?
Choose flat-soled leather shoes. - The patient is taught to avoid high heels and that leather shoes are preferred. The feet should be washed, but not soaked, in warm water daily. Heating pad use should be avoided. Commercial callus and corn removers should be avoided. The patient should see a specialist to treat these problems.
To assist an older patient with diabetes to engage in moderate daily exercise, which action is most important for the nurse to take?
Determine what type of activities the patient enjoys.
The nurse has administered 4 oz of orange juice to an alert patient whose blood glucose was 62 mg/dL. Fifteen minutes later, the blood glucose is 67 mg/dL. Which action should the nurse take next?
Give the patient 4 to 6 oz more orange juice.
Which action should the nurse take after a patient treated with intramuscular glucagon for hypoglycemia regains consciousness?
Give the patient a snack of peanut butter and crackers.
A few weeks after an 82-yr-old patient with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage) therapy and taught about appropriate diet and exercise, the home health nurse makes a visit. Which finding should the nurse promptly discuss with the health care provider?
Glomerular filtration rate is decreased. - The decrease in renal function may indicate a need to adjust the dose of metformin or change to a different medication.
A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?
Glycosylated hemoglobin level - The glycosylated hemoglobin (A1C or HbA1C) test shows the overall control of glucose over 90 to 120 days.
A patient with diabetic ketoacidosis is brought to the emergency department. Which prescribed action should the nurse implement first?
Infuse 1 L of normal saline per hour. - The most urgent patient problem is the hypovolemia associated with diabetic ketoacidosis (DKA), and the priority is to infuse IV fluids. The other actions can be done after the infusion of normal saline is initiated.
Which laboratory value reported to the nurse by the unlicensed assistive personnel (UAP) indicates an urgent need for the nurse's assessment of the patient?
Noon blood glucose of 52 mg/dL - The nurse should assess the patient with a blood glucose level of 52 mg/dL for symptoms of hypoglycemia and give the patient a carbohydrate-containing beverage such as orange juice.
A patient who was admitted with diabetic ketoacidosis secondary to a urinary tract infection has been weaned off an insulin drip 30 minutes ago. The patient reports feeling lightheaded and sweaty. Which action should the nurse take first?
Obtain a glucose reading using a finger stick.
A 27-yr-old patient admitted with diabetic ketoacidosis (DKA) has a serum glucose level of 732 mg/dL and serum potassium level of 3.1 mEq/L. Which action prescribed by the health care provider should the nurse take first?
Place the patient on a cardiac monitor.
The nurse is taking a health history from a 29-yr-old pregnant patient at the first prenatal visit. The patient reports that she has no personal history of diabetes, but her mother has diabetes. Which action will the nurse plan to take?
Schedule the patient for a fasting blood glucose level.
Which patient action indicates good understanding of the nurse's teaching about administration of aspart (NovoLog) insulin?
The patient cleans the skin with soap and water before insulin administration.
Which action by a patient indicates that the home health nurse's teaching about glargine and regular insulin has been successful?
The patient disposes of the open vials of glargine and regular insulin after 4 weeks. - Insulin can be stored at room temperature for 4 weeks.
A 28-yr-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?
The patient increases daily exercise when ketones are present in the urine.
Which patient action indicates a good understanding of the nurse's teaching about the use of an insulin pump?
The patient programs the pump for an insulin bolus after eating.
A female patient is scheduled for an oral glucose tolerance test. Which information from the patient's health history is important for the nurse to communicate to the health care provider regarding this test?
The patient uses oral contraceptives. - Oral contraceptive use may falsely elevate oral glucose tolerance test (OGTT) values.
The nurse is assessing a 55-yr-old female patient with type 2 diabetes who has a body mass index (BMI) of 31 kg/m2.Which goal in the plan of care is most important for this patient?
The patient will reach a glycosylated hemoglobin level of less than 7%. - The complications of diabetes are related to elevated blood glucose, and the most important patient outcome is the reduction of glucose to near-normal levels.
A 30-yr-old patient has a new diagnosis of type 2 diabetes. The nurse will discuss the need to schedule a dilated eye examination
as soon as possible.
An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to
insert an IV catheter.
A patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about
lifestyle changes to lower blood glucose. - The patient's impaired fasting glucose indicates prediabetes, and the patient should be counseled about lifestyle changes to prevent the development of type 2 diabetes.
A 26-yr-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to
monitor blood glucose every 4 hours and notify the clinic if it continues to rise - Infection and other stressors increase blood glucose levels and the patient will need to test blood glucose frequently, treat elevations appropriately with lispro insulin, and call the health care provider if glucose levels continue to be elevated.