Diabetes study guide chapter worksheet

when caring for patient with metabolic syndrome, what should the nurse give the highest priority to teaching the patient about? a. achieving a normal weight b. preforming daily aerobic exercise c. eliminating red meat from the diet d. monitoring the blood glucose periodically

a. achieving a normal weight

a patent with diabetes calls the clinic because she is experiencing nausea and flu-like symptoms. which advice from the nurse will be the best for this patient? a. administer the usual insulin dosage b. hold fluid intake until nausea subsides c. come to the clinic immediately for evaluation d. monitor the blood glucose every 1 to 2 hours and all if it rises over 150

a. administer the usual insulin dosage

what characterizes type 2 diabetes? (select all that apply) a. beta-cell exhaustion b. insulin resistance c. genetic predisposition d. altered production of adipokines e. inherited defect in insulin receptors f. inappropriate glucose production by the liver

a. beta-cell exhaustion b. insulin resistance c. genetic predisposition d. altered production of adipokines e. inherited defect in insulin receptors f. inappropriate glucose production by the liver

individualized nutrition therapy for patients using conventional, fixed insulin regimens should include teaching the patient to a. eat regular meals at regular times b. restrict calories to promote moderate weight loss c. eliminate sucrose and other simple sugars from the diet d. limit saturate fat intake to 30% of dietary calorie intake

a. eat regular meals at regular times

the patient with diabetes has a blood glucose level of 248. which manifestations in the patient would the nurse understand as being related to this blood glucose level? (select all that apply) a. headache b. unsteady gait c. abdominal cramps d. emotional changes e. increase in urination f. weakness and fatigue

a. headache c. abdominal cramps e. increase in urination f. weakness and fatigue

a 72 year old woman is diagnosed with diabetes. what odes the nurse recognize about the management of diabetes in the oleo adult? a. it is more difficult to achieve strict glucose control than in younger patients b. it usually is not treated unless the patient becomes severely hyperglycemic c. it does not include treatment with insulin because of limited dexterity and vision d. it usually requires that a younger family member be responsive for care of the patient

a. it is more difficult to achieve strict glucose control than in younger patients

the nurse is teaching the patient with prediabetes ways to prevent or delay the development of type 2 diabetes. what information should be included? (select all that apply) a. maintain a healthy weight b. exercise for 60 minutes a day c. have blood pressure checked regularly d. assess for visual changes on monthly basis e. monitor for polyuria, polyphagia, and polydipsia

a. maintain a healthy weight e. monitor for polyuria, polyphagia, and polydipsia

the patient with type 2 diabetes is being put on acarbose (Precose) and wants to know why she is taking it. what should the nurse include in this patient's teaching? (select all that apply) a. take with the first bite of each meal b. it is not used in patient with heart failure c. endogenous glucose production is decreased d. effectiveness is measured by 2-hour postprandial glucose e. it delays glucose absorption from the gastrointestinal tract

a. take with the first bite of each meal d. effectiveness is measured by 2-hour postprandial glucose e. it delays glucose absorption from the gastrointestinal tract

Two days following a self-managed hypoglycemic episode at home, the patient tells the nurse that his blood glucose levels since the episode have been between 80-90. which the best response by the nurse a. that is a good range for your glucose levels b. you should call your health care provider because you need to have your insulin increased c. that levels is too low in view of your recent hypoglycemia and you should increase your food intake d. you should take only half your insulin dosage for the next few days to get your glucose level back up

a. that is a good range for your glucose levels

which class of oral glucose-lowering agents is most commonly used for people with type 2 diabetes because it reduces hepatic glucose production and enhances uptake of glucose? a. insulin b. Biguanide c. Meglitinide D. Sulfonylurea

b. Biguanide

what disorders and diseases are related to marcovascular complications of diabetes? (select all that apply) a. chronic kidney disease b. coronary artery disease c. microaneurysms and destruction of retinal vessels d. Ulceration and amputation of the lower extremities e. capillary and arteriole membrane thickening specific to diabetes

b. coronary artery disease d. Ulceration and amputation of the lower extremities

the patient with diabetes has been diagnosed with autonomic neuropathy. what problems should the nurse expect to find in this patients? (select all that apply) a. painless foot ulcers b. erectile dysfunction c. burning foot pain at night d. loss of fine motor skills e. vomiting undigested food f. painless myocardial infarction

b. erectile dysfunction e. vomiting undigested food f. painless myocardial infarction

which statement best describes atherosclerotic disease affecting the cerebrovascular, cardiovascular, and peripheral vascular systems in patients with diabetes? a. it can be prevented by tight glucose control b. it occurs with a high frequency and earlier onset than in non diabetic population c. it is caused by the hyperinsulinemia related to insulin resistance common in type 2 diabetes d. it cannot be modified by reduction of risk factors such as smoking, obesity, and high fat intake

b. it occurs with a high frequency and earlier onset than in non diabetic population

what should the goals of nutrition therapy for the patient with type 2 diabetes include? a. ideal body weight b. normal serum glucose and lipid intake c. a special diabetic diet using diabetic foods d. five small meals per day with a bedtime snack

b. normal serum glucose and lipid intake

In type 1 diabetes there is an osmotic effect of glucose when insulin deficiency prevents the use of glucose for energy. Which classic symptom is caused the osmotic effect of glucose? a. fatigue b. polydipsia c. polyphagia d. recurrent infections

b. polydipsia

why are the hormones cortisol, glucagon, epinephrine, and growth hormone referred to as counter regulatory hormones? a. Decrease glucose production b. Stimulate glucose output by the liver c. Increase glucose transport into the cells d. independently regulate glucose level in the blood

b. stimulate glucose output by the liver

the following interventions are planned for a diabetic patient. which intervention can the nurse delegate to unlicensed assistive personnel a. discuss complications of diabetes b. check that the bath water is not too hot c. check the patient's technique for drawing up insulin d. teach the patient to use a meter for self-monitoring of blood glucose

b. check that the bath water is not too hot

when teaching the patient with diabetes about insulin administration, the nurse should include which instruction for the patient? a. pull back on the plunger after inserting the needle to check for blood b. consistently use the same size of insulin syringe to avoid dosing errors c. clean the skin at the injection site with an alcohol swab before each injection d. rotate injection sites from arms to thighs to abdomen with each injection to prevent lipodystrophies

b. consistently use the same size of insulin syringe to avoid dosing errors

a diabetic patient is found unconscious at home and a family member calls the clinic. after determining that a glucometer is not available, what should the nurse a dive the family member to do? a. have the patient drink some orange juice b. administer 10 U of regular insulin subcutaneously c. call for an ambulance to transport the patient to a medical facility d. administer glucagon 1 mg intramuscularly or subcutaneously

d. administer glucagon 1 mg intramuscularly or subcutaneously

Lispro insulin (Humalog) with NPH insulin is ordered for a patient with newly diagnosed type 1 diabetes. The nurse knows that when lispro insulin is used, when should it be administered? a. only once a day b. 1 hour before meals c. 30-45 minutes before meals d. at bedtime or within 15 minutes of meals

d. at bedtime or within 15 minutes of meals

what describes the primary difference in treatment for diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome? a. DKA requires administration of bicarbonate to correct acidosis b. potassium replacement is not necessary in management of HHS c. HHS requires greater fluid replacement to correct dehydration d. administration of glucose is withheld in HHS until the blood glucose reaches a normal level

c. HHS requires greater fluid replacement to correct dehydration

which laboratory results would indicate that the patient has prediabetes? a. glucose tolerance result of 132 b. glucose tolerance result of 240 c. fasting blood glucose result of 80 d. fasting blood glucose result of 120

d. fasting blood glucose result of 120

the nurse determines that a patient with a 2-hour OGTT of 152 md/dL has a. diabetes b. elevated A1C c. impaired fasting gluose d. impaired glucose tolerance

d. impaired glucose tolerance

the nurse should observe the patient for symptoms of ketacidosis when a. illnesses causing nausea and vomiting lead to bicarbonate loss with body fluids b. glucose levels become so high that osmotic diuresis promotes fluid and electrolyte loss c. an insulin deficit causes the body to metabolize large amounts of fatty acids rather than glucose for energy the patient skips meals after taking insulin, leading to rapid metabolism of glucose and breakdown of fats for energy

c. an insulin deficit causes the body to metabolize large amounts of fatty acids rather than glucose for energy

the nurse assess the diabetic patient's technique of self-monitoring of blood glucose (SMBG) 3 months after initial instruction. which error in the performance of SMBG notes by the nurse requires interventions? a. doing the SMBG before and after exercise b. puncturing the finger on the side of finger pad c. cleaning the puncture site with alcohol before the puncture d. holding the hand down for a few minutes before the puncture

c. cleaning the puncture site with alcohol before the puncture

The patient with newly diagnosed diabetes is displaying shakiness, confusion, irritability and slurred speech. what should the nurse expect is happening? a. DKA b. HHS c. hypoglycemia d. hyperglycemia

c. hypoglycemia

a patient taking insulin has recorded fasting blood glucose levels above 200 on awakening for the last 5 mornings. what should the nurse advise the patient to do first? a. increase the evening insulin dose to prevent dawn phenomenon b. use a single-dose insulin regime with an intermediate-acting insulin c. monitor the glucose level at bedtime, between 2:00 and 4:00 am, and on arising d. decrease the evening insulin dosage to prevent night hypoglycemia and the Somogyi effect

c. monitor the glucose level at bedtime, between 2:00 and 4:00 am, and on arising

the nurse is assessing a newly admitted diabetic patient. which observation should be addressed as the priority by the nurse? a. bilateral numbness of both hands b. stage II pressure ulcer on the right hand c. rapid respirations with deep inspiration d. areas of lumps and dents on the abdomen

c. rapid respirations with deep inspiration

following the teaching of foot care to a diabetic patient, the nurse determines that additional instruction is needed when the patient makes which statement? a. i should wash my feet daily with soap and warm water b. i should always wear shoes to protect my feet from injury c. if my feet are cold, I should wear socks instead of using a heating pad d. I'll know if i have sores or lesions on my feet because they will be painful

d. I'll know if i have sores or lesions on my feet because they will be painful

In addition to promoting the transport of glucose from the blood into the cell, what does insulin do? a. Enhance the breakdown of adipose tissue for energy b. Stimulates hepatic glycogenolysis and gluconeogensis c. Prevents the transport of triglycerides into adipose tissue d. accelerates the transport of amino acids into cells and their synthesis into protein

d. accelerates the transport of amino acids into cells and their synthesis into protein

During routine health screening, a patient is found to have fasting plasma glucose (FPG) of 132 mg/dL. At a follow-up visit, a diagnosis would be made based on which laboratory results? (select all that apply) a. A1C of 7.5% b. Glycosuria of 3+ c. FPG > 126 mg/dL d. random blood glucose of 126 mg/dL e. A 2 hour oral glucose tolerance test (OGTT) of 19- mg/dL

a. A1C of 7.5% c. FPG > 126 mg/dL

what are the manifestations of diabetic ketoaciosis a. thirst b. ketonuria c. dehydration d. metabolic acidosis e. kussumaul respirations f. sweet, fruity breath odor

a. thirst b. ketonuria c. dehydration d. metabolic acidosis e. kussumaul respirations f. sweet, fruity breath odor

when teaching the patient with type 1 diabetes, what should the nurse emphasize as the major advantage of using an insulin pump? a. tight glycemic control can be maintained b. errors in insulin dosing are less likely to occur c. complications of insulin therapy are prevented d. frequent blood glucose monitoring is unnecessary

a. tight glycemic control can be maintained

a patient with diabetes is learning to mix regular insulin and NPH insulin in the same syringe. the nurse determines that additional teaching is needed when the patient does what? a. withdrawals the NPH does into the syringe first b. injects air equal to the NPH does into the NPH vial first c. Removes any air bubbles after withdrawing the first insulin d. adds air equal to the insulin dose in the regular vial and withdrawals the dose

a. withdrawals the NPH does into the syringe first

a nurse woking in an outpatient clinic plans a screening program for diabetes. what recommendations for screening should be included? a. OGTT for all minority populations every year b. FGP for all individuals at age 45 and then every 3 years c. testing people under the age of 21 for islet cell antibodies d. testing for type 2 diabetes in all overweight or obese individuals

b. FGP for all individuals at age 45 and then every 3 years

To precent hyperglycemia or hypoglycemia relater to exercise, what should the nurse teach the patient using glucose-lowering agents about the best time for exercise? a. only after a 15-g carbohydrate snack is eating b. about 1 hour after eating when blood glucose levels are rising c. when glucose monitoring reveals that the blood glucose is in the normal range d. when blood glucose levels are high, because exercise always has a hypoglycemia effect

b. about 1 hour after eating when blood glucose levels are rising

which patient should the nurse plan to teach how to prevent or delay the development of diabetes? a. an obese 50-year-old Hispanic woman b. a child whose father had type 1 diabetes c. a 34-year-old woman whose parents both have type 2 diabetes d. a 12-year-old boy whose father has maturity onset diabetes of the young (MODY)

c. a 34-year-old woman whose parents both have type 2 diabetes

A patient with type 1 diabetes use 20 U of 70/30 neutral protamine Hagedorn (NPH/regular) in the morning and at 6.00 pm. when teaching the patient about this regimen, what should the nurse emphasize? a. hypoglycemia is most likely to occur before the noon meal b. flexibility in food intake is possible because insulin is available 24 hours a day c. a set meal pattern with a bedtime snack is necessary to prevent hypoglycemia d. premeal glucose checks are required to determine needed changes in daily glucose

c. a set meal pattern with a bedtime snack is necessary to prevent hypoglycemia

which tissues require insulin to enable movement of glucose into the tissue cells (select all that apply) ? a. liver b. brain c. adipose d. blood cells. e. skeletal muscle

c. adipose e. skeletal muscle

the home care nurse should intervene to correct a patient whose insulin administration includes a. warming a pre filled refrigerated syringe in the hands before administration b. storing syringes pre filled with NPH and regular insulin needle-up in the refrigerator c. placing the insulin bottle currently in use in a small container on the bathroom countertop d. mixing an evening dose of regular insulin with insulin glargine in one syringe for administration

d. mixing an evening dose of regular insulin with insulin glargine in one syringe for administration