NUR202 Evolve: Introductory Quiz - Diabetes
A patient newly diagnosed with type 1 diabetes mellitus receives teaching about prevention of eye changes. Which statement indicates that additional teaching is required?
"In 5 years, I will need to have an eye examination every year."
The nurse is instructing a patient who has been newly diagnosed with diabetes mellitus. Which intervention does the nurse teach the patient that will help prevent microvascular complications of diabetes?
"Keep your blood sugar in good control."
The nurse is teaching the parents of a pediatric patient who has recently been diagnosed with type 1 diabetes mellitus. What statement will the nurse include about the pathophysiology of the disease?
"The body starts to attack itself and destroy the cells that make insulin in the pancreas."
The nurse is caring for a patient who is experiencing diabetic ketoacidosis. The patient's family member asks the nurse, "Why is my brother breathing so fast and taking such deep breaths?" What is the nurse's best response?
"The brain is triggered to increase the depth and rate of breaths in order to correct the acid-base balance of the blood."
The nurse is assessing an older adult patient with type 2 diabetes and notes that the patient has optic nerve atrophy. What statement will the nurse include when teaching the patient about this condition?
"This results from lack of oxygen vessel swelling."
A patient recently diagnosed with type 2 diabetes mellitus states, "I don't understand how I got diabetes. I don't eat sugary foods." How does the nurse respond?
"Type 2 diabetes is caused by resistance to insulin or an inability to make sufficient insulin."
The nurse is providing discharge instructions for a patient who was admitted with diabetic ketoacidosis. What information does the nurse include when teaching the patient about the pathophysiology of the condition?
"When insulin is deficient, fats break down, causing acidosis."
The nurse is caring for a patient with diabetes mellitus who tells the nurse, "I sometimes have episodes of seeing double. What causes that?" What is the nurse's best response?
"You are likely experiencing an episode of low blood sugar when this happens."
The nurse is caring for a 29-year-old patient who presents to the primary care clinic for an annual well exam. The patient asks the nurse, "Should I be tested for diabetes?" What is the nurse's best response? .
-"If you have a first-degree relative with diabetes, you should be tested for diabetes." -"If you have been diagnosed with vascular disease, you should be screened for diabetes."
A home health nurse is providing education to a patient with type 2 diabetes mellitus. The patient asks the nurse, "Why do some diabetics have eye and kidney problems?" What is the nurse's best response?
-"Too much glucose affects the organ's cell integrity." -"Chronic high blood sugar thickens basement membranes, leading to organ failure." -"Low oxygen in the vessels due to increased blood glucose causes low oxygen to the organs."
Which conditions are typical features of metabolic syndrome?
-Abdominal obesity. -Hyperglycemia. -Hypertension. -Hyperlipidemia.
The nurse is caring for a patient with diabetes mellitus with autonomic neuropathy. What nursing intervention will the nurse perform for this patient?
-Assess the patient for urine retention. -Apply lotion to areas of dry, cracked skin. -Instruct the patient to move positions slowly to avoid getting dizzy.
What are the distinguishing characteristics of type 1 diabetes mellitus (DM) that the nurse should remember?
-Autoimmune disorder. -Beta cells are destroyed. -Triggered by viral infections.
The nurse is concerned that a patient with diabetes mellitus is at risk for developing chronic kidney disease (CKD). What findings did the nurse use to make this clinical determination?
-Blood pressure 168/90 mm Hg. -12-year history of type 2 diabetes mellitus. -Fasting blood glucose levels between 180 and 200 mg/dL. -Stopped taking prescribed angiotensin receptor blocker (ARB).
What macrovascular complications may occur as a result of diabetes mellitus?
-Cardiovascular disease. -Cerebrovascular disease.
A patient with diabetes mellitus reports a burning or tingling sensation in the toes. A primary health care provider suspects distal symmetric neuropathy. The nurse recognizes that which findings indicate motor alterations in the intrinsic muscles of the foot associated with this condition?
-Claw toes. -High arch. -Hammertoes.
Which are microvascular complications of diabetes mellitus?
-Eye and vision complications. -Diabetic neuropathy. -Diabetic nephropathy. -Male erectile dysfunction.
Which are counterregulatory hormones?
-Glucagon. -Epinephrine. -Norepinephrine. -Growth hormone. -Cortisol.
What should the nurse expect to assess in a patient with diabetes diagnosed with distal symmetric polyneuropathy?
-Hammertoes. -Loss of sensation of the lower legs. -Tingling sensation in the feet and legs.
What are the actions of incretin hormones?
-Increase insulin secretion. -Inhibit glucagon secretion. -Slow the rate of gastric emptying.
What is the role of incretin hormones in glucose regulation?
-Increase insulin secretion. -Slow rate of gastric emptying. -Prevent hyperglycemia after meals.
The nurse is caring for a patient who has been on a hunger strike for 30 days and has no body fat and poor muscle definition. What mechanisms have been providing this patient with energy?
-Lipolysis. -Proteolysis.
What should the nurse include when reviewing microvascular complications of a patient with type 2 diabetes mellitus?
-Neuropathy. -Retinopathy. -Nephropathy.
The nurse is preparing teaching material for a patient newly diagnosed with type 1 diabetes mellitus. What should the nurse include about the main metabolic effects of insulin? .
-Suppresses liver production of glucose. -Stimulates glucose uptake in heart muscle. -Stimulates glucose uptake in skeletal muscle. -Suppresses liver production of very-low-density lipoproteins.
Which statements about the etiology and genetic risk for diabetes mellitus are correct?
-Type 2 diabetes results from genetic susceptibility in addition to controllable risk factors. -Type 1 diabetes results from genetic susceptibility. -Viral infections may act as a trigger for type 1 diabetes.
The nurse is reviewing the implications of culture on the development of diabetes. Which patient will the nurse determine has the greatest risk for developing type 2 diabetes mellitus?
44-year-old healthy American Indian patient with a family history of type 2 diabetes.
What best describes the etiology of type 1 diabetes mellitus?
Autoimmune disorder.
Which is a chronic complication that can occur in patients with diabetes?
Cell death from macrovascular changes
The nurse is caring for a patient with a pheochromocytoma. The patient has malignant hypertension and uncontrolled elevated blood glucose requiring an insulin infusion. What is the nurse's best understanding of the pathophysiological alteration of the patient's glucose regulation?
Counterregulatory hormones cause an increase in blood glucose.
Which sign/symptom is an indicator of hyperglycemia in diabetes mellitus?
Excessive urination.
The patient with diabetes is at risk for eye and vision complications. What is the distinguishing characteristic of proliferative diabetic retinopathy?
Formation of new retinal blood vessels.
The nurse is aware that insulin deficiency leads to metabolic acidosis. Which manifestation is a result of metabolic acidosis?
Fruity odor on the breath.
Which hormone is responsible for maintaining blood glucose levels during periods of fasting from food?
Glucagon.
Which of the following is the process of converting proteins to glucose?
Gluconeogenesis.
Which laboratory assessment finding may be indicative of diabetes mellitus?
Glycosylated hemoglobin of 7.5% in a 30-year-old adult
A patient with type 2 diabetes mellitus is experiencing cardiovascular autonomic neuropathy (CAN). What should the nurse include on this patient's care plan to address safety?
Instruct to change positions slowly.
Which statement about pre-diabetes is correct?
It describes people at risk for type 2 diabetes who have a fasting glucose level of 100 to 125 mg/dL.
The nurse is caring for a patient with diabetes. What distinguishing characteristic of glucagon must the nurse be aware of?
It triggers the release of glucose from cell storage sites.
The nurse is reviewing the medical record of a patient with type 2 diabetes mellitus. What information suggests that the patient has been focusing on changing modifiable risk factors?
Latest low-density lipoprotein (LDL) cholesterol level 68 mg/dL
Which medication taken by a patient with diabetes mellitus will protect the kidneys and help prevent diabetic nephropathy?
Lisinopril.
The nurse is admitting a patient with diabetic ketoacidosis to the intensive care unit (ICU). What arterial blood gas (ABG) result will the nurse likely find when reviewing the patient's laboratory results?
Low pH, low CO2, low HCO3.
A patient being treated for cardiovascular disease has factors that increase the risk for developing type 2 diabetes mellitus. On which health problem should the nurse focus when assessing this patient?
Metabolic syndrome.
During a clinic visit, a patient with type 2 diabetes mellitus has a sudden onset of nausea and vomiting. What should the nurse suspect is occurring with the patient?
Myocardial infarction.
What can slow the progression of diabetic neuropathies?
Normal blood glucose levels.
Which finding is seen in a patient with type 2 diabetes mellitus?
Obesity.
What mechanism causes electrolyte imbalances in the patient with diabetes who is experiencing extremely elevated blood glucose levels?
Osmotic diuresis.
A patient with type 2 diabetes experiences a stroke and the nurse is caring for the patient in the intensive care unit (ICU). What factor puts this patient at greater risk for a poor clinical outcome?
Patients with diabetes experience brain damage that would normally not cause damage in a patient without diabetes.
Which statement about blood pressure, as it relates to diabetes mellitus, is correct?
Patients with diabetes should keep their blood pressure below 140/80 mm Hg.
A patient with type 2 diabetes mellitus is experiencing an eye hemorrhage and vision changes. What should the nurse suspect is occurring with this patient?
Proliferative diabetic retinopathy.
The nurse is providing education to a patient with diabetes mellitus who has manifestations of cardiovascular disease. What is the nurse's priority action?
Reduce modifiable risk factors.
The nurse is caring for a patient with diabetes who has autonomic neuropathy of the feet. What is the effect of this condition?
Skin cracks and fissures.
A patient with diabetes mellitus tells the nurse that he has been experiencing bloating, gas, and diarrhea. What pathophysiological finding, common in diabetes mellitus, does the nurse recognize as the likely cause of the patient's complaint?
Sluggish movement of the small intestine.
A patient with type 2 diabetes, retinopathy, and complaints of painful "pins and needles" sensations in the feet presents to the primary care clinic. The nurse notes the patient's low-density lipoprotein cholesterol (LDL) level is at 75mg/dL. What can the nurse determine regarding the patient's LDL level?
The level is higher than the recommended level and should be addressed by the health care provider.
What role does the liver play in the production, conversion, and release of insulin?
The liver converts a prohormone into insulin before releasing it into the bloodstream.
Which explanation best assists a patient in differentiating type 1 diabetes from type 2 diabetes?
Those with type 2 diabetes make insulin, but in inadequate amounts.
Which is a feature of metabolic syndrome?
Triglycerides 220 mg/dL.
The nurse is caring for a patient with diabetes mellitus who is being screened for nephropathy. What laboratory test will the nurse reference as the test used to screen for early nephropathy?
Urine for albumin.
Which assessment finding is identified as a risk for type 2 diabetes mellitus (DM) and cardiovascular disease (CVD)?
Waist circumference of 40 inches or more.
