Nur354Exam4 Multiple choice
Priority Decision: When caring for a patient with metabolic syndrome, the nurse should give the highest priority to teaching the patient about which treatment plan? A) achieving a normal weight B) performing daily aerobic exercise C) eliminating red meat from the diet D) monitoring the blood glucose periodically
a
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 surgars from the diet D) limit saturated fat intake to 30% of dietary calorie intake
a
Which class of oral glucose-lowering agents(OA) is most commonly used for people with type 2 diabetes because it reduces hepatic glucose production and enhances tissue uptake of glucose? A) insulin B) biguanide C) meflitinide D) sulfonylurea
b
Which patient should the nurse plan to teach how to prevent or delay the development of diavetes? A) an obese 40 year old Hispanic woman B) a child whose father has 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
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 e
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
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 each day C) have blood pressure checked regularly D) assess for visual changes on a monthly basis E) monitor for polyuria, polyphagia, and polydipsia
a e
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 by the osmotic effect of glucose? A) fatigue B) polydipsia C) polyphagia D)recurrent infections
b
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
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) withdraws the NPH dose into the syringe first B) injects air equal to the NPH dose into the NPH vial first C) removes any air bubbles after withdrawing the first insulin D) adds air equals to the insulin dose into the regular vial and withdraws the dose
a
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
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 b c d e f
Patient Centered Care: The patient with type 2 diabetes is being put on acarbose(Precose) and wants to know about taking it. What should the nurse include in this patient's teaching(select all that apply)? A) take it 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 proprandial glucose E) it delays glucose absorption from the gastrointestinal(GI) tract
a d e
Teamwork and Collaboration: The following interventions are planned for a patient with diabetes. Which intervention can the nurse delegate to unlicensed assistive personnel(UAP)? 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
a patient with type 1 diabetes uses 20 U of Novolin 70/30 (NPH/regular) in the morning and at 6:00pm. When teaching the patient about this regimen, what should the nurse emphasize? A) hypoglycemia is most likely to occur before the noon meal B) a set meal pattern with a bedtime snack is necessary to prevent hypoglycemia C) flexibility in food intake is possible because insulin is available 24 hours a day D) Premeal glucose check are required to determine needed changes in daily dosing
b
Priority Decision: The nurse is assessing a newly admitted patient with diabetes. Which observation should be addressed as the priority by the nurse? A) bilateral numbness of both hands B) stage 2 pressure ulcer on the right heel C) rapid respirations with deep inspiration D) areas of lumps and dents on the abdomen
c
Priority decision: a patient taking insulin has recorded fasting glucose levels above 200 mg/dL(11..1 mmol/L) on awakening for the last five morning. What should the nurse advise the patient to do first? A) increase the evening insulin dose to prevent the dawn phenomenon B) use a single-dose insulin regimen with an intermediate-acting insulin C) monitor the glucose level at bedtime, between 2 am and 4 am, and on arising D) decrease the evening insulin dosage to prevent night hypoglycemia and the Somogyi effect
c
In addition to promoting the transport of glucose from the blood into the cell, what does insulin do? A) enhances the breakdown of adipose tissue for energy B) stimulates hepatic glycogenolysis and gluconeogenesis C) prevents the transport of triglycerides into adipose tissue D) increases amino acid transport into cells and protein synthesis
d
Lispro insulin(Humalog) with NPH(Humulin N) insulin is ordered for a patient with dewly diagnoses 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 to 45 minuted before meals D) at mealtime or within 15 minutes of meals
d
The nurse determines that a patient with a 2 hour OGTT of 152 mg/d has A) diabetes B) elevated A1C C) impaired fasting glucose D) impaired glucose tolerance
d
The patient with type 2 diabetes has had trouble controlling his blood glucose with several OAs but wants to avoid the risks of insulin. The HCP told him a medication will be prescribed that will increase insulin synthesis and release from the pancreas, inhibit glucagon secretion, and slow gastric emptying. The nurse knows this is which medication that will have to be injected? A) dopamine receptor agonist, bromocriptine(Cycloset) B) Dipeptidyl peptidase-4(DPP-4) inhibitor, sitagliptin(Januvia) C) Sodium-glucose co-transporter 2(SGLT2) inhibitor, canagliflozin(Invokana) D) Glucagon-like peptide-1 receptor agonist, exenatide extended release(Bydureon)
d
Which laboratory results would indicate that the patient has prediabetes? A) glucose tolerance result of 132 mg/dL(7.3 mmol/L) B) glucose tolerance result of 240 mg/dL(13.3 mmol/L) C) fasting blood glucose result of 80 mg/dL(4.4 mmol/L) D) fasting blood glucose result of 120 mg/dL(6.7 mmol/L)
d
During routine health screening, a patient is found to have fasting plasma glucose(FPG) of 132 mg/dL(7.33 mmol/L). At a follow-up visit, a diagnosis of diabetes would be made based on which laboratory results(select all that apply)? A) A1C of 7.5% B) Glycosuria of 3+ C) FPG > 127 mg/dL(7.0 mmol/L D) random blood glucose of 126 mg/dL(7.0 mmol/L) E) a 2 hour oral glucose tolerance test(OFTT) of 190 mg/dL(10.5 mmol/L)
a c
The home care nurse should intervene to correct a patient whose insulin administration includes A) warming a prefilled syringe in the hands before administration B) storing syringes prefilled with NPH and regular insulin needle up in the refrigerator C) placing the insulin bottle currently in use in a small container in the bathroom countertop D) mixing an evening dose of regular insulin with insulin glargine in one syringe for administration
d