NURS 3320 Lifespan (exam 11) diabetes

The family of a client in the hospital with *diabetes* *type* *1* out of control asks the nurse to explain the client's recent *weight* *loss* while eating more than usual. How will the nurse respond? -Fatty acids enter the glycolytic pathway to release energy. -Glucose is unused without insulin, so body fats are used for energy. -Surplus glucose is stored as glycogen in the liver. -Lack of insulin raises circulating blood glucose levels.

*Glucose* is *unused* *without* *insulin*, so body *fats* are *used* for *energy*.

Which may be a potential cause of hypoglycemia in the client diagnosed with diabetes mellitus? -The client has eaten but has not taken or received insulin. -The client has not been exercising. -The client has not complied with the prescribed treatment regimen. -The client has not eaten but continues to take insulin or oral antidiabetic medications.

The client has not eaten but continues to take insulin or oral antidiabetic medications.

A client is managing his type 2 diabetes with exercise and diet. He has a fasting blood sugar level (FBS) of 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (.05). Based on these findings, which of the following can the nurse assume? -The client is at risk for developing hyperglycemia. -The client is achieving normal glycemic control. -The client is at risk for an insulin reaction. -The client needs to modify his diet related to the low readings.

The client is achieving normal glycemic control.

A patient provides a return demonstration of how to draw up insulin in a syringe and self-inject. What is the primary purpose of giving the patient feedback? -To anticipate and prepare to answer any questions the client has -To provide critical or necessary information -To give the client advice on what to do -To provide praise and ignore small errors

To provide critical or necessary information

A client with type 1 diabetes has started a new exercise routine. Knowing there may be some increased risks associated with exercise, the health care provider should encourage the client to: -be careful that he or she is not experiencing rebound hyperglycemia. -carry a snack with a rapidly absorbed form of glucose to prevent profound hypoglycemia. -watch for rapid weight loss. -monitor for respiratory disorders.

carry a snack with a rapidly absorbed form of glucose to prevent profound hypoglycemia.

A pregnant client with type I diabetes asks the nurse about how to best control her blood sugar while she is pregnant. The best reply would be for the woman to: -exercise for 1 to 2 hours each day to keep the blood glucose down. -begin oral hyperglycemic medications along with the insulin she is currently taking. -check her blood sugars frequently and adjust insulin accordingly. -limit weight gain to 15 pounds during the pregnancy.

check her blood sugars frequently and adjust insulin accordingly.

A client with diabetes is undergoing testing for glycosylated hemoglobin. The nurse instructs the client that this test measures average blood glucose over what time period? -the past 3 or 4 months -the past 7 to 10 days -the past 1 or 2 months -the past 12 to 24 hours

the past 3 or 4 months

A 7-year-old child is diagnosed as having type 1 diabetes. What is one of the first symptoms usually noticed by parents when this illness develops? -craving for sweets -weight loss -swelling of soft tissue -severe itching

weight loss

What signs and symptoms are associated with hypoglycemia? -Nervousness, diaphoresis, and confusion -Polydipsia, pallor, and irritability -Polyphagia and flushed, dry skin -Polyuria, headache, and fatigue

Nervousness, diaphoresis, and confusion

Select the most common symptoms of diabetes. Select all that apply. -Polyhydramnios -Polydipsia -Polyuria -Polyphagia -Polycythemia

Polydipsia Polyuria Polyphagia

A patient has been newly diagnosed with type 2 diabetes, and the nurse is assisting with the development of a meal plan. What step should be taken into consideration prior to making the meal plan? -Ensuring that the patient understands that some favorite foods may not be allowed on the meal plan and substitutes will need to be found -Reviewing the patient's diet history to identify eating habits and lifestyle and cultural eating patterns -Making sure that the patient is aware that quantity of foods will be limited -Determining whether the patient is on insulin or taking oral antidiabetic medication

Reviewing the patient's diet history to identify eating habits and lifestyle and cultural eating patterns

The nurse is discussing diabetes with a group of individuals who are at risk for the disease. Which statement by a participant indicates an understanding of the role of insulin in the disease? -"Insulin causes fat to be broken down to provide energy for the body." -"Insulin is used to move carbohydrate particles from the gastrointestinal system to the liver." -"Insulin assists glucose molecules to enter the cells of muscle and fat tissues." -"Insulin is stimulated by the liver to break down proteins and provide the body with nutrients."

"Insulin assists glucose molecules to enter the cells of muscle and fat tissues."

The nurse is explaining *glycosylated* *hemoglobin* testing to a diabetic client. Which of the following provides the best reason for this order? -Best indicator for the nutritional state of the client -Is less costly than performing daily blood sugar test -Provides best information on the body's ability to maintain normal blood functioning -Reflects the amount of glucose stored in hemoglobin over past several months.

*Reflects* the *amount* of *glucose* *stored* in *hemoglobin* over *past* *several* *months*.

An obese adult has recently been diagnosed with *type* *2* *diabetes*. The nurse knows that the most likely *treatment* *plan* for this client will include which topics? -Daily monitoring for urine ketones and weight loss measures. -Weight loss, glucose monitoring, and oral antihyperglycemic medications -Injectable insulin, nutrition management, and adequate hydration -Continuous subcutaneous insulin infusion (CSII) and nutrition management

*Weight* *loss*, *glucose* *monitoring*, and *oral* *antihyperglycemic* medications

An infant is born to a mother with gestational diabetes. Which *long-term* *maternal* *complication* is associated with this diagnosis? -Development of long-term hypertension -Development of cardiovascular complications and heart disease -Weight gain during pregnancy causing a large for gestational age infant -Increased risk of development of type 2 diabetes

-Increase risk of development of type 2 diabetes

The nurse monitoring a client receiving insulin glulisine notices the client has become confused, diaphoretic, and nauseated. The nurse checks the client's *blood* *glucose* and it is *60 mg/dL* (3.33 mmol/L). Which can a nurse give to treat a client with a *hypoglycemic* episode? (Select all that apply.) -Orange or other fruit juice -Hard candy such as Lifesavers -Milk -Sugared soda -Glucose tablets

-Orange or other fruit juice -Hard candy such as Lifesavers -Milk -Sugared soda -Glucose tablets

Which of the following lab results indicates a need for additional diagnostic testing? -Serum potassium 4.2 mEq/L (4.2 mmol/L) -Fasting blood glucose level 75 mg/dL (4.16 mmol/L) -2 hour oral GTT 175 mg/dL (9.7 mmol/L) -Hemoglobin A1C 5.0% (.05)

2 hour oral GTT 175 mg/dL (9.7 mmol/L)

A client tells the nurse that she has been working hard for the past 3 months to control her type 2 diabetes with diet and exercise. To determine the effectiveness of the client's efforts, the nurse should check: -fasting blood glucose level. -serum fructosamine level. -glycosylated hemoglobin level. -urine glucose level.

glycosylated hemoglobin level.

The client with *diabetes* asks the nurse why shoes and socks are removed at each office visit. The nurse gives which assessment finding as the explanation for the *inspection* of *feet*? -retinopathy -opthalmologic changes -peripheral neuropathy -nephropathy

peripheral *neuropathy*

The nurse screening for diabetes mellitus at a health fair obtains these results. Which client should be referred to a primary health care provider for further evaluation? -hemoglobin A1C 5.6% -fasting blood glucose 89 mg/dl (4.9 mmol/l) -random blood glucose 195 mg/dl (10.8 mmol/l) -urine ketones negative

random blood glucose 195 mg/dl (10.8 mmol/l)