PrepU Chap 46: Assessment and Mgmt of a Patients with Diabetes

After being sick for 3 days, a client with a history of diabetes mellitus is admitted to the hospital with diabetic ketoacidosis (DKA). The nurse should evaluate which diagnostic test results to prevent dysrhythmias? A. Serum calcium level B. Serum potassium level C. Serum sodium level D. Serum chloride level

B. Serum potassium level

A client with diabetes mellitus has a blood glucose level of 40 mg/dL. Which rapidly absorbed carbohydrate would be most effective? A. 1/2 cup fruit juice or regular soft drink B. 1.2 tbsp honey or syrup C. 4 oz of skim milk D. three to six LifeSavers candies

A. 1/2 cup fruit juice or regular soft drink

The nurse expects that a type 1 diabetic patient may receive what percentage of his or her usual morning dose of insulin preoperatively? A. 50% to 60% B. 25% to 40% C. 85% to 90% D. 10% to 20%

A. 50% to 60%

Which factor is the focus of nutrition intervention for clients with type 2 diabetes? A. protein metabolism B. carbohydrate intake C. blood glucose level D. weight loss

B. carbohydrate intake

A 1200-calorie diet and exercise are prescribed for a client with newly diagnosed type 2 diabetes. The nurse is teaching the client about meal planning using exchange lists. The teaching is determined to be effective based on which statement by the client? A. "For dinner I ate 2 ounces of sliced turkey, 1 cup mashed sweet potatoes, half a cup of carrots, half a cup of peas, a 3-ounce dinner roll, 1 medium banana, and a diet soda." B. "For dinner I ate 2 cups of cooked pasta with 3-ounces of boiled shrimp, 1 cup plum tomatoes, half a cup of peas in a garlic-wine sauce, 2 cups fresh strawberries, and ice water with lemon." C. "For dinner I ate 4-ounces of sliced roast beef on a bagel with lettuce, tomato, and onion; 1 ounce low-fat cheese; 1 tablespoon mayonnaise; 1 cup fresh strawberry shortcake; and unsweetened iced tea." D. "For dinner I ate a 3-ounce hamburger on a bun, with ketchup, pickle, and onion; a green salad with 1 teaspoon Italian dressing; 1 cup of watermelon; and a diet soda."

"For dinner I ate a 3-ounce hamburger on a bun, with ketchup, pickle, and onion; a green salad with 1 teaspoon Italian dressing; 1 cup of watermelon; and a diet soda."

A patient who is 6 months' pregnant was evaluated for gestational diabetes mellitus. The doctor considered prescribing insulin based on the serum glucose result of: A. 120 mg/dl, I hour postprandial B. 138 mg/dl, 2 hours postprandial C. 90 mg/dl before meals D. 80 mg/dl, 1 hour postprandial

B. 138 mg/dl, 2 hours postprandial

A health care provider prescribes short-acting insulin for a patient, instructing the patient to take the insulin 20 to 30 minutes before a meal. The nurse explains to the patient that Humulin-R taken at 6:30 AM will reach peak effectiveness by: A. 12:30 PM B. 8:30 AM C. 10:30 AM D. 2:30 PM

B. 8:30 AM

A client with diabetes mellitus must learn how to self-administer insulin. The physician has ordered 10 units of U-100 regular insulin and 35 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction? A. "Inject insulin into healthy tissue with large blood vessels and nerves." B. "Administer insulin into sites above muscles that you plan to exercise heavily later that day." C. "Rotate injection sites within the same anatomic region, not among different regions." D. "Administer insulin into areas of scar tissue or hypertrophy whenever possible."

C. "Rotate injection sites within the same anatomic region, not among different regions."

A patient who is diagnosed with type 1 diabetes would be expected to: A. Have no damage to the islet cells of the pancreas B. Be restricted to an American Diabetic Association diet C. Need exogenous insulin D. Receive daily doses of a hypoglycemic agent

C. Need exogenous insulin

Which type of insulin acts most quickly? A. Regular B. Glargine C. NPH D. Lispro

D. Lispro

A client is diagnosed with diabetes mellitus. The client reports visiting the gym regularly and is a vegetarian. Which of the following factors is important to consider when the nurse assesses the client? A. History of radiographic contrast dyes that used insulin B. The client's consumption of carbohydrates C. The client's mental & emotional status D. The client's exercise routine

B. The client's consumption of carbohydrates

When administering insulin to a client with type 1 diabetes, which of the following would be most important for the nurse to keep in mind? A. Technique for injecting B. Area for insulin injection C. Duration of the insulin D. Accuracy of the dosage

D. Accuracy of the dosage

A nurse is preparing a client with type 1 diabetes for discharge. The client can care for himself; however, he's had a problem with unstable blood glucose levels in the past. Based on the client's history, he should be referred to which health care worker? A. Dietician B. Social Worker C. Home health nurse D. Psychiatrist

A. Dietician

A client is admitted with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which laboratory finding should the nurse expect in this client? A. Arterial pH 7.25 B. Blood glucose level 1,100 mg/dl C. Blood urea nitrogen (BUN) 15 mg/dl D. Plasma bicarbonate 12 mEq/L

B. Blood glucose level 1,100 mg/dl

A client is diagnosed with diabetes mellitus. Which assessment finding best supports a nursing diagnosis of Ineffective coping related to diabetes mellitus? A. Failure to monitor blood glucose levels B. Skipping insulin doses during illness C. Recent weight gain of 20 b (9.1 kg) D. Crying whenever diabetes is mentioned

D. Crying whenever diabetes is mentioned

Which statement is correct regarding glargine insulin? A. Its peak action occurs in 2 to 3 hours B. It is absorbed rapidly C. It is given twice daily D. It cannot be mixed with any other type of insulin

D. It cannot be mixed with any other type of insulin

Lispro (Humalog) is an example of which type of insulin? A. Intermediate-acting B. Short-acting C. Long-acting D. Rapid-acting

D. Rapid-acting

A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously? A. Glargine B. NPH C. Lente D. Regular

D. Regular

A client with diabetes mellitus develops sinusitis and otitis media accompanied by a temperature of 100.8° F (38.2° C). What effect do these findings have on his need for insulin? A. They increase the need for insulin B. They have no effect C. They cause wide fluctuations in the need for insulin D. They decrease the need for insulin

A. They increase the need for insulin

Which combination of adverse effects should a nurse monitor for when administering IV insulin to a client with diabetic ketoacidosis? A. Hypocalcemia and hyperkalemia B. Hypokalemia and hypoglycemia C. Hypernatremia and hypercalcemia D. Hyperkalemia and hyperglycemia

B. Hypokalemia and hypoglycemia

A nurse is providing education to a client who is newly diagnosed with diabetes mellitus. What are classic symptoms associated with diabetes? A. increased weight gain, appetite, and thirst B. Increased thirst, hunger, and urination C. Increased weight loss, dehydration, and fatigue D. Loss of appetite, increased urination, and dehydration

B. Increased thirst, hunger, and urination

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? A. Automatic neuropathy B. Retinopathy C. Nephropathy D. Sensory neuropathy

D. Sensory neuropathy

A client with status asthmaticus requires endotracheal intubation and mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose levels hourly and watch for which early signs and symptoms associated with hypoglycemia? A. Polyuria, polydipsia, and polyphagia B. Bradycardia, thirst, and anxiety C. Dry skin, bradycardia, and somnolence D. Sweating, tremors, and tachycardia

D. Sweating, tremors, and tachycardia

A client with diabetes comes to the clinic for a follow-up visit. The nurse reviews the client's glycosylated hemoglobin test results. Which result would indicate to the nurse that the client's blood glucose level has been well-controlled? A. 7.5% B. 8.0% C. 6.5% D. 8.5%

C. 6.5%

During a follow-up visit 3 months after a new diagnosis of type 2 diabetes, a client reports exercising and following a reduced-calorie diet. Assessment reveals that the client has only lost 1 pound and did not bring the glucose-monitoring record. Which value should the nurse measure? A. Glucose via a urine dipstick test B. Fasting blood glucose level C. Glycosylated hemoglobin level D. Glucose via an oral glucose tolerance test

C. Glycosylated hemoglobin level

Which of the following factors would a nurse identify as a most likely cause of diabetic ketoacidosis (DKA) in a client with diabetes? A. The client continues medication therapy despite adequate food intake B. The client has been exercising more than usual C. The client has eaten and has not taken or received insulin D. The client has not consumed sufficient calories

C. The client has eaten and has not taken or received insulin

Which intervention is essential when performing dressing changes on a client with a diabetic foot ulcer? A. Cleaning the wound with a providone-iodine solution B. Debriding the wound three times per day C. Using sterile technique during the dressing change D. Applying a heating pad

C. Using sterile technique during the dressing change

A client with type 1 diabetes asks the nurse about taking an oral antidiabetic agent. The nurse explains that these medications are effective only if the client: A. is pregnant and has type 2 diabetes B. has type 1 diabetes C. has type 2 diabetes D. prefers to take insulin orally

C. has type 2 diabetes

A client with type 1 diabetes is admitted to an acute care facility with diabetic ketoacidosis. To correct this acute diabetic emergency, which measure should the health care team take first? A. Determining the cause of diabetic ketoacidosis B. Correct diabetic ketoacidosis C. Administer insulin D. initiate fluid replacement therapy

D. initiate fluid replacement therapy

What is a characteristic of type 2 diabetes? A. presence of islet antibodies B. ketosis-prone when insulin absent C. little or no insulin D. insulin resistance

D. insulin resistance

After teaching a client with type 1 diabetes who is scheduled to undergo an islet cell transplant, which client statement indicates successful teaching? A. "I will receive a whole organ with extra cells to produce insulin." B. "This transplant will provide me with a cure for my diabetes." C. "They'll need to create a connection from the pancreas to allow enzymes to drain." D. "I might need insulin later on but probably not as much or as often."

D. "I might need insulin later on but probably not as much or as often."

Which information should be included in the teaching plan for a client receiving glargine, which is "peakless" basal insulin? A. Administer the total drug dosage in 2 doses B. Draw up the drug first, then add regular insulin C. Glargine is rapidly absorbed and has a fast onset of action D. Do not mix with other insulins

D. Do not mix with other insulins

A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which finding suggests that the client has developed hyperglycemia? A. Decreased appetite B. Diaphoresis C. Cheyne-Stokes respirations D. Increased urine output

D. Increased urine output

A client with a history of type 1 diabetes is demonstrating fast, deep, labored breathing and has fruity odored breath. What could be the cause of the client's current serious condition? A. All options are correct B. hypersomolar hyperglycemic nonketotic syndrome C. hepatic disorder D. ketoacidosis

D. ketoacidosis