Diabetes

The nurse is instructing a client how to take his prescribed pramlintide. Which of the following would be most appropriate?

"Give it by subcutaneous injection immediately before your major meals."

A young man has been diagnosed with type 2 diabetes and has been prescribed glyburide. Which of the following statements suggests that the nurse should perform further health education?

"I'll plan to take my glyburide each night before I go to bed."

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

A 59-year-old man with type 2 diabetes is prescribed metformin. When the patient returns to the clinic, he reports that he has lost 8 pounds in a month. How should the nurse respond?

"Please continue taking the medication and monitoring your weight. This is an expected outcome of this drug therapy."

A nurse is assigned to administer glargine to a patient at a health care facility. What precaution should the nurse take when administering glargine?

Avoid mixing glargine with other insulin.

The nurse is discussing diabetes mellitus with a group of people who are involved in a weight loss program. The nurse relates to the group that the parameters for a diagnosis of diabetes are a fasting plasma glucose test (FPG) greater than or equal to what level on two separate occasions?

125mg/dL

The nurse is teaching a class to parents of children who have just been diagnosed with type 1 diabetes mellitus. The nurse informs the parents that recognition of hypoglycemia may be delayed in children because signs and symptoms are vague and the children may be unable to communicate them to parents or caregivers. Because of these difficulties, most pediatric diabetologists recommend maintaining blood glucose levels in what range?

Between 100 and 200 mg/dL

A patient receives a dose of insulin lispro at 8 AM. The nurse would be alert for signs and symptoms of hypoglycemia at which time?

Between 8:30 and 9:30 am

When learning about type 1 diabetes what would the student nurses learn is a distinguishing characteristic of this disease?

Exogenous insulin is required for life

Patients with type 2 diabetes have nonfunctioning beta pancreatic cells.

False

A diabetic patient is taking regular and NPH insulin to manage his diabetes. What is the best evaluation tool to measure the overall patient response to the insulin therapy?

Glycosylated hemoglobin (HbAlc) levels

Which of the following are risk factors for type 2 diabetes that a nurse should recognize in a client? Select all that apply:

Obesity, impaired glucose tolerance, history of gestational diabetes

A nurse is caring for a patient with diabetes mellitus who is receiving an oral antidiabetic drug. Which of following ongoing assessments should the nurse perform when caring for this patient?

Observe the patient for hypoglycemic episodes

When administering insulin, which of the following would be most appropriate?

Insert the needle at a 45 degree angle

A client newly diagnosed with type 1 diabetes asks the nurse why he cannot just take a pill. The nurse would incorporate knowledge of which of the following when responding to this client?

Insulin is needed because the beta cells of the pancreas are no longer functioning.

Which of the following represent the American Diabetes Association recommended HbA1c goal? (Choose one)

Less than 7%

A female client is admitted into the critical care unit with a diagnosis of myocardial infarct and subsequent bypass grafts. She has had type 1 diabetes for 10 years. The nurse understands that strict control of the client's hyperglycemia is critical to prevent what outcomes? (Select all that apply.)

Post-op infections, increased mortality

The physician prescribes glyburide for Tim, a newly diagnosed type 2 diabetic. The nurse knows that this medication acts by which mechanism?

Produces hypoglycemia by increasing insulin secretion from the pancreas

An insulin dependent diabetic is having trouble with hypoglycemia late in the morning. During the health history the nurse becomes aware of the most likely cause. What would cause the late morning hypoglycemia?

The patient jogs two miles in the morning before he goes to work.

A 2-month-old male child is diagnosed with diabetes. His parents are having difficulty measuring 2 units of insulin in the U-100 syringe. What would the nurse expect the physician to order?

U-10 (10 units/mL) insulin

The nurse is caring for a client with type 2 diabetes who is being treated with a regimen called BIDS. The nurse is aware that this regimen consists of what medications?

bedtime insulin plus daytime sulfonylurea

When reviewing sites for insulin administration with a client, which site, if stated by the client as an appropriate site, indicates the need for additional teaching?

buttocks

The pathophysiology class is studying diabetes. A student asks the instructor what is considered a sign of a hypoglycemic reaction. The instructor's response would be what?

diaphoresis

Ms. Newton, a newly diagnosed diabetic, is prescribed glyburide. As the nurse providing instruction, you identify which occurrence as a classic symptom of hyperglycemia?

excessive urination

Patients with type 2 diabetes have nonfunctioning beta pancreatic cells.

false

Stress typically results in hypoglycemia.

false

A nurse is caring for a patient who has developed a hypoglycemic reaction. Which of the following interventions should the nurse perform if swallowing and gag reflexes are present in the patient?

give oral fluids or candy

After teaching a class about the various drugs used to control blood glucose, the instructor determines that the teaching was successful when the class identifies which of the following as a biguanide?

metformin

A patient is admitted to the Emergency Department in diabetic ketoacidosis (DKA) with a blood glucose level of 33 mmol/L. The physician orders an initial dose of 25 U insulin IV. Which type of insulin will be administered?

regular insulin

Glycosylated hemoglobin measures average blood glucose over what time period? (Choose one)

the past 3 or 4 months

A female client is a newly diagnosed diabetic. She is a stay-at-home mother and responsible for meal planning and management of the home. What will the home care nurse teach this client? (Select all that apply.)

• Assist the client in making menus that will meet the needs of both the client and the family. • Reinforce instructions on dealing with hypoglycemia. • Watch the client draw up and administer her insulin.

A nurse should take the following steps prior to administering insulin glargine (Lantus) to a client? Select all that apply:

• Check the expiration date on the vial. • Check the physician's orders for the type and dosage of insulin. • Remove all air bubbles from the syringe barrel.

What instructions would be important to give to a 50-year-old client with type 2 diabetes who has been switched from glyburide (DiaBeta), a sulfonylurea, to repaglinide, a meglitinide?

"It stimulates insulin production, so you need to eat soon after taking the medication."

The nurse is caring for a client who receives an injection of regular insulin before each meal. How many minutes before a meal should regular insulin be injected?

30 to 45

A student asks the nursing instructor what insulin has the quickest therapeutic effect once administered. What would be the best response?

Regular (Humulin R)

A man is brought to the emergency department. He is nonresponsive, and his blood glucose level is 32 mg/dL. Which of the following would the nurse expect to be ordered?

glucagon

Which of the following would a nurse identify as an example of a sulfonylurea?

glyburide

A hospital patient's medication administration record specifies a dose of NPH insulin to be administered subcutaneously at 8 AM. The nurse has checked the patient's blood glucose level prior to administering the drug and it is 55 mg/dl. How should the nurse respond to this assessment finding?

hold the dose of insulin and consult with the patient's primary care provider

When describing the effects of incretins on blood glucose control to a group of students, which of the following would an instructor include?

increases insulin release

The nurse monitoring a client receiving insulin glulisine (Apidra) notices the client has become confused, diaphoretic, and nauseated. The nurse checks the client's blood glucose and it is 60 mg/dL. Which of the following can a nurse give to treat a client with a hypoglycemic episode? Select all that apply:

• Orange or other fruit juice • Glucose tablets • Hard candy