MDC 2 Final Exam NCLEX Practice Questions Diabetes
When the nurse is caring for a patient with type 1 diabetes, what clinical manifestation would be a priority to closely monitor? a.Hypoglycemia b.Hyponatremia c.Ketonuria d.Polyphagia
a.Hypoglycemia
A client with type 1 diabetes mellitus is receiving short-acting insulin to maintain control of blood glucose levels. In providing glucometer instructions, the nurse would instruct the client to use which site for most accurate findings? a.Finger b.Upper arm c.Thigh d.Forearm
a.Finger
The nurse is educating the client with diabetes on setting up a sick plan to manage blood glucose control during times of minor illness such as influenza. Which is the most important teaching item to include? a.Increase frequency of glucose self-monitoring. b.Decrease food intake until nausea passes. c.Do not take insulin if not eating. d.Take half the usual dose of insulin until symptoms resolve.
a.Increase frequency of glucose self-monitoring.
The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action? a.It carries glucose into body cells. b.It aids in the process of gluconeogenesis. c.It stimulates the pancreatic beta cells. d.It decreases the intestinal absorption of glucose.
a.It carries glucose into body cells.
A nurse is teaching a client with type 1 diabetes how to treat adverse reactions to insulin. To reverse hypoglycemia, the client ideally should ingest an oral carbohydrate. However, this treatment isn't always possible or safe. Therefore, the nurse should advise the client to keep which alternate treatment on hand? a.Epinephrine b.Glucagon c.50% dextrose d.Hydrocortisone
b.Glucagon
The nurse is teaching a client with diabetes about proper foot care. Which statement by the client indicates that teaching was effective? a."I will go barefoot in my house so that my feet are exposed to air." b."I must inspect my shoes for foreign objects before putting them on." c."I will soak my feet in warm water to soften calluses before trying to remove them." d."I must wear canvas shoes as much as possible to decrease pressure on my feet."
b."I must inspect my shoes for foreign objects before putting them on."
The nurse is teaching a client about the manifestations and emergency management of hypoglycemia. Which response by the client indicates a correct understanding of what to do if the client feels hungry and shaky? a."I will drink a glass of water." b."I will eat three graham crackers." c."I will give myself 1 mg of glucagon." d."I will sit down and rest."
b."I will eat three graham crackers."
The clinic nurse is providing teaching to a client with newly diagnosed diabetes. Which statement by the client indicates a correct understanding about the need to wear a MedicAlert bracelet? a."If I become hyperglycemic, it is a medical emergency." b."If I become hypoglycemic, I could become unconscious." c."Medical personnel may need confirmation of my insurance." d."I may need to be admitted to the hospital suddenly."
b."If I become hypoglycemic, I could become unconscious."
A client newly diagnosed with diabetes mellitus asks why he needs ketone testing when the disease affects his blood glucose levels. How should the nurse respond? a."The spleen releases ketones when your body can't use glucose." b."Ketones will tell us if your body is using other tissues for energy." c."Ketones can damage your kidneys and eyes." d."Ketones help the physician determine how serious your diabetes is."
b."Ketones will tell us if your body is using other tissues for energy."
A 60-year-old client comes to the ED reporting weakness, vision problems, increased thirst, increased urination, and frequent infections that do not seem to heal easily. The physician suspects that the client has diabetes. Which classic symptom should the nurse watch for to confirm the diagnosis of diabetes? a.Numbness b.Increased hunger c.Fatigue d.Dizziness
b.Increased hunger
A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which finding suggests that the client has developed hyperglycemia? a.Cheyne-Stokes respirations b.Increased urine output c.Decreased appetite d.Diaphoresis
b.Increased urine output
A client with typically well controlled diabetes has a glycosylated hemoglobin (HbA1C) level of 9.4%. Which response by the nurse is most appropriate? a."Keep up the good work." b."This is not good at all." c."Have you been doing something differently? d."You need an increase in your insulin dose."
c."Have you been doing something differently?
A client with type 1 diabetes has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse is most accurate in stating: a."The test must be repeated following a 12-hour fast." b."It looks like you aren't following the ordered diabetic diet." c."It tells us about your sugar control for the last 3 months." d."Your insulin regimen must be altered significantly."
c."It tells us about your sugar control for the last 3 months."
A client expresses fear and anxiety over the life changes associated with diabetes, stating, "I am scared I can't do it all and I will get sick and be a burden on my family." What is the nurse's best response? a."It is overwhelming, isn't it?" b."Let's see how much you can learn today, so you are less nervous." c."Let's tackle it piece by piece. What is most scary to you?" d."Many people live with diabetes and do it just fine."
c."Let's tackle it piece by piece. What is most scary to you?"
Which instruction should a nurse give to a client with diabetes mellitus when teaching about "sick day rules"? a."Don't take your insulin or oral antidiabetic agent if you don't eat." b."It's okay for your blood glucose to go above 300 mg/dl while you're sick." c."Test your blood glucose every 4 hours." d."Follow your regular meal plan, even if you're nauseous."
c."Test your blood glucose every 4 hours."
The intensive care nurse is caring for a client admitted in a hyperglycemic-hyperosmolar state. Which of these prescriptions made by the primary health care provider will the nurse question? a.Add 20 mEq of KCl to each liter of IV fluid b.IV regular insulin at 2 units/hr c.IV normal saline at 100 mL/hr d.1 ampule Sodium Bicarbonate IV now
d.1 ampule Sodium Bicarbonate IV now
A client with type 2 diabetes who is taking metformin (Glucophage) is seen in the diabetic clinic. The fasting blood glucose is 108 mg/dL (6.0 mmol/L), and the glycosylated hemoglobin (HbA1C) is 8.2%. Which action will the nurse take next? a.Instruct the client to continue with the current diet and metformin use. b.Discuss the need to check blood glucose several times every day. c.Talk about the possibility of adding rapid-acting insulin to the regimen. d.Ask the client about current dietary intake and medication use.
d.Ask the client about current dietary intake and medication use.
Which nursing action will the home health nurse delegate to a home health aide who is making daily visits to a client with newly diagnosed type 2 diabetes? a.Assist the client's spouse in choosing appropriate dietary items. b.Evaluate the client's use of a home blood glucose monitor. c.Inspect the extremities for evidence of poor circulation. d.Assist the client with washing the feet and applying moisturizing lotion.
d.Assist the client with washing the feet and applying moisturizing lotion.
The nurse is performing an admission assessment on a 52-year-old client admitted with type 2 diabetes. Physical Assessment Diagnostic Findings Provider Prescriptions Lungs clear Glucose 179 mg/dL (9.9 mmol/L)Regular insulin 8 units if blood glucose 250 to 275 mg/dL (13.9 to 15.3 mmol/L)Right great toe mottled and cold to touchHemoglobin A1c 6.9%Regular insulin 10 units if glucose 275 to 300 mg/dL (15.3 to 16.7 mmol/L)Client states wears eyeglasses to readAfter completing the above assessment, which complication of diabetes does the nurse report to the primary health care provider? a.Poor glucose control b.Visual changes c.Respiratory distress d.Decreased peripheral perfusion
d.Decreased peripheral perfusion
Which assessment finding is most important in determining nursing care for a client with diabetes mellitus? a.Respirations of 12 breaths/minute b.Cloudy urine c.Blood sugar 170 mg/dL d.Fruity breath
d.Fruity breath
A nurse expects to find which signs and symptoms in a client experiencing hypoglycemia? a.Polyuria, headache, and fatigue b.Polyphagia and flushed, dry skin c.Polydipsia, pallor, and irritability d.Nervousness, diaphoresis, and confusion
d.Nervousness, diaphoresis, and confusion
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? a.Making sure that the patient is aware that quantity of foods will be limited b.Ensuring that the patient understands that some favorite foods may not be allowed on the meal plan and substitutes will need to be found c.Determining whether the patient is on insulin or taking oral antidiabetic medication d.Reviewing the patient's diet history to identify eating habits and lifestyle and cultural eating patterns
d.Reviewing the patient's diet history to identify eating habits and lifestyle and cultural eating patterns
The diabetic client asks the nurse why shoes and socks are removed at each office visit. Which assessment finding is most significant in determining the protocol for inspection of feet? a.Autonomic neuropathy b.Retinopathy c.Sensory neuropathy d.Nephropathy
c.Sensory neuropathy
Which instruction about insulin administration should a nurse give to a client? a."Always follow the same order when drawing the different insulins into the syringe." b."Shake the vials before withdrawing the insulin." c."Store unopened vials of insulin in the freezer at temperatures well below freezing." d."Discard the intermediate-acting insulin if it appears cloudy."
a."Always follow the same order when drawing the different insulins into the syringe."
The nurse is providing discharge teaching to a client with type 2 diabetes and peripheral neuropathy. Which statement by the client indicates a need for further teaching about injury prevention? a."I can break in my shoes by wearing them all day." b."I need to monitor my feet daily for blisters or skin breaks." c."I will never go barefoot." d."I need to quit smoking."
a."I can break in my shoes by wearing them all day."
The nurse is teaching a client with newly diagnosed type 2 diabetes about the importance of weight control. Which comment by the client indicates a need for further teaching? a."I will begin exercising for at least an hour a day." b."I will monitor my diet and avoid empty calories." c."If I lose weight, I may not need to use the insulin anymore." d."Weight loss can be a sign of diabetic ketoacidosis."
a."I will begin exercising for at least an hour a day."
A physician orders blood glucose levels every 4 hours for a 4-year-old child with brittle type 1 diabetes. The parents are worried that drawing so much blood will traumatize their child. How can the nurse best reassure the parents? a."Your child will need less blood work as his glucose levels stabilize." b."Your child is young and will soon forget this experience." c."I'll see if the physician can reduce the number of blood draws." d."Our laboratory technicians use tiny needles and they're really good with children."
a."Your child will need less blood work as his glucose levels stabilize."
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.4 oz of skim milk c.1/2 tbsp honey or syrup d.three to six LifeSavers candies
a.1/2 cup fruit juice or regular soft drink
The nurse is administering lispro insulin. Based on the onset of action, how long before breakfast should the nurse administer the injection? a.10 to 15 minutes b.30 to 40 minutes c.1 to 2 hours d.3 hours
a.10 to 15 minutes
When the dawn phenomenon occurs, the patient has relatively normal blood glucose until approximate what time of day? a.3 AM b.5 AM c.7 AM d.9 AM
a.3 AM
What is the duration of regular insulin? a.4 to 6 hours b.3 to 5 hours c.12 to 16 hours d.24 hours
a.4 to 6 hours
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.6.5% b.7.5 % c.8.0% d.8.5%
a.6.5%
A client is receiving insulin lispro at 7:30 AM. The nurse ensures that the client has breakfast by which time? a.7:45 AM b.8:00 AM c.8:15 AM d.8:30 AM
a.7:45 AM
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.8:30 AM. b.10:30 AM. c.12:30 PM. d.2:30 PM.
a.8:30 AM.
A client newly diagnosed with type 1 diabetes has an unusual increase in blood glucose from bedtime to morning. The physician suspects the client is experiencing insulin waning. Based on this diagnosis, the nurse expects which change to the client's medication regimen? a.Administering a dose of intermediate-acting insulin before the evening meal b.Changing the time of evening injection of intermediate-acting insulin from dinnertime to bedtime c.Decreasing evening bedtime dose of intermediate-acting insulin and administering a bedtime snack d.Increasing morning dose of long-acting insulin
a.Administering a dose of intermediate-acting insulin before the evening meal
A nurse is caring for a diabetic patient with a diagnosis of nephropathy. What would the nurse expect the urinalysis report to indicate? a.Albumin b.Bacteria c.Red blood cells d.White blood cells
a.Albumin
Which is the best referral that the community health nurse can suggest to a client who has been newly diagnosed with diabetes? a.American Diabetes Association (ADA) b.Centers for Disease Control and Prevention c.Primary health care provider office d.Pharmaceutical representative
a.American Diabetes Association (ADA)
A client with type 1 diabetes arrives in the emergency department breathing deeply and stating, "I can't catch my breath." The client's vital signs are: T 98.4°F (36.9°C), P 112 beats/min, R 38 breaths/min, BP 91/54 mm Hg, and O2 saturation 99% on room air. Which action will the nurse take first? a.Check the blood glucose. b.Administer oxygen. c.Offer reassurance. d.Attach a cardiac monitor.
a.Check the blood glucose.
Which factors will cause hypoglycemia in a client with diabetes? Select all that apply. a.Client has not consumed food and continues to take insulin or oral antidiabetic medications. b.Client has not consumed sufficient calories. c.Client has been exercising more than usual. d.Client has been sleeping excessively. e.Client is experiencing effects of the aging process.
a.Client has not consumed food and continues to take insulin or oral antidiabetic medications. b.Client has not consumed sufficient calories. c.Client has been exercising more than usual.
The nurse working on a medical surgical endocrine unit has just received change-of-shift report. Which client will the nurse see first? a.Client with type 1 diabetes whose insulin pump is beeping "occlusion" b.Newly diagnosed client with type 1 diabetes who is reporting thirst c.Client with type 2 diabetes who has a blood glucose of 150 mg/dL (8.3 mmol/L) d.Client with type 2 diabetes with a blood pressure of 150/90 mm Hg
a.Client with type 1 diabetes whose insulin pump is beeping "occlusion"
A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and symptoms? a.Coma, anxiety, confusion, headache, and cool, moist skin b.Kussmaul respirations, dry skin, hypotension, and bradycardia c.Polyuria, polydipsia, hypotension, and hypernatremia d.Polyuria, polydipsia, polyphagia, and weight loss
a.Coma, anxiety, confusion, headache, and cool, moist skin
Which combination of adverse effects should a nurse monitor for when administering IV insulin to a client with diabetic ketoacidosis? a.Hypokalemia and hypoglycemia b.Hypocalcemia and hyperkalemia c.Hyperkalemia and hyperglycemia d.Hypernatremia and hypercalcemia
a.Hypokalemia and hypoglycemia
The client who is managing diabetes through diet and insulin control asks the nurse why exercise is important. Which is the best response by the nurse to support adding exercise to the daily routine? a.Increases ability for glucose to get into the cell and lowers blood sugar b.Creates an overall feeling of well-being and lowers risk of depression c.Decreases need for pancreas to produce more cells d.Decreases risk of developing insulin resistance and hyperglycemia
a.Increases ability for glucose to get into the cell and lowers blood sugar
A patient is diagnosed with type 1 diabetes. What clinical characteristics does the nurse expect to see in this patient? Select all that apply. a.Ketosis-prone b.Little or no endogenous insulin c.Obesity at diagnoses d.Younger than 30 years of age e.Older than 65 years of age
a.Ketosis-prone b.Little or no endogenous insulin d.Younger than 30 years of age
The nurse is assessing a patient with nonproliferative (background) retinopathy. When examining the retina, what would the nurse expect to assess? Select all that apply. a.Leakage of fluid or serum (exudates) b.Microaneurysms c.Focal capillary single closure d.Detachment e.Blurred optic discs
a.Leakage of fluid or serum (exudates) b.Microaneurysms c.Focal capillary single closure
A client with diabetes is receiving an oral anti diabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer? a.Metformin b.Glyburide c.Repaglinide d.Glipizide
a.Metformin
The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer? a.NPH b.Iletin II c.Lispro (Humalog) d.Glargine (Lantus)
a.NPH
The nurse caring for four clients with diabetes has these activities to perform. Which activity is appropriate to delegate to unlicensed assistive personnel (UAP)? a.Perform a blood glucose check on a client who requires insulin. b.Verify the infusion rate on a continuous infusion insulin pump. c.Assess a client who reports tremors and irritability. d.Monitor a client who is reporting palpitations and anxiety.
a.Perform a blood glucose check on a client who requires insulin.
A nurse is teaching a diabetic support group about the causes of type 1 diabetes. The teaching is determined to be effective when the group is able to attribute which factor as a cause of type 1 diabetes? a.Presence of autoantibodies against islet cells b.Obesity c.Rare ketosis d.Altered glucose metabolism
a.Presence of autoantibodies against islet cells
Which clinical characteristic is associated with type 1 diabetes (previously referred to as insulin-dependent diabetes mellitus)? a.Presence of islet cell antibodies b.Obesity c.Rare ketosis d.Requirement for oral hypoglycemic agents
a.Presence of islet cell antibodies
Lispro (Humalog) is an example of which type of insulin? a.Rapid-acting b.Intermediate-acting c.Short-acting d.Long-acting
a.Rapid-acting
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.Sweating, tremors, and tachycardia b.Dry skin, bradycardia, and somnolence c.Bradycardia, thirst, and anxiety d.Polyuria, polydipsia, and polyphagia
a.Sweating, tremors, and tachycardia
A nurse is preparing to administer two types of insulin to a client with diabetes mellitus. What is the correct procedure for preparing this medication? a.The short-acting insulin is withdrawn before the intermediate-acting insulin. b.The intermediate-acting insulin is withdrawn before the short-acting insulin. c.Different types of insulin are not to be mixed in the same syringe. d.If administered immediately, there is no requirement for withdrawing one type of insulin before another.
a.The short-acting insulin is withdrawn before the intermediate-acting insulin.
A client with diabetes mellitus is receiving an oral antidiabetic agent. When caring for this client, the nurse should observe for signs of: a.hypoglycemia b.polyuria c.blurred vision d.polydipsia
a.hypoglycemia
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.ketoacidosis b.hyperosmolar hyperglycemic nonketotic syndrome c.hepatic disorder d.All options are correct.
a.ketoacidosis
A client has been recently diagnosed with type 2 diabetes, and reports continued weight loss despite increased hunger and food consumption. This condition is called: a.polyphagia. b.polydipsia. c.polyuria. d.anorexia.
a.polyphagia.
A client newly diagnosed with diabetes is not ready to learn diabetes control during the hospital stay. Which information is the priority for the nurse to teach the client and the client's family? Select all that apply. a. Pathophysiology of diabetes b.Causes and treatment of hypoglycemia c.Dietary control of blood glucose d.Insulin administration e.Physical activity and exercise
b.Causes and treatment of hypoglycemia d.Insulin administration
A client has just been diagnosed with type 1 diabetes. When teaching the client and family how diet and exercise affect insulin requirements, the nurse should include which guideline? a."You'll need more insulin when you exercise or increase your food intake." b."You'll need less insulin when you exercise or reduce your food intake." c."You'll need less insulin when you increase your food intake." d."You'll need more insulin when you exercise or decrease your food intake."
b."You'll need less insulin when you exercise or reduce your food intake."
A client with type 1 diabetes mellitus received regular insulin at 7:00 a.m. The client will need to be monitored for hypoglycemia at which time? a.7:30 a.m. b.11:00 a.m. c.2:00 p.m. d.7:30 p.m.
b.11:00 a.m.
A nurse is teaching a client with diabetes mellitus about self-management of his condition. The nurse should instruct the client to administer 1 unit of insulin for every: a.10 g of carbohydrates. b.15 g of carbohydrates. c.20 g of carbohydrates. d.25 g of carbohydrates.
b.15 g of carbohydrates.
Glycosylated hemoglobin reflects blood glucose concentrations over which period of time? a.1 month b.3 months c.6 months d.9 months
b.3 months
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.Duration of the insulin b.Accuracy of the dosage c.Area for insulin injection d.Technique for injecting
b.Accuracy of the dosage
Which clinical manifestation of type 2 diabetes occurs if glucose levels are very high? a.Hyperactivity b.Blurred vision c.Oliguria d.Increased energy
b.Blurred vision
The nurse has just taken change-of-shift report on a group of clients on the medical-surgical unit. Which client does the nurse assess first? a.Client taking repaglinide (Prandin) who has nausea and back pain b.Client taking glyburide (Diabeta) who is dizzy and sweaty c.Client taking metformin (Glucophage) who has abdominal cramps d.Client taking pioglitazone (Actos) who has bilateral ankle swelling
b.Client taking glyburide (Diabeta) who is dizzy and sweaty
The nurse in the endocrine clinic is providing education for a client who has just been diagnosed with diabetes. Which factor is most important for the nurse to assess before providing instruction to the client about the disease and its management? a.Current lifestyle b.Educational and literacy level c.Sexual orientation d.Current energy level
b.Educational and literacy level
The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which of the following would the nurse include as associated with type 2 diabetes? a.Onset most common during adolescence b.Insulin production insufficient c.Less common than type 1 diabetes d.Little to no relation to pre-diabetes
b.Insulin production insufficient
A client who was diagnosed with type 1 diabetes 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blood glucose level? a.Cool, moist skin b.Rapid, thready pulse c.Arm and leg trembling d.Slow, shallow respirations
b.Rapid, thready pulse
A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously? a.Glargine b.Regular c.NPH d.Lente
b.Regular
A nurse is explaining the action of insulin to a client with diabetes mellitus. During client teaching, the nurse reviews the process of insulin secretion in the body. The nurse is correct when she states that insulin is secreted from the: a.adenohypophysis. b.beta cells of the pancreas. c.alpha cells of the pancreas. d.parafollicular cells of the thyroid.
b.beta cells of the pancreas.
Health teaching for a patient with diabetes who is prescribed Humulin N, an intermediate NPH insulin, would include which of the following advice? a. "Your insulin will begin to act in 15 minutes." b. "You should expect your insulin to reach its peak effectiveness by 12 noon if you take it at 8:00 AM." c. "You should take your insulin after you eat breakfast and dinner." d. "Your insulin will last 8 hours, and you will need to take it three times a day."
c. "You should take your insulin after you eat breakfast and dinner."
A 16-year-old client newly diagnosed with type 1 diabetes has a very low body weight despite eating regular meals. The client is upset because friends frequently state, "You look anorexic." Which statement by the nurse would be the best response to help this client understand the cause of weight loss due to this condition? a."I will refer you to a dietician who can help you with your weight." b."You may be having undiagnosed infections, causing you to lose extra weight." c."Your body is using protein and fat for energy instead of glucose." d."Don't worry about what your friends think, the carbohydrates you eat are being quickly digested, increasing your metabolism."
c."Your body is using protein and fat for energy instead of glucose."
A nurse is caring for a client with type 1 diabetes who exhibits confusion, light-headedness, and aberrant behavior. The client is conscious. The nurse should first administer: a.I.M. or subcutaneous glucagon. b.I.V. bolus of dextrose 50%. c.15 to 20 g of a fast-acting carbohydrate such as orange juice. d.10 units of fast-acting insulin.
c.15 to 20 g of a fast-acting carbohydrate such as orange juice.
Which of these clients with diabetes will the endocrine unit charge nurse assign to an RN who has floated from the labor/delivery unit? a.A client with sensory neuropathy who needs teaching about foot care b.A client with diabetic ketoacidosis who has an IV running at 250 mL/hr c.A client who needs blood glucose monitoring and insulin before each meal d.A client who was admitted with fatigue and shortness of breath
c.A client who needs blood glucose monitoring and insulin before each meal
A client with type 1 diabetes is to receive a short-acting insulin and an intermediate-acting insulin subcutaneously before breakfast. The nurse would administer the insulin at which site as the preferred site? a.Arms b.Thighs c.Abdomen d.Upper buttock
c.Abdomen
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.Plasma bicarbonate 12 mEq/L c.Blood glucose level 1,100 mg/dl d.Blood urea nitrogen (BUN) 15 mg/dl
c.Blood glucose level 1,100 mg/dl
A client with long-standing type 1 diabetes is admitted to the hospital with unstable angina pectoris. After the client's condition stabilizes, the nurse evaluates the diabetes management regimen. The nurse learns that the client sees the physician every 4 weeks, injects insulin after breakfast and dinner, and measures blood glucose before breakfast and at bedtime. Consequently, the nurse should formulate a nursing diagnosis of: a.Impaired adjustment. b.Defensive coping. c.Deficient knowledge (treatment regimen). d.Health-seeking behaviors (diabetes control).
c.Deficient knowledge (treatment regimen).
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.Fasting blood glucose level b.Glucose via a urine dipstick test c.Glycosylated hemoglobin level d.Glucose via an oral glucose tolerance test
c.Glycosylated hemoglobin level
Which is the best nursing explanation for the symptom of polyuria in a client with diabetes mellitus? a.With diabetes, drinking more results in more urine production. b.Increased ketones in the urine promote the manufacturing of more urine. c.High sugar pulls fluid into the bloodstream, which results in more urine production. d.The body's requirement for fuel drives the production of urine.
c.High sugar pulls fluid into the bloodstream, which results in more urine production.
NPH is an example of which type of insulin? a.Rapid-acting b.Short-acting c.Intermediate-acting d.Long-acting
c.Intermediate-acting
Which type of insulin acts most quickly? a.Regular b.NPH c.Lispro d.Glargine
c.Lispro
A patient who is diagnosed with type 1 diabetes would be expected to: a.Be restricted to an American Diabetic Association diet. b.Have no damage to the islet cells of the pancreas. c.Need exogenous insulin. d.Receive daily doses of a hypoglycemic agent.
c.Need exogenous insulin.
An intensive care client with diabetic ketoacidosis (DKA) is receiving an insulin infusion. When the cardiac monitor shows ventricular ectopy, which assessment will the nurse make? a.Urine output b.12-lead electrocardiogram (ECG) c.Potassium level d.Rate of IV fluids
c.Potassium level
Laboratory studies indicate a client's blood glucose level is 185 mg/dl. Two hours have passed since the client ate breakfast. Which test would yield the most conclusive diagnostic information about the client's glucose use? a.Fasting blood glucose test b.6-hour glucose tolerance test c.Serum glycosylated hemoglobin (Hb A1c) d.Urine ketones
c.Serum glycosylated hemoglobin (Hb A1c)
A client with type 2 diabetes controlled with Metformin is recovering from surgery. The primary health care provider has placed the client on insulin in addition to the metformin. What is the nurse's best response about why the client needs to take insulin? a."Your diabetes is getting worse, so you will need to take insulin." b."You can't take your metformin while in the hospital." c.Stress, such as surgery, increases blood glucose levels. You'll need insulin to control your blood glucose temporarily." d."You must take insulin from now on because the surgery will affect your diabetes."
c.Stress, such as surgery, increases blood glucose levels. You'll need insulin to control your blood glucose temporarily."
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 have no effect. b.They decrease the need for insulin. c.They increase the need for insulin. d.They cause wide fluctuations in the need for insulin.
c.They increase the need for insulin.
The nurse in the endocrine clinic is reviewing type 1 and type 2 diabetes with a group of nursing students. Which explanation by the students indicates their understanding of the types of diabetes? a.Most clients with type 1 diabetes are born with it. b.People with type 1 diabetes are often obese. c.Those with type 2 diabetes make insulin, but in inadequate amounts. d.People with type 2 diabetes do not develop typical diabetic complications.
c.Those with type 2 diabetes make insulin, but in inadequate amounts.
A client with type 2 diabetes asks the nurse why he can't have a pancreatic transplant. Which of the following would the nurse include as a possible reason? a.Increased risk for urologic complications b.Need for exocrine enzymatic drainage c.Underlying problem of insulin resistance d.Need for lifelong immunosuppressive therapy
c.Underlying problem of insulin resistance
The nurse is teaching a client about self-administration of insulin and about mixing regular and neutral protamine Hagedorn (NPH) insulin. Which information is important to include in the teaching plan? a.If two different types of insulin are ordered, they need to be given in separate injections. b.When mixing insulin, the NPH insulin is drawn up into the syringe first. c.When mixing insulin, the regular insulin is drawn up into the syringe first. d.There is no need to inject air into the bottle of insulin before withdrawing the insulin.
c.When mixing insulin, the regular insulin is drawn up into the syringe first.
After teaching a client with type 1 diabetes who is scheduled to undergo an islet cell transplant, which client statement indicates successful teaching? a."This transplant will provide me with a cure for my diabetes." b."I will receive a whole organ with extra cells to produce insulin." 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."
A client with a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNS) has a history of type 2 diabetes that is being controlled with an oral diabetic agent, tolazamide. Which laboratory test is the most important for confirming this disorder? a.Serum potassium level b.Serum sodium level c.Arterial blood gas (ABG) values d.Serum osmolarity
d.Serum osmolarity
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 not consumed sufficient calories. c.The client has been exercising more than usual. d.The client has eaten and has not taken or received insulin.
d.The client has eaten and has not taken or received insulin.
A client receives a daily injection of glargine insulin at 7:00 a.m. When should the nurse monitor this client for a hypoglycemic reaction? a.Between 8:00 and 10:00 a.m. b.Between 4:00 and 6:00 p.m. c.Between 7:00 and 9:00 p.m. d.This insulin has no peak action and does not cause a hypoglycemic reaction.
d.This insulin has no peak action and does not cause a hypoglycemic reaction.
A client recently admitted with new-onset type 2 diabetes will be discharged with a meter for self-monitoring of blood glucose (SMBG) levels. When is the best time for the nurse to explain to the client the proper use of the glucose monitor? a.Day of discharge b.On admission c.When the client states readiness d.While performing the test in the hospital
d.While performing the test in the hospital
A nurse is providing dietary instructions to a client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend: a.increasing saturated fat intake and fasting in the afternoon. b.increasing intake of vitamins B and D and taking iron supplements. c.eating a candy bar if light-headedness occurs. d.consuming a low-carbohydrate, high-protein diet and avoiding fasting.
d.consuming a low-carbohydrate, high-protein diet and avoiding fasting.
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: a.urine glucose level. b.fasting blood glucose level. c.serum fructosamine level. d.glycosylated hemoglobin level.
d.glycosylated hemoglobin level.
