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Diabetes
| Question | Answer |
|---|---|
| The nurse is explaining the underlying pathophysiology of type 1 diabetes to a newly diagnosed patient. Which information accurately explains why the type 1 diabetic does not produce adequate insulin? | d. The body’s immune system destroyed beta cells. |
| Type 2 diabetes cases compose approximately what percentage of all known cases of diabetes? | d. 95% |
| The nurse is educating a patient with gestational diabetes. Which statement indicates that the patient needs additional teaching? | c. “This problem goes away completely once I give birth.” |
| A patient asks the nurse if stress can be a potential cause of type 2 diabetes. Which response is most appropriate for the nurse to make? | b. “Periods of stress cause increases in glycogen production by the adrenal cortex.” |
| The nurse is counseling an overweight, noncompliant, 30-year-old female with type 2 diabetes. Which change is most important for the nurse to suggest? | a. Begin an exercise program and lose weight. |
| The nurse is educating the patient about the significance of islet cell antibodies. Which statement accurately describes islet cell antibodies? | a. Islet cell antibodies cause beta cells to quit producing insulin and lead to type 1 diabetes mellitus (DM). |
| The nurse is educating a 50-year-old patient about diabetes monitoring. Which statement reinforces the American Diabetes Association’s (ADA’s) recommendation? | a. Obtain regularly scheduled fasting blood glucose levels. |
| A patient recently diagnosed with type 1 diabetes mellitus (DM) asks why she is experiencing increased thirst. Which explanation is most appropriate? | High glucose levels in the blood pull cellular water into circulating volume and increase thirst. |
| The nurse is caring for a patient with ketosis. Which statement indicates that the patient correctly understands the phenomenon? | b. “The condition resulted when my body tried to break down and use my stores of fats.” |
| The nurse is caring for a patient with type 1 diabetes who is diaphoretic and clammy. The patient complains of hunger but denies pain. The nurse performs a bedside blood glucose check. What should the nurse do next? | c. Give 6 ounces of orange juice. |
| Which laboratory values are consistent with a patient in ketoacidosis? | a. Blood urea nitrogen (BUN) of 35 mg/dL |
| The patient comes to the emergency room complaining of abdominal pain. The nurse assesses dry, hot skin, fruity breath, and deep respirations. To which problem should the nurse attribute these findings? | b. Ketoacidosis |
| Which reason best explains why diabetics are prone to infection? | b. Atherosclerotic vascular changes decrease blood supply to tissues. |
| The nurse notes that the HbA1c level of an assigned patient demonstrated a drop from 9.4% to 5.4%. What can the nurse infer from these findings? | a. The patient’s blood glucose control has improved over the last several months. |
| The nurse is caring for an older adult patient who is diabetic. The nurse cautions against the technique of “tight control” of hyperglycemia. Which statement explains why this management method is not recommended? | c. Older adults may experience cardiovascular problems from hypoglycemia. |
| Which goal is the primary objective of a diabetic diet? | a. Adequate nutrition with weight control |
| The patient takes his NovoLog 70/30 at 0700. When should the nurse suggest that the patient schedule exercise? | c. 1300. |
| The nurse is discussing insulin administration with an assigned patient. The patient reports that she prefers to use only certain sites for insulin injections and questions the need to rotate sites. What response by the nurse is most appropriate? | b. “Rotating injection sites helps enhance insulin absorption.” |
| A long-term diabetic patient reports that he has been diagnosed with early cardiovascular disease. How does diabetes predispose the patient to cardiovascular complications? | a. Hyperglycemic periods cause thickening of the basement membrane in vessels, which causes atherosclerosis. |
| The nurse is caring for a patient who struggles to maintain glycemic control at night and during early morning hours. Which statement correctly explains the reason for this problem? | a. Counterregulatory hormones produce hyperglycemia. |
| A patient with type 1 diabetes mellitus (DM) is preparing for a moderate 30-minute exercise period. Which action best indicates that the patient understands condition management? | d. The patient consumes a simple carbohydrate snack after 30 minutes of activity. |
| The nurse is reviewing the patient’s prescribed insulin regimen. The nurse notes that the physician has ordered a long-lasting insulin. Which medication best meets this criteria? | a. Lantus |
| Which genetic factor(s) increase(s) the risk of a person developing diabetes mellitus (DM)? (select all that apply.) | a. Number of relatives with DM, d. Genetic closeness of relatives with DM e. Race |
| Which factor(s) may cause diabetes mellitus (DM)? (select all that apply.) | a. Genetic b. Microbiologic c. Metabolic e. Immunologic |
| Which statement(s) explain(s) a reason for weight loss in type 1 diabetics? (select all that apply.) | a. Loss of body fluid c. Metabolization of body fats |
| Which requirement(s) is/are part of the criteria for “tight control” of hyperglycemia? (select all that apply.) | b. Administer insulin injections three times a day based on glucometer readings. c. Maintain fasting glucose within normal limits. d. Maintain normal weight for height and age. e. Maintain cholesterol within normal limits. |
| When discussing exercise programs with the diabetic, which instruction(s) is/are important for the nurse to include? (select all that apply.) | a. Delay exercise until glucose controlled. c. Keep a quick source of glucose readily available while exercising. d. Begin slowly and build up to 30 to 45 minutes. e. Only use the abdominal injection site for insulin. |
| The nurse is caring for a patient suspected of having ketoacidosis. Which manifestation(s) is/are characteristic with early ketoacidosis? (select all that apply.) | a. Fruity breath b. Polyuria d. Thirst |
| The nurse watches a patient perform an insulin injection. Which observation(s) indicate(s) that the patient needs additional instruction? (select all that apply.) | c. The patient rubs the injection site after administration of the insulin injection. d. The patient draws up the cloudy insulin and then the clear insulin. e. The patient shakes the insulin bottle before administration. |
| The nurse explains that the three cardinal signs of type 1 diabetes mellitus (DM) are , , and . | The three Ps—polydipsia, polyphagia, and polyuria—are the cardinal signs of diabetes. |
| Type 1 | 34. Little or no endogenous insulin 35. Threat of renal, retinal, and neurologic complications |
| Type 2 | 33. Adult onset 36. Rarely develops ketosis |
| Gestational | 32. Occurs during pregnancy |
| Prediabetes | 31.Weight loss and exercise can delay onset of diabetes |
| A 30-year-old female is admitted for a urinary tract infection with sepsis. A urinalysis reveals presence of ketones, glucose, and nitrates. Which question would you ask to further assess possible diabetes mellitus? | 3. “Have you been thirstier than usual? Do you find you urinate more now?” |
| Which teaching technique(s) would be most useful for an older adult patient with diabetes? (Select all that apply.) | 1. Set a time for the teaching session that is agreeable to the patient. 3. Allow time for the patient to jot down important points. 7. Repeat key concepts frequently; if the patient does not understand, try rephrasing the concept. |
| A patient newly diagnosed with diabetes is given diet instructions. What should you do to effectively motivate the patient to comply with dietary recommendations? (Select all that apply.) | 1. Emphasize good food choices. 2. Apply diet prescriptions to patient-preferred foods 4. Focus on the benefits of diet compliance. 5. Involve meal preparers in diet teaching. |
| A 50-year-old female was recently diagnosed with type 2 diabetes mellitus and wants to start a healthy lifestyle to control her disease. What initial recommendation should you make? | 3. Maintain adequate glucose control. |
| You answer the call light for a patient with diabetes. The patient states that she feels shaky and weak. You note pallor and moist skin. List your nursing actions in priority order. | 4. Assess level of consciousness. 3. Check fingerstick glucose. 1. Give patient 6 oz of juice. 2. Document interventions. |
| A patient who works as a personal trainer is diagnosed with insulin-dependent diabetes. What should you teach about self-administration of regular insulin? | 4. Use the abdomen as an insulin injection site. |
| You are visiting an older adult patient who has successfully managed type 2 diabetes for years. , you note that the patient has severe arthritis, poor vision, and several dry, red areas on the lower extremities. What is the priority patient problem? | 2. Potential for ineffective self-health management due to aging. |
| You determine that the fingerstick blood glucose reading for a patient with diabetes is 750 mg/dL. What is your priority action? | 2. Assess the vital signs of the patient. |
| The nursing assistant tells you that a patient with diabetes has a blood glucose level of 60 mg/dL. What symptoms would you be most likely to observe with this glucose level? | 1. Confusion, tremulousness, pallor, sweating, and weakness |
| During a routine checkup, the health care provider tells a patient with diabetes that test results reveal albuminuria. Which long-term complication is specific to this test result? | 2. Nephropathy |
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