Final Exam Diabetes
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| In preparing the staff in-service for a presentation about diabetes the nurse includes which information | Diabetes increases the risk for the development of cardiovascular disease
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| The Client w/ diabetes asks the nurse why is it necessary to maintain glucose no lower than 74 | which is the nurses best response
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| In monitoring client w/ hypoglycemia, the nurse recognizes which action of glucagon | glucagon prevents hypoglycemia by promoting glucose release from liver storage sites
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| the nurse Correlates polyuria seen in clients with untreated diabetes w/ which physiologic response | Hyperosmolarity of the EFC secondary to hyperglycemia
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| The nurse correlates which assessment finding in the client with diabetes w/ decreasing renal function | Protein in the urine during a random UA (protein in urine is the start of renal failure)
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| A client Newly dx w type 1 diabetes who wears glasses and has myopia asks the nurse how frequently should he see the ophthalmologist, what is the nurses best response | the disease increases your risk for cataracts, glaucoma and retinal blood vessel changes so you should see the opthamologist yearly even when you do not have a new vision problem
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| During assessment of a client w/ 15 yr hx of diabetes the nurse that the client has decreased tactile sensation of both feet. Which action does the nurse take first | Examine the client’s feet for signs of injury
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| Which is the nurses best response about developing diabetes to the client who is father has type 1 dm | You have a greater susceptibility for developing diabetes 1 & 20 to 50 chance
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| To delay the onset of macrovascular and microvascular complications in the diabetic client, the nurse stresses which action | Controlling hyperglycemia
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| The nurse recognizes which client for being as greatest risk undiagnosed w/ diabetes | 45 year old native american woman
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| A client whose mother has Type 2 diabetes asks the nurse what are the chances of developing type 2 diabetes because of her mothers disease. What is the nurse’s best response | Children of people w/ type 2 have a 15% chance of developing the disease, but the environmental factors (obesity) also influence your risk
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| The nurse includes which information when teaching the newly diagnosed w/ type 1 dm about when to measure for urine ketone bodies | whenever you are ill or your blood sugar is consistently higher than 300 mg/dL
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| Client w/ type 2 is prescribed to take oral sulfonylurea agent, to control blood glucose levels, which precaution does the nurse need to include in the teaching plan r/t this medication | Avoid taking NSAIDS
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| The client w/ type 2 diabetes has been recently changed to the medication from oral antidiabetic agents Glyburide and glucophage, to the glyburide/metformin glucovance. the nurse includes which information of teaching about taking this medication | Glucovance contains a combination of glyburide and metformin
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| Which statement by the client w/ type 2 diabetes who is taking Starlix indicates understanding of this therapy | Ill take this medicine 15 minutes before I eat.
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| The client has been taking (Actose)-Proglitazone for 6 months and reports to the nurse that his urine has become darker since starting medication, which is the nurse’s first action | Review the results of the liver enzymes study's and notify the physician
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| The client w/ diabetes asks why there is more than 1 injection required each day | Which is the nurses best response
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| Which statement made by the client indicates further teaching about injection site rotation and injection site selection | The abdominal site is best because it is closest to the pancreas (it is best because of better absorption)
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| The client who has been using insulin control for 20 yrs has a spongy swelling at the site used most frequently for the site of insulin injection, which is the nurses best action | Instruct the client to use a different site
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| A client w/ diabetes is prescribed to take insulin, Glargine once daily & regular insulin 4 times daily how will the nurse teach this pt to take these medications when the 1st dose of regular insulin occurs the same time of day as insulin glargine dose | Draw up and inject the insulin glargine first and then draw up and inject the dose of regular insulin
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| The client on an intensified insulin regimen consistently has a fasting glucose between 70-80 if post prandial: below 200 & HGba1C of: 5.5%, which is the interpretation of the nurses findings | the client is demonstrating good control of blood glucose (hgba1c: 4-6%) (prandial: below 200)
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| The client w/ diabetes is visually impaired and is wondering if the syringes can be prefilled and stored later which is the nurse’s best response | yes prefilled syringes can be stored for up to 3 weeks in the refrigerator in a vertical position with the needle pointing up
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| To prevent complications of infection r/t infusion pumps what should the nurse teach the client | Change the needle every 3 days
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| Which is response from the client requires additional teaching regarding nutrition therapy | “ I should try to keep my diet free from carbohydrates”
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| Client newly diagnosed w/ type 2 diabetes tells the nurse, since increasing fiber intake I am experiencing flatulence, diarrhea, & abdominal cramping which is the nurse’s best response | Decrease your fiber now and then gradually add high fiber back into diet
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| The nurse recommends the pen type injector insulin delivery system for the type of client w. which clinical presentation | Pen type injector is best for greater accuracy w/ small doses, especially doses under 5 units, not good for ppl w/ visual/neuro impairments (answer): the client using intensive therapy who must use insulin in small frequent doses
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| The nurse teaches which action to the diabetic client who self injects insulin to prevent or limit local irritation at the injection site | Allow insulin to warm to room temp before injection (cold insulin is most common cause of irritation not infection)
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| To reduce complication w/ diabetes the nurse teaching the client w/ normal renal function to modify intake of which nutritional group | Fats- diabetes leads to hyperlipidemia= arterial sclerosis & vascular insufficiency
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| A client w diabetes has proliferative retinopathy, nephropathy and peripheral neuropathy, what should the nurse teach this client about exercise | Swimming or water aerobics 30 minutes each day would be the safest form of exercise routine for you
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| The nurse assess for which clinical manifestation in the client w/ uncontrollable diabetes and ketoacidosis | Increase rate & depth of respirations
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| The nurse determines of which of the ABG values are consistent w/ ketoacidosis in client w/ diabetes | pH 7.28, HCO3 18 mEq/L, PCO2 9mm Hg, PO2 98 mm Hg
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| Which priority intervention does the nurse take when pt has Kussmaul respirations as a result of diabetic ketoacidosis | Administration of IV insulin- will reduce this type of respiration
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| The client w/ type 1 diabetes asks whether an occasional glass of wine is allowed Which is the nurse’s best response | One glass of wine can be ingests w. a meal and can be considered as 2 fat exchanges
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| The nurse monitors which problem of which nutritional problem w/older adults w/ diabetes | Malnutrition
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| The nurse teaches the newly dx’s client w/ type 1 diabetes that insulin needs can be decreased by what action | Walking 1 mile each day
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| Which finding in the client w/ diabetes indicates that exercise should be avoided at this time | Ketone bodies in the urine
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| 2 months after a simultaneous kidney + pancreas transplantation the client is dx as being in acute organ rejection episode the client makes statement to the nurse: I was doing so well with my new organs and the thought of having to go back to living on he | you can have an acute episode, but doesn’t mean it’s failed- (answer): you should keep in mind that 1 acute rejection episode does not mean you will lose the new organs those episodes can be reversed w/ the right treatment
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| Which statement by the client getting ready for d/c after pancreas transplantation indicates the need for further teaching about the prescribed drug regimen | if i develop an infection i should stop taking my corticosteroid
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| The nurse correlates w/ which lab value w/ inadequate function of a transplanted pancreas | 50% decrease urine amylase (anything that has to do w/ urine)-decreased anything urine is the indication
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| 3 hours after surgery the nurse notes that the breath of the client w.type 1 diabetes has a fruity odor. Which is the nurses best 1st action | Testing urine for ketone bodies
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| The client w/ type 1 diabetes has a glucose level of 160 mg dL on arrival to the operating room, what is the nurses best action | Document the findings as the only action
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| The nurse teaches which intervention to prevent injury in the diabetic client who has numbness and reduced sensation secondary to peripheral neuropathy | Use a bath thermometer to test the water temperature-(examination of the feet does not PREVENT the injury. Inspecting for injury does not prevent it)
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| A client w/ a 20 yr hx of diabetes w/ severe burning pain in the feet and hands as a result of peripheral neuropathy asks the nurse why an antidepressant has been prescribed | What is the nurses best response
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| the nurse monitors for which clinical manifestation of decreased renal function in the client with a history of diabetes | A sustained increased of BP 130/84- to 50/100
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| For the diabetic client w/ microalbuminuria teaches the client to decrease which part of their dietary intake | decreased percentage of total derived from proteins
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| Which statement by the diabetic client w/ a UTI indicates that teaching was effective regarding antibiotic therapy | even if i feel completely well, i should take the medication until it is gone
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| The home care nurse administers a ½ a cup of Oj to the pt with diabetes who is experiencing hypoglycemic episodes. The clinical manifestations have not changed after 5 mins, which is the nurses next best action | administer an additional 1/2 cup of orange juice
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| Which precaution should the nurse institute for the client receiving IM glucagon caused by hyperglycemia and is unable to swallow | position the client on his/her side
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| The nurse monitors which lab disorder in a client receiving IV insulin for hyperglycemia | serum potassium level of 2.5
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| what instruction should the nurse emphasize when teaching the diabetic client about how to alter diabetes management during a period of illness that includes nausea and vomiting | monitor your blood glucose levels at least every 4 hours
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| The nurse recognizes the ketosis is rare in type 2 diabetes w/ hyperglycemia is r/t which reason | There is enough insulin produced by type 2 diabetes to prevent fat catabolism but not enough to prevent hyperglycemia
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| Which clinical manifestation indicates to the nurse that the therapy for the client w/hyperglycemic, hyperosmolar, nonketotic syndrome HHNS needs to be adjusted | The client’s score on the glasgow coma scale has not changed for 3 hours ago
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| The nurse administered 6 units of regular insulin and 10 of NPH @ 7am how many units did she give |
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| At what time is the client most susceptible to hypoglycemia r/t the NPH | 4pm- the peak of NPH (rationale): NPH is immediate acting w/ an onset of 1.5 hrs. and peaks between 4-12 hours, duration of 22 hours
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| Which statement by the client w/ diabetes need further teaching about wearing a medical alert bracelet | This bracelet identifies me as a diabetic in case I become unconscious
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| The nurse monitors for which clinical manifestations in the diabetic client admitted w/ DKA | Tachycardia & orthostatic hypotension
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| Which statement by the client recently dx w/type 2 indicates understanding in the importance of maintaining weight within the prescribed range | I might need to NOT need take medication if my weight is maintained
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| Which of the following statements by the client w/ type 2 diabetes indicates the need for further teaching about diabetic management and follow up care | clients with diabetes need to be seen at least annually to monitor for long term complications including visual changes microalbuminuria and lipid analysis
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| A client recently dx’s w. type 1 diabetes tell the nurse I don’t know if I will be able to stick myself w/ a needle. What is the nurses best response | Tell me about the injection that is concerning you
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| The nurse is d/c a client who has recently been dx’s w/ type 1 and refers the client to the American Diabetes Assoc. Which statement by the client indicates an understanding of the resources available fr. this organization | They can help me find a local diabetic nurse educator/instructor
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