Deck 25: Diabetes Mellitus and the Metabolic Syndrome

Question 1

The nurse is providing care for a client newly diagnosed with type 2 diabetes mellitus. The health-care provider prescribes the antidiabetic noninsulin drug glipizide to be taken once daily. Which finding on the client's record causes the nurse to contact the health-care provider?
1)The client has a previous diagnosis of moderate renal dysfunction.
2)The client does not have insurance and will be paying for prescriptions.
3)The client has a previous history of an allergic reaction to sulfa.
4)The client is currently being treated for hyperlipidemia.

Answer 1

3

Question 2

The nurse observes hyperpigmented, velvety macular lesions on the neck during the assessment of a diabetic client. Which conclusion does the nurse draw from this observation?
1)The client has lipoatrophy.
2)The client has lipohypertrophy.
3)The client has acanthosis nigricans.
4)The client has pigmented pretibial papules.

Answer 2

3

Question 3

The nurse reviews the laboratory reports of a client with diabetes mellitus and concludes that the client has diabetic nephropathy. Which finding supports the nurse's conclusion?
1)Ketones in urine
2)Glucose in urine
3)Albumin in urine
4)Protein in urine

Answer 3

3

Question 4

The laboratory report of a client shows arterial blood pH of 7.6, blood glucose level of 650 mg/dL, and serum bicarbonate level of 17 mEq/L. Which conclusion does the nurse draw from these laboratory findings?
1)The client has diabetic ketoacidosis.
2)The client has hyperosmolar hyperglycemic syndrome.
3)The client has prediabetes.
4)The client is compromised due to another illness.

Question 5

The nurse is providing care for a client with diabetes mellitus. The nurse obtains a glucose blood level of 55 mg/dL. For which complication does the nurse prepare the client?
1)Bradycardia
2)Anhidrosis
3)Anorexia
4)Seizure

Question 6

Which diagnostic test helps in detecting the natural insulin secretion from the pancreas?
1)Urinalysis
2)C-peptide test
3)Islet cell autoantibodies test
4)Oral glucose tolerance test (OGTT)

Question 7

While preparing a client for the oral glucose tolerance test (OGTT), the nurse asks the client to ingest soda that contains 80 g of carbohydrates. After 2 hours, the nurse measures the postprandial blood glucose level and concludes that the client has diabetes mellitus. Which blood glucose finding supports the nurse's conclusion? 1.160 mg/dL
2)190 mg/dL
3)250 mg/dL
4)100 mg/dL

Question 8

The nurse observes sweating, dizziness, and disorientation in the client with a known history of diabetes mellitus. Finger-stick blood glucose level is 40 mg/dL. When consulting the health-care provider, which treatment option does the nurse anticipate being most beneficial to the client?
1)Administering 25 g of glucose intravenously
2)Administering 1 mg of glucagon subcutaneously
3)Administering 50 mL of 50% dextrose intravenously
4)Administering sweetened orange juice orally

Question 9

The nurse in a maternal care clinic is performing the initial assessment on a client who just learned about being pregnant. Which finding alerts the nurse to a possibility of the client developing gestational diabetes mellitus?
1)Blood pressure of 118/70 mm Hg
2)Negative family history of diabetes
3)Body mass index of 32
4)First pregnancy

Question 10

Which is the most common complication expected in clients with type 1 diabetes?
1)Diabetic ketoacidosis
2)Hyperosmolar hyperglycemic syndrome
3)Metabolic syndrome
4)Exogenous insulin dependency

Question 11

The nurse is assessing the medical records of different clients with diabetes. Which client has a reduced risk of cardiovascular disease?
1)The client with a blood pressure of 130/90 mm Hg, low-density lipoprotein (LDL) levels of 140 mg/dL, high-density lipoprotein (HDL) levels of 40 mg/dL, and triglyceride levels of 170 mg/dL
2)The client with a blood pressure of 128/90 mm Hg, LDL levels of 120 mg/dL, HDL levels of 50 mg/dL, and triglyceride levels of 160 mg/dL
3)The client with a blood pressure of 115/75 mm Hg, LDL levels of 100 mg/dL, HDL levels of 70 mg/dL, and triglyceride levels of 140 mg/dL
4)The client with a blood pressure of 140/90 mm Hg, LDL levels of 130 mg/dL, HDL levels of 45 mg/dL, and triglyceride levels of 175 mg/dL

Question 12

The nurse is assessing the blood glucose levels of a client at regular intervals. The nurse finds 55 mg/dL of blood glucose at 2:00 a.m. and 150 mg/dL at 7:00 a.m. Which mechanism does the nurse suspect behind the change in the glucose levels in the client?
1)Somogyi effect
2)Dawn phenomenon
3)Prediabetes
4)Rebound hypoglycemia

Question 13

The nurse is providing care for a client just diagnosed with type 1 diabetes mellitus. For which reason does the nurse anticipate a C-peptide test for the client?
1)To evaluate residual pancreatic function
2)To monitor the status of pancreatic beta cells
3)To monitor the red blood cell count
4)To evaluate the presence of renal dysfunction

Question 14

The nurse is reviewing the medical records of different clients. Which client does the nurse expect to have metabolic syndrome?
1)The male client with a waist circumference of 38 inches and triglyceride levels of 100 mg/dL
2)The female client with a waist circumference of 37 inches and triglyceride levels of 160 mg/dL
3)The male client with a waist circumference of 32 inches and triglyceride levels of 130 mg/dL
4)The female client with a waist circumference of 30 inches and triglyceride levels of 120 mg/dL

Question 15

The mother of an adolescent diabetic client tells the nurse, "My daughter is skipping insulin doses frequently because she is concerned about weight gain." Which condition does the nurse document for this client?
1)Insulin purging
2)Autonomic neuropathy
3)Peripheral neuropathy
4)Psychological insulin resistance

Question 16

The nurse is providing care to a diabetic client who is experiencing prolonged wound healing. Which condition does the nurse suspect in the client?
1)Immunosuppression
2)Peripheral neuropathy
3)Transient ischemic attack
4)Accelerated atherosclerosis

Question 17

The nurse reviews the laboratory reports of a client and concludes that the client has diabetes. Which finding helped the nurse to reach this conclusion?
1)A fasting plasma glucose level of 100 mg/dL
2)A glycated hemoglobin (HbA1c) value of 7
3)A postprandial blood glucose level of 170 mg/dL
4)Random plasma glucose testing of 180 mg/dL

Question 18

The nurse is caring for a client with immune-mediated type 1 diabetes. Which does the nurse expect to be the cause of this condition in the client?
1)The client has hyperinsulinism.
2)The client has destruction of beta cells.
3)The client has insulin resistance.
4)The client has autoimmune disorders.

Question 19

After reviewing the medical records of an adult female client, the nurse concludes the client has metabolic syndrome. Which findings helped the nurse to reach this conclusion?
1)Triglyceride level of 140 mg/dL, waist circumference of 32 inches, and fasting blood glucose level of 80 mg/dL
2)High-density lipoprotein (HDL) cholesterol of 40 mg/dL, blood pressure of 138/90 mm Hg, and fasting blood glucose level of 130 mg/dL
3)Fasting blood glucose of 90 mg/dL, triglyceride level of 120 mg/dL, and waist circumference of 30 inches
4)Blood pressure of 120/80 mm Hg, waist circumference of 34 inches, and triglyceride level of 130 mg/dL

Question 20

The nurse is teaching a group of staff nurses about managing hyperosmolar hyperglycemic syndrome (HHS) in clients. Which response by an attending nurse indicates effective learning?
1)"Fluids are administered before administering IV insulin to the client."
2)"IV insulin will be administered until blood glucose is 150 mg/dL."
3)"IV insulin administration is to be followed by subcutaneous insulin."
4)"Fluid administration is to be followed by IV fluid administration."

Question 21

After reviewing the laboratory reports of a client with diabetes, the nurse finds that the client has diabetic ketoacidosis. Which findings support the nurse's conclusion? Select all that apply.
1)Client's arterial blood pH of 6
2)Trace elements of ketones in urine
3)Serum bicarbonate level of 12 mEq/L
4)Blood glucose level of 300 mg/dL
5)PaO₂ is 97% on room air

Question 22

Which symptoms does the nurse observe in a client with hyperosmolar hyperglycemic syndrome (HHS)? Select all that apply.
1)Polyuria
2)Confusion
3)Polydipsia
4)Hypertension
5)Anorexia

Question 23

The nurse suspects nocturnal hypoglycemia in a diabetic client. Which symptoms does the nurse expect to observe in this client? Select all that apply.
1)Sleep disturbance
2)Vivid nightmares
3)Severe dehydration
4)Morning headache
5)All of the above

Question 24

Which symptoms are associated with autonomic neuropathy? Select all that apply.
1)Anhidrosis
2)Gastroparesis
3)Microalbuminuria
4)Paresthesias in the feet
5)Postural hypotension

Question 25

A client with diabetes is prescribed exenatide (Byetta). Which are the immediate effects of the drug that can be observed in the client? Select all that apply.
1)Weight loss
2)Delay in gastric emptying
3)Glucose-dependent insulin secretion
4)Improved beta cell mass and function
5)Suppression of postprandial glucagon