Question 1

Which of the following laboratory results is a goal for reducing a person's risk for diabetes and heart disease?&#10;A) Triglycerides over 1.69 mmol/L (150 mg/dL)&#10;B) Cholesterol over 5.18 mmol/L (200 mg/dL)&#10;C) High-density lipoprotein under 1.03 mmol/L (40 mg/dL)&#10;D) Fasting blood glucose under 6.11 mmol/L (110 mg/dL)

Accepted Answer

Fasting blood glucose under 6.11 mmol/L (110 mg/dL) is a goal for reducing a person's risk for diabetes and heart disease. Elevated blood glucose levels are a risk factor for both conditions. Triglycerides over 1.69 mmol/L (150 mg/dL), cholesterol over 5.18 mmol/L (200 mg/dL), and low high-density lipoprotein levels are also risk factors for heart disease but are not specific goals for reducing diabetes risk.

Question 2

The nurse assists an older male adult with type 2 diabetes mellitus to improve his glucose control. What does the nurse instruct this individual to do when he plans to walk more than usual in one day?&#10;A) Omit antidiabetic medication.&#10;B) Wear sturdy open-toed shoes.&#10;C) Supplement his caloric intake.&#10;D) Prepare to administer insulin.

Accepted Answer

Increased physical activity can lower blood glucose levels, so individuals with diabetes may need to consume additional calories to prevent hypoglycemia, especially if they are engaging in more activity than usual.

Question 3

Which one of the following is the most important goal when planning nursing care for an older patient with diabetes mellitus?&#10;A) Stabilize the serum glucose.&#10;B) Prevent disease progression.&#10;C) Set walking distance goals.&#10;D) Plan for consistent exercise.

Accepted Answer

Prevent disease progression.

Question 4

An older male adult with diabetes mellitus complains to the nurse that his feet feel like they are burning. What should the nurse recommend to this older adult to improve his discomfort?&#10;A) Well-fitting leather shoes&#10;B) Knee-high nylon stockings&#10;C) Soaking feet in warm water&#10;D) Antifungal powder on feet

Accepted Answer

The burning sensation in the feet could be a symptom of diabetic neuropathy, a complication of diabetes that occurs when high blood sugar levels damage the nerves in the feet. Wearing well-fitting leather shoes can help prevent pressure points and improve circulation in the feet, reducing the discomfort associated with neuropathy. Knee-high nylon stockings, soaking feet in warm water, or applying antifungal powder are not likely to address the underlying cause of the burning sensation and may not be appropriate for individuals with diabetes.

Question 5

An older male adult comes to a primary care setting, and his reason for seeking health care is to get a prescription for sildenafil (Viagra). Which laboratory report can help to explain why this individual needs sildenafil?

A) Serum potassium 4.5 mEq/L
B) Prothrombin time 13 seconds
C) Hemoglobin 140-180 g/L (14.0-18.0 g/dL)
D) Glycosylated hemoglobin (Hgb A1c) over 8%

Accepted Answer

A high glycosylated hemoglobin (Hgb A1c) level indicates poor blood glucose control in diabetes, which can lead to vascular and nerve damage. Sildenafil is commonly prescribed for erectile dysfunction that may occur due to diabetes-related vascular damage in older men.

Question 6

Which of the following is a true statement about diabetes mellitus?&#10;A) Type 2 diabetes results from a failure of the pancreas to produce insulin.&#10;B) Diabetes is diagnosed after two fasting plasma glucose readings over 5.6-6.9 mmol/L (125 mg/dL).&#10;C) Non-insulin dependent diabetes mellitus is another name for type 1 diabetes.&#10;D) The incidence of diabetes mellitus does not increase with age.

Accepted Answer

Diabetes is diagnosed after two fasting plasma glucose readings over 5.6-6.9 mmol/L (125 mg/dL). Type 2 diabetes actually results from a problem with insulin resistance or an inability of the body to properly use insulin, rather than a failure of the pancreas to produce insulin. Non-insulin dependent diabetes mellitus was actually an older term used synonymously for type 2 diabetes, not type 1 diabetes. Additionally, the incidence of diabetes increases with age.

Question 7

Which comorbidity commonly associated with type 2 diabetes mellitus enhances the development of the microvascular complications of diabetes mellitus?&#10;A) Dyslipidemia&#10;B) Hypothyroidism&#10;C) Venous insufficiency&#10;D) Chronic constipation

Accepted Answer

Dyslipidemia, specifically high levels of triglycerides and low levels of high-density lipoprotein cholesterol, is a common comorbidity associated with type 2 diabetes mellitus that enhances the development of microvascular complications such as diabetic nephropathy, neuropathy, and retinopathy. Hypothyroidism, venous insufficiency, and chronic constipation are not typically associated with an increased risk of microvascular complications in diabetes mellitus.

Question 8

An older female adult who has diabetes mellitus takes glipizide (Glucotrol) and tells the nurse that her blood sugars have been higher than normal since she began using a vaginal cream for hot flashes. Which one of the following interventions is the best one for the nurse to implement?

A) Ask if she had a fever or infection recently.
B) Verify the expiration date of the medication.
C) Review her diet for increased carbohydrates.
D) Ascertain if the vaginal cream contains estrogen.

Accepted Answer

Glipizide is a medication that stimulates insulin production, which can lower blood sugar levels. However, some medications, like vaginal creams with estrogen, can interfere with insulin and raise blood sugar levels. Therefore, it is important to ascertain if the vaginal cream contains estrogen and if so, consider an alternative medication or adjust the dosage of glipizide as needed. Option A may be explored if the patient develops signs of infection or fever in the future, but it does not address the immediate concern. Option B is irrelevant to the situation. Option C may be considered if the patient reports a recent change in dietary habits, but it may not be the only reason for the high sugar levels.

Question 9

An older adult with type 2 diabetes mellitus has a sensory impairment and unstable blood sugars. Which alteration in sensory function does the nurse address in the plan of care for stabilizing his blood sugar?

A) The older adult requires reading glasses at 2.0 strength.
B) The older adult has difficulty hearing in crowded rooms.
C) The older adult enjoys spicy food more than bland food.
D) The older adult awakens with periodic left-foot numbness.

Accepted Answer

The answer of An older adult with type 2 diabetes...

Question 10

Gerontological nurses have an important educational role in the treatment of diabetes, and must advocate for and encourage older adults to obtain care that can delay or minimize complications. Hyperosmolar nonketotic syndrome is a metabolic complication of diabetes mellitus (DM). What signs should the nurse be aware of when planning care for an older adult who has DM and may develop this syndrome?

A) Auditory impairments that can cause difficulty hearing instructions
B) A decline in the patient's visual acuity
C) Altered ability to recognize hunger and thirst
D) Changes in hepatic or renal function

Accepted Answer

Altered ability to recognize hunger and thirst is a sign of hyperosmolar nonketotic syndrome, which can lead to severe dehydration and electrolyte imbalances. Auditory impairments or a decline in visual acuity may pose challenges for the patient in receiving instructions, but they are not specific signs of this syndrome. Changes in hepatic or renal function are also not specific signs of hyperosmolar nonketotic syndrome.

Deck 17: Diabetes Mellitus