Deck 40: Nursing Care of Patients With Disorders of the Endocrine Pancreas

Question 1

The nurse is providing care for a marathon runner who is recently diagnosed with DM. Which explanation regarding exercise is best for the nurse to provide?

A)"You will need to avoid regular exercise since it will lower your blood sugar."
B)"You can still exercise, but running is too strenuous for someone with diabetes."
C)"You always need to take some emergency glucose with you when you are running."
D)"Exercise needs to be coordinated with the time your insulin is peaking."

Answer 1

"You always need to take some emergency glucose with you when you are running."

Question 2

The nurse is monitoring laboratory BG levels for a patient diagnosed with type 2 DM. Which test result does the nurse use to evaluate the patient's compliance with treatment?

A)Fasting BG test
B)Random BG testing
C)Oral glucose tolerance test
D)Glycohemoglobin testing

Answer 2

Glycohemoglobin testing

Question 3

A patient is admitted to the hospital with hyperosmolar hyperglycemia. The patient is 40 percent overweight and has a BG value of 987 mg/dL. Which is the priority focus while planning nursing care for this patient?

A)BG level
B)Hydration status
C)Presence of an illness
D)Age-related changes

Answer 3

Hydration status

Question 4

The nurse is evaluating the knowledge of a patient recently diagnosed with type 1 DM. Which statement by the patient indicates a need for additional information?

A)"My pancreas may have started to attack itself after a childhood viral infection"
B)"I may be genetically prone since diabetes goes back for several generations."
C)"I will learn to carefully check my BG since I am prone to ketoacidosis."
D)"I know that I am obese and can reduce my need for insulin with weight loss."

Question 5

The nurse is preparing a patient with type 2 DM for surgery. The patient expresses concern about the use of insulin at this time. Which reason does the nurse understand that insulin therapy is appropriate in regard to surgery?

A)Surgery is a stressor causing counter-regulatory hormones to increase BG.
B)Insulin promotes healing and eliminates the common causes of infection.
C)Critically ill patients with diabetes require a lower BG from insulin therapy.
D)Ongoing insulin therapy is required for the type 2 diabetic after having surgery.

Question 6

The nurse is providing information to a patient recently diagnosed with type 2 DM. The health care provider (HCP) prescribes an oral hypoglycemic medication for BG control. Which information is the best comparison the nurse can give the patient between insulin and an oral hypoglycemic?

A)Oral hypoglycemic agents act as an insulin replacement.
B)Oral hypoglycemic agents stimulate a partially working pancreas.
C)Insulin is used for a type 2 diabetic with a history of ketoacidosis.
D)Insulin is used by a type 2 diabetic to control BG levels.

Question 7

A patient with type 1 diabetes has frequent episodes of hypoglycemia, even with multiple daily BG self-monitoring throughout the day. Which method of self-monitoring does the nurse recognize as being more effective for this patient?

A)The patient needs a pocket-sized glucose monitor.
B)The patient will benefit from continuous monitoring.
C)The patient needs to check for urine ketones regularly.
D)The patient is a good candidate for a therapy pet.

Question 8

A patient with type 1 DM expresses concern about developing retinopathy due to a chronic disease. Which information does the nurse provide to give the patient the best reassurance?

A)Newer laser surgery can improve sight after retinal hemorrhage.
B)The high incidence of cataracts can be surgically corrected.
C)Diabetes is low as a cause for blindness in the United States.
D)Good control of BG and blood pressure can reduce the risk.

Question 9

A patient with diabetes has peripheral neuropathy. What should the nurse do to prevent related complications?

A)Wash, dry, and inspect feet daily.
B)Use a lubricating lotion on feet daily.
C)Wear loose comfortable shoes in the house.
D)Soak feet in soap and water for 20 minutes daily.

Question 10

The nurse is researching the current information available regarding the long-term complications for patients diagnosed with diabetes. Which finding is accurate?

A)Chronic hypoglycemia causes a variety of serious complications.
B)Most complications involve either the large or tiny vessels of the body.
C)Type 1 diabetics are at greatest risk for complications even with tight control.
D)Patients with HbA1c levels below 6 percent are less likely to experience complications.

Question 11

The nurse is providing care for a patient with type 2 DM who has been treated with an oral hypoglycemic agent. The HCP prescribes for the addition of insulin. Which situation does the nurse recognize as being the least valid reason for giving this patient insulin?

A)The patient is unable to effectively follow a diabetic diet.
B)The patient's pancreas is unable to produce adequate insulin.
C)The amount of insulin is high, but the body cells are resistant.
D)The pancreas has worn out leading to little or no insulin production.

Question 12

The nurse is providing care for a patient with diabetes who experiences frequent periods of hyperglycemia. Which comment by the patient is indicative to the nurse of a major cause of this BG imbalance?

A)"My job is really busy in tax season."
B)"My diet never seems to fill me up."
C)"I have increased my daily exercise."
D)"I frequently substitute cookies for bread."

Question 13

The nurse is planning to review information with a patient diagnosed with diabetes. Which information does the nurse include regarding an increased risk for and treatment of infection?

A)IV antibiotics are the preferable for effective treatment of infection.
B)White blood cells (WBCs) become sluggish and ineffective against infection with hypoglycemia.
C)Circulation may not be adequate to heal a wound or fight infection.
D)Routine vaccinations to prevent infection are not effective with diabetes.

Question 14

A patient being treated with rosiglitazone for type 2 DM is receiving a routine follow-up assessment. In addition to HbA1c and a fasting plasma glucose test, which other laboratory test should the nurse expect to be monitored in this patient?

A)Blood lipids
B)Liver function tests
C)Urine for microalbumin
D)Complete blood count (CBC)

Question 15

The nurse is assisting with nutrition teaching for a patient who voices concern over coping with a diabetic diet. Which response by the nurse about medical nutrition therapy is correct?

A)"Your diet will be a well-balanced, individualized meal plan that is healthy for your whole family."
B)"Sugars and fats need to be avoided, but the dietitian will help you find acceptable alternatives."
C)"You will require special foods, but stores now stock a variety of choices for people with diabetes."
D)"The diet stresses high-protein and low-carbohydrate intake, but people adapt to the restrictions."

Question 16

The nurse is collecting data on a new patient in a HCP's office. Data includes the following: 65-year-old male, abdominal obesity with waist circumference of 42 inches, blood pressure 140/88 mm Hg, and fasting glucose of 120 mg/dL. Which health concerns by the HCP is least expected?

A)Probability of type 2 diabetes
B)Risk of cardiovascular issues
C)Damage to weight bearing joints
D)History of family health issues

Question 17

The nurse is discussing the management of an older adult client recently diagnosed with type 2 DM. Which information is least helpful?

A)An emergency call system should be placed in the home.
B)The family can promote healthy eating by supplying meals.
C)If hyperglycemia is controlled, BG levels can be relaxed.
D)A week's supply of insulin can be drawn up and refrigerated.

Question 18

The nurse is reinforcing teaching for a patient who is on four injections of regular insulin daily. About how many hours after each injection of insulin does the nurse teach the patient to be alert for symptoms of hypoglycemia? 1.1/2 hour

A)3 hours
B)8 hours
C)12 hours

Question 19

A female patient is prescribed glyburide for control of BG. What precaution does the nurse teach the patient about this medication?

A)"Avoid drinking alcohol."
B)"Do not take it if you skip a meal."
C)"You will need to use two forms of birth control."
D)"Be sure it is discontinued before any tests involving contrast dye."

Question 20

The nurse is providing information to a patient recently diagnosed with type 1 diabetes mellitus (DM). The patient expresses a desire to understand the disease. Which information provided by the nurse is accurate?

A)Insulin is released into the gastrointestinal tract to aid in the digestion process.
B)Glucose is carried into cells when glucose transporters are activated in the membrane.
C)Diabetes is most frequently caused by the inability of the pancreas to release insulin.
D)Type 1 and type 2 DM are reversible with dietary, weight loss, and exercise programs.

Question 21

The nurse is employed at a clinic for patients diagnosed with diabetes. Which patient does the nurse identify as being at greatest risk for needing dialysis?

A)The non-Hispanic adult with type 1 DM since early childhood
B)The older adult with type 2 DM, unstable BG, and hypertension
C)The patient who is African American with type 2 DM and hypertension
D)The patient who is Asian with type 1 DM and well-controlled BG

Question 22

A patient is diagnosed with diabetic ketoacidosis. Which manifestations should the nurse expect to observe in this patient? (Select all that apply.)

A)Dehydration
B)Hypertension
C)Flulike symptoms
D)Kussmaul's respirations
E)Edema associated with fluid overload

Question 23

A patient is upset to learn that a recent HbA1c level is 10.3 percent. Which average BG level does the nurse provide based upon this percentage if the equation 28.7 * HbA_1c - 46.7 is used? (Round to the nearest whole number.)

Question 24

The nurse is contributing to a dietary presentation for patients in a multicultural community with diabetes. Which intervention will be least likely to meet the needs of the attendees?

A)Suggestions for culture sensitive substitutes
B)Presentation of the standard diabetic diet
C)Opportunity for patients to ask questions privately
D)Advance preparation regarding culturally preferred foods

Question 25

The nurse is providing teaching to a patient with reactive hypoglycemia. Which instructions related to glucose monitoring should the nurse provide? (Select all that apply.)

A)"It is important to check your BG at bedtime."
B)"It is important to check your BG 1 hour before meals."
C)"You will need to check your BG 2 hours after meals."
D)"You should check your BG when you get up in the morning."
E)"Checking your BG once a day, at the same time each day, is sufficient."