Deck 38: Care of Patients With Diabetes and Hypoglycemia

Question 1

At 2:00 AM,the CNA reports that a patient with type 1 diabetes is extremely wet with perspiration,is cool to the touch,and is complaining of hunger.The nurse should:

A)give insulin by sliding scale based on glucometer reading.
B)notify the night supervisor of the patient's deteriorating condition.
C)give 6 ounces of orange juice.
D)ambulate the patient in the hall to use up excess glucose with exercise.

Answer 1

give 6 ounces of orange juice.

Question 2

A patient recently diagnosed with type 1 diabetes mellitus questions the nurse about her increased thirst level.What should be included in the response by the nurse?

A)Diabetes results in a lack of protein absorption causing reduced amino acids, resulting in thirst.
B)Elevated levels of blood glucose pull cellular water into circulating volume.
C)Thirst results from the body's increased loss of fluids through polyuria.
D)Appetites of both food and water signal the changes of diabetes.

Answer 2

Elevated levels of blood glucose pull cellular water into circulating volume.

Question 3

The patient comes to the emergency room with dry hot skin,fruity breath,and deep respirations and is complaining of abdominal pain.The nurse interprets these signs and symptoms as:

A)an insulin reaction.
B)ketoacidosis.
C)rebound hyperglycemia.
D)hypoglycemia.

Answer 3

ketoacidosis.

Question 4

The nurse explains to a newly diagnosed type 1 diabetic that the beta cells can no longer produce adequate insulin because:

A)they are inhibited by pituitary disorder.
B)an allergic response has altered their response to hyperglycemia.
C)alpha cells have proliferated in the islets of Langerhans.
D)the body's immune system has destroyed them.

Question 5

The nurse reinforces the American Diabetes Association's recommendation that all people over age 45,especially if overweight,monitor themselves for diabetes by:

A)having regularly scheduled fasting blood glucose level testing.
B)adhering to weight reduction diets.
C)exercising regularly.
D)using stress reduction techniques.

Question 6

The nurse cautions that the technique of "tight control" of hyperglycemia is not recommended for the older adult because the older adult:

A)may not be able to test and administer sliding-scale insulin.
B)is at a lower risk for hyperglycemia.
C)is prone to cardiovascular problems resultant from hypoglycemia.
D)has an unstable metabolic rate.

Question 7

The nurse would anticipate laboratory values from a patient in ketoacidosis to reveal:

A)increased blood urea nitrogen (BUN).
B)normal or decreased CO2.
C)increased arterial pH.
D)decreased glucose.

Question 8

The nurse is caring for a patient who is experiencing problems with maintaining glycemic control at night and during the early morning hours.The nurse correctly recognizes that:

A)hyperglycemia is produced from counterregulatory hormones.
B)hyperglycemia of dawn phenomenon does not react to insulin.
C)hypoglycemia quickly follows the dawn phenomenon.
D)hyperglycemia of dawn phenomenon is not changed by food intake.

Question 9

The nurse is aware that diabetics are prone to infection,which can be attributed to:

A)high glucose levels.
B)atherosclerotic vascular changes.
C)deficient protein reserve.
D)inadequacy of blood cell production.

Question 10

A patient asks the nurse if stress can be a potential cause of type 2 diabetes.What should be included in the response provided by the nurse?

A)Stress decreases the number of alpha cells in the pancreas, thus increasing the workload on the beta cells.
B)Periods of stress cause increases in glycogen production by the adrenal cortex.
C)Stress is directly associated with decreased insulin tolerance.
D)The inhibition of beta cells to glucose is increased in periods of stress.

Question 11

The patient takes his NovoLog 70-30 at 7:00 AM.The nurse suggests the best time to schedule exercise would be at:

A)7:30 AM before peak action of insulin.
B)10:00 AM at peak action of insulin.
C)1:00 PM after peak action of insulin.
D)any time after injection.

Question 12

The nurse is discussing insulin administration with an assigned patient.The patient reports that she prefers to use only certain sites for insulin injections.The patient questions why rotation of the sites is important.What response by the nurse is most appropriate?

A)"Rotating your injection sites will help to reduce your risk of infection."
B)"If you do not rotate injection sites you are at risk for an erratic absorption of your medication."
C)"Unsightly fatty tumors can develop when you do not adequately rotate injection sites."
D)"Failing to rotate injection sites will improve your ability prevent an insulin reaction."

Question 13

The nurse uses a visual aid to demonstrate that among diabetics,type 2 diabetics comprise up to _____% of all known cases.

A)70
B)75
C)80
D)95

Question 14

The nurse notes that the HbA?c level of an assigned patient demonstrated a drop from 9.4% to 5.4%.What inference can best be made about this patient?

A)The patient is demonstrating improved control of hyperglycemia over the last several months.
B)The patient has been less compliant with the prescribed treatment regimen.
C)The patient is experiencing a reduction in insulin sensitivity.
D)The patient has less need for insulin.

Question 15

The diet of the diabetic is geared toward adequate nutrition and:

A)control of weight.
B)exclusion of all sweets.
C)increase in fats for energy.
D)avoidance of all fast foods.

Question 16

The patient inquires about the significance of islet cell antibodies.The nurse's most informative response is that islet cell antibodies:

A)will cause beta cells to quit producing insulin, resulting in diabetes mellitus (DM).
B)protect beta cells from viral attack.
C)increase production of insulin from beta cells.
D)decrease the size of the pancreas.

Question 17

The nurse recognizes a need for further information when a young woman with gestational diabetes says:

A)"Gestational diabetes results from the hormonal changes of pregnancy."
B)"I will need to exercise regularly and lose weight to reduce my risk of becoming a diabetic."
C)"I'll be free of diabetes when this baby is born."
D)"The baby will have to be monitored for hypoglycemia during my pregnancy."

Question 18

The nurse is caring for a patient who was hospitalized with ketosis.The nurse recognizes that the patient correctly understands the phenomenon when she reports what about the condition?

A)"I had taken too much insulin to decrease my body's levels of glucose."
B)"The condition resulted when my body tried to break down and use my stores of fats."
C)"When my blood glucose goes over 150 mg/dL, I am at risk for this condition."
D)"I was exercising too much and had too sharp reductions in my blood glucose level."

Question 19

A long-term diabetic patient reports that the physician has told him he has the early symptoms of cardiovascular disease.The nurse correctly understands that diabetes predisposes the patient to cardiovascular complications for which reason?

A)The periods of hyperglycemia that result in diabetes damage the basement membrane causing atherosclerosis.
B)Hypoglycemic periods result in increased release of cortisol resulting in hypertension.
C)Insulin constricts the cardiovascular vessels.
D)Diabetes causes a decrease in the body's ability to digest fats by the pancreas.

Question 20

The nurse counsels the 30-year-old woman with type 2 diabetes who is overweight and noncompliant that control of diabetes would most improve if she were to:

A)lose weight.
B)take more Glucophage.
C)eat a high-protein diet.
D)take insulin.

Question 21

Matching
The nurse associates the type of diabetes with the characteristics that may be seen with the specific disease.Match the type of diabetes with the symptoms that are associated with it.(The options may be used once, more than once, or not at all.)

Weight loss and exercise can delay onset of diabetes

A)Type 1
B)Type 2
C)Gestational
D)Prediabetes

Question 22

Matching
The nurse associates the type of diabetes with the characteristics that may be seen with the specific disease.Match the type of diabetes with the symptoms that are associated with it.(The options may be used once, more than once, or not at all.)

Occurs during pregnancy

A)Type 1
B)Type 2
C)Gestational
D)Prediabetes

Question 23

The nurse is aware that the weight loss experienced by type 1 diabetics is attributed to: (Select all that apply.)

A)loss of body fluid.
B)insulin intolerance.
C)metabolization of body fats.
D)stress of disease.
E)altered diet.

Question 24

The nurse outlines the criteria for "tight control" of hyperglycemia as: (Select all that apply.)

A)glucose testing two times a day.
B)insulin injections three times a day based on glucometer readings.
C)fasting glucose remaining within normal limits.
D)maintaining normal weight for height and age.
E)maintaining cholesterol within normal limits.

Question 25

The nurse is caring for a patient suspected of having ketoacidosis.What early manifestation(s)may be noted with this condition? (Select all that apply.)

A)Fruity breath
B)Polyuria
C)Nausea
D)Thirst
E)Sunken eyes

Question 26

Matching
The nurse associates the type of diabetes with the characteristics that may be seen with the specific disease.Match the type of diabetes with the symptoms that are associated with it.(The options may be used once, more than once, or not at all.)

Rarely develops ketosis

A)Type 1
B)Type 2
C)Gestational
D)Prediabetes

Question 27

When discussing exercise programs with the diabetic,the nurse should stress that the patient should: (Select all that apply.)

A)delay the exercise program until glucose is under control.
B)check glucose after exercise.
C)have a quick source of glucose available while exercising.
D)begin slowly and build up to 30 to 45 minutes.
E)use abdomen only for injection site for insulin.

Question 28

Matching
The nurse associates the type of diabetes with the characteristics that may be seen with the specific disease.Match the type of diabetes with the symptoms that are associated with it.(The options may be used once, more than once, or not at all.)

Little or no endogenous insulin

A)Type 1
B)Type 2
C)Gestational
D)Prediabetes

Question 29

The nurse is observing a patient administer insulin.Which observation indicates the need for further instruction? (Select all that apply.)

A)The patient uses a 90-degree angle to administer the injection.
B)The patient cleans the injection site with alcohol before the injection.
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.

Question 30

The nurse explains that genetic factor(s)that increase(s)the risk of a person developing diabetes mellitus include: (Select all that apply.)

A)the number of relatives who have diabetes mellitus.
B)whether the relatives are related on the maternal side.
C)whether the relatives are male.
D)the genetic closeness of the relatives.
E)severity of the relatives' disease.

Question 31

The nurse is reviewing the patient's prescribed insulin regimen.The nurse notes that the physician has ordered a long-lasting insulin.Which medication will best meet this criteria?

A)Lantus
B)NovoLog
C)Humalog
D)Regular

Question 32

The nurse explains that the three cardinal signs of type 1 diabetes mellitus are __________,__________,and __________.

Question 33

A patient with type 1 diabetes mellitus is preparing for a moderate 30-minute exercise period.Which action best indicates understanding of condition management?

A)The patient reduces insulin use during days when exercise periods are planned.
B)The patient administers insulin after exercise rather than before exercise.
C)The patient eats a high-carbohydrate snack before the exercise period.
D)The patient consumes a simple carbohydrate snack after 30 minutes of activity.

Question 34

The nurse is aware that among the microbiologic factor(s)that may cause diabetes mellitus are: (Select all that apply.)

A)hepatitis B.
B)coxsackievirus.
C)influenza virus.
D)chickenpox.
E)mumps.

Question 35

Matching
The nurse associates the type of diabetes with the characteristics that may be seen with the specific disease.Match the type of diabetes with the symptoms that are associated with it.(The options may be used once, more than once, or not at all.)

Threat of renal,retinal,and neurologic complications

A)Type 1
B)Type 2
C)Gestational
D)Prediabetes

Question 36

Matching
The nurse associates the type of diabetes with the characteristics that may be seen with the specific disease.Match the type of diabetes with the symptoms that are associated with it.(The options may be used once, more than once, or not at all.)

Adult onset

A)Type 1
B)Type 2
C)Gestational
D)Prediabetes