Deck 24: Endocrine and Immune Disorders

Question 1

A nurse is educating an older adult with diabetes mellitus on minimizing the risk of cardiovascular disease. The nurse focuses on lipid levels. Which of the following are the recommended goals for lipid levels? (Select all that apply.)

A) Cholesterol <200
B) Low-density lipoprotein (LDL) >100
C) High-density lipoprotein (HDL) >40 (men), >50 (women)
D) Hb A₁C value of ³6.5%
E) Triglycerides <150

Answer 1

Cholesterol <200
High-density lipoprotein (HDL) >40 (men), >50 (women)
Triglycerides <150

Question 2

Which is the most likely reason that type 2 diabetes mellitus is often difficult to diagnose in older adults?

A) Presenting symptoms occur very quickly.
B) The disease rarely occurs in older adults.
C) The classic symptoms may not be present in older adults.
D) There are no recognizable symptoms; it is a "silent killer."

Answer 2

The classic symptoms may not be present in older adults.

Question 3

An older adult with type 2 DM who is being treated with insulin wants to increase his activity level and begin a walking program. What recommendations should the nurse provide to this patient?

A) A walking program is not recommended for an older adult with diabetes.
B) The walking regimen needs to be done on a regularly scheduled basis.
C) Regular exercise should not exceed 30 minutes three times a week.
D) Insulin can most probably be discontinued if the individual adheres to the walking program.

Answer 3

The walking regimen needs to be done on a regularly scheduled basis.

Question 4

Hyperglycemia is harder to detect in older adults due to which of the following?

A) There is a higher tolerance for elevated levels of circulating glucose in older adults.
B) Older adults tend to metabolize glucose at a faster rate than younger adults.
C) Fingerstick glucose monitoring is inaccurate in older adults.
D) The classic signs of elevated glucose levels, polyuria, polyphagia, and polydipsia are rarely present in older adults.

Question 5

A client is newly diagnosed with type 2 diabetes mellitus. Which diagnostic test will best evaluate the management plan prescribed for this client?

A) A yearly funduscopic examination by an ophthalmologist
B) Regular foot examinations by a podiatrist
C) Quarterly hemoglobin A₁C
D) Biannual cholesterol testing

Question 6

A nurse is educating an older adult with diabetes on glucose self-monitoring. When developing the teaching plan, the nurse includes which of the following goals in the teaching plan? The patient will: (Select all that apply.)

A) demonstrate the technique for obtaining a blood sample.
B) verbalize actions to take when results indicate an error on the machine.
C) state the correct timing of blood glucose monitoring.
D) state the signs and symptoms of both hyperglycemia and hypoglycemia.
E) demonstrate technique for storing and transporting insulin correctly.

Question 7

An older patient asks a nurse: "I went to my diabetes doctor and everything was stable. The nurse practitioner spent the entire time teaching me about decreasing my risks of heart disease. It seemed odd that she did not focus on teaching me how to better control my diabetes. Do you know why?" The nurse formulates a response based on the understanding that: (Select all that apply.)

A) promoting cardiovascular health has the potential to minimize the complications of DM.
B) there is little evidence that demonstrates that the course of DM can be altered in an older adult.
C) the benefits of better control of blood pressure and lipid levels are seen much quicker than the benefits of better glycemic control.
D) older adults are less receptive to teaching about diabetes than they are to teaching about cardiovascular disease.
E) diabetes is not a common chronic condition in older adults.

Question 8

A nurse is caring for an older adult who is diagnosed with type 2 Diabetes. The patient is prescribed oral medication for diabetes. The nurse can expect that which of the following medications is prescribed as a first-line therapy?

A) Insulin
B) Sulfonylureas
C) Metformin
D) Chlorpropramide

Question 9

A nurse works in an outpatient diabetes clinic. The nurse knows that the minimum standard of care for a patient with diabetes includes the following at each visit: (Select all that apply.)

A) Monitoring weight and BP
B) Inspecting the feet
C) Obtaining hemoglobin A1C
D) Reviewing self-management skills
E) Obtaining fasting lipid profile and serum creatinine

Question 10

A nurse is caring for an older adult who has metabolic syndrome. The nurse knows that the following conditions are common in persons with metabolic syndrome: (Select all that apply.)

A) Glucose levels that are higher than normal
B) Increased waist circumference
C) Blood pressure that is lower than normal
D) Increased blood cholesterol levels
E) Decreased triglyceride levels