Deck 37: Diabetes Mellitus and Its Complications

Question 1

When developing a care plan for a patient with type 1 diabetes, the nurse should consider which pathophysiological concept?

A) In type 1 diabetes, there is a complete lack of insulin secretion.
B) In type 1 diabetes, there is a relative deficiency in insulin.
C) In type 1 diabetes, there is insulin resistance.
D) In type 1 diabetes, there is an over secretion of insulin.

Answer 1

In type 1 diabetes, there is a complete lack of insulin secretion.

Question 2

Which patient statement indicates to the nurse that the patient needs more teaching about type 2 diabetes?

A) "Type 2 diabetes is also call juvenile-onset diabetes."
B) "I am not dependent on insulin to control my blood glucose levels."
C) "Most people with diabetes have type 2 diabetes."
D) "From time-to-time, I may need insulin to control my blood glucose levels."

Answer 2

"Type 2 diabetes is also call juvenile-onset diabetes."

Question 3

What is the most appropriate response by the nurse when a 20-year-old woman pregnant with her first child and diagnosed with gestational diabetes mellitus (GDM) asks if she will develop diabetes in the future?

A) "There is a chance that you may develop diabetes in the next 10-20 years, so monitoring would be appropriate."
B) "It is impossible to tell-we don't know anything about the risk factors for diabetes."
C) "Your risk for developing diabetes in the future is high because you are young."
D) "You cannot develop gestational diabetes (GDM) in future pregnancies, this only happens with your first pregnancy."

Answer 3

"There is a chance that you may develop diabetes in the next 10-20 years, so monitoring would be appropriate."

Question 4

Which laboratory finding indicates to the nurse that a patient has an impaired fasting glucose (IFG)?

A) Increased insulin and decreased glucagon levels two hours after fasting
B) An blood glucose level 2 hours after an oral glucose tolerance test that is high but not diagnostic of diabetes
C) A fasting blood glucose level is diagnostic for diabetes
D) A fasting blood glucose level or A1c higher than normal but not diagnostic for diabetes

Question 5

The staff development nurse is teaching a class on diabetes to newly hired nurses at General Hospital. The nurse explains that during glycogenolysis which of the following occurs?

A) Insulin increases, glucagon decreases.
B) Insulin decreases, glucagon and norepinephrine/epinephrine increase.
C) Insulin and growth hormone increase, cortisol decreases.
D) Insulin decreases; glucagon, cortisol, growth hormone and epinephrine increase.

Question 6

How should the nurse respond when a patient with diabetes asks about the role of beta cells in the pancreas?

A) "Beta cells secrete glucagon."
B) "Beta cells secrete insulin."
C) "Beta cells secrete somatostatin."
D) "Beta cells secrete pancreatic polypeptide."

Question 7

When preparing a nursing care plan for an adolescent with diabetes, which concept should the nurse keep in mind?

A) More insulin is needed as adolescents begin to engage in sports.
B) More insulin is needed as more growth hormone is released during adolescence.
C) More insulin is needed as the adolescents ingests less calories.
D) More insulin is needed during sleep in adolescents.

Question 8

Which statement by the parent of a child with an eating disorder indicates that more teaching is needed?

A) "Diabetes is not connected to eating disorders in children."
B) "Diabetic complications can be accelerated in children with eating disorders."
C) "If my child develops diabetes, the rate of complications may be higher than usual."
D) "My child may experience uncontrolled diabetes."

Question 9

The public health nurse is conducting a community screening for diabetes. Which of the following people does the nurse identify as being at highest risk for type 1 diabetes?

A) A person with an affected sibling
B) A person with an affected father
C) A person with multiple affected first-degree relatives
D) A person with an affected mother

Question 10

A child diagnosed with type 1 diabetes six months ago is being seen in the clinic because the mother has questions about why her child has not needed insulin for the past week. Which response by the mother indicates that more teaching is needed?

A) "I still need to check my child's blood glucose levels."
B) "The honeymoon period will most likely end in a few months."
C) "This period of insulin production is temporary."
D) "My child no longer has diabetes."

Question 11

The ethics committee at General Hospital is discussing issues involved in genomic screening of patients with type 2 diabetes. Which factor should be considered by the interdisciplinary team when making a decision about implementing genomic screening?

A) Genomic screening is less costly than frequent HbA1c level testing.
B) Genomic screening may reduce the time required to find the best treatment regimen.
C) Nutrition and exercise programs do not offer better use of limited financial resources.
D) HbA1c testing provides results that reduce the time required to find the best treatment regimen.

Question 12

When conducting community screening for diabetes, which population should the community health nurse recognize as being at highest risk?

A) Hispanics/Latinos
B) Caucasians
C) African Americans
D) Asian Americans

Question 13

Which data indicates a diagnosis of diabetes in a patient being assessed for unexplained weight loss?

A) A1C > 6.5%
B) Symptoms of diabetes plus casual plasma glucose concentration > 150mg/dL
C) Fasting plasma glucose < 126 mg/dL
D) 2-hour plasma glucose > 150 mg/dL

Question 14

A woman in her 26th week of pregnancy is undergoing a one-step 75-gram oral glucose tolerance test (OGTT). Which finding indicates that gestational diabetes is present?

A) A fasting plasma glucose level of 92 mg/dL
B) A 1-hour plasma glucose level of 160 mg/dL
C) A 2-hour plasma glucose level of 145 mg/dL
D) A 3-hour plasma glucose level of 135 mg/dL

Question 15

The nurse caring for a patient with uncontrolled diabetes notes deep and rapid respirations. The nurse documents this respiratory pattern as:

A) Kussmaul respiration.
B) Cheyne-Stokes respiration.
C) shortness of breath.
D) orthopnea.

Question 16

Which laboratory values should the nurse expect in a patient with diabetic ketoacidosis?

A) Plasma glucose level of 200 mg/dL
B) Ketonuria
C) Serum bicarbonate > 18 mEq/L
D) Arterial pH > 7.3

Question 17

The plan of care for a patient in diabetic ketoacidosis, with a blood glucose level of 450 mg/dL, should include strategies for:

A) administration of short-acting subcutaneous insulin.
B) administration of long-acting subcutaneous insulin.
C) administration of oral hypoglycemic agents.
D) administration of intravenous short-acting insulin.

Question 18

The nurse is assessing a patient with hyperglycemic hyperosmolar syndrome (HHS). Which finding would differentiate HHS from diabetic ketoacidosis (DKA)?

A) Lack of ketonuria
B) Electrolyte imbalances
C) Fluid volume deficit
D) Hyperglycemia

Question 19

When teaching a patient newly diagnosed with type 1 diabetes about autonomic nervous system symptoms of hypoglycemia, which would the nurse include?

A) Sweating and tremors
B) Irritability and confusion
C) Incoordination and difficulty speaking
D) Visual disturbances and drowsiness

Question 20

Which finding should the nurse expect when assessing a patient with symmetrical distal polyneuropathy due to diabetes?

A) Distal sensory loss in one limb
B) Distal pain in lower legs that worsens at night
C) Sharp, shooting pain in the distal legs
D) Leg pain that progresses from proximal to distal