Deck 22: Diabetes Mellitus

Question 1

An adolescent client has a BMI of 28 and fasting glucose level of 125 mg/dL. Which recommendation should the nurse expect for this client?

A) No action since a fasting blood sugar of 125 mg/dL is not abnormal
B) Immediate referral to an endocrinologist for further evaluation
C) A high-fiber diet, strenuous exercise daily, and weight loss of > 20%
D) Weight loss of 7%, low-fat diet, and moderate exercise for prevention of type 2 diabetes

Answer 1

Weight loss of 7%, low-fat diet, and moderate exercise for prevention of type 2 diabetes

Question 2

A school-age client with type 1 diabetes mellitus wants to know why the medication is in an injection instead of a pill. Which response should the nurse make to this client?

A) "The type of medication you need depends on your blood sugar levels, and yours meet the criteria for insulin."
B) "Medications available in pill form can be used for type 1 diabetes if the treatment is started early enough in the disease."
C) "Younger clients diagnosed with diabetes are prescribed insulin because it is long lasting and easier to keep track of than pills."
D) "Medications available in pill form only work if your body makes some insulin, and in type 1 diabetes the cells that make insulin do not work."

Answer 2

"Medications available in pill form only work if your body makes some insulin, and in type 1 diabetes the cells that make insulin do not work."

Question 3

A client with newly diagnosed diabetes asks when the frequent urination will stop. Which response should the nurse make to this client?

A) "Once your blood sugar is less than 200 you won't be as thirsty and so won't urinate as frequently."
B) "Limiting the amount of fluids in the evening may help to decrease the number of times you wake up during the night to urinate."
C) "Frequent urination is a common event with diabetes and should be expected to continue regardless of how well your blood sugar is controlled."
D) "Without enough insulin, glucose is not absorbed into the cells but is excreted by the kidneys along with large amounts of water causing frequent urination."

Answer 3

"Without enough insulin, glucose is not absorbed into the cells but is excreted by the kidneys along with large amounts of water causing frequent urination."

Question 4

A client with diabetes has a blood glucose level of 320 mg/dL and ketones in the urine. What should the nurse explain about these findings?

A) Ketones are naturally found in large numbers in the urine and are not a sign of pathology.
B) Uncontrolled glucose resulting in ketoacidosis is a very serious medical problem that can lead to comma or even death.
C) Ketones are a by-product of glucose metabolism and occur in varying amounts in the urine depending on the caloric intake of the client.
D) Ketoacidosis results when there is an over compensation of insulin by the body in response to a large consumption of complex carbohydrates.

Question 5

The nurse notes that a client with diabetes has muscle wasting. What should the nurse consider as being the reason for this finding?

A) Fat catabolism
B) Protein catabolism
C) Ketone metabolism
D) Glucose metabolism

Question 6

The nurse is helping a client with diabetes mellitus with meal planning. What should the nurse emphasize about carbohydrate intake?

A) Low-fiber foods are needed to improve insulin sensitivity.
B) There is no set amount of carbohydrates to ingest each day
C) Eat a small amount of foods with high fiber content to avoid constipation.
D) No fewer than 100 grams of simple carbohydrates because complex carbohydrates take much longer to metabolize.

Question 7

The nurse is discussing diet planning with a client who takes insulin as treatment for type 2 diabetes mellitus. What should the nurse encourage this client to do?

A) Adjust carbohydrates for snacks, but only eat them if hungry between meals.
B) Eat a larger snack if hunger occurs in the middle of the day and skip the next meal
C) Subtract several servings of carbohydrates from the daily meals and use them for snacks.
D) Add several servings of carbohydrates as snacks throughout the day without adjustments to meals.

Question 8

A 60-year-old male client who is African American has diabetes, a BMI of 27, blood pressure 150/90 mm Hg, cholesterol 242 mg/dL, triglycerides 240 mg/dL, LDL 200 mg/dL, and HDL 23 mg/dL. Which factors should the nurse identify as placing this client at risk for cardiovascular disease?

A) Race, age, and moderate weight
B) Obesity, low LDL, and diabetes
C) Diabetes, tobacco cessation, and obesity
D) Diabetes, hypertension, and age

Question 9

The nurse learns that a client of Asian descent uses ginseng to help control diabetes. Which action should the nurse take with this client?

A) Review possible interactions with current medications
B) Inform that ginseng has been shown to be effective in clinical trials
C) Advise to only take the amount prescribed by the traditional healer
D) Remind that ginseng is a natural plant-based remedy with no side effects

Question 10

The school nurse develops a health plan for a student with diabetes. Which direction is appropriate for the nurse to include in this plan?

A) Closely monitoring eating habits at school
B) Providing the student a snack before gym period
C) Monitoring immunizations to be sure the child is up to date
D) Storing any medication that will be administered during school hours in a safe place.

Question 11

The nurse prepares an educational handout for overweight clients with diabetes. Which strategy should the nurse include that focuses on weight loss?

A) High-fiber diet, surgery, and exercise
B) Low-carbohydrate diet, increased exercise, and surgery
C) Low-protein diet, coping strategies to avoid overeating, and exercise
D) Increased exercise, reduction of daily calories, and ways to avoid behaviors that have been barriers in the past for weight loss

Question 12

A client with diabetes has been following a low-carbohydrate low-fat diet to lose weight but has been feeling dizzy and tired in the afternoons at work. What should the nurse explain to this client?

A) A low-carbohydrate diet is good for diabetics and has been shown to improve glucose control
B) Increased exercise is beneficial for clients with diabetes but should be increased very slowly over time
C) A low-fat diet has been proven to increase the rate of metabolism in diabetic clients and help with weight control
D) Diets that restrict calories from specific food groups are not recommended for diabetics and could result in hypoglycemia especially with increased exercise

Question 13

A school-age client with diabetes experiences episodes of hyperglycemia despite receiving teaching about foods and snacks. Which food choice that the client makes indicates to the nurse that additional teaching is required?

A) Popcorn
B) Hot dogs
C) Peanut butter
D) Orange juice

Question 14

At school, a client with type 1 diabetes mellitus sees the school nurse because of feeling sweaty and shaky. Which action should the nurse take?

A) Call the ambulance if the blood glucose is less than 200
B) Provide a large candy bar and send the client back to class
C) Provide a bottle of soda for the client to drink until symptoms subside
D) Provide 15 grams of glucose and recheck blood glucose in 15 minutes

Question 15

The parents of a child with type 1 diabetes mellitus ask how to prevent episodes of hypoglycemia. Which recommendation should the nurse make to these parents?

A) Provide three large meals daily but avoid snacks
B) Provide snacks during the day and prior to exercise
C) Avoid extra calories and closely maintain the prescribed diet plan
D) Send candy bars to school with the student in case hypoglycemia symptoms occur

Question 16

A client with diabetes has a blood glucose level of 480 mg/dL and is experiencing weakness and confusion. Which information would be helpful to identify the reason for the client's symptoms?

A) Drank a bottle of beer last night before bed
B) Skipped breakfast because of being late for work
C) Takes insulin as prescribed and follows a healthy diet
D) Has not taken insulin for the past four days because of a flu-like illness