Deck 19: Nursing Care of People With Diabetes Mellitus

Question 1

The nurse determines that a person has evidence of peripheral vascular disease associated with diabetes. What did the nurse most likely ascertain to make this clinical decision?

A)Even hair distribution on legs.
B)Feet warm and dry bilaterally.
C)Intermittent claudication of the lower legs.
D)Intact skin between toes.

Answer 1

Intermittent claudication of the lower legs.

Question 2

A person with diabetes wants to check the feet every day but is unable to lift the legs because of arthritic knees. '''Which technique should the nurse advise for this person?

A)'Prop a mirror against the wall and lift the foot, checking for any skin breakdown.'
B)'Wear only soft shoes or socks.'
C)'Check the inside of socks when changing for any bleeding.'
D)'Don't worry about it unless pain in the feet is present.'

Answer 2

'Prop a mirror against the wall and lift the foot, checking for any skin breakdown.'

Question 3

A person prescribed glipizide (Minidiab)for type 2 diabetes experiences episodes of hypoglycaemia when taking the medication. For what would the nurse ascertain in this person?

A)Taking a calcium channel blocker.
B)Waiting two hours to eat as recommended.
C)Taking over-the-counter medications for reflux such as cimetidine (Tagamet).
D)Taking an oral contraceptive.

Answer 3

Taking over-the-counter medications for reflux such as cimetidine (Tagamet).

Question 4

A person with type 2 diabetes asks what can be done to prevent heart problems. ''What should the nurse instruct the person to do to avoid this long-term complication?

A)Avoid high-sugar-content fruits.
B)Perform vigorous aerobic exercise at least two times per week.
C)Restrict oral fluids.
D)Cease smoking.

Question 5

A person with type 2 diabetes reports drinking orange juice when feeling 'shaky.' What should the nurse instruct this person?

A)'Go to the hospital emergency department if this happens again.'
B)'Call the doctor immediately if this happens again.'
C)Nothing. This is an appropriate intervention for the person to make.
D)'If this happens again, check your blood glucose level with your monitor.'

Question 6

A person with diabetes seeks help for a back problem because the feet are becoming numb. What should the nurse suspect this person is experiencing?

A)Tetany.
B)Carpopedal spasm.
C)Gastroparesis.
D)Polyneuropathy.

Question 7

A person with diabetes mentions a plan to lose 15 kg in 2 months. What should this statement indicate to the nurse?

A)Gastric bypass surgery is needed.
B)The person is highly motivated.
C)The goal is unrealistic.
D)The goal is achievable.

Question 8

The nurse is instructing a person with type 1 diabetes about care during sick days. What should be included in these instructions?

A)Monitor blood glucose level at least every eight hours.
B)Administer one-half of the prescribed insulin dose.
C)Restrict fluid intake.
D)Self-administer insulin dose as prescribed.

Question 9

A person with diabetes is unable to lose weight despite careful dieting and consuming only sugar-free soft drinks. How should the nurse respond to this person?

A)'How much water are you drinking every day?'
B)'Sugar-free drinks still have some calories.'
C)'Are you sure you are buying only sugar-free items?'
D)'It is very difficult to stick to a weight loss diet.'

Question 10

A person with type 2 diabetes recovering from surgery is upset about having to take insulin. How should the nurse respond to this person?

A)'Didn't your doctor tell you that you would be on insulin now?'
B)'After surgery it is necessary to change over to insulin injections.'
C)'We will teach you how to give yourself the insulin injections.'
D)'It's just until you are able to take your other medication and start to recover from the surgery.'

Question 11

A person with type 1 diabetes comes into the emergency department with deep respirations, lethargy and extreme thirst. What is the person demonstrating?

A)Hypoglycaemia.
B)Hyperosmolar hyperglycaemic state.
C)Possible diabetic ketoacidosis (DKA).
D)A respiratory infection.

Question 12

The nurse is preparing to mix 20 units of NPH insulin with 8 units of regular insulin into one syringe for injection. Select the order of the steps the nurse should follow:
1) Wipe tops of both vials with alcohol.
2) Inject 8 units of air into the regular insulin vial.
3) Inject 20 units of air into the NPH insulin vial.
4) Withdraw 20 units of NPH insulin into the syringe.
5) Withdraw 8 units of regular insulin into the syringe.

Question 13

Which medication is classified as an ultra-short-acting insulin?

A)Protaphane.
B)Isophane NPH.
C)Insulin glargine.
D)Insulin aspart.

Question 14

During a visit, the nurse finds a safety hazard in the home of a person with diabetes. What did the nurse observe in this person's home?

A)Hand grips next to the toilet.
B)Throw rugs in the kitchen and bathroom.
C)Night lights.
D)Bed at the lowest level.

Question 15

A person is concerned about losing weight despite constant eating and about the frequency of urination. What should the nurse realise this person is describing?

A)Polyphagia and polydipsia.
B)Retinopathy and polyphagia.
C)Polyphagia and polyuria.
D)Neuropathy and polydipsia.

Question 16

A person is scheduled for an oral glucose tolerance test. Which plasma glucose level indicates the presence of diabetes mellitus two hours after the person ingests 75 g of glucose?

A)2)2 mmol/L.
B)4)4 mmol/L.
C)8)8 mmol/L.
D)11.1 mmol/L.

Question 17

A person with type 2 diabetes is admitted to the intensive care unit with a blood glucose level of 40 mmol/L. Which nursing action would be appropriate for this person?

A)Change intravenous fluids from normal saline to dextrose when blood glucose levels reach 14-16 mmol/L.
B)Permit activity as tolerated.
C)Monitor neurological functioning every 8 hours.
D)Restrict intravenous fluids.

Question 18

A person says, 'I'm glad I only have diabetes. Many of my friends have heart problems.' What would be an appropriate response for the nurse to make to this person?

A)'Diabetes can affect your heart if it is not properly controlled.'
B)'I agree that you are fortunate to only have diabetes.'
C)'You are lucky because heart problems are much more serious than diabetes.'
D)'Your friends probably have diabetes too.'

Question 19

A person with type 2 diabetes wants to lose 10 kg and asks for help with meal planning. What would be appropriate for this person to aid with weight loss and blood glucose level maintenance?

A)Plan for a small breakfast, moderate-sized lunch and large dinner with a bedtime snack.
B)Eat the largest meal of the day for breakfast and two small meals for lunch and dinner.
C)Eat the largest meal in the middle of the day at lunch with smaller meals for breakfast and dinner.
D)Plan for three equal-sized meals with one or two snacks.

Question 20

An older person newly diagnosed with type 2 diabetes says, 'I don't want to be using a needle for the rest of my life.' What would be an appropriate response for the nurse to make to this person?

A)'You need it for now. There's a chance you won't need it after you get well.'
B)'You will get used to it, as the needle barely hurts.'
C)'You can always decide not to use a needle.'
D)'I'll teach you how to give yourself insulin.'