Deck 51: Caring for Clients With Diabetes Mellitus

Question 1

The nurse performs a fingerstick blood glucose level of a client with diabetes before lunch. The nurse would notify the physician for which blood glucose level?

A) 90 mg/dL
B) 115 mg/dL
C) 130 mg/dL
D) 145 mg/dL

Answer 1

145 mg/dL

Question 2

A client is using the glycemic index as a means to maintain his blood glucose levels. Which appropriate glycemic index food would the nurse suggest that the client consume when he is exercising?

A) 25
B) 45
C) 65
D) 85

Answer 2

85

Question 3

A client with diabetes mellitus who has hyperlipidemia and is overweight is complaining about weight gain. When responding to the client, which of the following would the nurse need to incorporate as the reason?

A) Lack of response to leptin
B) Lack of exercise
C) Inadequate blood glucose control
D) Lack of sleep

Answer 3

Lack of response to leptin

Question 4

A client with diabetes comes to the clinic for a follow-up visit. The nurse reviews the client's glycosylated hemoglobin test results. Which result would indicate to the nurse that the client's blood glucose level has been well-controlled?

A) 6.5%
B) 7.5 %
C) 8.0%
D) 8.5%

Question 5

A client with diabetes is receiving an oral antidiabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer?

A) Metformin
B) Glyburide
C) Repaglinide
D) Glipizide

Question 6

When administering insulin to a client with type 1 diabetes, which of the following would be most important for the nurse to keep in mind?

A) Duration of the insulin
B) Accuracy of the dosage
C) Area for insulin injection
D) Technique for injecting

Question 7

The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which of the following would the nurse include as associated with type 2 diabetes?

A) Onset most common during adolescence
B) Insulin production insufficient
C) Less common than type 1 diabetes
D) Little to relation to pre-diabetes

Question 8

The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action?

A) It enhances transport of glucose across the cell wall.
B) It aids in the process of gluconeogenesis.
C) It stimulates the pancreatic beta cells.
D) It decreases the intestinal absorption of glucose.

Question 9

The nurse is teaching an older client how to self-administer insulin. Which of the following would be most helpful to the client who is having difficulty drawing up the correct dosage of insulin in the syringe?

A) Magnifier
B) Insulin pen
C) Jet injector
D) Insulin pump

Question 10

A client is receiving insulin lispro at 7:30 AM. The nurse ensures that the client has breakfast by which time?

A) 7:35 AM
B) 7:45 AM
C) 8:00 AM
D) 8:30 AM

Question 11

A male client, aged 42, is diagnosed with diabetes mellitus. He visits the gym regularly and is a vegetarian. Which of the following factorsis important when assessing the client?

A) The client's consumption of carbohydrates
B) History of radiographic contrast studies that used iodine
C) The client's mental and emotional status
D) The client's exercise routine

Question 12

The nurse is providing information about foot care to a client with diabetes. Which of the following would the nurse include?

A) "Wash your feet in hot water every day."
B) "Use a razor to remove corns or calluses."
C) "Be sure to apply a moisturizer to feet daily."
D) "Wear well-fitting comfortable rubber shoes."

Question 13

A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously?

A) Glargine
B) Regular
C) NPH
D) Lente

Question 14

Which of the following factors would a nurse identify as a most likely cause of diabetic ketoacidosis (DKA) in a client with diabetes?

A) The client continues medication therapy despite adequate food intake.
B) The client has not consumed sufficient calories.
C) The client has been exercising more than usual.
D) The client has eaten and has not taken or received insulin.

Question 15

A client with type 1 diabetes is to receive a short-acting insulin and an intermediate-acting insulin subcutaneously before breakfast. The nurse would administer the insulin at which site as the preferred site?

A) Arms
B) Thighs
C) Abdomen
D) Upper buttock

Question 16

A client with type 2 diabetes asks the nurse why he can't have a pancreatic transplant. Which of the following would the nurse include as a possible reason?

A) Increased risk for urologic complications
B) Need for exocrine enzymatic drainage
C) Underlying problem of insulin resistance
D) Need for lifelong immunosuppressive therapy

Question 17

The nurse is reviewing the initial laboratory test results of a client diagnosed with DKA. Which of the following would the nurse expect to find?

A) Blood glucose level of 250 mg/dL
B) Blood pH of 6.9
C) Serum bicarbonate of 19 mEq/L
D) PaCO₂ of 40 mm Hg

Question 18

A nurse educates a group of clients with diabetes mellitus on the prevention of diabetic nephropathy. Which of the following suggestions would be most important?

A) Control blood glucose levels.
B) Drink plenty of fluids.
C) Take the antidiabetic drugs regularly.
D) Eat a high-fiber diet.

Question 19

After teaching a client with type 1 diabetes, who is scheduled to undergo an islet cell transplant, which client statement indicates successful teaching?

A) "This transplant will provide me with a cure for my diabetes."
B) "I will receive a whole organ with extra cells to produce insulin."
C) "They'll need to create a connection from the pancreas to allow enzymes to drain."
D) "I might need insulin later on but probably not as much or as often."

Question 20

A client is found to be comatose and hypoglycemic with a blood sugar of 50 mg/dL. Which of the following would the nurse do first?

A) Infuse 1000 mL D W over a 12-hour period.5
B) Administer 50% glucose intravenously.
C) Check the client's urine for the presence of sugar and acetone.
D) Encourage the client to drink orange juice with added sugar.

Question 21

After teaching a group of students about diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic nonketotic syndrome (HHNKS), the instructor determines that additional teaching is needed when the students identify which of the following as characteristic of HHNKS?

A) Blood glucose level over 500 mg/dL
B) Elevated serum potassium levels
C) Decreased serum sodium levels
D) Blood pH level between 7.35 to 7.45

Question 22

Which of the following would the nurse most likely assess in a client with diabetes who is experiencing autonomic neuropathy?

A) Skeletal deformities
B) Paresthesias
C) Erectile dysfunction
D) Soft tissue ulceration

Question 23

Which of the following would lead a nurse to suspect that a client is experiencing hypoglycemia?

A) Flushed hot skin
B) Air hunger
C) Slow bounding pulse
D) Thirst

Question 24

A client who is suspected of having diabetes is undergoing a postprandial glucose test. Which result would the nurse interpret as suggestive of diabetes?

A) 70 mg /dL
B) 110 mg/dL
C) 160 mg/dL
D) 220 mg/dL

Question 25

A group of students are reviewing the various types of drugs that are used to treat diabetes mellitus. The students demonstrate understanding of the material when they identify which of the following as an example of an alpha-glucosidase inhibitor?

A) Metformin
B) Glyburide
C) Miglitol
D) Rosiglitazone