Deck 37: Care of Patients with Diabetes and Hypoglycemia

Question 1

The nurse is caring for a patient who struggles to maintain glycemic control at night and during early morning hours.Which statement correctly explains the reason for this problem?

A) Counterregulatory hormones produce hyperglycemia.
B) Hyperglycemia of dawn phenomenon does not react to insulin.
C) Hypoglycemia quickly follows the dawn phenomenon.
D) Food intake fails to change hyperglycemia of dawn phenomenon.

Answer 1

Counterregulatory hormones produce hyperglycemia.

Question 2

Which reason best explains why diabetics are prone to infection?

A) High glucose levels provide an environment conducive to bacterial growth.
B) Atherosclerotic vascular changes decrease blood supply to tissues.
C) Diabetics display abnormal phagocyte function.
D) Diabetics display decreased leukocyte function.

Answer 2

Atherosclerotic vascular changes decrease blood supply to tissues.

Question 3

A patient asks the nurse if stress can be a potential cause of type 2 diabetes.Which response is most appropriate for the nurse to make?

A) "Stress decreases the number of alpha cells in the pancreas, and increases the workload on the beta cells."
B) "Periods of stress cause increases in glycogen production by the adrenal cortex."
C) "Stress is directly associated with decreased insulin tolerance."
D) "The inhibition of beta cells to glucose is increased in periods of stress."

Answer 3

"Periods of stress cause increases in glycogen production by the adrenal cortex."

Question 4

The nurse is caring for an older adult patient who is diabetic.The nurse cautions against the technique of "tight control" of hyperglycemia.Which statement explains why this management method is not recommended?

A) Older adults may not accurately test and administer sliding-scale insulin.
B) Older adults possess lower risk for hyperglycemia.
C) Older adults may experience cardiovascular problems from hypoglycemia.
D) Older adults possess an unstable metabolic rate.

Question 5

The nurse is counseling an overweight,noncompliant,30-year-old female with type 2 diabetes.Which change is most important for the nurse to suggest?

A) Begin an exercise program and lose weight.
B) Obtain annual eye examinations.
C) Keep a food diary.
D) Inspect feet daily.

Question 6

The nurse is explaining the underlying pathophysiology of type 1 diabetes to a newly diagnosed patient.Which information accurately explains why the type 1 diabetic does not produce adequate insulin?

A) A pituitary disorder inhibits beta cells.
B) An allergic response alters beta cell responses to hyperglycemia.
C) Alpha cells proliferated in the islets of Langerhans.
D) The body's immune system destroyed beta cells.

Question 7

A patient recently diagnosed with type 1 diabetes mellitus (DM)asks why she is experiencing increased thirst.Which explanation is most appropriate?

A) Diabetes results in a lack of protein absorption that decreases amino acids and causes increased thirst.
B) High glucose levels in the blood pull cellular water into circulating volume and increase thirst.
C) Thirst results from the body's increased loss of fluids from frequent urination.
D) Diabetes causes large amount of fluid to shut to the pancreas, which dehydrates the body.

Question 8

The nurse is caring for a patient with type 1 diabetes who is diaphoretic and clammy.The patient complains of hunger but denies pain.The nurse performs a bedside blood glucose check.What should the nurse do next?

A) Administer insulin as scheduled.
B) Notify the charge nurse.
C) Give 6 ounces of orange juice.
D) Document the findings.

Question 9

The patient takes his NovoLog 70/30 at 0700.When should the nurse suggest that the patient schedule exercise?

A) 0730.
B) 1000.
C) 1300.
D) Scheduling exercise is unnecessary.

Question 10

The nurse is educating the patient about the significance of islet cell antibodies.Which statement accurately describes islet cell antibodies?

A) Islet cell antibodies cause beta cells to quit producing insulin and lead to type 1 diabetes mellitus (DM).
B) Islet cell antibodies protect beta cells from viral attack.
C) Islet cell antibodies increase production of insulin from beta cells.
D) Islet cell antibodies decrease the size of the pancreas.

Question 11

The nurse is caring for a patient with ketosis.Which statement indicates that the patient correctly understands the phenomenon?

A) "I took too much insulin to decrease my body's glucose levels."
B) "The condition resulted when my body tried to break down and use my stores of fats."
C) "My blood glucose went over 150 mg/dL and caused this condition."
D) "I exercised too much reduced my blood glucose level too dramatically."

Question 12

Which goal is the primary objective of a diabetic diet?

A) Adequate nutrition with weight control
B) Exclusion of all sweets
C) Increased fat intake for greater energy
D) Elimination of all fast foods

Question 13

The patient comes to the emergency room complaining of abdominal pain.The nurse assesses dry,hot skin,fruity breath,and deep respirations.To which problem should the nurse attribute these findings?

A) An insulin reaction
B) Ketoacidosis
C) Rebound hyperglycemia
D) Hypoglycemia

Question 14

The nurse is discussing insulin administration with an assigned patient.The patient reports that she prefers to use only certain sites for insulin injections and questions the need to rotate sites.What response by the nurse is most appropriate?

A) "Rotating injection sites helps reduce your risk of infection."
B) "Rotating injection sites helps enhance insulin absorption."
C) "Unsightly fatty tumors can develop when you do not adequately rotate injection sites."
D) "Rotating injection sites decreases your risk of an insulin reaction."

Question 15

A long-term diabetic patient reports that he has been diagnosed with early cardiovascular disease.How does diabetes predispose the patient to cardiovascular complications?

A) Hyperglycemic periods cause thickening of the basement membrane in vessels, which causes atherosclerosis.
B) Hypoglycemic periods increase cortisol release, which causes hypertension.
C) Insulin constricts the cardiovascular vessels, which causes congestive heart failure.
D) Diabetes decrease in the body's ability to digest fats by the pancreas, which leads to increased coronary artery blockage.

Question 16

The nurse is educating a 50-year-old patient about diabetes monitoring.Which statement reinforces the American Diabetes Association's (ADA's)recommendation?

A) Obtain regularly scheduled fasting blood glucose levels.
B) Strictly adhere to weight reduction diets.
C) Exercise regularly in intervals lasting a minimum of 30 minutes.
D) Use stress reduction techniques.

Question 17

Type 2 diabetes cases compose approximately what percentage of all known cases of diabetes?

A) 70%
B) 75%
C) 80%
D) 95%

Question 18

Which laboratory values are consistent with a patient in ketoacidosis?

A) Blood urea nitrogen (BUN) of 35 mg/dL
B) Carbon dioxide (CO₂) of 40 mEq/L
C) pH of 7.54
D) Blood glucose of 70 mg/dL

Question 19

The nurse is educating a patient with gestational diabetes.Which statement indicates that the patient needs additional teaching?

A) "Gestational diabetes happens because of the hormonal changes of pregnancy."
B) "I should exercise regularly and lose weight to reduce my risk of becoming a diabetic."
C) "This problem goes away completely once I give birth."
D) "The baby will have to be monitored for hypoglycemia during my pregnancy."

Question 20

The nurse notes that the HbA?c level of an assigned patient demonstrated a drop from 9.4% to 5.4%.What can the nurse infer from these findings?

A) The patient's blood glucose control has improved over the last several months.
B) The patient has been less compliant with the prescribed treatment regimen.
C) The patient is experiencing a reduction in insulin sensitivity.
D) The patient has less need for insulin.

Question 21

Which factor(s)may cause diabetes mellitus (DM)?

A) Genetic
B) Microbiologic
C) Metabolic
D) Allogenic
E) Immunologic

Question 22

When discussing exercise programs with the diabetic,which instruction(s)is/are important for the nurse to include?

A) Delay exercise until glucose controlled.
B) Check glucose immediately after exercising.
C) Keep a quick source of glucose readily available while exercising.
D) Begin slowly and build up to 30 to 45 minutes.
E) Only use the abdominal injection site for insulin.

Question 23

Which requirement(s)is/are part of the criteria for "tight control" of hyperglycemia?

A) Perform glucose testing twice daily.
B) Administer insulin injections three times a day based on glucometer readings.
C) Maintain fasting glucose within normal limits.
D) Maintain normal weight for height and age.
E) Maintain cholesterol within normal limits.

Question 24

Which statement(s)explain(s)a reason for weight loss in type 1 diabetics?

A) Loss of body fluid
B) Insulin intolerance
C) Metabolization of body fats
D) Stress of disease
E) Altered diet

Question 25

The nurse associates the type of diabetes with the characteristics that may be seen with the specific disease.Match the type of diabetes with the symptoms that are associated with it.(The options may be used once, more than once, or not at all.)

Little or no endogenous insulin

A)Type 1
B)Type 2
C)Gestational
D)Prediabetes

Question 26

A patient with type 1 diabetes mellitus (DM)is preparing for a moderate 30-minute exercise period.Which action best indicates that the patient understands condition management?

A) The patient reduces insulin use during days when exercise periods are planned.
B) The patient administers insulin after exercise rather than before exercise.
C) The patient eats a high-carbohydrate snack before the exercise period.
D) The patient consumes a simple carbohydrate snack after 30 minutes of activity.

Question 27

The nurse associates the type of diabetes with the characteristics that may be seen with the specific disease.Match the type of diabetes with the symptoms that are associated with it.(The options may be used once, more than once, or not at all.)

Adult onset

A)Type 1
B)Type 2
C)Gestational
D)Prediabetes

Question 28

The nurse associates the type of diabetes with the characteristics that may be seen with the specific disease.Match the type of diabetes with the symptoms that are associated with it.(The options may be used once, more than once, or not at all.)

Occurs during pregnancy

A)Type 1
B)Type 2
C)Gestational
D)Prediabetes

Question 29

The nurse watches a patient perform an insulin injection.Which observation(s)indicate(s)that the patient needs additional instruction?

A) The patient uses a 90-degree angle to administer the injection.
B) The patient cleans the injection site with alcohol before the injection.
C) The patient rubs the injection site after administration of the insulin injection.
D) The patient draws up the cloudy insulin and then the clear insulin.
E) The patient shakes the insulin bottle before administration.

Question 30

The nurse associates the type of diabetes with the characteristics that may be seen with the specific disease.Match the type of diabetes with the symptoms that are associated with it.(The options may be used once, more than once, or not at all.)

Threat of renal,retinal,and neurologic complications

A)Type 1
B)Type 2
C)Gestational
D)Prediabetes

Question 31

The nurse is reviewing the patient's prescribed insulin regimen.The nurse notes that the physician has ordered a long-lasting insulin.Which medication best meets this criteria?

A) Lantus
B) NovoLog
C) Humalog
D) Regular

Question 32

The nurse is caring for a patient suspected of having ketoacidosis.Which manifestation(s)is/are characteristic with early ketoacidosis?

A) Fruity breath
B) Polyuria
C) Nausea
D) Thirst
E) Sunken eyes

Question 33

Which genetic factor(s)increase(s)the risk of a person developing diabetes mellitus (DM)?

A) Number of relatives with DM
B) Body mass index (BMI)
C) Sedentary lifestyle
D) Genetic closeness of relatives with DM
E) Race

Question 34

The nurse associates the type of diabetes with the characteristics that may be seen with the specific disease.Match the type of diabetes with the symptoms that are associated with it.(The options may be used once, more than once, or not at all.)

Rarely develops ketosis

A)Type 1
B)Type 2
C)Gestational
D)Prediabetes

Question 35

The nurse explains that the three cardinal signs of type 1 diabetes mellitus (DM)are __________,__________,and __________.

Question 36

The nurse associates the type of diabetes with the characteristics that may be seen with the specific disease.Match the type of diabetes with the symptoms that are associated with it.(The options may be used once, more than once, or not at all.)

Weight loss and exercise can delay onset of diabetes

A)Type 1
B)Type 2
C)Gestational
D)Prediabetes