Deck 44: Coordinating Care for Patients With Diabetes Mellitus

Question 1

The nurse suspects that a patient with type 2 diabetes mellitus is experiencing autonomic neuropathy.What did the nurse assess to make this clinical determination?

A) Bloating
B) Foot pain
C) Tingling of the fingers
D) Numbness of the lower legs

Answer 1

Bloating

Question 2

A patient with type 1 diabetes mellitus will be self-monitoring blood glucose levels at home.What is the minimum number of measurements that this patient should make each day?

A) 1
B) 3
C) 4
D) 8

Answer 2

4

Question 3

A middle-aged patient is surprised to learn of the diagnosis of type 1 diabetes mellitus.What should the nurse respond?

A) "It is odd since it is usually a disease of childhood."
B) "You probably developed it because of an infection."
C) "Type 1 diabetes mellitus can occur at any stage of life."
D) "It usually means that another disease process is present."

Answer 3

"Type 1 diabetes mellitus can occur at any stage of life."

Question 4

An older patient with type 1 diabetes mellitus has poor oral intake.What should be considered to ensure adequate blood glucose control?

A) Hold all prandial doses
B) Consider increasing longer-acting insulin
C) Increase the frequency of correctional doses
D) Administer prandial and correctional insulin together

Question 5

A patient with type 2 diabetes mellitus is being evaluated for hyperosmolar hyperglycemic state (HHS).Which finding would be consistent with this medical diagnosis?

A) pH 7.31
B) Abdominal pain
C) Blood glucose 250 mg/dL
D) Serum bicarbonate 28 mEq/L

Question 6

A patient experiencing diabetic ketoacidosis (DKA)is receiving a normal saline infusion and intravenous insulin.What additional medication should the nurse expect to be prescribed for this patient?

A) Diuretic
B) Laxative
C) Antibiotic
D) Potassium

Question 7

A patient is prescribed Regular insulin 5 units subcutaneous injection now.Which syringe should the nurse use for this dose if all are readily available?

A) U-30
B) U-50
C) U-100
D) U-500

Question 8

During a home visit the nurse is concerned that a patient with type 2 diabetes mellitus would benefit from additional teaching.What did the nurse observe to make this clinical decision?

A) Exercising with a treadmill
B) Walking barefoot in the back yard
C) Eating one-half apple and cheese for a snack
D) Stated a weight loss of 2 lbs.over the last month

Question 9

Which statement best describes the pathophysiology of type 2 diabetes mellitus?

A) An absolute lack of insulin is present
B) The cells resist glucose from entering
C) Pancreatic cells stop producing insulin
D) An autoimmune disorder damages pancreatic cells

Question 10

The nurse is evaluating teaching provided to a patient with type 1 diabetes mellitus.Which patient observation indicates that medication teaching has been effective?

A) Uses a 1 mL syringe to measure insulin dose
B) Places a new injection an inch away from previous injection site
C) Inserts the needle at a 25-degree angle prior to injecting the medication
D) Provides an injection in the thigh after an abdominal injection in the morning

Question 11

A patient is newly diagnosed with type 2 diabetes mellitus.Which medication classification should the nurse expect to be prescribed for this patient?

A) Biguanides
B) Meglitinides
C) Sulfonylureas
D) Thiazolidinediones

Question 12

The nurse is reviewing the results of patient's recent hemoglobin A1c level drawn to evaluate type 1 diabetes management.Which result indicates that treatment has been successful?

A) > or = 8%
B) < or = 6.5%
C) > 110 mg/dL
D) > 140 mg/dL

Question 13

A patient with type 1 diabetes mellitus is experiencing elevated blood glucose levels in the morning.Which action should be taken to determine the reason for this elevation?

A) Check urine for glucose level
B) Restrict oral fluids after 1800 hours
C) Measure blood glucose at 0200 hours
D) Limit carbohydrate intake to 45 grams with evening meal

Question 14

The nurse is reviewing type 1 diabetes mellitus with a group of patients newly diagnosed with the disorder.What should the nurse explain as the major cause for the disorder?

A) Autoimmune process
B) Cancer of the pancreas
C) Alteration in lipid and protein utilization
D) Malfunction of carbohydrate metabolism

Question 15

The nurse notices that a patient who has been drinking large volumes of water and eating large meals throughout the day continues to lose weight.Which health problem should the nurse suspect this patient is experiencing?

A) Hypercortisolism
B) Hyperaldosteronism
C) Type 1 diabetes mellitus
D) Type 2 diabetes mellitus

Question 16

A patient with type 1 diabetes mellitus has not taken insulin for several days.Which observation indicates that diabetic ketoacidosis (DKA)could be developing?

A) Slow heart rate
B) Deep rapid respirations
C) Decreased urine output
D) Increased blood pressure

Question 17

A patient with type 1 diabetes mellitus is scheduled for a hemoglobin A1c level.What should the nurse emphasize to the patient to prepare for this test?

A) Schedule the test for first thing in the morning
B) Have the test drawn at any time during the day
C) Avoid eating and drinking anything after midnight the day before the test
D) Restrict the intake of red meat for three days before having the test

Question 18

A patient with type 1 diabetes mellitus develops symptoms of hypoglycemia only when the blood glucose level drops to 40 mg/dL.What should be done to reverse this condition?

A) Raise glycemic targets
B) Cut insulin dose in half
C) Add an extra snack to the meal plan
D) Eliminate the evening dose of insulin

Question 19

A patient with type 2 diabetes mellitus is prescribed a glucagon-like peptide-1 agonist.What clinical symptom should the nurse instruct the patient to expect when taking this medication?

A) Nausea
B) Diarrhea
C) Dry mouth
D) Decreased appetite

Question 20

A patient with type 1 diabetes mellitus is preparing to play tennis.What should be done first before engaging in this physical activity?

A) Drink 1 liter of fluid
B) Measure blood glucose level
C) Eat one serving of carbohydrate
D) Take a dose of prescribed medication

Question 21

The nurse is caring for a patient with type 2 diabetes mellitus.Why should the nurse assess capillary refill in this patient?

A) Evaluate for diabetic neuropathy
B) Determine if foot care is being done
C) Estimate current blood glucose level
D) Assess for microvascular complications

Question 22

The nurse is evaluating care provided to a patient with type 2 diabetes mellitus.Which data indicates that the patient is managing the disease process effectively?

A) Hemoglobin A1c level 8.2%
B) Weight gain of 3 lbs.over the last 2 months
C) Reddened area noted on the sole of the left foot
D) Eye doctor appointment scheduled for the next week