Question 1

Type 2 diabetes mellitus is characterized by which underlying pathophysiology?

Accepted Answer

Type 2 diabetes mellitus is characterized by insulin resistance, which means that the body's cells have a decreased response to insulin, leading to increased glucose levels in the blood. This is different from type 1 diabetes, which is caused by the inability of the pancreas to produce insulin. Excessive insulin production is not characteristic of type 2 diabetes, and impaired insulin uptake is a consequence of insulin resistance.

Question 2

The nurse is concerned that a client with potential hepatic failure is at risk for developing ascites.Which assessment finding supports the development of liver failure as manifested by ascites?

Accepted Answer

Ascites is the accumulation of fluid in the peritoneal cavity, causing increased abdominal girth. This can occur in individuals with liver failure due to decreased liver function and increased pressure in the portal vein. Gallbladder pain, yellow-tinged skin, and bleeding and bruising easily are all potential manifestations of liver failure but do not specifically support the development of ascites.

Question 3

The nurse is completing an assessment interview with an older adult client being seen for a yearly physical examination.Which client statement would indicate a possible diagnosis of diabetes mellitus?

Accepted Answer

Increased thirst is a common symptom of diabetes mellitus, indicating high blood sugar levels leading to dehydration. The other statements do not necessarily indicate diabetes mellitus, as they could be symptoms of a variety of conditions or simply part of the aging process.

Question 4

A nurse is caring for a client who was recently admitted for treatment of cirrhosis.The client is currently experiencing ascites,+3 pitting edema,and oliguria.Which nursing diagnosis should the nurse select as a priority for this client?

Accepted Answer

The client's presenting symptoms of ascites, +3 pitting edema, and oliguria all indicate an excess of fluid in the body. Therefore, the priority nursing diagnosis should be Excess Fluid Volume.

Question 5

The healthcare provider prescribes sitagliptin (Januvia)for a client with type 2 diabetes mellitus.For which potential side effect should the nurse monitor in this client?

Accepted Answer

Sitagliptin has been associated with an increased risk of acute pancreatitis. The other options are not commonly associated with sitagliptin.

Question 6

The nurse is caring for a client recovering from a liver transplant necessitated by cirrhosis of the liver.Which postoperative outcome would be a priority for this client?

Accepted Answer

Normal serum bilirubin levels are a priority for this client recovering from a liver transplant because cirrhosis is a liver disease which causes an accumulation of bilirubin in the blood. Therefore, normal levels of bilirubin indicate that the transplanted liver is functioning properly. Moist membranes of the mouth, ability to move the legs, and normal pupil reaction are important, but they are not as critical to the recovery of a liver transplant client as normal serum bilirubin levels.

Question 7

The nurse is caring for a 76-year-old client with type 2 diabetes who is recovering from surgery following a hip fracture.In addition to blood glucose level,what should the nurse recognize as a sign of hyperosmolar hyperglycemic state (HHS)?

Accepted Answer

Increased urine output is a sign of HHS due to the increased glucose levels in the blood causing the kidneys to work harder to remove the excess glucose through urine. Excessive sweating, insomnia, and edema are not typical signs of HHS.

Question 8

The nurse is providing education to the caregivers of a client with cirrhosis of the liver.The caregivers indicate that they've heard of portal hypertension,but they aren't sure which symptoms could indicate that their loved one is experiencing this condition.Which symptoms of portal hypertension should the nurse discuss with the caregivers?

Accepted Answer

Portal hypertension can cause the development of varices in the esophagus and rectum, resulting in hemorrhoids and gastrointestinal bleeding. The other options, muscle wasting and hypothermia, are not typically associated with portal hypertension. Bleeding gums may be a sign of bleeding disorders or gum disease, but not necessarily portal hypertension.

Question 9

Which test is commonly used to screen for type 2 diabetes in the general population?

Accepted Answer

The fasting plasma glucose test is the most commonly used test to screen for type 2 diabetes in the general population. This test measures the level of glucose in the blood after an overnight fast. A level of 126 mg/dL or higher on two separate occasions indicates diabetes. The oral glucose tolerance test and urine ketone levels are also useful for diagnosing diabetes, but they are not as commonly used in screening. Serum cholesterol levels are not used to screen for diabetes.

Question 10

The nurse is planning care for a client with type 2 diabetes mellitus.Which nursing diagnosis would be most appropriate for this client?

Accepted Answer

A)A client with diabetes mellitus is at the greatest risk for infection. No other information is given in the question with regard to risk for self neglect, ineffective tissue perfusion, or impaired tissue integrity as potential nursing diagnoses.
B)A client with diabetes mellitus is at the greatest risk for infection. No other information is given in the question with regard to risk for self neglect, ineffective tissue perfusion, or impaired tissue integrity as potential nursing diagnoses.
C)A client with diabetes mellitus is at the greatest risk for infection. No other information is given in the question with regard to risk for self neglect, ineffective tissue perfusion, or impaired tissue integrity as potential nursing diagnoses.
D)A client with diabetes mellitus is at the greatest risk for infection. No other information is given in the question with regard to risk for self neglect, ineffective tissue perfusion, or impaired tissue integrity as potential nursing diagnoses.

Question 11

What collaborative interventions are likely to improve outcomes for an 11-year-old client diagnosed with type 2 diabetes mellitus? Select all that apply.

Accepted Answer

A collaborative approach that involves the client, their family and healthcare professionals is essential to manage type 2 diabetes mellitus. Weaning off medication may not be appropriate for every client and must be done under medical supervision. However, the client's food intake based on age, sex and physical activity, and physical activity for at least 30 to 60 minutes per day most days of the week are key components of diabetes management. Adequate rest and sleep may support general health but alone may not improve outcomes. Family participation in lifestyle change is also important, as it can reinforce positive behaviors and provide a supportive environment for the client.

Question 12

Health promotion and prevention related to type 1 diabetes should include

Accepted Answer

A)Currently, there is no known way to prevent type 1 diabetes. Therefore, prevention related to type 1 diabetes is related to preventing the short- and long-term complications of the disease process. Although vaccinations are available against some viruses that may trigger type 1 diabetes, vaccinations against all viruses are not available, and many other triggers exist that may cause type 1 diabetes in susceptible individuals. Nurses may refer clients to a nutritionist or exercise therapist after diagnosis, but proper nutrition or exercise will not prevent type 1 diabetes.
B)Currently, there is no known way to prevent type 1 diabetes. Therefore, prevention related to type 1 diabetes is related to preventing the short- and long-term complications of the disease process. Although vaccinations are available against some viruses that may trigger type 1 diabetes, vaccinations against all viruses are not available, and many other triggers exist that may cause type 1 diabetes in susceptible individuals. Nurses may refer clients to a nutritionist or exercise therapist after diagnosis, but proper nutrition or exercise will not prevent type 1 diabetes.
C)Currently, there is no known way to prevent type 1 diabetes. Therefore, prevention related to type 1 diabetes is related to preventing the short- and long-term complications of the disease process. Although vaccinations are available against some viruses that may trigger type 1 diabetes, vaccinations against all viruses are not available, and many other triggers exist that may cause type 1 diabetes in susceptible individuals. Nurses may refer clients to a nutritionist or exercise therapist after diagnosis, but proper nutrition or exercise will not prevent type 1 diabetes.
D)Currently, there is no known way to prevent type 1 diabetes. Therefore, prevention related to type 1 diabetes is related to preventing the short- and long-term complications of the disease process. Although vaccinations are available against some viruses that may trigger type 1 diabetes, vaccinations against all viruses are not available, and many other triggers exist that may cause type 1 diabetes in susceptible individuals. Nurses may refer clients to a nutritionist or exercise therapist after diagnosis, but proper nutrition or exercise will not prevent type 1 diabetes.

Question 13

Which potential cause of type 2 diabetes influences insulin's ability to regulate glucose metabolism and uptake by the liver,skeletal muscles,and adipose tissue?

Accepted Answer

Obesity can lead to insulin resistance, where the body's cells become less responsive to insulin's signaling to take up glucose from the bloodstream. This can eventually result in type 2 diabetes.

Question 14

The nurse is caring for a client who complains of jaundice and pruritus.The healthcare provider suspects that the client has liver disease.What modifiable risk factor for cirrhosis of the liver might the nurse see in the client's history?

Accepted Answer

Excessive alcohol consumption is a modifiable risk factor for liver disease and can lead to cirrhosis. Smoking, occupational exposure to hepatic toxins, and family history of fatty liver disease are also risk factors, but are not modifiable.

Question 15

The nurse is identifying risk factors for liver disease among individuals who visit the community health center.Which does the nurse recognize as factors contributing to increased risk among certain ethnic groups? Select all that apply.

Accepted Answer

Variations in alcohol metabolism and stress due to socioeconomic factors are known risk factors contributing to increased risk of liver disease among certain ethnic groups. Pollution, climate, and consuming alcohol with food are not specifically linked to increased risk of liver disease among ethnic groups.

Question 16

The nurse is counseling a couple who is planning a pregnancy.The woman was diagnosed with type 1 diabetes when she was 14 years old.She is now 27.Which examination should the nurse prepare the woman to have before,during,and after the pregnancy?

Accepted Answer

Diabetes can cause damage to the blood vessels in the retina, leading to diabetic retinopathy. This examination is important to assess and monitor any changes in the woman's vision during pregnancy.

Question 17

After reviewing the population demographics for an urban community,the community health nurse determines that community members would benefit from teaching on type 2 diabetes mellitus in children.What findings support this nurse's conclusion? Select all that apply.

Accepted Answer

A)The risk factors for diabetes include race, ethnicity, and family history. Type 2 diabetes mellitus rates are greater among youth ages 10 to 19 with higher rates among U.S. minority populations than in non-Hispanic Whites. Frequency of obtaining the annual flu vaccination and socioeconomic status are not risk factors for the development of type 2 diabetes in children.
B)The risk factors for diabetes include race, ethnicity, and family history. Type 2 diabetes mellitus rates are greater among youth ages 10 to 19 with higher rates among U.S. minority populations than in non-Hispanic Whites. Frequency of obtaining the annual flu vaccination and socioeconomic status are not risk factors for the development of type 2 diabetes in children.
C)The risk factors for diabetes include race, ethnicity, and family history. Type 2 diabetes mellitus rates are greater among youth ages 10 to 19 with higher rates among U.S. minority populations than in non-Hispanic Whites. Frequency of obtaining the annual flu vaccination and socioeconomic status are not risk factors for the development of type 2 diabetes in children.
D)The risk factors for diabetes include race, ethnicity, and family history. Type 2 diabetes mellitus rates are greater among youth ages 10 to 19 with higher rates among U.S. minority populations than in non-Hispanic Whites. Frequency of obtaining the annual flu vaccination and socioeconomic status are not risk factors for the development of type 2 diabetes in children.
E)The risk factors for diabetes include race, ethnicity, and family history. Type 2 diabetes mellitus rates are greater among youth ages 10 to 19 with higher rates among U.S. minority populations than in non-Hispanic Whites. Frequency of obtaining the annual flu vaccination and socioeconomic status are not risk factors for the development of type 2 diabetes in children.

Question 18

Which goal would be most appropriate to include in the nursing care plan of a client with type 2 diabetes?

Accepted Answer

A)Clients with type 2 diabetes are at high risk for foot problems related to diabetic peripheral neuropathy. Therefore, an appropriate goal for clients with type 2 diabetes includes inspecting feet at least once daily. Clients with type 2 diabetes should record carbohydrate intake, not fat intake. Although fasting glucose levels are important, postprandial blood glucose levels provide the most useful information for evaluating glycemic control in clients with type 2 diabetes. Teaching proper hand hygiene may be appropriate when teaching clients with diabetes about insulin injections, but teaching hand hygiene when toileting is not specific for clients with type 2 diabetes.
B)Clients with type 2 diabetes are at high risk for foot problems related to diabetic peripheral neuropathy. Therefore, an appropriate goal for clients with type 2 diabetes includes inspecting feet at least once daily. Clients with type 2 diabetes should record carbohydrate intake, not fat intake. Although fasting glucose levels are important, postprandial blood glucose levels provide the most useful information for evaluating glycemic control in clients with type 2 diabetes. Teaching proper hand hygiene may be appropriate when teaching clients with diabetes about insulin injections, but teaching hand hygiene when toileting is not specific for clients with type 2 diabetes.
C)Clients with type 2 diabetes are at high risk for foot problems related to diabetic peripheral neuropathy. Therefore, an appropriate goal for clients with type 2 diabetes includes inspecting feet at least once daily. Clients with type 2 diabetes should record carbohydrate intake, not fat intake. Although fasting glucose levels are important, postprandial blood glucose levels provide the most useful information for evaluating glycemic control in clients with type 2 diabetes. Teaching proper hand hygiene may be appropriate when teaching clients with diabetes about insulin injections, but teaching hand hygiene when toileting is not specific for clients with type 2 diabetes.
D)Clients with type 2 diabetes are at high risk for foot problems related to diabetic peripheral neuropathy. Therefore, an appropriate goal for clients with type 2 diabetes includes inspecting feet at least once daily. Clients with type 2 diabetes should record carbohydrate intake, not fat intake. Although fasting glucose levels are important, postprandial blood glucose levels provide the most useful information for evaluating glycemic control in clients with type 2 diabetes. Teaching proper hand hygiene may be appropriate when teaching clients with diabetes about insulin injections, but teaching hand hygiene when toileting is not specific for clients with type 2 diabetes.

Question 19

Which type of infection has been implicated in destruction of pancreatic beta cells and thus causes type 1 diabetes?

Accepted Answer

Viral infections, particularly Coxsackie B virus and enterovirus, have been shown to cause destruction of pancreatic beta cells, leading to type 1 diabetes.

Question 20

The nurse,teaching a class to a group of community members about the importance of weight loss in decreasing the risk of type 2 diabetes mellitus,is asked why weight loss reduces the risk associated with the development of this health problem.Which response by the nurse is most appropriate?

Accepted Answer

Excess body weight is associated with increased insulin resistance leading to impaired insulin release, which is a major risk factor for the development of type 2 diabetes mellitus. Therefore, weight loss can decrease this risk by improving the body's ability to release insulin.

Quiz 12: Metabolism