Question 1

The nurse is providing care for a marathon runner who is recently diagnosed with DM. Which explanation regarding exercise is best for the nurse to provide?

Accepted Answer

Carrying emergency glucose is important for managing potential hypoglycemia during exercise.

Question 2

The nurse is monitoring laboratory BG levels for a patient diagnosed with type 2 DM. Which test result does the nurse use to evaluate the patient's compliance with treatment?

Accepted Answer

Glycohemoglobin testing (such as HbA1c) provides an average blood glucose level over the past 2 to 3 months, making it a useful measure for evaluating a patient's compliance with treatment over time.

Question 3

A patient is admitted to the hospital with hyperosmolar hyperglycemia. The patient is 40 percent overweight and has a BG value of 987 mg/dL. Which is the priority focus while planning nursing care for this patient?

Accepted Answer

The priority focus for a patient with hyperosmolar hyperglycemia is hydration status, as these patients are at high risk for severe dehydration due to osmotic diuresis.

Question 4

The nurse is evaluating the knowledge of a patient recently diagnosed with type 1 DM. Which statement by the patient indicates a need for additional information?

Accepted Answer

Type 1 diabetes mellitus (DM) is primarily caused by an autoimmune destruction of insulin-producing beta cells in the pancreas, not by obesity or lifestyle factors. Weight loss is more commonly associated with the management of type 2 diabetes, where insulin resistance is a key feature and can be improved with weight loss.

Question 5

The nurse is preparing a patient with type 2 DM for surgery. The patient expresses concern about the use of insulin at this time. Which reason does the nurse understand that insulin therapy is appropriate in regard to surgery?

Accepted Answer

Surgery acts as a physical stressor on the body, leading to an increase in counter-regulatory hormones such as cortisol, glucagon, and epinephrine. These hormones work against insulin, leading to elevated blood glucose (BG) levels. Insulin therapy helps manage this stress-induced hyperglycemia.

Question 6

The nurse is providing information to a patient recently diagnosed with type 2 DM. The health care provider (HCP) prescribes an oral hypoglycemic medication for BG control. Which information is the best comparison the nurse can give the patient between insulin and an oral hypoglycemic?

Accepted Answer

Oral hypoglycemic agents work by stimulating the pancreas to produce more insulin, which is beneficial for patients with type 2 diabetes who still have some pancreatic function. Unlike insulin, which is a replacement therapy, oral agents enhance the body's existing capacity to manage blood glucose.

Question 7

A patient with type 1 diabetes has frequent episodes of hypoglycemia, even with multiple daily BG self-monitoring throughout the day. Which method of self-monitoring does the nurse recognize as being more effective for this patient?

Accepted Answer

Continuous glucose monitoring (CGM) provides real-time, dynamic glucose information, allowing for more effective management of glucose levels and reduction of hypoglycemia risk, especially in type 1 diabetes patients who experience frequent fluctuations.

Question 8

A patient with type 1 DM expresses concern about developing retinopathy due to a chronic disease. Which information does the nurse provide to give the patient the best reassurance?

Accepted Answer

Good control of blood glucose (BG) and blood pressure can significantly reduce the risk of developing retinopathy in patients with diabetes. This approach focuses on prevention and management of the underlying condition to avoid complications such as retinopathy.

Question 9

A patient with diabetes has peripheral neuropathy. What should the nurse do to prevent related complications?

Accepted Answer

Inspecting feet daily helps in early detection of injuries or infections, which is crucial for preventing complications in diabetic patients with peripheral neuropathy.

Question 10

The nurse is researching the current information available regarding the long-term complications for patients diagnosed with diabetes. Which finding is accurate?

Accepted Answer

Diabetes complications often involve damage to both large (macrovascular) and small (microvascular) blood vessels, leading to issues such as cardiovascular disease and neuropathy.

Question 11

The nurse is providing care for a patient with type 2 DM who has been treated with an oral hypoglycemic agent. The HCP prescribes for the addition of insulin. Which situation does the nurse recognize as being the least valid reason for giving this patient insulin?

Accepted Answer

The least valid reason for adding insulin to a patient's treatment regimen who is already on oral hypoglycemic agents is because the patient is unable to effectively follow a diabetic diet. Insulin therapy is typically added to address physiological issues related to insulin production or action, not dietary non-compliance.

Question 12

The nurse is providing care for a patient with diabetes who experiences frequent periods of hyperglycemia. Which comment by the patient is indicative to the nurse of a major cause of this BG imbalance?

Accepted Answer

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Question 13

The nurse is planning to review information with a patient diagnosed with diabetes. Which information does the nurse include regarding an increased risk for and treatment of infection?

Accepted Answer

Diabetes can lead to poor circulation, which impairs the body's ability to heal wounds and fight infections effectively.

Question 14

A patient being treated with rosiglitazone for type 2 DM is receiving a routine follow-up assessment. In addition to HbA1c and a fasting plasma glucose test, which other laboratory test should the nurse expect to be monitored in this patient?

Accepted Answer

Rosiglitazone can cause liver toxicity, so liver function tests should be monitored regularly.

Question 15

The nurse is assisting with nutrition teaching for a patient who voices concern over coping with a diabetic diet. Which response by the nurse about medical nutrition therapy is correct?

Accepted Answer

Medical nutrition therapy for diabetes involves creating a well-balanced, individualized meal plan that can be healthy for the entire family, not just the person with diabetes. This approach promotes overall health and can be adapted to fit the nutritional needs of each family member, making it a practical and inclusive strategy for managing diabetes.

Question 16

The nurse is collecting data on a new patient in a HCP's office. Data includes the following: 65-year-old male, abdominal obesity with waist circumference of 42 inches, blood pressure 140/88 mm Hg, and fasting glucose of 120 mg/dL. Which health concerns by the HCP is least expected?

Accepted Answer

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Question 17

The nurse is discussing the management of an older adult client recently diagnosed with type 2 DM. Which information is least helpful?

Accepted Answer

The answer of The nurse is discussing the management of...

Question 18

The nurse is reinforcing teaching for a patient who is on four injections of regular insulin daily. About how many hours after each injection of insulin does the nurse teach the patient to be alert for symptoms of hypoglycemia? 1.1/2 hour

Accepted Answer

Regular insulin typically starts to lower blood glucose within 30 minutes of injection, peaks in 2 to 3 hours, and keeps working for up to 6 hours. Therefore, patients should be alert for symptoms of hypoglycemia, especially around 3 hours after injection when the insulin's action is peaking.

Question 19

A female patient is prescribed glyburide for control of BG. What precaution does the nurse teach the patient about this medication?

Accepted Answer

Glyburide can cause a disulfiram-like reaction with alcohol, so patients are advised to avoid alcohol consumption while taking this medication.

Question 20

The nurse is providing information to a patient recently diagnosed with type 1 diabetes mellitus (DM). The patient expresses a desire to understand the disease. Which information provided by the nurse is accurate?

Accepted Answer

Type 1 diabetes involves the destruction of insulin-producing beta cells in the pancreas, leading to insufficient insulin. Insulin facilitates glucose entry into cells by activating glucose transporters in the cell membrane.

Quiz 40: Nursing Care of Patients With Disorders of the Endocrine Pancreas