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?

Accepted Answer

The normal range for blood glucose levels in a client with diabetes is 80-130 mg/dL before meals. A level of 145 mg/dL is outside of this range and may require adjustment of the client's medication regimen. The other options are within the normal range and would not require notification of the physician.

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?

Accepted Answer

During exercise, foods with a high glycemic index (such as 85) are recommended because they are quickly digested and absorbed, providing a rapid source of energy which is beneficial for sustaining activity levels.

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?

Accepted Answer

Leptin is a hormone involved in regulating energy balance and body weight. A lack of response to leptin can lead to increased appetite and weight gain, which is relevant for a client with diabetes and hyperlipidemia.

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?

Accepted Answer

Glycosylated hemoglobin, also known as hemoglobin A1c (HbA1c), measures the average blood glucose level over the past 2-3 months. An HbA1c level of 6.5% or lower is considered well-controlled, indicating that the client's blood glucose level has been within the target range. HbA1c levels between 7% and 8% indicate that the client's blood glucose level has been above the target range and may require medication adjustment or lifestyle changes. HbA1c levels above 8% indicate poor blood glucose control and possible complications.

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?

Accepted Answer

Metformin is a biguanide oral antidiabetic agent that works by increasing insulin sensitivity in the tissues, meaning that the tissues are better able to use the available insulin to take up glucose from the bloodstream. The other options (Glyburide, Repaglinide, and Glipizide) are sulfonylureas, which work by stimulating the pancreas to release more insulin. While this can be helpful in some cases, it does not address the issue of insulin resistance in the tissues, which is often a key factor in the development of type 2 diabetes.

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?

Accepted Answer

Accuracy of the dosage is most important for the nurse to keep in mind when administering insulin to a client with type 1 diabetes. This is because the dosage of insulin must be precise in order to effectively control blood sugar levels.

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?

Accepted Answer

Type 2 diabetes is characterized by insulin resistance and/or insufficient insulin production. It is commonly seen in adults and is often associated with lifestyle factors such as obesity and physical inactivity. It is more common than type 1 diabetes and is often preceded by 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?

Accepted Answer

Insulin primarily enhances transport of glucose across the cell wall, which allows glucose to enter the cells and be used for energy.

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?

Accepted Answer

A magnifier would be most helpful to the client who is having difficulty drawing up the correct dosage of insulin in the syringe because it would allow the client to see the markings on the syringe more clearly.

Question 10

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

Accepted Answer

Insulin lispro is a rapid-acting insulin that starts to work within 15 minutes, so the client should eat breakfast by 7:35 AM to prevent hypoglycemia.

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?

Accepted Answer

Monitoring carbohydrate intake is crucial for managing diabetes, as it directly affects blood sugar levels.

Question 12

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

Accepted Answer

Moisturizing the feet daily helps to prevent dry skin and cracks, which can be entry points for infection in individuals with diabetes. Hot water can cause burns due to neuropathy, razors can cause cuts and infections, and rubber shoes can cause sweating and are not breathable, leading to potential foot problems.

Question 13

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

Accepted Answer

Regular insulin is the only type of insulin that can be given intravenously. It has a rapid onset of action and a short duration of action, making it effective at rapidly lowering blood glucose levels in patients with DKA. Glargine, NPH, and Lente are all long-acting insulins that are not suitable for intravenous administration.

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?

Accepted Answer

Diabetic ketoacidosis occurs when there is a lack of insulin in the body. This can happen when a person with diabetes does not take their insulin medication or when there is not enough insulin being produced by the body. In this scenario, the client has eaten but has not taken or received insulin, which is the most likely cause for their DKA.

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?

Accepted Answer

The abdomen is the preferred site for insulin injections as it has the fastest absorption rate and is the easiest site for clients to self-administer. The arms and thighs may have a slower absorption rate, and the upper buttock is not recommended due to the risk of injecting into a muscle.

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?

Accepted Answer

Type 2 diabetes is primarily characterized by insulin resistance, not a lack of insulin production, which is why a pancreatic transplant is not typically a solution.

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?

Accepted Answer

DKA (Diabetic Ketoacidosis) is characterized by metabolic acidosis, which results in a low blood pH, typically below 7.3. A blood pH of 6.9 indicates severe acidosis, which is expected in DKA.

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?

Accepted Answer

Controlling blood glucose levels is the most important factor in preventing diabetic nephropathy as it helps to decrease damage to the kidneys caused by high blood sugar levels over time. While the other three options may also be important for overall management of diabetes, they are not as crucial to preventing nephropathy specifically.

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?

Accepted Answer

Option D is the correct answer because it indicates that the client understands that the transplant may not cure their diabetes entirely but may reduce the amount of insulin needed. The other options indicate a misunderstanding of the transplant procedure or expectations.

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?

Accepted Answer

The priority action in a client who is comatose and hypoglycemic is to administer glucose to rapidly restore blood sugar levels. Administering 50% glucose intravenously provides the fastest route for absorption and is the appropriate immediate action. Infusing 1000 mL of D W over a 12-hour period would be too slow, checking for the presence of sugar and acetone in the urine does not address the immediate need to raise blood sugar levels, and encouraging the client to drink orange juice with added sugar may be too slow and not effective if the client is comatose.

Quiz 51: Caring for Clients With Diabetes Mellitus