Question 1

What collaborative interventions are likely to improve outcomes for an 11-year-old client diagnosed with type 2 diabetes mellitus? Select all that apply.
A)Weaning off oral medications
B)Food intake based on age, sex, and physical activity
C)Obtaining adequate rest and sleep
D)Physical activity to be at least 30 to 60 minutes per day most days of the week
E)Family participation in the lifestyle change

Accepted Answer

A)The child with type 2 diabetes mellitus will most likely be treated with oral hypoglycemic agents. Weaning off of these medications will not improve the client's long-term prognosis. The child with type 2 diabetes mellitus does not have a need for adequate rest and sleep to improve the long-term prognosis. Plans to improve the client's long-term prognosis should focus on food intake that is based on the client's age, sex, and physical activity, obtaining the required physical activity that is recommended for most days of the week, and family support to comply with lifestyle changes that the client needs.
B)The child with type 2 diabetes mellitus will most likely be treated with oral hypoglycemic agents. Weaning off of these medications will not improve the client's long-term prognosis. The child with type 2 diabetes mellitus does not have a need for adequate rest and sleep to improve the long-term prognosis. Plans to improve the client's long-term prognosis should focus on food intake that is based on the client's age, sex, and physical activity, obtaining the required physical activity that is recommended for most days of the week, and family support to comply with lifestyle changes that the client needs.
C)The child with type 2 diabetes mellitus will most likely be treated with oral hypoglycemic agents. Weaning off of these medications will not improve the client's long-term prognosis. The child with type 2 diabetes mellitus does not have a need for adequate rest and sleep to improve the long-term prognosis. Plans to improve the client's long-term prognosis should focus on food intake that is based on the client's age, sex, and physical activity, obtaining the required physical activity that is recommended for most days of the week, and family support to comply with lifestyle changes that the client needs.
D)The child with type 2 diabetes mellitus will most likely be treated with oral hypoglycemic agents. Weaning off of these medications will not improve the client's long-term prognosis. The child with type 2 diabetes mellitus does not have a need for adequate rest and sleep to improve the long-term prognosis. Plans to improve the client's long-term prognosis should focus on food intake that is based on the client's age, sex, and physical activity, obtaining the required physical activity that is recommended for most days of the week, and family support to comply with lifestyle changes that the client needs.
E)The child with type 2 diabetes mellitus will most likely be treated with oral hypoglycemic agents. Weaning off of these medications will not improve the client's long-term prognosis. The child with type 2 diabetes mellitus does not have a need for adequate rest and sleep to improve the long-term prognosis. Plans to improve the client's long-term prognosis should focus on food intake that is based on the client's age, sex, and physical activity, obtaining the required physical activity that is recommended for most days of the week, and family support to comply with lifestyle changes that the client needs.

Question 2

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?
A)Viral infection
B)Exposure to toxins
C)Young age
D)Obesity

Accepted Answer

A)In obesity, insulin has a decreased ability to influence glucose metabolism and uptake by the liver, skeletal muscles, and adipose tissue. Viral infections and chemical toxins are known triggers for type 1 diabetes, not type 2 diabetes. Older age, not young age, can increase cellular resistance to the effects of insulin and increase the risk of developing type 2 diabetes.
B)In obesity, insulin has a decreased ability to influence glucose metabolism and uptake by the liver, skeletal muscles, and adipose tissue. Viral infections and chemical toxins are known triggers for type 1 diabetes, not type 2 diabetes. Older age, not young age, can increase cellular resistance to the effects of insulin and increase the risk of developing type 2 diabetes.
C)In obesity, insulin has a decreased ability to influence glucose metabolism and uptake by the liver, skeletal muscles, and adipose tissue. Viral infections and chemical toxins are known triggers for type 1 diabetes, not type 2 diabetes. Older age, not young age, can increase cellular resistance to the effects of insulin and increase the risk of developing type 2 diabetes.
D)In obesity, insulin has a decreased ability to influence glucose metabolism and uptake by the liver, skeletal muscles, and adipose tissue. Viral infections and chemical toxins are known triggers for type 1 diabetes, not type 2 diabetes. Older age, not young age, can increase cellular resistance to the effects of insulin and increase the risk of developing type 2 diabetes.

Question 3

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?
A)Muscle wasting
B)Hypothermia
C)Bleeding gums
D)Hemorrhoids

Accepted Answer

A)Obstruction to portal blood flow causes a rise in portal venous pressure, resulting in splenomegaly, ascites, and engorgement of veins in the esophagus, rectum, and abdomen. Bleeding gums indicate insufficient vitamin K production in the liver. Muscle wasting is commonly associated with the poor nutritional intake seen in clients with cirrhosis. Hypothermia is an unrelated finding.
B)Obstruction to portal blood flow causes a rise in portal venous pressure, resulting in splenomegaly, ascites, and engorgement of veins in the esophagus, rectum, and abdomen. Bleeding gums indicate insufficient vitamin K production in the liver. Muscle wasting is commonly associated with the poor nutritional intake seen in clients with cirrhosis. Hypothermia is an unrelated finding.
C)Obstruction to portal blood flow causes a rise in portal venous pressure, resulting in splenomegaly, ascites, and engorgement of veins in the esophagus, rectum, and abdomen. Bleeding gums indicate insufficient vitamin K production in the liver. Muscle wasting is commonly associated with the poor nutritional intake seen in clients with cirrhosis. Hypothermia is an unrelated finding.
D)Obstruction to portal blood flow causes a rise in portal venous pressure, resulting in splenomegaly, ascites, and engorgement of veins in the esophagus, rectum, and abdomen. Bleeding gums indicate insufficient vitamin K production in the liver. Muscle wasting is commonly associated with the poor nutritional intake seen in clients with cirrhosis. Hypothermia is an unrelated finding.

Question 4

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?
A)"I'm slightly winded when I walk up a flight of stairs, but it passes quickly."
B)"I feel a bit tired by mid-afternoon and take a 30-minute nap most days."
C)"I sometimes have muscle aches in my upper legs at night."
D)"I've been experiencing increased thirst during the past several months."

Accepted Answer

A)Excessive thirst can be associated with high glucose levels and may be a symptom of undiagnosed diabetes mellitus. Fatigue that responds to a short nap, having some muscle aches at night, and being slightly short of breath after walking up a flight of stairs with a quick recovery may be within the normal functioning of a healthy older client.
B)Excessive thirst can be associated with high glucose levels and may be a symptom of undiagnosed diabetes mellitus. Fatigue that responds to a short nap, having some muscle aches at night, and being slightly short of breath after walking up a flight of stairs with a quick recovery may be within the normal functioning of a healthy older client.
C)Excessive thirst can be associated with high glucose levels and may be a symptom of undiagnosed diabetes mellitus. Fatigue that responds to a short nap, having some muscle aches at night, and being slightly short of breath after walking up a flight of stairs with a quick recovery may be within the normal functioning of a healthy older client.
D)Excessive thirst can be associated with high glucose levels and may be a symptom of undiagnosed diabetes mellitus. Fatigue that responds to a short nap, having some muscle aches at night, and being slightly short of breath after walking up a flight of stairs with a quick recovery may be within the normal functioning of a healthy older client.

Question 5

Health promotion and prevention related to type 1 diabetes should include
A)teaching clients at high risk how to prevent type 1 diabetes.
B)teaching clients with type 1 diabetes how to prevent complications.
C)providing clients with vaccinations against viruses that cause type 1 diabetes.
D)referring clients to a nutritionist and exercise therapist.

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 6

Which goal would be most appropriate to include in the nursing care plan of a client with type 2 diabetes?
A)The client will record daily fat intake.
B)The client will use hand hygiene when toileting.
C)The client will monitor fasting glucose levels.
D)The client will inspect feet at least once daily.

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 7

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?
A)Increased abdominal girth
B)Gallbladder pain
C)Yellow-tinged skin
D)Bleeding and bruising easily

Accepted Answer

A)Ascites is the accumulation of the fluid in the abdomen and is a result of liver failure. The client with ascites would have an increased abdominal girth. Jaundice is manifested as yellow-tinged skin and is the result of hepatic disorders. The client experiencing hepatic problems might have bleeding and bruising issues due to inadequate vitamin K. Obstructed biliary flow could be the cause of gallbladder pain.
B)Ascites is the accumulation of the fluid in the abdomen and is a result of liver failure. The client with ascites would have an increased abdominal girth. Jaundice is manifested as yellow-tinged skin and is the result of hepatic disorders. The client experiencing hepatic problems might have bleeding and bruising issues due to inadequate vitamin K. Obstructed biliary flow could be the cause of gallbladder pain.
C)Ascites is the accumulation of the fluid in the abdomen and is a result of liver failure. The client with ascites would have an increased abdominal girth. Jaundice is manifested as yellow-tinged skin and is the result of hepatic disorders. The client experiencing hepatic problems might have bleeding and bruising issues due to inadequate vitamin K. Obstructed biliary flow could be the cause of gallbladder pain.
D)Ascites is the accumulation of the fluid in the abdomen and is a result of liver failure. The client with ascites would have an increased abdominal girth. Jaundice is manifested as yellow-tinged skin and is the result of hepatic disorders. The client experiencing hepatic problems might have bleeding and bruising issues due to inadequate vitamin K. Obstructed biliary flow could be the cause of gallbladder pain.

Question 8

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)?
A)Excessive sweating
B)Increased urine output
C)Insomnia
D)Edema

Accepted Answer

A)Older adults with type 2 diabetes who have undergone a major surgery are at high risk for developing hyperosmolar hyperglycemic state (HHS). Symptoms of HHS include greatly elevated blood glucose levels, high plasma osmolarity, and altered level of consciousness. Other symptoms include increased urine output, dry skin and mucous membranes (not excessive sweating), extreme thirst, and lethargy (not insomnia). HHS leads to dehydration and fluid loss, not edema.
B)Older adults with type 2 diabetes who have undergone a major surgery are at high risk for developing hyperosmolar hyperglycemic state (HHS). Symptoms of HHS include greatly elevated blood glucose levels, high plasma osmolarity, and altered level of consciousness. Other symptoms include increased urine output, dry skin and mucous membranes (not excessive sweating), extreme thirst, and lethargy (not insomnia). HHS leads to dehydration and fluid loss, not edema.
C)Older adults with type 2 diabetes who have undergone a major surgery are at high risk for developing hyperosmolar hyperglycemic state (HHS). Symptoms of HHS include greatly elevated blood glucose levels, high plasma osmolarity, and altered level of consciousness. Other symptoms include increased urine output, dry skin and mucous membranes (not excessive sweating), extreme thirst, and lethargy (not insomnia). HHS leads to dehydration and fluid loss, not edema.
D)Older adults with type 2 diabetes who have undergone a major surgery are at high risk for developing hyperosmolar hyperglycemic state (HHS). Symptoms of HHS include greatly elevated blood glucose levels, high plasma osmolarity, and altered level of consciousness. Other symptoms include increased urine output, dry skin and mucous membranes (not excessive sweating), extreme thirst, and lethargy (not insomnia). HHS leads to dehydration and fluid loss, not edema.

Question 9

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?
A)"Excess body weight impairs the body's release of insulin."
B)"The amount of food taken in by those who are overweight requires more insulin to adequately metabolize, resulting in diabetes."
C)"The physical inactivity associated with obesity causes a reduced ability by the body to produce insulin."
D)"Thin people are less likely to become diabetic."

Accepted Answer

A)Beta cells of the body release insulin. Their actions are hindered as the amount of adipose tissue in the body increases. The amount of food taken in is not the issue as much as the excess body weight. The body does require more insulin with a greater food intake, but that does not necessarily result in diabetes. While obesity is a risk factor for the development of diabetes, this does not meet the question posed by the client. Inactivity is directly linked to obesity, but it does not present a direct tie to the production of insulin.
B)Beta cells of the body release insulin. Their actions are hindered as the amount of adipose tissue in the body increases. The amount of food taken in is not the issue as much as the excess body weight. The body does require more insulin with a greater food intake, but that does not necessarily result in diabetes. While obesity is a risk factor for the development of diabetes, this does not meet the question posed by the client. Inactivity is directly linked to obesity, but it does not present a direct tie to the production of insulin.
C)Beta cells of the body release insulin. Their actions are hindered as the amount of adipose tissue in the body increases. The amount of food taken in is not the issue as much as the excess body weight. The body does require more insulin with a greater food intake, but that does not necessarily result in diabetes. While obesity is a risk factor for the development of diabetes, this does not meet the question posed by the client. Inactivity is directly linked to obesity, but it does not present a direct tie to the production of insulin.
D)Beta cells of the body release insulin. Their actions are hindered as the amount of adipose tissue in the body increases. The amount of food taken in is not the issue as much as the excess body weight. The body does require more insulin with a greater food intake, but that does not necessarily result in diabetes. While obesity is a risk factor for the development of diabetes, this does not meet the question posed by the client. Inactivity is directly linked to obesity, but it does not present a direct tie to the production of insulin.

Question 10

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.
A)Pollution
B)Variations in alcohol metabolism
C)Stress due to socioeconomic factors
D)Consuming alcohol with food
E)Climate

Accepted Answer

A)Alcohol consumption is a leading cause of death for several ethnic populations. It is thought that contributing factors include variations in alcohol metabolism, socioeconomic factors that lead to stress, and consuming alcohol without food. Climate and pollution are not factors.
B)Alcohol consumption is a leading cause of death for several ethnic populations. It is thought that contributing factors include variations in alcohol metabolism, socioeconomic factors that lead to stress, and consuming alcohol without food. Climate and pollution are not factors.
C)Alcohol consumption is a leading cause of death for several ethnic populations. It is thought that contributing factors include variations in alcohol metabolism, socioeconomic factors that lead to stress, and consuming alcohol without food. Climate and pollution are not factors.
D)Alcohol consumption is a leading cause of death for several ethnic populations. It is thought that contributing factors include variations in alcohol metabolism, socioeconomic factors that lead to stress, and consuming alcohol without food. Climate and pollution are not factors.
E)Alcohol consumption is a leading cause of death for several ethnic populations. It is thought that contributing factors include variations in alcohol metabolism, socioeconomic factors that lead to stress, and consuming alcohol without food. Climate and pollution are not factors.

Question 11

Which type of infection has been implicated in destruction of pancreatic beta cells and thus causes type 1 diabetes?
A)Fungal
B)Parasitic
C)Viral
D)Bacterial

Accepted Answer

A)Triggers for the development of type 1 diabetes include genetic predisposition, environmental factors, viral infections, or chemical toxins. Fungal, parasitic, and bacterial infections have not been linked to the development of type 1 diabetes.
B)Triggers for the development of type 1 diabetes include genetic predisposition, environmental factors, viral infections, or chemical toxins. Fungal, parasitic, and bacterial infections have not been linked to the development of type 1 diabetes.
C)Triggers for the development of type 1 diabetes include genetic predisposition, environmental factors, viral infections, or chemical toxins. Fungal, parasitic, and bacterial infections have not been linked to the development of type 1 diabetes.
D)Triggers for the development of type 1 diabetes include genetic predisposition, environmental factors, viral infections, or chemical toxins. Fungal, parasitic, and bacterial infections have not been linked to the development of type 1 diabetes.

Question 12

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?
A)Gastrointestinal examination for gastric hypotony
B)Neural examination for diabetic peripheral neuropathy
C)Eye examination for diabetic retinopathy
D)Renal examination for urinary incontinence

Accepted Answer

A)Pregnant women with type 1 diabetes are at an increased risk for diabetic retinopathy. Women with type 1 diabetes who are planning a pregnancy should have eye examinations before the pregnancy, during each trimester, and for 1 year postpartum. Older adults, not pregnant women, are at increased risk for gastric hypotony and urinary incontinence related to type 1 diabetes. Pregnant women with type 1 diabetes are not at increased risk for diabetic peripheral neuropathy compared to other clients with type 1 diabetes.
B)Pregnant women with type 1 diabetes are at an increased risk for diabetic retinopathy. Women with type 1 diabetes who are planning a pregnancy should have eye examinations before the pregnancy, during each trimester, and for 1 year postpartum. Older adults, not pregnant women, are at increased risk for gastric hypotony and urinary incontinence related to type 1 diabetes. Pregnant women with type 1 diabetes are not at increased risk for diabetic peripheral neuropathy compared to other clients with type 1 diabetes.
C)Pregnant women with type 1 diabetes are at an increased risk for diabetic retinopathy. Women with type 1 diabetes who are planning a pregnancy should have eye examinations before the pregnancy, during each trimester, and for 1 year postpartum. Older adults, not pregnant women, are at increased risk for gastric hypotony and urinary incontinence related to type 1 diabetes. Pregnant women with type 1 diabetes are not at increased risk for diabetic peripheral neuropathy compared to other clients with type 1 diabetes.
D)Pregnant women with type 1 diabetes are at an increased risk for diabetic retinopathy. Women with type 1 diabetes who are planning a pregnancy should have eye examinations before the pregnancy, during each trimester, and for 1 year postpartum. Older adults, not pregnant women, are at increased risk for gastric hypotony and urinary incontinence related to type 1 diabetes. Pregnant women with type 1 diabetes are not at increased risk for diabetic peripheral neuropathy compared to other clients with type 1 diabetes.

Question 13

The nurse is planning care for a client with type 2 diabetes mellitus. Which nursing diagnosis would be most appropriate for this client?
A)Self Neglect
B)Risk for Infection
C)Risk for Decreased Cardiac Tissue Perfusion
D)Impaired Tissue Integrity

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 14

Which test is commonly used to screen for type 2 diabetes in the general population?
A)Fasting plasma glucose
B)Oral glucose tolerance test
C)Urine ketone levels
D)Serum cholesterol levels

Accepted Answer

A)Tests used to screen for type 2 diabetes in the general population include fasting plasma glucose and glycated hemoglobin (A1C). Oral glucose tolerance tests are primary used for screening for gestational diabetes in pregnant women, although they can also be used for clients with suspected diabetes. Urine ketone levels and serum cholesterol levels are not used for screening. Urine ketone levels are used primarily to monitor clients with type 1 diabetes. Serum cholesterol levels are measured to assess the risk for cardiovascular disease, which may or may not be related to diabetes.
B)Tests used to screen for type 2 diabetes in the general population include fasting plasma glucose and glycated hemoglobin (A1C). Oral glucose tolerance tests are primary used for screening for gestational diabetes in pregnant women, although they can also be used for clients with suspected diabetes. Urine ketone levels and serum cholesterol levels are not used for screening. Urine ketone levels are used primarily to monitor clients with type 1 diabetes. Serum cholesterol levels are measured to assess the risk for cardiovascular disease, which may or may not be related to diabetes.
C)Tests used to screen for type 2 diabetes in the general population include fasting plasma glucose and glycated hemoglobin (A1C). Oral glucose tolerance tests are primary used for screening for gestational diabetes in pregnant women, although they can also be used for clients with suspected diabetes. Urine ketone levels and serum cholesterol levels are not used for screening. Urine ketone levels are used primarily to monitor clients with type 1 diabetes. Serum cholesterol levels are measured to assess the risk for cardiovascular disease, which may or may not be related to diabetes.
D)Tests used to screen for type 2 diabetes in the general population include fasting plasma glucose and glycated hemoglobin (A1C). Oral glucose tolerance tests are primary used for screening for gestational diabetes in pregnant women, although they can also be used for clients with suspected diabetes. Urine ketone levels and serum cholesterol levels are not used for screening. Urine ketone levels are used primarily to monitor clients with type 1 diabetes. Serum cholesterol levels are measured to assess the risk for cardiovascular disease, which may or may not be related to diabetes.

Question 15

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.
A)60% of community families have both parents diagnosed with type 2 diabetes mellitus.
B)35% of school-age children do not routinely receive the annual flu vaccination.
C)50% of children between the ages of 10 and 19 are African American.
D)25% of children between the ages of 10 and 19 are Hispanic.
E)75% of school-age children are raised in families where both parents are unemployed.

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 16

Type 2 diabetes mellitus is characterized by which underlying pathophysiology?
A)Excessive insulin production
B)Insulin resistance
C)Inability of the pancreas to produce insulin
D)Impaired insulin uptake

Accepted Answer

A)Type 2 diabetes occurs despite the availability of endogenous insulin, because insulin's functioning is impaired by insulin resistance. The level of insulin produced in type 2 diabetes varies; production could be increased or decreased, depending on the client. The pancreas is able to produce insulin, but the insulin cannot work properly due to insulin resistance. Glucose uptake, not insulin uptake, is impaired in type 2 diabetes.
B)Type 2 diabetes occurs despite the availability of endogenous insulin, because insulin's functioning is impaired by insulin resistance. The level of insulin produced in type 2 diabetes varies; production could be increased or decreased, depending on the client. The pancreas is able to produce insulin, but the insulin cannot work properly due to insulin resistance. Glucose uptake, not insulin uptake, is impaired in type 2 diabetes.
C)Type 2 diabetes occurs despite the availability of endogenous insulin, because insulin's functioning is impaired by insulin resistance. The level of insulin produced in type 2 diabetes varies; production could be increased or decreased, depending on the client. The pancreas is able to produce insulin, but the insulin cannot work properly due to insulin resistance. Glucose uptake, not insulin uptake, is impaired in type 2 diabetes.
D)Type 2 diabetes occurs despite the availability of endogenous insulin, because insulin's functioning is impaired by insulin resistance. The level of insulin produced in type 2 diabetes varies; production could be increased or decreased, depending on the client. The pancreas is able to produce insulin, but the insulin cannot work properly due to insulin resistance. Glucose uptake, not insulin uptake, is impaired in type 2 diabetes.

Question 17

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?
A)Excess Fluid Volume
B)Ineffective Peripheral Tissue Perfusion
C)Deficient Fluid Volume
D)Impaired Skin Integrity

Accepted Answer

A)The client experiencing ascites, edema, and oliguria should have a care plan for fluid volume excess. Hypotension and dry mucous membranes are associated with deficient fluid volume. Ineffective Tissue Perfusion would be the appropriate diagnosis for a client experiencing cyanosis or tissue necrosis. Edema can cause an alteration in skin integrity, but there is no evidence of such problems with this client.
B)The client experiencing ascites, edema, and oliguria should have a care plan for fluid volume excess. Hypotension and dry mucous membranes are associated with deficient fluid volume. Ineffective Tissue Perfusion would be the appropriate diagnosis for a client experiencing cyanosis or tissue necrosis. Edema can cause an alteration in skin integrity, but there is no evidence of such problems with this client.
C)The client experiencing ascites, edema, and oliguria should have a care plan for fluid volume excess. Hypotension and dry mucous membranes are associated with deficient fluid volume. Ineffective Tissue Perfusion would be the appropriate diagnosis for a client experiencing cyanosis or tissue necrosis. Edema can cause an alteration in skin integrity, but there is no evidence of such problems with this client.
D)The client experiencing ascites, edema, and oliguria should have a care plan for fluid volume excess. Hypotension and dry mucous membranes are associated with deficient fluid volume. Ineffective Tissue Perfusion would be the appropriate diagnosis for a client experiencing cyanosis or tissue necrosis. Edema can cause an alteration in skin integrity, but there is no evidence of such problems with this client.

Question 18

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?
A)Moist membranes of the mouth
B)Normal serum bilirubin levels
C)Ability to move the legs
D)Normal pupil reaction

Accepted Answer

A)An indication for liver transplant is increasing bilirubin levels. Normal bilirubin levels after surgery would indicate that the transplanted liver is functioning correctly. Normal pupil reaction, leg movement, and moist mouth membranes are all normal findings for any postoperative client.
B)An indication for liver transplant is increasing bilirubin levels. Normal bilirubin levels after surgery would indicate that the transplanted liver is functioning correctly. Normal pupil reaction, leg movement, and moist mouth membranes are all normal findings for any postoperative client.
C)An indication for liver transplant is increasing bilirubin levels. Normal bilirubin levels after surgery would indicate that the transplanted liver is functioning correctly. Normal pupil reaction, leg movement, and moist mouth membranes are all normal findings for any postoperative client.
D)An indication for liver transplant is increasing bilirubin levels. Normal bilirubin levels after surgery would indicate that the transplanted liver is functioning correctly. Normal pupil reaction, leg movement, and moist mouth membranes are all normal findings for any postoperative client.

Question 19

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?
A)Elevated blood lipid levels
B)Hyperglycemia
C)Pancreatitis
D)Renal insufficiency

Accepted Answer

A)A potential side effect of sitagliptin (Januvia)is pancreatitis, and the client must be monitored for this. Sitagliptin (Januvia)does not cause elevated blood lipids, hyperglycemia, or renal insufficiency.
B)A potential side effect of sitagliptin (Januvia)is pancreatitis, and the client must be monitored for this. Sitagliptin (Januvia)does not cause elevated blood lipids, hyperglycemia, or renal insufficiency.
C)A potential side effect of sitagliptin (Januvia)is pancreatitis, and the client must be monitored for this. Sitagliptin (Januvia)does not cause elevated blood lipids, hyperglycemia, or renal insufficiency.
D)A potential side effect of sitagliptin (Januvia)is pancreatitis, and the client must be monitored for this. Sitagliptin (Januvia)does not cause elevated blood lipids, hyperglycemia, or renal insufficiency.

Question 20

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?
A)Smokes two packs of cigarettes per day
B)Drinks a six-pack of beer each evening
C)History of occupational exposure to hepatic toxins
D)Family history of fatty liver disease

Accepted Answer

A)Risk factors for the development of cirrhosis of the liver include excessive alcohol intake. Smoking is a risk factor for lung disease. A family history of fatty liver disease and past history of exposure to hepatic toxins may contribute to the risk of liver disease, but they are not modifiable risk factors.
B)Risk factors for the development of cirrhosis of the liver include excessive alcohol intake. Smoking is a risk factor for lung disease. A family history of fatty liver disease and past history of exposure to hepatic toxins may contribute to the risk of liver disease, but they are not modifiable risk factors.
C)Risk factors for the development of cirrhosis of the liver include excessive alcohol intake. Smoking is a risk factor for lung disease. A family history of fatty liver disease and past history of exposure to hepatic toxins may contribute to the risk of liver disease, but they are not modifiable risk factors.
D)Risk factors for the development of cirrhosis of the liver include excessive alcohol intake. Smoking is a risk factor for lung disease. A family history of fatty liver disease and past history of exposure to hepatic toxins may contribute to the risk of liver disease, but they are not modifiable risk factors.

Quiz 12: Metabolism

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

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?

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?

Health promotion and prevention related to type 1 diabetes should include

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

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?

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) ?

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?

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.

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

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?

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

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

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.

Type 2 diabetes mellitus is characterized by which underlying pathophysiology?

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?

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?

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?

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?