Question 1

The nurse is identifying patients at risk for needing insulin. Which patients should the nurse identify as potentially needing insulin to maintain a normal blood glucose level?

Accepted Answer

The answer of The nurse is identifying patients at risk...

Question 2

An older patient with type 2 diabetes mellitus is upset because family members do not believe the patient has an illness and resist helping with diet and activity modifications. What should the nurse suggest to help this patient?

Accepted Answer

Inviting family to participate in a support group can help them understand the patient's condition better and provide the necessary support for lifestyle changes.

Question 3

The nurse is teaching a patient with diabetes about self-management. What should the nurse include regarding medications to treat diabetes mellitus?

Accepted Answer

Patients with type 2 diabetes may require a combination of oral medications and insulin to achieve normal blood glucose levels, whereas patients with type 1 diabetes always require an exogenous source of insulin. Patients with type 1 diabetes cannot achieve normal blood glucose levels with oral medications alone. Progression from type 1 to type 2 diabetes is not common and is not related to blood glucose control.

Question 4

The nurse is reviewing instruction provided to a graduate nurse regarding insulin therapy. Which statement made by the graduate indicates that further instruction is needed?

Accepted Answer

The answer of The nurse is reviewing instruction provided to...

Question 5

The nurse is caring for a patient with type 1 diabetes mellitus. Which patient statement requires immediate intervention by the nurse?

Accepted Answer

Regular insulin is clear, not cloudy. The statement about not mixing "cloudy regular insulin" with other insulins indicates a misunderstanding, as regular insulin should be clear and can be mixed with NPH (an intermediate-acting insulin), which is cloudy, under certain circumstances. This misunderstanding could lead to improper insulin administration.

Question 6

The nurse is trying to determine if a patient is experiencing manifestations of type 1 or type 2 diabetes mellitus. Which question should the nurse ask the patient to help determine the type?

Accepted Answer

Type 1 diabetes is often associated with increased hunger (polyphagia) due to the body's inability to produce insulin, leading to cells not receiving glucose for energy. This symptom is more specific to type 1 diabetes compared to type 2.

Question 7

The nurse instructs a patient with type 2 diabetes mellitus on the use of a glucometer for self-monitoring. Which patient statements about glucometer performance indicate that teaching has been effective?

Accepted Answer

These statements indicate effective teaching because they address important aspects of glucometer use: applying blood correctly (A), following manufacturer's cleaning recommendations (B), recognizing that certain conditions like sickle cell anemia may affect the device's accuracy (C), and ensuring enough blood is applied to the strip for an accurate reading (E). Statement D is incorrect because there is no known interaction between grapefruit juice and the mechanical function of glucometers.

Question 8

A patient with type 1 diabetes mellitus has a serum hematocrit level of 24%. What additional finding should the nurse report to the health care provider?

Accepted Answer

A serum hematocrit level of 24% indicates severe anemia, which could be related to hypoglycemia, as seen in choice A (capillary blood glucose of 60 mg/dL). Therefore, this finding should be reported to the healthcare provider. Choices B, C, and D are important findings in the management of diabetes but are not directly related to the patient's hematocrit level.

Question 9

The community nurse is teaching a group of members with type 1 or 2 diabetes mellitus who are planning to participate in an athletic triathlon. On which potential complication from this event should the nurse focus when teaching?

Accepted Answer

During an athletic triathlon, individuals with diabetes are at risk for developing hypoglycemia due to increased physical activity and decreased food intake. Diabetic ketoacidosis and hyperosmolar hyperglycemic state are more commonly seen in instances of prolonged hyperglycemia and illness. Impaired glucose tolerance is a pre-diabetic state and not directly related to participation in an athletic event.

Question 10

The nurse is planning care for a patient with type 1 diabetes mellitus. Which action should the nurse identify as being the most effective to reduce the development of complications?

Accepted Answer

Self-monitoring of blood glucose levels is the most effective action to reduce the development of complications in patients with type 1 diabetes. By monitoring blood glucose levels regularly, patients can adjust their insulin dosage, medication, or diet to maintain normal blood sugar levels and prevent complications such as diabetic retinopathy, neuropathy, and nephropathy. While performance of effective foot care, yearly eye exams, and knowing symptoms of urinary tract infections are important aspects of diabetes management, self-monitoring of blood glucose levels is essential for preventing long-term complications.

Question 11

A patient with type 2 diabetes mellitus is scheduled for laparoscopic adjustable gastric banding (LAGB) surgery. What should the nurse explain to the patient about this procedure and diabetes?

Accepted Answer

The nurse should explain that many patients with diabetes have positive outcomes after undergoing surgical weight loss procedures. It is important to note that diabetes is not necessarily cured by surgery, but weight loss can significantly improve blood glucose control and reduce comorbidities associated with diabetes. The other options are incorrect or irrelevant.

Question 12

A patient with type 2 diabetes mellitus has been instructed on an eating plan where 65% of all daily calories are to be carbohydrates. The patient's daily caloric intake is to be 1600 calories. If each serving of carbohydrates is 15 grams and each gram is 4 kilocalories, how many servings of carbohydrates should the patient be instructed to consume each day?

Accepted Answer

The answer of A patient with type 2 diabetes mellitus...

Question 13

A nurse is teaching a group of patients about the prevalence of type 2 diabetes in older adults. The nurse knows teaching has been effective when a patient states, "Statistically, in a group of 100 older adults in the United States, approximately:

Accepted Answer

According to the Centers for Disease Control and Prevention (CDC), approximately 27% of adults ages 65 and older in the United States have type 2 diabetes. In a group of 100 older adults, this would equate to approximately 27 individuals with the disease. Therefore, the correct answer is C - 27 will have type 2 diabetes.

Question 14

The nurse is caring for a patient who is prescribed 120 units of U-100 regular insulin to be administered at 0700 and 1600 hours. The physician has written an order for an equivalent dose of U-500 insulin to be provided. The nurse reviews the order with the primary health care provider and states, "120 units of U-100 insulin is equivalent to _______ units of U-500 insulin."

Accepted Answer

The answer of The nurse is caring for a patient...

Question 15

The nurse is reviewing the healthcare record of a patient with type 2 diabetes mellitus who has a foot wound. Which outcome of care would be the most important at this time? $$\begin{array} { | l | l | } 
\hline \begin{array} { l } 
\text { History and } \
\text { Physical: }
\end{array} & \begin{array} { l } 
\text { The patient has a } 1 \mathrm {~cm} \times 1 \mathrm {~cm} \text { open area } \
\text { on the bottom of the left foot }
\end{array} \
\hline \text { Vital Signs: } & \begin{array} { l } 
\text { Pulse } 85 \mathrm { bpm } , \text { Blood Pressure } 150 / 90 , \
\text { Weight } 425 \text { pounds, Height } 6 \text { feet, 1 } \
\text { inch. }
\end{array} \
\hline \text { Vision Screening: } & \begin{array} { l } 
\text { Snellen Results 20/800. Extensive } \
\text { diabetic retinopathy. States is unable to } \
\text { read typically sized newsprint. }
\end{array} \
\hline
\end{array}$$

Accepted Answer

The answer of The nurse is reviewing the healthcare record...

Question 16

A patient with diabetes mellitus has albuminuria, hypertension, and edema. What should the nurse expect to be prescribed for this patient?

Accepted Answer

Albuminuria, hypertension, and edema are all signs of diabetic nephropathy, which can progress to kidney failure. Weight loss strategies may help control blood sugar and blood pressure, which can slow the progress of diabetic nephropathy. Restricting activity and increasing salt intake may worsen the condition. Antibiotic therapy may be prescribed if there is an infection, but it is not the primary treatment for diabetic nephropathy.

Question 17

A patient with no previous history of diabetes mellitus has ketones in the urine. Which question should the nurse ask this patient?

Accepted Answer

Ketones in the urine can indicate that the body is using fat for energy instead of glucose, which can occur in situations of significant weight loss or inadequate glucose availability. Asking about weight loss strategies can help identify if the patient's diet or weight loss efforts are contributing to the presence of ketones.

Question 18

The nurse is teaching a patient with type 2 diabetes mellitus about glyburide (DiaBeta). The nurse knows teaching has been effective when the patient states, "I need to monitor for dizziness, lightheadedness, and sweating if I take:

Accepted Answer

The answer of The nurse is teaching a patient with...

Question 19

A patient with type 1 diabetes mellitus has difficulty swallowing and takes milk of magnesium every day for nausea and constipation. What should the nurse suspect is occurring with this patient?

Accepted Answer

Difficulty swallowing (dysphagia) is a common symptom of visceral neuropathy in patients with diabetes mellitus. Milk of magnesium is a common treatment for nausea and constipation, which can be caused by visceral neuropathy. Peripheral neuropathy is more commonly associated with symptoms such as pain, tingling, and numbness in the extremities. Age-related changes and reactions to insulin injections are not likely to cause difficulty swallowing or gastrointestinal symptoms.

Question 20

The nurse is assessing a patient with type 2 diabetes mellitus. What questions should the nurse ask to determine the patient's risk for a lower extremity amputation?

Accepted Answer

The answer of The nurse is assessing a patient with...

Quiz 20: Nursing Care of Patients With Diabetes Mellitus