Question 1

The nurse suspects that a patient with type 2 diabetes mellitus is experiencing autonomic neuropathy.What did the nurse assess to make this clinical determination?

Accepted Answer

Autonomic neuropathy in patients with diabetes can affect the nerves that control the gastrointestinal tract, leading to symptoms such as bloating. Foot pain, tingling of the fingers, and numbness of the lower legs are more indicative of peripheral neuropathy rather than autonomic neuropathy.

Question 2

A patient with type 1 diabetes mellitus will be self-monitoring blood glucose levels at home.What is the minimum number of measurements that this patient should make each day?

Accepted Answer

Patients with type 1 diabetes should measure their blood glucose levels at least four times a day: before meals and at bedtime. This is important for adjusting insulin dosage and preventing complications. Option A (1 measurement per day) is not enough to provide adequate monitoring, and options B and D (3 and 8 measurements per day) go beyond the recommended minimum.

Question 3

A middle-aged patient is surprised to learn of the diagnosis of type 1 diabetes mellitus.What should the nurse respond?

Accepted Answer

Type 1 diabetes mellitus can occur at any stage of life, including middle age. It is not exclusively a disease of childhood, as mentioned in option A. Option B is not a correct statement as type 1 diabetes does not develop due to an infection, although infections can make blood sugar control worse in someone who already has diabetes. Option D is not entirely accurate as type 1 diabetes can occur on its own without the presence of another disease process.

Question 4

An older patient with type 1 diabetes mellitus has poor oral intake.What should be considered to ensure adequate blood glucose control?

Accepted Answer

The answer of An older patient with type 1 diabetes...

Question 5

A patient with type 2 diabetes mellitus is being evaluated for hyperosmolar hyperglycemic state (HHS).Which finding would be consistent with this medical diagnosis?

Accepted Answer

In hyperosmolar hyperglycemic state (HHS), patients typically have normal or slightly elevated serum bicarbonate levels, such as 28 mEq/L, due to the absence of significant ketoacidosis.

Question 6

A patient experiencing diabetic ketoacidosis (DKA)is receiving a normal saline infusion and intravenous insulin.What additional medication should the nurse expect to be prescribed for this patient?

Accepted Answer

Diabetic ketoacidosis (DKA) involves an increase in serum potassium levels due to acidosis, insulin deficiency and dehydration, which may lead to hypokalemia. Thus, the nurse should expect an additional prescription for potassium replacement therapy. Diuretics are not typically used in the treatment of DKA, since patients with this condition are already dehydrated. Laxatives are also not prescribed for DKA. Antibiotics may be prescribed if a bacterial infection is contributing to the patient's metabolic acidosis or if the patient has evidence of sepsis. However, this information is not provided in the scenario, so it is not a necessary medication to expect in all cases of DKA.

Question 7

A patient is prescribed Regular insulin 5 units subcutaneous injection now.Which syringe should the nurse use for this dose if all are readily available?

Accepted Answer

The answer of A patient is prescribed Regular insulin 5...

Question 8

During a home visit the nurse is concerned that a patient with type 2 diabetes mellitus would benefit from additional teaching.What did the nurse observe to make this clinical decision?

Accepted Answer

Walking barefoot in the backyard is a concern for patients with diabetes due to the risk of foot injuries and infections. This could indicate a need for education regarding proper foot care and appropriate footwear. The other options do not necessarily indicate a need for additional teaching on diabetes management.

Question 9

Which statement best describes the pathophysiology of type 2 diabetes mellitus?

Accepted Answer

Type 2 diabetes is characterized by insulin resistance, which means the cells in the body do not respond properly to insulin and cannot effectively take up glucose from the blood. The pancreas may continue to produce insulin, but it is not used effectively because of the resistance.

Question 10

The nurse is evaluating teaching provided to a patient with type 1 diabetes mellitus.Which patient observation indicates that medication teaching has been effective?

Accepted Answer

Rotating injection sites by placing a new injection an inch away from the previous site helps prevent lipodystrophy and ensures better insulin absorption, indicating effective teaching.

Question 11

A patient is newly diagnosed with type 2 diabetes mellitus.Which medication classification should the nurse expect to be prescribed for this patient?

Accepted Answer

Biguanides, such as metformin, are often the first-line medication for patients with type 2 diabetes due to their effectiveness in reducing hepatic glucose production, improving insulin sensitivity, and promoting weight loss.

Question 12

The nurse is reviewing the results of patient's recent hemoglobin A1c level drawn to evaluate type 1 diabetes management.Which result indicates that treatment has been successful?

Accepted Answer

A hemoglobin A1c level of 6.5% or less indicates good control of blood sugar levels in a patient with type 1 diabetes. Higher levels indicate poor control and may increase the risk of long-term complications such as neuropathy, retinopathy, and nephropathy. Therefore, achieving a lower hemoglobin A1c level reflects successful treatment of type 1 diabetes.

Question 13

A patient with type 1 diabetes mellitus is experiencing elevated blood glucose levels in the morning.Which action should be taken to determine the reason for this elevation?

Accepted Answer

Checking blood glucose levels at 0200 hours (2am) is the best way to assess for the cause of morning hyperglycemia in a patient with type 1 diabetes mellitus. This is because this is the time when insulin concentrations are at their nadir and the dawn phenomenon occurs, leading to increased glucose release from the liver. Checking urine for glucose level, restricting oral fluids after 1800 hours, and limiting carbohydrate intake to 45 grams with evening meal may all help manage blood glucose levels, but they do not provide information about the cause of morning hyperglycemia in this patient.

Question 14

The nurse is reviewing type 1 diabetes mellitus with a group of patients newly diagnosed with the disorder.What should the nurse explain as the major cause for the disorder?

Accepted Answer

Type 1 diabetes mellitus is primarily caused by an autoimmune process where the body's immune system attacks and destroys the insulin-producing cells in the pancreas.

Question 15

The nurse notices that a patient who has been drinking large volumes of water and eating large meals throughout the day continues to lose weight.Which health problem should the nurse suspect this patient is experiencing?

Accepted Answer

The symptoms of excessive thirst, increased appetite, and weight loss are classic signs of Type 1 diabetes mellitus, where the body cannot produce insulin, leading to high blood sugar levels and the breakdown of fat and muscle for energy.

Question 16

A patient with type 1 diabetes mellitus has not taken insulin for several days.Which observation indicates that diabetic ketoacidosis (DKA)could be developing?

Accepted Answer

Deep rapid respirations (Kussmaul respirations) is a classic symptom of DKA. It is the body's attempt to compensate for the increased acid in the blood. Slow heart rate (bradycardia), decreased urine output, and increased blood pressure are not typically associated with DKA.

Question 17

A patient with type 1 diabetes mellitus is scheduled for a hemoglobin A1c level.What should the nurse emphasize to the patient to prepare for this test?

Accepted Answer

Unlike other blood glucose tests, hemoglobin A1c level does not require any special preparation or fasting. The test reflects the average blood glucose levels over the past 2-3 months, so it can be drawn at any time during the day.

Question 18

A patient with type 1 diabetes mellitus develops symptoms of hypoglycemia only when the blood glucose level drops to 40 mg/dL.What should be done to reverse this condition?

Accepted Answer

Raising glycemic targets can help prevent hypoglycemia unawareness by allowing the body to readjust to higher glucose levels, making it more sensitive to drops in glucose levels.

Question 19

A patient with type 2 diabetes mellitus is prescribed a glucagon-like peptide-1 agonist.What clinical symptom should the nurse instruct the patient to expect when taking this medication?

Accepted Answer

Glucagon-like peptide-1 agonists can decrease appetite, leading to potential weight loss, and this is a common clinical symptom that patients may experience. Nausea is also possible but less frequently reported. Diarrhea and dry mouth are less common side effects.

Question 20

A patient with type 1 diabetes mellitus is preparing to play tennis.What should be done first before engaging in this physical activity?

Accepted Answer

Before engaging in physical activity, a patient with type 1 diabetes mellitus should measure their blood glucose level to ensure that it is within a safe range. If the blood glucose level is too low, the patient should eat a serving of carbohydrates to raise it. If the blood glucose level is too high, the patient may need to adjust their medication dose or delay the physical activity. Drinking fluids and taking medication may also be necessary, but they should only be done after measuring the blood glucose level.

Quiz 44: Coordinating Care for Patients With Diabetes Mellitus