NURS 420 Chapter 49:
Nursing Management:
Diabetes Mellitus Test
Bank
- Which statement by a nurse to a patient newly diagnosed with type 2 diabetes is
correct?
a. Insulin is not used to control blood glucose in patients with type 2 diabetes.
b. Complications of type 2 diabetes are less serious than those of type 1 diabetes.
c. Changes in diet and exercise may control blood glucose levels in type 2 diabetes.
d. Type 2 diabetes is usually diagnosed when the patient is admitted with a
hyperglycemic coma.
ANS: C
For some patients with type 2 diabetes, changes in lifestyle are sufficient to achieve
blood glucose control. Insulin is frequently used for type 2 diabetes, complications are
equally severe as for type 1 diabetes, and type 2 diabetes is usually diagnosed with
routine laboratory testing or after a patient develops complications such as frequent
yeast infections.
DIF: Cognitive Level: Understand (comprehension) REF: 1166-1167
TOP: Nursing Process: Implementation - A 48-year-old male patient screened for diabetes at a clinic has a fasting plasma
glucose level of 120 mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about
a. self-monitoring of blood glucose.
b. using low doses of regular insulin.
c. lifestyle changes to lower blood glucose.
d. effects of oral hypoglycemic medications.
ANS: C
The patient’s impaired fasting glucose indicates prediabetes, and the patient should be
counseled about lifestyle changes to prevent the development of type 2 diabetes. The
patient with prediabetes does not require insulin or oral hypoglycemics for glucose
control and does not need to self-monitor blood glucose.
DIF: Cognitive Level: Apply (application) REF: 1156
TOP: Nursing Process: Planning
- A 28-year-old male patient with type 1 diabetes reports how he manages his exercise
and glucose control. Which behavior indicates that the nurse should implement
additional teaching?
a. The patient always carries hard candies when engaging in exercise.
b. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
c. The patient has a peanut butter sandwich before going for a bicycle ride.
d. The patient increases daily exercise when ketones are present in the urine.
ANS: D
When the patient is ketotic, exercise may result in an increase in blood glucose level.
Type 1 diabetic patients should be taught to avoid exercise when ketosis is present. The
other statements are correct.
DIF: Cognitive Level: Apply (application) REF: 1167
TOP: Nursing Process: Assessment - The nurse is assessing a 22-year-old patient experiencing the onset of symptoms of
type 1 diabetes. Which question is most appropriate for the nurse to ask?
a. “Are you anorexic?”
b. “Is your urine dark colored?”
c. “Have you lost weight lately?”
d. “Do you crave sugary drinks?”
ANS: C
Weight loss occurs because the body is no longer able to absorb glucose and starts to
break down protein and fat for energy. The patient is thirsty but does not necessarily
crave sugarcontaining fluids. Increased appetite is a classic symptom of type 1
diabetes. With the classic symptom of polyuria, urine will be very dilute.
DIF: Cognitive Level: Apply (application) REF: 1156
TOP: Nursing Process: Assessment
- A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several
months from now. Which test will the nurse schedule to evaluate the effectiveness of
treatment for the patient?
a. Urine dipstick for glucose
b. Oral glucose tolerance test
c. Fasting blood glucose level
d. Glycosylated hemoglobin level
ANS: D
The glycosylated hemoglobin (A1C or HbA1C) test shows the overall control of glucose
over 90 to 120 days. A fasting blood level indicates only the glucose level at one time.
Urine glucose testing is not an accurate reflection of blood glucose level and does not
reflect the glucose over a prolonged time. Oral glucose tolerance testing is done to
diagnose diabetes, but is not used for monitoring glucose control once diabetes has
been diagnosed.
DIF: Cognitive Level: Apply (application) REF: 1157
TOP: Nursing Process: Planning - A 55-year-old female patient with type 2 diabetes has a nursing diagnosis of
imbalanced nutrition: more than body requirements. Which goal is most important for
this patient?