Chapter 48. Management: Diabetes Mellitus

Chapter 48. Management: Diabetes Mellitus MULTIPLE CHOICE

ScienceMedicineNursing catadosis_97 Save Diabetes Mellitus NCLEX Style Ques...Teacher 36 terms ssandholmPreview Cushings/Addison's Practice Questi...44 terms alexisvu99Preview Diabetes multiple choice (lecture 7)...51 terms srobe53Preview Diabet 49 terms Dia 1. Which statement by a nurse to a patient newly diagnosed with type 2 diabetes is correct?

• Insulin is not used to control blood glucose in patients with type 2 diabetes.
• Complications of type 2 diabetes are less serious than those of type 1 diabetes.
• Changes in diet and exercise may control blood glucose levels in type 2 diabetes.
• 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.

• 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

• self-monitoring of blood glucose.
• using low doses of regular insulin.
• lifestyle changes to lower blood glucose.
• effects of oral hypoglycemic medications.

C

• 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?

• The patient always carries hard candies when engaging in exercise.
• The patient goes for a vigorous walk when his glucose is 200 mg/dL.
• The patient has a peanut butter sandwich before going for a bicycle ride.
• The patient increases daily exercise when ketones are present in the urine.

D

• 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?

• Are you anorexic?
• Is your urine dark colored?
• Have you lost weight lately?
• Do you crave sugary drinks?

C

• 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?

• Urine dipstick for glucose
• Oral glucose tolerance test
• Fasting blood glucose level
• Glycosylated hemoglobin level

D

• 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?

• The patient will reach a glycosylated hemoglobin level of less than 7%.
• The patient will follow a diet and exercise plan that results in weight loss.
• The patient will choose a diet that distributes calories throughout the day.
• The patient will state the reasons for eliminating simple sugars in the diet.

A

• A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM. The clinic nurse will plan to teach the patient to
• check glucose level before, during, and after swimming.
• delay eating the noon meal until after the swimming class.
• increase the morning dose of neutral protamine Hagedorn (NPH) insulin.
• time the morning insulin injection so that the peak occurs while swimming.

A

• The nurse determines a need for additional instruction when the patient with newly diagnosed type 1 diabetes says which of the following?
• I can have an occasional alcoholic drink if I include it in my meal plan.
• I will need a bedtime snack because I take an evening dose of NPH insulin.
• I can choose any foods, as long as I use enough insulin to cover the calories.
• I will eat something at meal times to prevent hypoglycemia, even if I am not hungry.

C

• In order to assist an older diabetic patient to engage in moderate daily exercise, which action is most important for the nurse to take?
• Determine what type of activities the patient enjoys.
• Remind the patient that exercise will improve self-esteem.
• Teach the patient about the effects of exercise on glucose level.
• Give the patient a list of activities that are moderate in intensity.

A

• Which statement by the patient indicates a need for additional instruction in administering insulin?
• I need to rotate injection sites among my arms, legs, and abdomen each day.
• I can buy the 0.5 mL syringes because the line markings will be easier to see.
• I should draw up the regular insulin first after injecting air into the NPH bottle.
• I do not need to aspirate the plunger to check for blood before injecting insulin.

A

• Which patient action indicates good understanding of the nurses teaching about administration of as part (NovoLog) insulin?
• The patient avoids injecting the insulin into the upper abdominal area.
• The patient cleans the skin with soap and water before insulin administration.
• The patient stores the insulin in the freezer after administering the prescribed dose.
• The patient pushes the plunger down while removing the syringe from the injection site

B

• A patient receives as part (NovoLog) insulin at 8:00 AM. Which time will it be most important for the nurse to monitor for symptoms of

hypoglycemia?

a. 10:00 AM

b. 12:00 AM

c. 2:00 PM

d. 4:00 PM

A

• Which patient action indicates a good understanding of the nurses teaching about the use of an insulin pump?
• The patient programs the pump for an insulin bolus after eating.
• The patient changes the location of the insertion site every week.
• The patient takes the pump off at bedtime and starts it again each morning.
• The patient plans for a diet that is less flexible when using the insulin pump.

A

• A 32-year-old patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime

coverage?

• Lispro (Humalog)
• Glargine (Lantus)
• Detemir (Levemir)
• NPH (Humulin N)

A

• Which information will the nurse include when teaching a 50-year-old patient who has type 2 diabetes about glyburide (Micronase, DiaBeta,

Glynase)?

• Glyburide decreases glucagon secretion from the pancreas.
• Glyburide stimulates insulin production and release from the pancreas.
• Glyburide should be taken even if the morning blood glucose level is low.
• Glyburide should not be used for 48 hours after receiving IV contrast media.

B

• The nurse has been teaching a patient with type 2 diabetes about managing blood glucose levels and taking glipizide (Glucotrol). Which

patient statement indicates a need for additional teaching?

• If I overeat at a meal, I will still take the usual dose of medication.
• Other medications besides the Glucotrol may affect my blood sugar.
• When I am ill, I may have to take insulin to control my blood sugar.
• My diabetes wont cause complications because I dont need insulin.

D

• When a patient who takes metformin (Glucophage) to manage type 2 diabetes develops an allergic rash from an unknown cause, the health

care provider prescribes prednisone (Deltasone). The nurse will anticipate that the patient may

• need a diet higher in calories while receiving prednisone.
• develop acute hypoglycemia while taking the prednisone.
• require administration of insulin while taking prednisone.
• have rashes caused by metformin-prednisone interactions.

C

• A hospitalized diabetic patient received 38 U of NPH insulin at 7:00 AM. At 1:00 PM, the patient has been away from the nursing unit for 2

hours, missing the lunch delivery while awaiting a chest x-ray. To prevent hypoglycemia, the best action by the nurse is to

• save the lunch tray for the patients later return to the unit.
• ask that diagnostic testing area staff to start a 5?xtrose IV.
• send a glass of milk or orange juice to the patient in the diagnostic testing area.
• request that if testing is further delayed, the patient be returned to the unit to eat.

D