Diabetes Mellitus NCLEX Practice Quiz 2

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SESSIO

15 terms KIM A client's blood gases reflect diabetic acidosis. The nurse should expect:

• Increased pH
• Decreased PO2
• Increased PCO2
• Decreased HCO3
• Decreased HCO3

The nurse knows that glucagon may be given in the treatment of hypoglycemia because it:

• Inhibits gluconeogenesis
• Stimulates the release of insulin
• Increases blood glucose levels
• Provides more storage of glucose.
• Increases blood glucose levels

A client with type 1 diabetes mellitus has a fingerstick glucose level of 258mg/dl at bedtime. An order for sliding scale insulin exists. The nurse

should:

• Call the physician
• Encourage the intake of fluids
• Administer the insulin as ordered
• Give the client 1/2 c. of orange juice
• Administer the insulin as ordered

The physician orders 36 units of NPH and 12 units of regular insulin. The nurse plans to administer these drugs using one (1) syringe.Tip: Identify the steps in this procedure by listing them in priority order, simply drag and drop the choices below.Invert NPH vial and withdraw NPH dose Invert regular insulin bottle and withdraw regular insulin dose Inject air equal to regular dose into regular dose Inject air equal to NPH dose into NPH vial A short-acting (regular insulin) and intermediate-acting insulin (NPH) are compatible. They can be mixed by drawing the regular insulin first followed by the NPH. In order to properly resuspend the insulin, vials should be carefully rolled between the palms of the hands several times.When mixing insulin NPH with other preparations of insulin (eg, insulin aspart, insulin glulisine, insulin lispro, insulin regular), insulin NPH should be drawn into the syringe after the other insulin preparations. After mixing NPH with regular insulin, the formulation should be used immediately.The nurse is teaching a client regarding the administration of insulin as part of the discharge plan. Which of the following insulin has the most rapid onset of action?

• insulin regular (Humulin R)
• lispro (Admelog)
• glargine (Toujeo)
• insulin NPH (Humulin N)
• lispro (Admelog)

A client with diabetes mellitus states, "I cannot eat big meals; I prefer to snack throughout the day." The nurse should carefully explain that:

• Regulated food intake is basic to control
• Salt and sugar restriction is the main concern
• Small, frequent meals are better for digestion
• Large meals can contribute to a weight problem
• Regulated food intake is basic to control

A client with diabetes mellitus has an above-knee amputation because of severe peripheral vascular disease, Two days following surgery, when

preparing the client for dinner, it is the nurse's primary responsibility to:

• Check the client's serum glucose level
• Assist the client out of bed to the chair
• Place the client in a High-Fowler's position
• Ensure that the client's residual limb is elevated
• Check the client's serum glucose level

Which of the following nursing interventions should be taken for a client who complains of nausea and vomits one hour after taking his glyburide (DiaBeta)?

• Give glyburide again
• Give subcutaneous insulin and monitor blood glucose
• Monitor blood glucose closely, and look for signs of hypoglycemia
• Monitor blood glucose, and assess for signs of hyperglycemia
• Monitor blood glucose closely, and look for signs of hypoglycemia

Which of the following chronic complications is associated with diabetes?

• Dizziness, dyspnea on exertion, and coronary artery disease
• Retinopathy, neuropathy, and coronary artery disease
• Leg ulcers, cerebral ischemic events, and pulmonary infarcts
• Fatigue, nausea, vomiting, muscle weakness, and cardiac arrhythmias
• Retinopathy, neuropathy, and coronary artery disease

Rotating injection sites when administering insulin prevents which of the following complications?

• Insulin edema
• Insulin lipodystrophy
• Insulin resistance
• Systemic allergic reactions
• Insulin lipodystrophy

Which of the following methods of insulin administration would be used in the initial treatment of hyperglycemia in a client with diabetic ketoacidosis?

• Subcutaneous
• Intramuscular
• IV bolus only
• IV bolus, followed by continuous infusion
• IV bolus, followed by continuous infusion

Insulin forces which of the following electrolytes out of the plasma and into the cells?

• Calcium
• Magnesium
• Phosphorus
• Potassium
• Potassium

Which of the following causes of Hyperglycaemic Hyperosmolar Non-Ketotic Syndrome (HHNS) is most common?

• Insulin overdose
• Removal of the adrenal gland
• Undiagnosed, untreated hyperpituitarism
• Undiagnosed, untreated diabetes mellitus
• Undiagnosed, untreated diabetes mellitus

A client is in diabetic ketoacidosis (DKA) secondary to infection. As the condition progresses, which of the following symptoms might the nurse see?

• Kussmaul's respirations and a fruity odor on the breath
• Shallow respirations and severe abdominal pain
• Decreased respiration and increased urine output
• Cheyne-stokes respirations and foul-smelling urine
• Kussmaul's respirations and a fruity odor on the breath

Clients with type 1 diabetes may require which of the following changes to their daily routine during periods of infection?

• No changes
• Less insulin
• More insulin
• Oral antidiabetic agents
• More insulin

Marlisa has been diagnosed with diabetes mellitus type 1. She asks Nurse Errol what this means. What is the best response by the nurse? Select all that apply.

• "Your alpha cells should be able to secrete insulin, but cannot."
• "The exocrine function of your pancreas is to secrete insulin."
• "Without insulin, you will develop ketoacidosis (DKA)."
• "The endocrine function of your pancreas is to secrete insulin."
• "It means your pancreas cannot secrete insulin."
• "Without insulin, you will develop ketoacidosis (DKA)."
• "The endocrine function of your pancreas is to secrete insulin."
• "It means your pancreas cannot secrete insulin."

Dr. Shrunk orders intravenous (IV) insulin for Rita, a client with a blood sugar of 563. Nurse AJ administers insulin lispro (Humalog) intravenously (IV). What does the best evaluation of the nurse reveal? Select all that apply.

• The nurse could have given the insulin subcutaneously.
• The nurse should have contacted the physician.
• The nurse should have used regular insulin (Humulin R).
• The nurse used the correct insulin.
• The nurse could have given the insulin intramuscularly.
• The nurse should have contacted the physician.
• The nurse should have used regular insulin (Humulin R).

Ben injects his insulin as prescribed, but then gets busy and forgets to eat. What will the best assessment of the nurse reveal?

• The client will be very thirsty.
• The client will complain of nausea.
• The client will need to urinate.
• The client will have moist clammy skin. will have moist clammy skin.
• The client will have moist clammy skin. will have moist clammy skin.