Diabetes NCLEX Questions

Diabetes NCLEX Questions ScienceMedicineNursing adrianna_lane Save Diabetes Mellitus NCLEX Style Ques...Teacher 36 terms ssandholmPreview Diabetes 44 terms marvelousbrittany8 Preview Diabetes NCLEX Questions 133 terms CaseyLeigh23 Preview Diabet 30 terms salu The nurse is admitting a patient diagnosed with type 2 diabetes mellitus. The nurse should expect the following symptoms during an assessment,

except:

• Hypoglycemia
• Frequent bruising
• Ketonuria
• Dry mouth

Correct answer: A. Hypoglycemia

Option A: Hypoglycemia does not occur in type 2 diabetes unless the patient is on insulin therapy or taking other diabetes medication.Option B: Type 2 diabetes can affect blood circulation which makes it easier for the skin to bruise.Option C: The presence of ketones in the urine happens due to a lack of available insulin.Option D: Losing a lot of fluids caused by frequent urination can lead to dehydration hence patients can develop dry mouth.Glycosylated hemoglobin (HbA1C) test measures the average blood glucose control of an individual over the previous three months. Which of the following values is considered a diagnosis of pre-diabetes?

A. 6.5-7%

B. 5.7-6.4%

C. 5-5.6%

• <5.6%

Correct answer: B. 5.7-6.4%

Option B: Glycosylated hemoglobin levels between 5.7%-6.4% is considered as pre-diabetes.Option A: Glycosylated hemoglobin levels over 6.5 % are considered diagnostic of diabetes.

Options C and D: Glycosylated hemoglobin levels less than 5.6 % are normal.

Rotation sites for insulin injection should be separated from one another by 2.5 cm (1 inch) and should be used only every:

• Third day
• Every other day
• 1-2 weeks
• 2-4 weeks

Correct answer: C. 1-2 weeks

Rotation of sites for insulin injection should be done every week or two. Frequently using the same spot over time can cause fat cells to break down or build up (lipodystrophy) causing lumps under the skin and may interfere with insulin absorption.A clinical feature that distinguishes a hypoglycemic reaction from a ketoacidosis reaction is:

• Blurred vision
• Diaphoresis
• Nausea
• Weakness

Correct answer: B. Diaphoresis

A hypoglycemic reaction activates a fight-or-flight response in the body which then triggers the release of epinephrine and norepinephrine resulting in diaphoresis.Clinical nursing assessment for a patient with microangiopathy who has manifested impaired peripheral arterial circulation includes all of the

following, except:

• Integumentary inspection for the presence of brown spots on the lower extremities
• Observation for paleness of the lower extremities
• Observation for blanching of the feet after the legs are elevated for 60 seconds
• Palpation for increased pulse volume in the arteries of the lower extremities

Correct answer: D. Palpation for increased pulse volume in the arteries of the lower extremities Option D: One of the signs and symptoms of impaired peripheral arterial circulation is the absence of a pulse or a weak pulse in the legs or feet.Option A: This happens when high pressure in the veins pushes blood into the skin tissue causing reddish-brown staining in the skin tissue. When skin is stained like this, it is very fragile and may break down or, if knocked, fail to heal as usual.Options B and C: When a person develops impaired peripheral arterial circulation, the extremities — usually the legs — don't receive enough blood flow and oxygen to keep up with demand leading to a change in the color of the legs.Albert, a 35-year-old insulin-dependent diabetic, is admitted to the hospital with a diagnosis of pneumonia. He has been febrile since admission.His daily insulin requirement is 24 units of NPH. Every morning Albert is given NPH insulin at 0730. Meals are served at 0830, 1230, and 1830. The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of:

• 1130 and 1330
• 1330 and 1930
• 1530 and 2130
• 1730 and 2330

Correct answer: B. 1330 and 1930

The peak time of insulin is the time it is working the hardest to lower the blood glucose. NPH insulin is an intermediate-acting insulin that has an onset of 1 to 3 hours after injection, peaks 4 to 12 hours later, and is effective for about 12 to 16 hours.

A nurse is providing a bedtime snack for his patient. This is based on the knowledge that intermediate-acting insulins are effective for an

approximate duration of:

• 6-8 hours
• 10-14 hours
• 14-18 hours
• 24-28 hours

Correct answer: C. 14-18 hours

Option C: Intermediate-acting insulins include Humulin N and Novolin N. They have an onset of two to four hours, peak of 4 to 12 hours, and a duration of 14 to 18 hours.Option A: Regular or short-acting insulins include Humulin R and Novolin R. They have an onset of half an hour, a peak of two to three hours, and a duration of six to eight hours.Option D: Long-acting insulins include Levemir and Lantus. They have an onset of several hours, minimal or no peak, and a duration of 24 hours or more.A nurse went to a patient's room to do routine vital signs monitoring and found out that the patient's bedtime snack was not eaten. This should

alert the nurse to check and assess for:

• Elevated serum bicarbonate and decreased blood pH
• Signs of hypoglycemia earlier than expected
• Symptoms of hyperglycemia during the peak time of NPH insulin
• Sugar in the urine

Correct answer: B. Signs of hypoglycemia earlier than expected.

Eating a bedtime snack can prevent blood glucose levels from dropping very low during the night and lessen the Somogyi effect where glucose levels drop significantly between 2:00 a.m. and 3:00 a.m.A client is taking NPH insulin daily every morning. The nurse instructs the client that the most likely time for a hypoglycemic reaction to occur is:

• 2-4 hours after administration
• 6-14 hours after administration
• 16-18 hours after administration
• 18-24 hours after administration

Correct answer: B. 6-14 hours after administration

The peak time of insulin is the time it is working the hardest to lower the blood glucose. NPH insulin is an intermediate-acting insulin that has an onset of 1 to 3 hours after injection, peaks 4 to 12 hours later, and is effective for about 12 to 16 hours.An external insulin pump is prescribed for a client with DM. The client asks the nurse about the functioning of the pump. The nurse bases the

response on the information that the pump:

• Gives a small continuous dose of regular insulin subcutaneously, and the client can self-administer a bolus with an additional dosage from the

pump before each meal.

• It is timed to release programmed doses of regular or NPH insulin into the bloodstream at specific intervals.
• It is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases the insulin into the bloodstream.
• It continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels.

Correct answer: A. Gives a small continuous dose of regular insulin subcutaneously, and the client can self-administer a bolus with an additional dosage from the pump before each meal.An insulin pump provides a small continuous dose of regular insulin subcutaneously throughout the day and night, and the client can self- administer a bolus with additional dosage from the pump before each meal as needed. Regular insulin is used in an insulin pump. An external pump is not attached surgically to the pancreas.

A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the ER. Which finding would a nurse expect to note as confirming this diagnosis?

• Elevated blood glucose level and a low plasma bicarbonate
• Decreased urine output
• Increased respiration and an increase in pH
• Comatose state

Correct answer: A. Elevated blood glucose level and a low plasma bicarbonate

Option A: In diabetic acidosis, the arterial pH is less than 7.35. plasma bicarbonate is less than 15mEq/L, and the blood glucose level is higher than 250mg/dl and ketones are present in the blood and urine.Options B and C: The client would be experiencing polyuria, and Kussmaul's respirations would be present.Option D: A comatose state may occur if DKA is not treated, but coma would not confirm the diagnosis A client with DM demonstrates acute anxiety when first admitted for the treatment of hyperglycemia. The most appropriate intervention to

decrease the client's anxiety would be to:

• Administer a sedative
• Make sure the client knows all the correct medical terms to understand what is happening
• Ignore the signs and symptoms of anxiety so that they will soon disappear
• Convey empathy, trust, and respect toward the client

Correct answer: D. Convey empathy, trust, and respect toward the client.

Option D: The most appropriate intervention is to address the client's feelings related to anxiety.

Option A: Administering a sedative is not the most appropriate intervention.

Option B: A client will not relate to medical terms, particularly when anxiety exists.

Option C: The nurse should not ignore the client's anxious feelings.

A nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The priority nursing diagnosis would be:

• High risk for deficient fluid volume

B. Deficient knowledge: disease process and treatment

C. Imbalanced nutrition: less than body requirements

D. Disabled family coping: compromised

Correct answer: A. High risk for deficient fluid volume

Option A: Increased blood glucose will cause the kidneys to excrete the glucose on the urine. This glucose is accompanied by fluids and electrolytes, causing osmotic diuresis leading to dehydration. This fluid loss must be replaced when it becomes severe.Options B, C, and D are not related specifically to the issue of the question.A nurse is caring for a client admitted to the ER with DKA. In the acute phase the priority nursing action is to prepare to:

• Administer regular insulin intravenously
• Administer 5% dextrose intravenously
• Correct the acidosis
• Apply an electrocardiogram monitor

Correct answer: A. Administer regular insulin intravenously

Option A: Lack (absolute or relative) of insulin is the primary cause of DKA.

Options B and C: Treatment consists of insulin administration (regular insulin), IV fluid administration (normal saline initially), and potassium replacement, followed by correcting acidosis.

Option D: Applying an electrocardiogram monitor is not a priority action.