Diabetes Practice Questions

Diabetes Practice Questions ScienceMedicineNursing KJFerrell03 Save Diabetes Mellitus NCLEX Style Ques...Teacher 36 terms ssandholmPreview Diabetes 23 terms violet0119Preview Diabetes Practice Questions 24 terms katelyn_kelley9 Preview Diabet 13 terms ach Which of the following is the appropriate initial action by the nurse when preparing insulin administration?

• Injecting air into the regular insulin
• Withdrawing the cloudy insulin first before the clear insulin
• Injecting air into the cloudy insulin but withdrawing the clear insulin first
• Withdrawing the clear insulin and cloudy insulin in separate syringes

C - This action ensures prevention of contamination of the rapid-acting insulin. In case of emergency (DKA), rapid effect of the clear insulin is maintained. Injecting air into the cloudy insulin will promote easy aspiration of the medication, once the syringe already contains the clear insulin.The client with insulin-dependent diabetes mellitus (IDDM) has been brought to the emergency room. What should the nurse watch for if blood pH is 7.28?

• Lactic acidosis
• Ketoacidosis
• Metabolic alkalosis
• Respiratory Acidosis

B - Ketoacidosis is characterized by low blood pH. Type 1 diabetic clients are prone to ketoacidosis.Which of the following laboratory test best indicate compliance of the diabetic client and insulin therapy?

• 2-hour postprandial blood glucose
• Fasting blood glucose
• Glycosylated hemoglobin (HbA1c)
• Oral glucose tolerance test

C - Glycosylated hemoglobin (HbA1c) is the best indicator of diabetic control. If reflects blood glucose level for the past 3 to 4 months

The diabetic client is having ketoacidosis. Which of the following is the appropriate initial nursing action?

• Start an intravenous glucose
• Administer insulin per IV
• Give a glass of orange juice
• Give a cup of skim milk

B - Ketoacidosis is characterized by severe hyperglycemia. The emergency management of ketoacidosis is regular insulin IV The client has been diagnosed to have IDDM. Which order should you question?

• Propranolol
• Insulin injection
• Acetaminophen
• Diltiazem

A - Propranolol, a beta-adrenergic blocker causes hypoglycemia. It is contraindicated among diabetes clients.The nurse is planning care for a client with hyperthyroidism. Which of the following nursing interventions are appropriate? SELECT ALL THAT APPLY

• Instill isotonic eye drops as necessary
• Provide several, small, well-balanced meals
• Provide rest periods
• Keep the environment warm
• Encourage frequent visitors and conversation
• Weigh the client daily

A, B, C, F - the client with hyperthyroidism may experience exopthalmos. This requires instillation of eye drops to prevent dryness and ulceration of the cornea. The client experiences weight loss because of hypermetabolism. Several, small, well-balanced meals are given to improve nutritional status of the client and daily weights should be monitored. Weight is the most objective indicator of nutritional status. The client is usually exhausted due to restlessness and agitation. Frequent rest periods help the client regain energy.After thyroidectomy, which of the following is the priority assessment to observe laryngeal nerve damage?

• Hoarseness of voice
• Difficulty in swallowing
• Tetany
• Fever

A - Laryngeal nerve damage is manifested by severe hoarseness of voice or "whispery voice."

A child with Type 1 diabetes mellitus is brought to an emergency room by the mother, who states that the child has been complaining of abdominal pain and has a fruity odor of the breath. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which intravenous infusion?

• Potassium
• NPH Insulin
• 5% dextrose
• Normal saline

D - Rehydration is the initial step in resolving diabetic ketoacidosis. Normal saline is the initial IV rehydration fluid. NPH insulin is never administered by the IV route. Dextrose solutions are added to the treatment when the blood glucose level reaches an acceptable level.Intravenously administered potassium may be required, depending on the potassium level, but would not be part of the initial treatment.A client with diabetes mellitus has a glycosylated hemoglobin level of 9%. Based on this result, the nurse plans to teach the client about the

need to:

• Avoid infection
• Take in adequate fluids
• Prevent and recognize hypoglycemia
• Prevent and recognize hyperglycemia

D- In the test result for glycosylated hemoglobin A1c, 7% or less indicates good control, 7% to 8% indicates fair control, and 8% or higher indicates poor control. This test measures the amount of glucose that has become permanently bound to the red blood cells from circulating glucose.A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in an emergency room. Which finding would a nurse expect to note as confirming this diagnosis?

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

D- In DKA, the arterial pH is lower than 7.35, plasma bicarbonate is lower than 15 mEq/L, the blood glucose level is higher than 250 mg/dL, and ketones are present in the blood and urine. The client would be experiencing polyuria, and Kussmaul's respirations would be present. A comatose state may occur if DKA is not treated, but coma would not confirm the diagnosis.A client with diabetes mellitus demonstrates acute anxiety when first admitted for the treatment of hyperglycemia. The appropriate intervention

to decrease the client's anxiety is to:

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

B- The appropriate intervention is to address the client's feelings related to the anxiety. Administering a sedative is not the most appropriate intervention. The nurse should not ignore the client's anxious feelings. A client will not relate to medical terms, particularly when anxiety exists.

A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose level was 950 mg/dL. A continuous intravenous infusion of regular insulin is intiated, along with intravenous rehydration with normal saline. The serum glucose level is now 240 mg/dL. The nurse would next prepare to administer which of the following?

• Ampule of 50% dextrose
• NPH insulin subcutaneously
• Intravenous fluids containing 5% dextrose
• Phenytoin (Dilantin) for the prevention of seizures

C- During management of DKA, when the blood glucose level falls to 250 to 300 mg/dL, the infusion rate is reduced and 5% dextrose is added to maintain a blood glucose level of about 250 mg/dL, or until the client recovers from ketosis. NPH insulin is not used to treat DKA. Fifty percent dextrose is used to treat hypoglycemia. Phenytoin (Dilantin) is not a usual treatment measure for DKA.A physician has prescribed propylthiouracil (PTU) for a client with hyperthyroidism and the nurse develops a plan of care for the client. A priority nursing assessment to be included in the plan regarding this medication is to assess for:

• Relief of pain
• Signs of renal toxicity
• Signs and symptoms of hyperglycemia
• Signs and symptoms of hypothyroidism

D- Excessive dosing with propylthiouracil (PTU) may convert the client from a hyperthyroid state to a hypothyroid state. If this occurs, the dosage should be reduced. Temporary administration of thyroid hormone may be required. Propylthiouracil is not used for pain and does not cause hyperglycemia or renal toxicity.A nurse develops a plan of care for a client with hyperparathyroidism who is receiving calcitonin salmon (Calcimar). Which of the following outcome criteria has the highest priority regarding this medication?

• Relief of pain
• Absence of side effects
• Achievement of normal serum calcium levels
• Verbalization of appropriate medication knowledge

C- Calcitonin can lower plasma calcium levels in clients with hypercalcemia caused by hyperparathyroidism. The therapeutic effect in this client situation would be a reduction in serum calcium levels. Options A, B, and D are incorrect outcome criteria.A physician prescribes levothyroxine sodium (Synthroid), 0.15 mg orally daily, for a client with hypothyroidism. The nurse will prepare to

administer this medication:

• In the morning to prevent insomnia
• Only when the client complains of fatigue and cold intolerance
• At various times during the day to prevent tolerance from occurring
• Three times daily in equal doses of 0.5 mg each to ensure consistent serum drug levels

A- Levothyroxine (Synthroid) is a synthetic thyroid hormone that increases cellular metabolism. Levothyroxine should be given in the morning in a single dose to prevent insomnia and should be given at the same time each day to maintain an adequate drug level. Therefore, options B, C, and D are incorrect.