Med Surg 2 - Diabetes Mellitus N-CLEX Style Questions

Med Surg 2 - Diabetes Mellitus N-CLEX Style Questions ScienceMedicineNursing natz_devalon Save Diabetes Mellitus NCLEX Style Ques...Teacher 36 terms ssandholmPreview Med-Surg Exam 1 (Diabetes) 24 terms amelvargasPreview

Chapter 46: Management of Patient...

39 terms gsmg16Preview med su 24 terms han A nurse is caring for a client who has blood glucose of 52 mg/dL. The client is lethargic but arousable. Which of the following actions should the Nurse perform first?

• Recheck Blood glucose in 15 min.
• Provide a carbohydrate and protein food.
• Provide 4 oz grape juice.
• Report findings to the provider.
• INCORRECT: Blood glucose is rechecked in 15 min after a rapidly absorbed carbohydrate is ingested, but is not the priority nursing action.
• INCORRECT: A carbohydrate and protein food is given to the client if the next meal is more than 1 hr away after the blood glucose returns to

a normal range. This is not the priority Nursing action.

• CORRECT: The client's acute need for a rapidly absorbed carbohydrate. such as grape juice, takes priority when treating the blood glucose

52 mg/dL.

• INCORRECT: Reporting the findings to the provider is not the priority action.

A nurse is preparing to administer a dose of aspart insulin (NovoLog) to a client who has type 1 diabetes mellitus. Which of the following is an appropriate action by the nurse?

• Check the client's blood glucose immediately after breakfast.
• Administer the insulin when breakfast arrives.
• Hold breakfast for 1 hr after insulin administration.
• Clarify the prescription because insulin should not be administered at this time.
• INCORRECT: Blood glucose should checked prior to insulin administration to prevent an episode of hypoglycemia.
• CORRECT: Administer aspart insulin when breakfast arrives to avoid a hypoglycemic episode. Apart insulin is rapid-acting, and the client

should eat immediately after the nurse administers the medication.

• INCORRECT: Aspart insulin is rapid-acting and is administered 5 to 10 min before breakfast. Breakfast should be available at the time injection.
• INCORRECT: Aspart insulin is administered at breakfast time and can be prescribed for administration 2 to 3 times a day.

A nurse is teaching foot care to a client who has diabetes mellitus. Which of the following information should the nurse include in the teaching?(Select all that apply.)

• Remove calluses using over-the-counter remedies.
• Apply lotion between toes.
• Perform nail care after Bathing.
• Trim toenails straight across.

E Wear closed-toe shoes

• INCORRECT: A podiatrist should remove calluses or corns. Commercial over-the-counter remedies can increase the risk for tissue injury and

an infection.

• INCORRECT: Applying lotion between the toes increases moisture for growth of micro-organisms, which can lead to infection
• CORRECT: Perform nail care after bathing, when toenatils are soft and easier to trim.
• CORRECT: Trim toenails straight across to prevent injury to soft tissue of the toes.
• CORRECT: Wear closed-toe shoes to prevent injury to soft tissue of the toes and feet.

A nurse is assisting with the care of a client who has diabetic ketoacidosis. The nurse should anticipate that the client's condition will be treated initially with which of the following IV solutions?

• Dextrose 5% in 0.9% sodium chloride
• 0.45% sodium chloride
• 0.9% sodium chloride
• Dextrose 5% in 0.45% sodium chloride
• INCORRECT: The nurse should add glucose to the IV infusion when the serum glucose is 250 mg/dL, not 350 mg/dL, to prevent

hypoglycemia and minimize cerebral edema.

• INCORRECT: The admistration of an IV infusion of 0.45% sodium chloride should follow the isotonic fluid and is used as maintenance fluids.
• CORRECT: The nurse should anticipate that the client's conditon will be intially treated with a rapid infusion of 0.9% sodium chloride, an

isotonic fluid, to mainatin blood perfusion to vital organs.

• INCORRECT: The nurse should add glucose to the IV infusion when the serum glucose is 250 mg?dL, not 350 mg/dL, to prevent

hypoglycemia and minimize cerebral edema.A nurse is reviewing the laboratory findings for a client who has hyperglycemic hyperosmolar state (HHS). Which of the following is an expected finding for this client?

• Serum sodium 143 mEq/L
• Serum Glucose 635 mg/dL
• Serum BUN 15 mg/dL
• Serum pH. 7.35
• INCORRECT: This finding is within the expected reference range. An expected finding for a client who has HHS is an elevated serum sodium

due to dehydration.

• CORRECT: Extreme hyperglycemia is an expected finding for a client who has HHS.
• INCORRECT: This finding is within the expected reference range. An elevated BUN is an expected finding for a client who has HHS.
• INCORRECT: A pH greater than 7.4 is an expected finding for a client who has HHS>

Describe the disease process of type 1 Diabetes Mellitus It is an autoimmune dysfunction involving the destruction of beta cells in the pancreas triggered by a certain genetic tissue type or viral infection

A nurse is teaching a diabetic support group about the causes of type 1 diabetes. The teaching is determined to be effective when the group is able to attribute which of the following factors as a cause of type 1 diabetes?

a) Altered glucose metabolism

b) Presence of autoantibodies against islet cells

c) Rare ketosis

d) Obesity

• There is evidence of an autoimmune response in type 1 diabetes. This is an abnormal response in which antibodies are directed against normal

tissues of the body, responding to these tissues as if they were foreign. Autoantibodies against islet cells and against endogenous (internal) insulin have been detected in people at the time of diagnosis and even several years before the development of clinical signs of type 1 diabetes.A nurse is preparing to discharge a patient with coronary artery disease (CAD) and hypertension (HTN) who is at risk for type 2 diabetes. Which of the following information is important to include in the discharge teaching?

a) How to recognize signs of diabetic ketoacidosis (DKA)

b) How to control blood glucose through lifestyle modification with diet and exercise

c) How to self-inject insulin

d) How to monitor ketones daily

• Persons at high risk for type 2 diabetes receive standard lifestyle recommendations plus metformin, standard lifestyle recommendations plus

placebo, or an intensive program of lifestyle modifications. The 16-lesson curriculum of the intensive program of lifestyle modifications focuses on weight reduction of greater than 7% of initial body weight and physical activity of moderate intensity. It also includes behavior modification strategies designed to help patients achieve the goals of weight reduction and participation in exercise. These findings demonstrate that type 2 diabetes can be prevented or delayed in persons at high risk for the disease.The nurse is administering lispro (Humalog) insulin. Based on the onset of action, how soon should the nurse administer the injection prior to breakfast?

• 10 to 15 minutes
• 1 to 2 hours
• 30 to 40 minutes
• 3 hours
• The onset of action of rapid-acting Humalog is within 10 to 15 minutes. It is used for rapid reduction of glucose level.

A patient with type 2 diabetes has recently been placed on acarbose (Precose); the nurse is explaining how to take this medication. The teaching is determined to be effective based on which of the following statements?

• "I will take this medication in the morning, 15 minutes before breakfast."
• "I will take this medication in the morning, with my first bite of breakfast."
• "This medication needs to be taken after the midday meal."
• "It does not matter what time of day I take this medication."
• Alpha-glucosidase inhibitors, such as acarbose (Precose) and miglitol (Glyset), delay absorption of complex carbohydrates in the intestine

and slow entry of glucose into systemic circulation. They must be taken with the first bite of food to be effective.