NCLEX Style Practice Questions - MedSurg DIABETES

NCLEX Style Practice Questions - MedSurg DIABETES ScienceMedicineNutrition jhess214 Save Diabetes Mellitus NCLEX Style Ques...Teacher 36 terms ssandholmPreview Med Surg Gastrointestinal NCLEX Q...86 terms Jasmine_Lawson4 Preview med surg diabetes questions 24 terms hannah1817Preview some o 30 terms Am The nurse is educating a pregnant client who has gestational diabetes. Which of the following statements should the nurse make to the client?Select all that apply.

• Cakes, candies, cookies, and regular soft drinks should be avoided.
• Gestational diabetes increases the risk that the mother will develop diabetes later in life.
• Gestational diabetes usually resolves after the baby is born.
• Insulin injections may be necessary.
• The baby will likely be born with diabetes
• The mother should strive to gain no more weight during the pregnancy.

ANS: A, B, C, D

Gestational diabetes can occur between the 16th and 28th week of pregnancy.If not responsive to diet and exercise, insulin injections may be necessary.Concentrated sugars should be avoided.Weight gain should continue, but not in excessive amounts.Usually, gestational diabetes disappears after the infant is born. However, diabetes can develop 5 to 10 years after the pregnancy.

The goal for pre-prandial blood glucose for those with Type 1 diabetes mellitus is:

• <80 mg/dl
• < 130 mg/dl
• <180 mg/dl
• <6%
• < 130 mg/dl

The guidelines for Carbohydrate Counting as medical nutrition therapy for diabetes mellitus includes all of the following EXCEPT:

• Flexibility in types and amounts of foods consumed
• Unlimited intake of total fat, saturated fat and cholesterol
• Including adequate servings of fruits, vegetables and the dairy group
• Applicable to with either Type 1 or Type 2 diabetes mellitus
• Unlimited intake of total fat, saturated fat and cholesterol

The nurse working in the physician's office is reviewing lab results on the clients seen that day. One of the clients who has classic diabetic symptoms had an eight-hour fasting plasma glucose test done. The nurse realizes that diagnostic criteria developed by the American Diabetes Association for diabetes include classic diabetic symptoms plus which of the following fasting plasma glucose levels?

• Greater than 106 mg/dl
• Greater than 126 mg/dl
• Higher than 140 mg/dl
• Higher than 160 mg/dl
• Higher than 160 mg/dl

When taking a health history, the nurse screens for manifestations suggestive of diabetes type I. Which of the following manifestations are considered the primary manifestations of diabetes type I and would be most suggestive of diabetes type I and require follow-up investigation?

• Excessive intake of calories, rapid weight gain, and difficulty losing weight
• Poor circulation, wound healing, and leg ulcers,
• Lack of energy, weight gain, and depression

d. An increase in three areas: thirst, intake of fluids, and hunger

D. An increase in three areas: thirst, intake of fluids, and hunger

The primary manifestations of diabetes type I are polyuria (increased urine output), polydipsia (increased thirst), polyphagia (increased hunger).

The nurse is working with an overweight client who has a high-stress job and smokes. This client has just received a diagnosis of Type II Diabetes and has just been started on an oral hypoglycemic agent. Which of the following goals for the client which if met, would be most likely to lead to an improvement in insulin efficiency to the point the client would no longer require oral hypoglycemic agents?

• Comply with medication regimen 100% for 6 months
• Quit the use of any tobacco products by the end of three months
• Lose a pound a week until weight is in normal range for height and exercise 30 minutes daily
• Practice relaxation techniques for at least five minutes five times a day for at least five months
• Lose a pound a week until weight is in normal range for height and exercise 30 minutes daily

When type II diabetics lose weight through diet and exercise they sometimes have an improvement in insulin efficiency sufficient to the degree they no longer require oral hypoglycemic agents.When working in the community, the nurse will recommend routine screening for diabetes when the person has one or more of seven risk criteria. Which of the following persons that the nurse comes in contact with most needs to be screened for diabetes based on the seven risk criteria?

• A woman who is at 90% of standard body weight after delivering an eight-pound baby
• A middle-aged Caucasian male
• An older client who is hypotensive
• A client with an HDL cholesterol level of 40 mg/dl and a triglyceride level of 300 mg/dl
• A client with an HDL cholesterol level of 40 mg/dl and a triglyceride level of 300 mg/dl

The seven risk criteria include: greater than 120% of standard body weight, Certain races but not including Caucasian, delivery of a baby weighing more than 9 pounds or a diagnosis of gestational diabetes, hypertensive, HDL greater than 35 mg/dl or triglyceride level greater than 250 or a triglyceride level of greater than 250 mg/dl, and, lastly, impaired glucose tolerance or impaired fasting glucose on prior testing.The nurse assisting in the admission of a client with diabetic ketoacidosis will anticipate the physician ordering which of the following types of intravenous solution if the client cannot take fluids orally?

• 0.45% normal saline solution
• Lactated Ringer's solution
• 0.9 normal saline solution
• 5% dextrose in water (D5W)
• 0.45% normal saline solution

You are doing some teaching with a client who is starting on a sulfonylurea antidiabetic agent. The client mentions that he usually has a couple of beers each night and takes an aspirin each day to prevent heart attack and/or strokes. Which of the following responses would be best on the part of the nurse?

• As long as you only drink two beers and take one aspirin, this should not be a problem
• The aspirin is alright but you need to give up drinking any alcoholic beverages
• Aspirin and alcohol will cause the stomach to bleed more when on a sulfonylurea drug
• Taking alcohol and/or aspirin with a sulfonylurea drug can cause development of hypoglycemia
• Taking alcohol and/or aspirin with a sulfonylurea drug can cause development of hypoglycemia

Alcohol and/or aspirin taken with a sulfonylurea can cause development of hypoglycemia.Which of the following things must the nurse working with diabetic clients keep in mind about Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)?

• This syndrome occurs mainly in people with Type I Diabetes
• It has a higher mortality rate than Diabetic Ketoacidosis
• The client with HHNS is in a state of overhydration
• This condition develops very rapidly
• It has a higher mortality rate than Diabetic Ketoacidosis

HHNS occurs only in people with Type II Diabetes. It is a medical emergency and has a higher mortality rate than Diabetic Ketoacidosis. This condition develops very slowly over hours or days.Which one of the following methods/techniques will the nurse use when giving insulin to a thin person? [Hint]

• Pinch the skin up and use a 90 degree angle
• Use a 45 degree angle with the skin pinched up
• Massage the area of injection after injecting the insulin
• Warm the skin with a warmed towel or washcloth prior to the injection
• Pinch the skin up and use a 90 degree angle

The best angle for a thin person is 90 degrees with the skin pinched up. The area is not massaged and it is not necessary to warm it.