Patho Diabetes NCLEX questions

Patho Diabetes NCLEX questions ScienceMedicineNursing salukidc Save Diabetes Mellitus NCLEX Style Ques...Teacher 36 terms ssandholmPreview pharmacology saunders 696 terms bauerumiPreview SIADH vs Diabetes Insipidus Quiz fo...10 terms florahill10Preview Diabet 172 term DEE "1. A patient with newly diagnosed type 2 diabetes mellitus asks the nurse what ""type 2"" means in relation to diabetes. The nurse explains to the patient that type 2 diabetes differs from type 1 diabetes primarily in that with type 2 diabetes

• the pt is totally dependent on an outside source of insulin
• there is a decreased insulin secretion and cellular resistance to insulin that is produced
• the immune system destroys the pancreatic insulin-producing cells
• the insulin precurosr that is secreted by the pancreas is not activated by the liver

B (Rationale: In type 2 diabetes, the pancreas produces insulin, but the insulin is insufficient for the body's needs or the cells do not respond to the insulin appropriately. The other information describes the physiology of type 1 diabetes) A 54-year-old patient admitted with type 2 diabetes, asks the nurse what "type 2" means. Which of the following is the most appropriate response by the nurse?"1. ""With type 2 diabetes, the body of the pancreas becomes inflamed."

• "With type 2 diabetes, insulin secretion is decreased and insulin resistance is increased."
• "With type 2 diabetes, the patient is totally dependent on an outside source of insulin."
• "With type 2 diabetes, the body produces autoantibodies that destroy b-cells in the pancreas.""

2 (Rationale: In type 2 diabetes mellitus, the secretion of insulin by the pancreas is reduced and/or the cells of the body become resistant to insulin")

"A client is admitted to the hospital with signs and symptoms of diabetes mellitus. Which findings is the nurse most likely to observe in this client?

Select all that apply:

"1. Excessive thirst

• Weight gain
• Constipation
• Excessive hunger
• Urine retention
• Frequent, high-volume urination

1, 4, 6

(Rationale: Classic signs of diabetes mellitus include polydipsia (excessive thirst), polyphagia (excessive hunger), and polyuria (excessive urination). Because the body is starving from the lack of glucose the cells are using for energy, the client has weight loss, not weight gain.Clients with diabetes mellitus usually don't present with constipation. Urine retention is only a problem is the patient has another renal-related condition.) A client with diabetes melllitus has a blood glucose of 644mg/dl. The nurse intreprets that this client is most at risk of developing which type of acid base imbalance?

• Metabolic acidosis
• Metabolic alkalosis
• Respiratory Acidosis
• Respiratory Alkalosis"

A

• Metabolic Acidosis

Rationale: DM can lead to metabolic acidosis. When the body does not have sufficient circulating insulin, the blood glucose level rises. At the same time, the cells of the body use all available glucose. The body then breaks down glycogen and fat for fuel. The by-products of fat metabolism are acidotic and can lead to the condition known as diabetic ketoacidosis.") A nurse is caring for a cient with type 1 diabetes mellitus. which client complaint would alert the nurse to the presence of a possible hypoglycemic reaction?"1. Tremors

• Anorexia
• Hot, dry skin
• Muscle cramps

1 (tremors decreased blood glucose levels produce autonomic nervous system symptoms, which are manifested classically as nervousness, irritability, and tremors. option 3 is more likely for hyperglycemia, and options 2 and 4 are unrelated to the signs of hypoglycemia.) "A nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include a fasting blood glucose of 120 mg/dL, temp of 101 F, pulse of 88 bpm, respirations of 22, and blood pressure of 100/72. Which finding would be of most concern to the nurse?"1. Pulse

• Respiration
• Temperature
• Blood pressure"

3 (temp. An elevated temperature may indicate infection. Infection is a leading cause of hyperglycemic hyperosmolar nonketotic syndrome or diabetic ketoacidosis. The other findings noted in the question are within normal limits.)

"A nurse shoud recognize which symptom as a cardinal sign of diabetes mellitus?"a. Nausea

• Seizure
• Hyperactivity
• Frequent urination

D (Polyphagia, polyuria, polydipsia, and weight loss are cardinal signs of DM. Other signs include irritability, shortened attention span, lowered frustration tolerance, fatigue, dry skin, blurred vision, sores that are slow to heal, and flushed skin.) A patient is admitted with diabetes mellitus, has a glucose level of 380 mg/dl, and a moderate level of ketones in the urine. As the nurse assesses for signs of ketoacidosis, which of the following respiratory patterns would the nurse expect to find?A-Central apnea B-Hypoventilation C-Kussmaul respirations D- Cheyne-Stokes respirations" C (Kussmaul respirations. In diabetic ketoacidosis, the lungs try to compensate for the acidosis by blowing off volatile acids and carbon dioxide.This leads to a pattern of Kussmaul respirations, which are deep and nonlabored.) "An 18-year-old female client, 5'4'' tall, weighing 113 kg (~250 lbs), comes to the clinic for a non-healing wound on her lower leg, which she has had for two weeks. Which disease process should the nurse suspect the client is developing?"A. Type 1 diabetes

• Type 2 diabetes
• Gestational diabetes
• Acanthosis nigricans"

B (Type 2 diabetes is a disorder usually occurring around the age of 40, but it is now being detected in children and young adults as a result of obesity and sedentary lifestyles. Non-healing wounds are a hallmark sign of type 2 diabetes. This client weights 248.6 lbs and is short.) Blood sugar is well controlled when Hemoglobin A1C is..."a. Below 7%

• Between 12%-15%
• Less than 180 mg/dL
• Between 90 and 130 mg/dL"

A( Below 7% A1c measures the percentage of hemoglobin that is glycated and determines average blood glucose during the 2 to 3 months prior to testing.Used as a diagnostic tool, A1C levels of 6.5% or higher on two tests indicate diabetes. A1C of 6% to 6.5% is considered prediabetes.)

During a diabetes screening program, a patient tells the nurse, "My mother died of complications of type 2 diabetes. Can I inherit diabetes?" The nurse explains that a.) as long as the patient maintains normal weight and exercises, type 2 diabetes can be prevented.b.) the patient is at a higher than normal risk for type 2 diabetes and should have periodic blood glucose level testing.c.) there is a greater risk for children developing type 2 diabetes when the father has type 2 diabetes.d.) although there is a tendency for children of people with type 2 diabetes to develop diabetes, the risk is higher for those with type 1 diabetes." A (Rationale: Offspring of people with type 2 diabetes are at higher risk for developing type 2 diabetes. The risk can be decreased, but not prevented, by maintenance of normal weight and exercising. The risk for children of a person with type 1 diabetes to develop diabetes is higher when it is the father who has the disease. Offspring of people with type 2 diabetes are more likely to develop diabetes than offspring of those with type 1 diabetes.) Of which of the following symptoms might an older woman with diabetes mellitus complain?1) anorexia 2)pain intolerance 3) weight loss 4) perineal itching 4) (perineal itching Rationale: Older women might complain of perineal itching due to vaginal candidiasis.) "Polydipsia and polyuria related to diabetes mellitus are primarily due to: "a. The release of ketones from cells during fat metabolism

• Fluid shifts resulting from the osmotic effect of hyperglycemia
• Damage to the kidneys from exposure to high levels of glucose
• Changes in RBCs resulting from attachment of excessive glucose to hemoglobin"

b (Fluid shifts resulting from the osmotic effect of hyperglycemia Rationale: The osmotic effect of glucose produces the manifestations of polydipsia and polyuria.)

Risk factors for type 2 diabetes include all of the following except:

"a. Advanced age

• Obesity
• Too much physical activity
• Physical inactivity"

C ("Additional risk factors for type 2 diabetes are a family history of diabetes, impaired glucose metabolism, history of gestational diabetes, and race/ethnicity. African-Americans, Hispanics/Latinos, Asian Americans, Native Hawaiians, Pacific Islanders, and Native Americans are at greater risk of developing diabetes than whites.")