Exam Review

A nurse is teaching a client with diabetes mellitus who asks, "Why is it necessary to maintain my blood glucose levels no lower than about 60 mg/dL?" How should the nurse respond?
A)
Glucose is the only fuel used by the body to produce the energy that it needs.
B)
Your brain needs a constant supply of glucose because it cannot store it.
C)
Without a minimum level of glucose, your body does not make red blood cells.
D)
Glucose in the blood prevents the formation of lactic acid and prevents acidosis
What is a major factor in the development of type 1 diabetes?
A)
A high-fat diet.
B)
A diet high in concentrated carbohydrates.
C)
An autoimmune response.
D)
Obesity.
Which of the following are complications of insulin therapy? (Select all that apply).
(SATA)
A)
Lipodystrophy.
B)
Dawn phenomenon.
C)
Hypoglycemia.
D)
Somogyi phenomenon.
E)
Insulin resistance.
The nurse is administering insulin lispro (Humalog) and will keep in mind that this insulin will start to have an effect within which time frame?
A)
15 minutes.
B)
1 to 2 hours.
C)
80 minutes.
D)
3 to 5 hours.

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Exam Review

A nurse teaches a client with diabetes mellitus about foot care. Which statements should the nurse include in this client's teaching? (Select all that apply).
(SATA)
A)
Do not walk around barefoot.
B)
Soak your feet in a tub each evening.
C)
Trim toenails straight across with a nail clipper.
D)
Treat any blisters or sores with Epsom salts.
E)
Wash your feet every other day.
A nurse teaches a client with diabetes mellitus about sick day management. Which statement should the nurse include in this client's teaching?
A)
When sick, avoid eating or drinking to reduce vomiting and diarrhea.
B)
Monitor your blood glucose levels at least every 4 hours while sick.
C)
If vomiting, do not use insulin or take your oral antidiabetic agent.
D)
Continue your prescribed exercise regimen even if you are sick.
The physician orders Dilantin oral suspension 80 mg po three times a day for seizures. The medication is supplied in 125 mg/5 mL. How many milliliters will the nurse administer?
Correct Answer:3.2 mL
A patient, newly diagnosed with hypothyroidism, has received a prescription for thyroid replacement therapy. The nurse will instruct the patient to take this medication at which time of day?
A)
In the morning.
B)
With the noon meal.
C)
With the evening meal.
D)
At bedtime.

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Exam Review

After obtaining a history and assessing a client with diabetes mellitus, the nurse can expect to see or gather information about the following clinical symptoms.
A)
Polydipsia, polyphagia, polyuria and glycosuria.
B)
Obesity and excessive sugar consumption.
C)
Weight loss, nervousness, dysuria.
D)
Albumin in the urine and blood glucose of 90mg/100ml of blood
Which comment made by a school-age child indicates that he needs more teaching about diabetes mellitus and exercise?
A)
I carry a piece of hard candy with me in case I start to feel shaky.
B)
I make sure I have emergency money when I have soccer practice or a game.
C)
Sometimes I skip my breakfast when I have a game in the morning.
D)
I play in soccer games that are scheduled after dinner.
A client presents with diaphoresis, palpitations, nervousness, and tachycardia approximately 4 hours after taking his usual morning insulin. Which treatment is appropriate for this client?
A)
Check blood glucose level and administer carbohydrates.
B)
Give nitroglycerin and perform an electrocardiogram (ECG).
C)
Check pulse oximetry and administer oxygen therapy.
D)
Restrict salt, administer diuretics, and perform paracentesis.
A nurse is providing diabetic teaching for a family of a client newly diagnosed with diabetes. The nurse determines that the family understands the reason for having glucagon on hand for emergency home use if the family indicates that the purpose of the medication is to treat:
A)
Hyperglycemia from insufficient insulin.
B)
Hypoglycemia from insulin overdose.
C)
Diabetic ketoacidosis.
D)
Hyperglycemia occurring on 'sick days.

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Exam Review

A patient who has type 2 diabetes is scheduled for an oral endoscopy and has been NPO (nothing by mouth) since midnight. What is the best action by the nurse regarding the administration of her oral antidiabetic drugs?
A)
Administer half the original dose.
B)
Withhold all medications as ordered.
C)
Contact the prescriber for further orders.
D)
Give the medication with a sip of water.
A 19-year-old woman has been diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine (Synthroid). After 6 months, she calls the nurse to say that she feels better and wants to stop the medication. Which response by the nurse is correct?
A)
"Medication therapy for hypothyroidism is usually lifelong, and you should not stop taking the medication
B)
"You need to stay on this medication until you become pregnant
C)
You need to stay on the medication for at least 1 year before a decision about stopping it can be made."
D)
"You can stop the medication if your symptoms have improved.
The physician orders Humulin NPH insulin 20 units plus Humulin R insulin 11 units subcutaneous every evening. The medication is supplied in 100 units/mL. How many units will the nurse administer?
The nurse is teaching a group of patients about management of diabetes. Which statement about basal dosing is correct?
A)
Basal dosing delivers a constant dose of insulin.
B)
With basal dosing, you can eat what you want and then give yourself a dose of insulin.
C)
Glargine insulin is given as a bolus with meals.
D)
Basal-bolus dosing is the traditional method of managing blood glucose levels.

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Exam Review

A patient with a history of chronic obstructive pulmonary disease (COPD) and type 2 diabetes has been treated for pneumonia for the past week. The patient has been receiving intravenous corticosteroids as well as antibiotics as part of his therapy. At this time, the pneumonia has resolved, but when monitoring the blood glucose levels the nurse notices that the level is still elevated. What is the best explanation for this elevation?
A)
The antibiotics may cause an increase in glucose levels.
B)
The corticosteroids may cause an increase in glucose levels.
C)
His type 2 diabetes has converted to type 1.
D)
The hypoxia caused by the COPD causes an increased need for insulin.
After teaching a client with diabetes mellitus to inject insulin, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?
A)
The lower abdomen is the best location because it is closest to the pancreas.
B)
I can reach my thigh the best, so I will use the different areas of my thighs.
C)
By rotating the sites in one area, my chance of having a reaction is decreased.
D)
Changing injection sites from the thigh to the arm will change absorption rates.
The complication of diabetic neuropathy places the client at risk for which of these conditions?
A)
Atherosclerosis.
B)
Diabetic retinopathy.
C)
Injury and undetected foot injury.
D)
Kidney failure.
After starting treatment for type 2 diabetes mellitus 6 months earlier, a patient is in the office for a follow-up examination. The nurse will monitor which laboratory test to evaluate the patient's adherence to the antidiabetic therapy over the past few months?
A)
Hemoglobin levels.
B)
Hemoglobin A1C level.
C)
Fingerstick fasting blood glucose level.
D)
Serum insulin levels.

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Exam Review

When a client's glucose level drops below 70 mg/dL, often before meals or when insulin action is peaking, the client is experiencing what condition?
A)
Diabetic ketoacidosis.
B)
Diabetic neuropathy.
C)
Hyperosmolar hyperglycemic nonketotic syndrome.
D)
Hypoglycemia.
A client had a subtotal thyroidectomy in the early morning. During evening rounds, the nurse assesses the client who now has nausea, a temperature of 105 degrees F (40.6 C), tachycardia, and extreme restlessness. What is the most likely cause of these signs and symptoms?
A)
Tetany.
B)
Hypoglycemia.
C)
Thyroid crisis.
D)
Diabetic Ketoacidosis.
After teaching a young adult client who is newly diagnosed with type 1 diabetes mellitus, the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the need for eye examinations?
A)
At my age, I should continue seeing the ophthalmologist as I usually do.
B)
I will see the eye doctor when I have a vision problem and yearly after age 40.
C)
My vision will change quickly. I should see the ophthalmologist twice a year.
D)
My vision will be fine, I will not need an eye examination.
A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement should the nurse include in this client's plan of care to delay the onset of microvascular and macrovascular complications?
A)
Maintain tight glycemic control and prevent hyperglycemia.
B)
Restrict your fluid intake to no more than 2 liters a day.
C)
Prevent hypoglycemia by eating a bedtime snack.
D)
Limit your intake of protein to prevent ketoacidosis.

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