DM

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Roxy22
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166262
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DM
Updated:
2012-08-17 00:22:51
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DM
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Diabetes Mellitus
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  1. A nurse is developing a teaching plan for a cllient with DM. A client with DM should:
    D. Wash and inspect the feet daily.
  2. Which of the following would be included in the teaching plan for a patient dx with DM?
    B. Elevated blood glucose levels contribute to complications of DM, such as dimished vision.
  3. The Diabetic Educator is teaching a class on complications of DM for newly dx diabetic children and their parents. The diabetic Educator would define hypoglycemia as what blood glucose level?
    A. Below 70 mg/dL
  4. The nurse is caring for a type 1 diabetic pt. who is being discharged home tomorrow. Pt. teaching includes assessing the pt.s self-care skills to determine if further diabetes teaching is required. What is the best way to assess the pt.s ability to prepare and give insulin?
    B. Direct observation of the self-care skill
  5. Which of the following is an age-related change that may affect DM and its management?
    D. Decreased renal function
  6. A client has ty 1 DM. Her husband finds her unconscious at home and administers glucagon, 0.5 mg sq. She awakens in 5 min.s. Why should her husband offer her a complex CHO snack as soon as possible?
    D. To restore liver glycogen and prevent secondary hypoglycemia
  7. A pt. is evaluated for ty 1 DM. Which pt. comment correlates best with this disorder?
    A. "I'm thirsty all the time. I just can't get enough to drink."
  8. The school nures is teaching the senior health class about risk factors for DM. What risk factor fro DM cannot be modified by the pt.?
    D. Advanced age
  9. A nurse is explaining the action of insulin to a client with DM. During pt. teaching, the nurse review the process of insulin secretion in the body. The nurse is correxct when she states that insulin is secreted from the:
    D. Beta cells of the pancreas.
  10. A pt. with newly dx ty 2 DM is admitted to the metabolic unit. The primary goal for this admission is education. Which goal should the nurse incorporate into her teaching plan?
    D. Weight reduction through diet and exercise
  11. A pt. wiht ty 1 DM is to receive a short-acting insulin and an itermediate-acting insulin sq before breakfast. The nurse would administer the insulin at which site as the preferred site?
    D. Abdomen
  12. The nursing instructor is discussing DM with thjunior nursing class. What would the instructor tell the class may develp in the pt. when ketone bodies accumulate in exessive amounts?
    C. Diabetic ketoacidosis
  13. When referred to a podiatrist, a pt. newly dx with DM asks, "Why do you need to check my feet whn i'm having a problem with my boldy sugar?" The nurse's most helpful response to this statement is:
    D. "DM can affect sensation in your feet and you can hurt yourself without realizing it."
  14. A pt. with DM is receiving an oral antidiabetic agen. Which of the following aspects should the nurse observe when caring for the pt.?
    B. Signs of hypoglycemia
  15. Which statement indicates that a pt. with DM understans proper foot care?
    A. "I'll wear cotton socks with well-fitting shoes."
  16. A pt. with ty 1 DM asks the nurse about taking an oral antidiabetic agent. The nurse explains that these medications are effective only if the pt.
    A. Has type 2 DM
  17. After being sickfor 3 days, a pt. with a history of DM is admitted to the hospital with diabetic ketoacidosis (DKA). The nurse should evaluate which diagnostic test results to prevent arrhythmias?
    D. Serum potassium level
  18. A pt. is taking glyburide (DiaBeta),  1.25 mg P.O. daily, to tx ty 2 DM. Which statement indicates the need for further pt. teaching about managing this disease?
    D. "I skip lunch when I don't feel hungry."
  19. An elderly pt. comes to the clinic with her daughter. The pt. is a diabetic and is concerned about foot care. The nures goes over foot care with the pt. and her daughter as the nurse realized that foot care is extremely important. Why would the nurese feel that foot care is so important to this pt.?
    A. Avoiding the complications associated with foot ulcers may mena the dirfference between institutionalization and continued independent living.
  20. A nurse is preparing to administer insulin to a child who's just been dx with ty 1 DM. When the child's mother stops the nurse in the hall, she's crying and anxious to talk about her son's condition. The nurse's best response is:
    D. "I'm going to give your son insulin. Then I'll be happy to talk with you."
  21. Which of the following are by products of fat breakdown, which accumulate in the blood and urine?
    A. Ketones
  22. The diabetic nurse is working for the summer at a camp for diabetic adolescents. When providing information on the prevention of hypoglycemia, what criteria would best help to prevent hypoglycemia?
    A. Always carry a form of fast-acting sugar.
  23. A nurse educates a group of pt.s with DM on the prevention of diabetic nephropathy, Which of the following suggestions would be most important?
    D. Control blood glucose levels.
  24. A nurse explains to a pt. that she will administer his first insulin dose in his abdomen. How does absorption at the abdominal site compare with absorption at other sites?
    A. Insulin is absorbed mor rapidly at abdominal injection sites than other sites.
  25. An adolescent pt. tells the nurse at school tha he is feeling nervous and hungry. The school nurse assesses the pt. and finds he has tachycarida and is diaphoretic. Whnat should the school nurse administer?
    C. Fruit juice, 4-6 oz.
  26. A nurse expexts to find which signs and symptoms in a pt. experiencing hypoglycemia?
    D. Nervousness, diaphoresis, and confusion
  27. Which of the following clinical characteristics is associated with ty 2 DM (previously referred to as non-insulin dependent diabetes mellitus [NIDDM])?
    B. Can control blood glucose through diet and exercise.
  28. A pt. with DM is receiving an oral antidiabetic agent. The nurse observes for which of the following symptoms when caring for this pt.?
    D. Signs of hypoglycemia
  29. A client with diabetes comes to the clinic for a follow-up visit. The nurse reviews the pt.s glycosylated hemoglobin test results. Which result would indicate to the nurse that the pt. blood glucose level has been well-controlled?
    B. 6.5%
  30. A 53-yr.-old pt. is brought to the ED, via squad, where you practice nursing. He is demonstrating fast, deep, labored breathing and has fruity odor to his breath. He has a history of ty 1 DM. What could be the cause of his current serious condition?
    D. Ketoacidosis
  31. A pt. with DM must learn how to self-administer insulin. The physician has ordered 10 U of U-100 R-insulin and 35 U of U-100 isophane insulin suspension (NPH) to be taken befor breakfast. When teaching the pt. how to select and rotate insulin injection sites, the nurse should provide which instruction?
    B. "Rotate injection sites within the same anatomic region, not among different regions."
  32. The nurse is doing pt. teaching with an adolescent newly dx with ty 1 DM and her family. The nurse teaches the pt. and family that what will decrease the body's need for insulin?
    C. Exercise
  33. A nurse is caring for a pt. with ty 1 DM whi exhibits confusion, light-headedness, and aberrant behavior. The pt. is conscious. The nurse should first administer:
    B. 15 to 20 g of a fast-acting CHO such as orange juice.
  34. A pt. with ty 1 DM has highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the pt. the nurse is most accurate in stating:
    D. "it tells us about your sugar control for the last 3 months."
  35. Which of the following should be included in the teaching plan for a pt. receiving glargine (Lantus), "peakless" basal insulin?
    D. Do not mix with other insulins
  36. Which of the following statements is correct regarding glargine (Lantus) insulin?
    B. It cannot be mixed with any other type of insulin.
  37. An agitated, confused pt. arrives in the ER. The pt.s hx includes ty 1 DM, HTN, and angina pectoris. Assessment reveals pallor, diaphoresis, headach, and intese reaction. After reconery, the nurse teaches the pt. to treat hypoglycemia by ingesting:
    C. 10-15  g of simple carbohydrate
  38. A pt.s blood glucose level is 45 mg/dL. The nurse should be alert for which s/sx?
    C. Coma, anxiety, confusion, headach, and cook, moist skin
  39. A newly admitted pt. with ty 1 DM asks the nurse what caused  her DM. The nurse is explaining to the pt. the etiology of ty 1 DM. Which of the following ecplanations is approprate?
    C. "Destruction of special cells in the pancreas causes a decrease in insulin production and the level of glucose  in the bloodstream increases because the body lacks insulin to break down the glucose."
  40. The Diabetic Educator is teaching a pt. about ty 2 DM. The Educator recognizes the pt. understands the primary tx for ty 2 DM when the pt. states what ?
    C. "I will follow the weight loss plan designed by the dietitian."
  41. Which intervention is essential when performing dressing changes on a pt. with  a diabetic foot ulcer?
    B. Using sterile technique during the dressing change
  42. The nurse is preparing a presentation for a group of adults at a local community center about DM. Which of the following would the nurse include as associated with ty 2 DM?
    A. Insulin production insufficient
  43. After teaching a pt. with ty 1 DM, who is scheduled to undergo an islet cell transplant, which pt. statement indicates sucessful teaching?
    B. "I might need insulin later on but probab;y not as much or as often."
  44. A pt. presents to the clinic complaining of symptoms that suggest DM. What criteria would support checking blood levels for the dx of DM?
    A. Fasting plasma glucose greater than or equal to 126 mg/dL
  45. The diabetic educator is assessing a hospitalized pt. to see if it is necessary to reinforce parts of the pt.s knowledge of basic diabetic self-care skills. What would be an appropriate way for the diabetic educator to assess the pt.s knowledge of nutritional therapy in DM?
    A. Monitor the pt.s daily food menus.
  46. Which of the following may be a potential cause of hypoglycemia in the pt. dx with DM?
    C. The pt. has not consumed food and has not taken or received insulin.
  47. Which of the following clinical manifestations of ty 2 DM occurs if glucose levels are very high?
    D. Blurred vision
  48. A pt. is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer IV?
    D. Regular
  49. A pt. newly dx with ty 2 DM is attending a nutrition class specifically designed for ty 2 diabetic. What general guideline would it be important to teach the pt. at this class?
    A. Control calorie intake to attain a resonable body weight.
  50. An adolescent, newly dx with ty 1 DM, asks the nurse what caused the DM. What would be the nurse's best response?
    D. "The causes of ty 1 DM are genetic, immunologic, and environmental."
  51. NPH is an example of which ty of insulin?
    D. Intermediate-acting
  52. A male pt., aged 42 is dx with DM. He visits the gym regularly and is a vegetarian. Which of the following factors is important when assessing the client?
    A. The pt. consumption of CHO
  53. The nurse performs a fingerstick blood glucose level of a pt. with DM before lunch. The nurse would notify the physician for which blood glucose level?
    C. 145 mg/dL
  54. Matt Thompson, a 37 yr. old farmer, has been dx with pre-diabetes. Following his physician visit, where he received the diagnosis, you begin your pt. education session to discuss tx strategies. What can be the consequences of untreated pre-diabetes?
    • A. All options are correct
    • B.Type 2 DM
    • C. CVA
    • D. Cardia disease
  55. A nurse is providing dietary instructions to pt. with hypoglycemia. To contron hypoglycemic episodes, the nurse should recommend:
    C. Consuming a low-carbohydrate, high-protein diet and avoiding fasting.
  56. You are caring for four pt.s, all dx with ty 1 dm. Based upon components of managing DM, which pt. will likely have the greatest success in maintaining tight glucose control to ty 1 DM?
    A. A pt. who adheres to a meal plan and meal schedule.
  57. Which of the following is the most rapid acting insulin?
    C. Humalog
  58. When administering insulin to a pt. with ty 1 dm, which of the following would be most important for the nurse to keep in mind?
    D. Accuracy of the dosage
  59. A pt. with dm has a prescription for 5 units of U-100 regular insulin and 25 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. At  about 4;30 pm the pt. experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms?
    D. Serum glucose level of 52 mg/dl
  60. A pt. tell the nurse that she has been working hard for the past 3 months to control her ty 2 dm wih diet and exercise. To determine the effectiveness of the pt.s efforts, the nurse should check:
    D. Serum fructosamine level.
  61.  The nurse instructor is teaching his students about foot care for the dm pt. The instructor teaches the students what general guidelines regarding foot care?
    B. Do not wear socks to bed.
  62. Which of the following clinical characteristics is associated with ty 1 dm (previously referred to as insulin-dependent diabetes mellitus (IDDM)?
    C. Obesity
  63. The nurse is teaching a newly dx diabetic about his insulin regimen. When administering Humalog insulin the nurse should teach teh pt. what?
    B. have the pt.s meal tray available.
  64. Which of the following factors would a nurse id as a most likely cause of diabetic ketoacidosis (DKA) in a pt. with DM?
    B. The pt. has eaten and has not taken or received insulin.
  65. In what pt. does hyperosmolar noketoticc syndrome occur?
    D. older people with either ty 2 dm or no known hx of dm
  66. You are teaching basic information to a newly dx ty 1 dm. What would the basic information include?
    D. How to mix insulin
  67. A nurse is preparing a pt. with ty 1 dm for discharge. The pt. can care for himself; however, he's had a problem with unstable blood glucose levels in the past. Based on the pt.s hx, he should be referred to which health care worker?
    C. Dietitian
  68. A diabetes nurse educator is providing a class on dm for the dieticians and staff nurses. The nurse educator discusses the ADA recommendations for levels of caloric intake. What do the ADA's recommendations include?
    A. 50% to 60 % of calories for carbohydrates, 20% to 30% from fat, and remaining 10% to 20% from protein.
  69. A hospitalized pt. is found to be comatose and hypoglycemic with a blood sugar of 50 mg/dl. Which of teh following would the nurse do first?
    D. Administer 50% glucose intravenously
  70. A 15 yr. old child is brought to the er with symptoms of hyperglycemia. A dx of dm is made. What classification will be used to describe a 15 yr. old child with dm who requires daily insulin injections?
    A. Ty 1 dm
  71. A pt. is admitted with HHNS. which laboratory finding should the nurse expect in this pt.?
    D. Blood glucose level 1,100 mg/dl
  72. A pt with a tentative dx of HHNS has a hx of ty 2 dm that is being controlled with an oral diabetic agent, tolazamide (Tolinase). Which laboratory test is the most important for confirming this disorder?
    D. Serum osmolarity
  73. An obese hispanic pt., age 65, is dx wiht ty 2 dm. Which statement about dm is true?
    A. Dm is more common in hispanics and blacks than inwhites.
  74. The nurse is describing the action of insulin in the body to a pt. newly dx with ty 1 dm. Which of the following would the nurse explain as being the primary action?
    B. It enhances transport of glucose across the cell wall
  75. A pt who was dx with ty 1 dm 14 yr.s ago is admitted to the medical-surgical unit with abdominal pain. On admission, the pt.s blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blodd glucose level?
    A. Rapid, thready pulse
  76. A nurse is assessing a pt. who is receiving total parenteral nutrition (TPN). Which finding suggests that the pt. has developed hyperglycemia?
    B. Increased urine output
  77. A nurse is teaching a pt wiht dm about self-management of his condition. The nurse should instruct teh pt. to administer 1 unit of insulin for every:
    C. 15 g of carbohydrates.
  78. The nursing instructor is quizzing one of her students who is caring for a diabetic in the clinical area. The instructor asks the student what is a contributing cause of ulcer to the foot in the diabetic pt. What should the student anser?
    A. Insensitive feet
  79. Which of the following factors is the focus of nutrition intervention for pt. with ty 2 dm?
    D. Weight loss
  80. A client newly dx with dm asks why he needs ketone testing when the disease affects his blood glucose levels. How should the nurse respond?
    D. Ketones will tell us if your body is using other tissues for energy.
  81. Laboroatory studies indicate a pt.s blood glucose level is 185 mg/dl. Two hours have passed since the pt. ate breakfast. Which test would yield the most conclusive diagnostic information about the pt.s glucose use?
    B. Serum glucosylated hemoglobin (Hb A1c)
  82. A 35 yr old female pt with ty 1 dm has come to the clinic because she just doesn't feel well. The pt. confides in the nurse that she is going through a divorce and a custody battle for her children ages 2-4. She has started drinking and has lost her job. What would the nurse suspect is causing this pt. to feel poorly?
    B. Ketoacidosis
  83. Which of the following categories of oral antidiabetic agents exert their primary action by directly stimulating the pancrease to secrete insulin?
    B. Sulfonylureas
  84. A pt. is using the glycemic index as a means to maintain his blood glucose levels. Which appropriate glycemic index food would the nurse suggest that the pt. consume when he is exercising?
    C. 85
  85. A nurse educator, you have been invited to your local senior center to discuss health-maintaining stategies for older adults. During your education session on nutrition, you approach the subject to dm, its symptoms and consequences. What is the prevalence of ty 1 dm?
    C. 5% to 10% of all dx cases
  86. A nurse is preparing the daily care plan for a pt. with newly dx dm. The priority nursing concern for this pt. should be;
    C. Providing pt. education at every opportunity.
  87. Which of the following factors is the focus of nutrition intervention for pt. wiht ty 2 dm?
    C. weight loss
  88. A pt. has just been dx with ty 1 dm. When teaching the pt. and family how diet and exercise affect insulin requirements, the nurse should include whid guideline?
    D. You'll need less insulin when you ecercise or reduce your food intake.
  89. A nurse expects to note an elevated serum glucose level in a pt. with HHNS. Which other laboratory finding should the nurse anticipate?
    B. Below-normal serum potassium level
  90. A 28 yr. old pregnant woman is spilling sugar in her urin. The physician orders a glucose tolerance test. The pt. asks the nurse what results indicate getational diabetes. The nurse should respond that the minimum parameter for indication fo gestational diabetes is a 2-hr. blood glucose level greater thatn what?
    C. 200 mg/dl
  91. Glycosylated hemoglobin reflects blood glucose levels over which period of time?
    C. 2 months
  92. The nurse is providing info about foot care to a pt. with dm. Which of the following would the nurse include?
    D. Be sure to apply a moisturizer to feet daily
  93. The nurse is reviewing the initial laboratory test results of a client dx with DKA. Which of the following would the nurse expect to find?
    C. Blood ph of 6.9
  94. In pharmacology class the student nurses are learnign about oral antidiabetic agents. What category of oral antidiabetic agents would the students learn enhance insulin action at the receptor site without increasing insulin secretion from the beta cells of the pancreas?
    D. Alpha glucosidase inhibitors
  95. You are a family nurse practitioner performing a preop physical examination. The pt. is a diabetic and you note a decrease in deep tendon reflexes in the right leg that make you suspect diabetic neuropathy. The pt. has no hx of diabetic neuropathies. What other indication of diabetic neuropath might the nurse practitioner expect to find if the pt  does have a diabetic neuropathy?
    D. Decreased vibratory sensation.
  96. A nurse obtains a fingerstick glucose level of 45 mg/dl on a pt. newly dx with dm. The pt. is alert and oriented, and the pt.s skin is warm and dry. how should the nurse intervene?
    D. Obtain a repeat fingerstick glucose level.
  97. Once digested, what percentage of carbohydrates is converted to glucose?
    C. 100%
  98. For a pt. with hyperglycemia, which assessment finding best supports a nursing dx of Deficient fluid volume?
    D. increased urine osmolarity
  99. A diabetic pt. calls the clinic complaining of having a flug bu. The nurse tells him to take his regular dose of insulin. What else would the nurse tell the pt.?
    C. check your blood glucose every hr.
  100. Which of the follwing would lead a nurse to suspect that a pt. is experiencing hypoglycemia?
    C. Slow bounding pulse
  101. A pt. with dm is prescribed to switch from animal to synthesized human insulin. Which of the/ following factors should the nurse moitor when caring for the pt.
    D. Low blood glucose levels
  102. A pt. has just been dx with ty 2 dm. the physician has prescribed an oral antidiabetic agent that will inhibit the production of glucose by the liver and terby aid in the control of blood glucose.
    A. Biguanide
  103. A student nurse is caring for a pt. with ty 1 dm who also has glycosuria. The nursing instructor asks this student nurse what the pt.s urine should look like. What would be the sudents bet response?
    B. Dilute urine
  104. Which of the following factors should the nurse take into consideration when planning meals and selecting the type and dosage of insulin or oral hypoglycemic agent for an elderly pt. with dm?
    D. Pt.s eating and sleeping habits.

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