diabetes Flashcards
Which of the following symptoms do NOT present in hyperglycemia?
A. Extreme thirst
B. Hunger
C. Blood glucose <60 mg/dL
D. Glycosuria
C
Type 1 diabetics typically have the following clinical characteristics:
A. Thin, young with ketones present in the urine
B. Overweight, young with no ketones present in the urine
C. Thin, older adult with glycosuria
D. Overweight, adult-aged with ketones present in the urine
A
Which of the following patients is at most risk for Type 2 diabetes?
A. A 6 year old girl recovering from a viral infection with a family history of diabetes.
B. A 28 year old male with a BMI of 49.
C. A 76 year old female with a history of cardiac disease.
D. None of the options provided.
B
The _____ ______ secrete insulin which are located in the _______.
A. Alpha cells, liver
B. Alpha cells, pancreas
C. Beta cells, liver
D. Beta cells, pancreas
D
A 36-year-old male is newly diagnosed with Type 2 diabetes. Which of the following treatments do you expect the patient to be started on initially?
A. Diet and exercise regime
B. Metformin BID by mouth
C. Regular insulin subcutaneous
D. None, monitoring at this time is sufficient enough
A
Which of the following statements are true regarding Type 2 diabetes treatment?
A. Insulin and oral diabetic medications are administered routinely in the treatment of Type 2 diabetes.
B. Insulin may be needed during times of surgery or illness.
C. Insulin is never taken by the Type 2 diabetic.
D. Oral medications are the first line of treatment for newly diagnosed Type 2 diabetics.
B
What statement or statements are INCORRECT regarding Diabetic Ketoacidosis?
A. DKA occurs mainly in Type 1 diabetics.
B. Ketones are present in the urine in DKA.
C. Cheyne-stokes breathing will always present in DKA.
D. Severe hypoglycemia is a hallmark sign in DKA.
E. Options C & D
E
A patient who has diabetes is nothing by mouth as prep for surgery. The patient states they feel like their blood sugar is low. You check the glucose and find it to be 52. The next nursing intervention would be to:
A. Administer Dextrose 50% IV per protocol
B. Continue to monitor the glucose
C. Give the patient 4 oz of fruit juice
D. None, this is a normal blood glucose reading
A
A patient with diabetes has a morning glucose of 2.5. The patient is sweaty, cold, and clammy. Which of the following nursing interventions is the MOST important?
A. Recheck the glucose level
B. Give the patient ½ cup (4 oz) of fruit juice
C. Call the doctor
D. Keep the patient nothing by mouth
B
A Type 2 diabetic may have all the following signs or symptoms EXCEPT:
A. Blurry vision
B. Ketones present in the urine
C. Glycosuria
D. Poor wound healing
B
The nurse teaches a 38-year-old man who was recently diagnosed with type 1 diabetes mellitus about insulin administration. Which statement by the patient requires an intervention by the nurse?
a. “I will discard any insulin bottle that is cloudy in appearance.”
b. “The best injection site for insulin administration is in my abdomen.”
c. “I can wash the site with soap and water before insulin administration.”
d. “I may keep my insulin at room temperature (75o F) for up to a month.”
a. “I will discard any insulin bottle that is cloudy in appearance.”
Intermediate-acting insulin and combination premixed insulin will be cloudy in appearance. Routine hygiene such as washing with soap and rinsing with water is adequate for skin preparation for the patient during self-injections. Insulin vials that the patient is currently using may be left at room temperature for up to 4 weeks unless the room temperature is higher than 86° F (30° C) or below freezing (less than 32° F [0° C]). Rotating sites to different anatomic sites is no longer recommended. Patients should rotate the injection within one particular site, such as the abdomen.
Which patient with type 1 diabetes mellitus would be at the highest risk for developing hypoglycemic unawareness?
a. A 58-year-old patient with diabetic retinopathy
b. A 73-year-old patient who takes propranolol (Inderal)
c. A 19-year-old patient who is on the school track team
d. A 24-year-old patient with a hemoglobin A1C of 8.9%
b. A 73-year-old patient who takes propranolol (Inderal)
Hypoglycemic unawareness is a condition in which a person does not experience the warning signs and symptoms of hypoglycemia until the person becomes incoherent and combative or loses consciousness. Hypoglycemic awareness is related to autonomic neuropathy of diabetes that interferes with the secretion of counterregulatory hormones that produce these symptoms. Older patients and patients who use â-adrenergic blockers (e.g., propranolol) are at risk for hypoglycemic unawareness.
The nurse caring for a patient hospitalized with diabetes mellitus would look for which laboratory test result to obtain information on the patient’s past glucose control?
a. Prealbumin level
b. Urine ketone level
c. Fasting glucose level
d. Glycosylated hemoglobin level
d. Glycosylated hemoglobin level
A glycosylated hemoglobin level detects the amount of glucose that is bound to red blood cells (RBCs). When circulating glucose levels are high, glucose attaches to the RBCs and remains there for the life of the blood cell, which is approximately 120 days. Thus the test can give an indication of glycemic control over approximately 2 to 3 months. The prealbumin level is used to establish nutritional status and is unrelated to past glucose control. The urine ketone level will only show that hyperglycemia or starvation is probably currently occurring. The fasting glucose level only indicates current glucose control.
A 51-year-old patient with diabetes mellitus is scheduled for a fasting blood glucose level at 8:00 AM. The nurse instructs the patient to only drink water after what time?
a. 6:00 PM on the evening before the test
b. Midnight before the test
c. 4:00 AM on the day of the test
d. 7:00 AM on the day of the test
b. Midnight before the test
Typically, a patient is ordered to be NPO for 8 hours before a fasting blood glucose level. For this reason, the patient who has a lab draw at 8:00 AM should not have any food or beverages containing any calories after midnight.
The newly diagnosed patient with type 2 diabetes has been prescribed metformin (Glucophage). What should the nurse tell the patient to best explain how this medication works?
a. Increases insulin production from the pancreas.
b. Slows the absorption of carbohydrate in the small intestine.
c. Reduces glucose production by the liver and enhances insulin sensitivity.
d. Increases insulin release from the pancreas, inhibits glucagon secretion, and decreases gastric emptying.
c. Reduces glucose production by the liver and enhances insulin sensitivity.
Metformin is a biguanide that reduces glucose production by the liver and enhances the tissue’s insulin sensitivity. Sulfonylureas and meglitinides increase insulin production from the pancreas. α-glucosidase inhibitors slow the absorption of carbohydrate in the intestine. Glucagon-like peptide receptor agonists increase insulin synthesis and release from the pancreas, inhibit glucagon secretion, and decrease gastric emptying.
