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Nursing 2 > Diabetes test > Flashcards

Diabetes test Flashcards

1
Q 
Which of the following symptoms do NOT present in hyperglycemia?*
A. Extreme thirst
B. Hunger
C. Blood glucose <60 mg/dL
D. Glycosuria
A 
Ans: C
Reason: 
The three P's: 
-polyuria (frequent urination)
-Polyphagia (extreme hunger)
-Polydipsia (extreme thirst)
*blood glucose that is <60 mg/ dL is hypoglycemia
-hyperglycemia has glycosuria (glucose in the urine) because the body cannot reabsorb any more glucose
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2
Q

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

Ans: A

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3
Q

A patient with diabetes has a morning glucose of 50. 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

A

Ans: B

reason:
-rule 15: give 15 grams of carbohydrates if blood glucose is low and then recheck. If blood glucose is still low. Give another 15 grams of carbs.

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4
Q

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.

A

Ans: B

reason: people who are overweight are more likely to get type 2 diabetes.
Normal BMI: 18.5-24.9

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5
Q

What secretes insulin and where is it located?

A

Ans:

Beta cells secrete insulin in the pancreas

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6
Q

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

Ans: A

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7
Q
  1. 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.
A

Ans: B

reason:
- body may be too weak to make insulin

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8
Q

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

A

Ans: E

reason:
- Kussmaul breathing (which is deep and rapid breathing) happens in DKA but NOT Cheyne-strokes (shallow breathing, apea {unable to breathe})
- severe hyperglycemia is a sign of DKA

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9
Q

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

Ans: A

reason:

  • If NPO and blood glucose is low, it is best to give D5W
  • becasue they are nothing by mouth and needs action.
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10
Q 
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
A

Ans: B
reason:
Ketones in urine is only present in type one diabetes in DKA

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11
Q

Which of the following patient statements about the diabetic diet regime is correct?*
A. “I’ll try to consume about 20% carbs and 40% fats on a daily basis.”
B. “Foods that are high in mono and poly fats are avocados, olives, and nuts.”
C. “Meats increase the glycemic index; therefore, I should only consume 5% of them on a daily basis.”
D. “I should completely avoid starchy vegetables like potatoes and corn.”

A

Ans: B

reason:
-should consume 40-60 carbs
25-30 fat
10-20 protein
-meats do not affect the glycemic index
-starchy vegetables are carbs and have no negative affect
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12
Q 
A patient with diabetes asks you about what type of exercise they should perform throughout the week. The best response is:*
A. Lifting weights
B. Sprinting
C. Swimming
D. Jumping
A

Ans: C

reason:
-aerobic exercises are the best way to prevent diabetes

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13
Q

Which of the following statements are INCORRECT about exercise management for the diabetic patient?*
A. “I will check my blood glucose prior to exercise. If it is less than 200 I will eat a complex carb snack prior to exercising.”
B. “I plan on exercising for an extended period. So I will check my blood glucose prior, during, and after exercising.”
C. “My blood glucose is 268 and I have ketones in my urine. Therefore, I will avoid exercising today.”
D. All of the options are correct statements.

A

Ans: A

reason:
- you should eat a simple carb.
- Do not exercise if you have DKA because your body cannot make insulin. If you exercise, it will not break down glucose, and will want more glucose. the glucose is not going into the cell, but in the bloodstream.

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14
Q

A patient has a blood glucose of 58 and is sweating, cold, and clammy. The patient is conscious. What is your next nursing intervention?*
A. Recheck the blood glucose in 5 minutes.
B. Give the patient 15 grams of a complex carbohydrate.
C. No intervention is needed because this is a normal blood glucose.
D. Give the patient 15 grams of a simple carbohydrate.

A

Ans: D

reason:
the rule of 15

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15
Q

A patient with Type 2 Diabetes is started on the medication Glyburide. Which of the following statements by the patient causes concern?*
A. “I will monitor my blood glucose regularly because I know this medication can cause a low blood sugar.”
B. “I will consume no more than 8 oz. of alcohol per week.”
C. “I will continue monitoring my diet and participating in exercise while taking this medication.”
D. “This medication works by stimulating the beta cells in the pancreas to make insulin.”

A

Ans: B

reason:
you cannot have alcohol if you are taking diabetic medication. It will decrease blood glucose more.

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16
Q

A patient is scheduled to take a morning dose of Metformin. The patient is scheduled for surgery tomorrow. Which of the following nursing interventions are correct?*
A. Administer the medication as ordered.
B. Hold the dose and notify the doctor for further orders.
C. Administer the medication as ordered but hold the next day’s dose.
D. Check the patient’s blood glucose prior to administering the medication

A

Ans: B

reason:
-Metformin (a blood thinner) can cause hemorrhaging during the surgery

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17
Q 
A patient is scheduled to take 10 units of Humulin N at 1100. When is the patient most susceptible for hypoglycemia?
A. 1900
B. 1300
C. 1130
D. 1500
A

Ans: A

  • Humulin N is a short-acting insulin
  • onset: 2-4 to an hour
  • peak 4-12 hours
  • duration 16-20 hours
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18
Q 
A patient taking the medication Precose asks when it is the best time to take this medication. Your response is:*
A. 1 hour prior to eating
B. 1 hour after eating
C. With the first bite of food
D. At bedtime
A

Ans: C

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19
Q 
A patient has a blood glucose of 400. Which of the following medications could be the cause of this?*
A. Glyburide
B. Atenolol
C. Bactrim
D. Prednisone
A

Ans: D

reason:
hormones cause an increase in glucose levels

20
Q

True or False: The Somogyi effect causes the patient to experience an increase in their blood glucose during the hours of 2-3 am.*
True
False

A

Ans: false

reason:
- The Somogyi effect causes a decrease in blood glucose at 2-3 am
- the body reacts to the change and releases hormones to increase glucose, but this will cause hyperglycemia by 7 am
- treatment would be decrease dose of intermediate insulin (NPH) or increase bedtime snack

21
Q 
Which of the following insulins has no peak but a duration of 24 hours?*
A. NPH
B. Novolog
C. Lantus
D. Humulin N
A

Ans: C
reason:
Lantus is a long acting insulin, which don’t have a peak

22
Q 
When is a patient most susceptible to hypoglycemic symptoms after the administration of insulin?*
A. Onset
B. Peak
C. Duration
D. Duration &amp; Peak
A

Ans: B
reason:
At an insulin’s peak, causes glucose to be at it’s lowest

23
Q

Explain Dawn phenomenon

A

Ans:

  • prebreakfast hyperglycemia
  • develops between 5 and 8 am
  • reasoning: nocturnal release of hormones
  • solution: increase evening dose of intermediate-acting insulin (NPH) at 10pm
24
Q 
A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome (HHNKS) is made. The nurse would IMMEDIATELY prepare to initiate which anticipated health care provider's prescription?
A. Endotracheal intubation
B. 100 units of NPH insulin
C. IV infusion with NS
D. IV infusion of sodium bicarbonate
A

Ans: C

reason:
- Since this person is unresponsive, the best response would be to administer NS

25
Q

An external insulin pump is prescribed for a client with diabetes and the client asks the nurse about the function of the pump. The nurse bases the response on which information about the pump?
A. It’s timed to release short duration of of NPH insulin into the bloodstream while regularly monitoring blood glucose levels
B. Continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels
C. Is surgically attached to the pancreas, which in turn releases the insulin into the bloodstream.
D. Gives a small continuous dose of short-duration administer a bolus with an additional dose from the pump before each meal

A

Ans: D

26
Q 
A client with a diagnosis of diabetic ketoacidosisis being treated into the emergency room. Which findings would the nurse expect to note to confirm diagnosis? select all that apply
A. increase pH
B. Comatose state
C. Deep, rapid breathing
D. decrease urine output
E. elevated blood glucose
F. Low plasma bicarbonate
A

Ans: C,E, F

reason:

  • In DKA, a person has low pH (less than 7.35)
  • low plasma bicarbonate (less than 15 [normal range: 23-30])
  • client is experiencing polyuria and deep and rapid breathing (Kussmaul breathing)
27
Q 
The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose should be taken if which symptoms develop?
A. Polyuria
B. Shakiness
C. Palpitations
D. Blurred vision
E. Lightheaded
F. Fruity breath odor
A

Ans: B,C and E

reason:

  • Polyuria, blurred vision and fruity breath are signs of hyperglycemia
  • shakiness, palpitations, double vision and light headedness are signs of hypoglycemia because they need glucose/ food
28
Q

A client with diabetes demonstrates acute anxiety when first admitted to the hospital for treatment of Hyperglycemia. What is the most appropriate action to take to decrease the client’s anxiety?
A. Administer a sedative
B. Convey empathy, trust , and respect toward the client
C. Ignore the signs and symptoms of anxiety so that they will soon disappear
D. Make sure that the client knows all the correct medical terms to understand what is happening

A

Ans: B

29
Q

The nurse provides instructions to a client newly diagnosed with type one diabetes. The nurse recognizes accurate understanding of measures to prevent DKA when the client makes which statement?
A. “I will stop taking my insulin if I’m to weak to eat”
B. “I will decrease my insulin dose during times of illness”
C. “I will adjust my insulin dose according to the level of glucose in my urine”
D. “I will notify my health care provider if my blood glucose level is higher than 250mg/ dl

A

Ans: D

reasoning:
- if you stop taking insulin, but still eat even though you are weak it can cause hyperglycemia and if you do take insulin but don’t eat, you may experience hypoglycemia
- During times of illness, it is imperative to take insulin because your body will be too weak to make insulin
- glucose in urine may indicate DKA, but measuring it is not an appropriate way to measure the amount of glucose one has

30
Q

A client is diagnosed with DKA. Initial blood glucose is 950 mg/ dl. A continuous IV infusion of short-acting insulin is initiated, along with IV rehydration with NS. The glucose level is now 240mg/ dl. The nurse would then administer which item next?
A. Ampule of 50% dextrose
B. NPH subqutaneously
C. Intravenous fluids containing dextrose
D. Phenytoin (Dilantin) to prevent seizures

A

Ans: C

reason:

  • only short duration insulin is used to treat DKA not NPH, which is an intermediate insulin
  • 50% Dextrose is the solution to fix hypoglycemia
31
Q 
The nurse is monitoring a client newly diagnosed with diabetes for signs of complications. Which, sign if exhibited in the client, would indicate hyperglycemia?
A. Polyuria
B. Diaphoresis
C. Hypertension
D. Increased pulse rate
A

Ans: A

reason:
- diaphoresis, hypertension and increase in pulse are indications of hypoglycemia

32
Q 
The nurse is preparing a plan of care for a client with diabetes who has hyperglycemia. The nurse places highest priority on which client problem?
A. Lack of knowledge
B. Inadequate fluid volume
C. Compromised family coping
D. Inadequate consumption of nutrients
A

Ans: B

Reason:
-needs to urinate to get rid of extra glucose from the body

33
Q

The home health nurse visits a client with a diagnosis of type one diabetes. The client relates a history of vomiting and diarrhea and tells the nurse that no food has been consumed for the least 24 hours. Which additional statement by the client indicates a need for further teaching?
A. “I need to stop my insulin”
B. “I need to increase my fluid intake”
C. “I need to monitor my blood glucose every 3 to 4 hours”
D. “I need to call the HCP because of these symptoms”

A

Ans: A
reason:
cannot stop taking insulin at all since person has type one diabetes

34
Q

The nurse is caring for a client admitted to the emergency department with DKA. In the acute phase, the nurse plans for which priority intervention?
A. Correct the acidosis
B. administer 5% dextrose intravenously
C. Apply a monitor for an electrocardiogram
D. Administer short-duration insulin intravenously

A

Ans: D
reason:
-short acting insulin is used to treat DKA

35
Q

A client with type one diabetes calls the nurse to report a recurrent episodes of hypoglycemia with exercising. Which statement by the client indicates an inadequate understanding of the peak of action of NPH insulin and exercise?
A. “The best time for me to exercise is after I eat”
B. “The best time for me to exercise is after breakfast”
C. “The best time for me to exercise is mid to late afternoon”
D. “The best time for me to exercise is after my morning snack”

A

Ans: C
reason:
- This is during the time when NPH is at it’s peak (4-12 hours)

36
Q 
The nurse performs a physical assessment on a client with type 2 diabetes. Findings include blood glucose of 120 mg/dl, temperature of 101 degrees F, pulse of 88 beats, min, respiration of 22, and BP  of 100/ 72mmHg. Which finding would bring most concern to the nurse?
A. pulse
B. respiration
C. temperature
D. blood pressure
A

Ans: C

reason:
- elevate temperature can indicate an infection

37
Q

The nurse is interviewing a client with type 2 diabetes. Which statement by the client indicate an understanding of the treatment for this disorder?
A. “I take oral insulin instead of shots”
B. “By taking these medications, I am able to eat more”
C. “When I become ill, I need to increase the number of pills i take”
D. “The medications I am taking help release the insulin I already make”

A

Ans: D

38
Q

The nurse is caring for a client who is 2 days post-op following an abdominal hysterectomy. the client has a history of diabetes and has been receiving regular insulin according to capillary blood glucose testing four times a day. A carbohydrate-controlled diet has been prescribed but the client has been complaining of nausea and is not eating. On entering the client’s room, the nurse finds the client to be confused and diaphoretic. Which action is most appropriate at this time?
A. Call a code to obtain assistance immediately
B. Obtain a capillary blood glucose level and perform a focused assessment
C. Asked an unlicensed assistive personnel (UAP) to stay with the client while obtaining 15 to 30 grams of carbs for the client to eat.
D. Stay with the client and ask a UAP to call the HCP for a prescription for IV 50% dextrose

A

Ans: B
reason:
An assessment must be the first step to clarify that it is hypoglycemia

39
Q

The nurse is teaching a patient newly diagnosed with type 1 diabetes about rotation of insulin injection sites. The nurse determines that teaching was effective when the patient states:

  1. “Rotate injection sties within one anatomical region”
  2. “Rotate injection site from one anatomical region to another”
  3. “Rotation of injection sites does not affect speed of absorption”
  4. “Rotation of injection sites does not prevent lipohypertrophy”
A

Ans: 1

reason:
rotation within one anatomical region is preferred to prevent day-to-day changes in absorption. Speed of injection is affected by choice of site. Lipohypertrophy can be prevented by rotation of sites.

40
Q

A patient with type 1 diabetes is exhibiting Kussmaul’s respirations, abdominal discomfort and lethargy. What intervention should the nurse perform?

  1. assess CBC
  2. administer insulin as ordered
  3. start IV dextrose
  4. assess neurological status
A

Ans: 2

reason:
These are signs of DKA. CBC and neurological status cannot aid in the diagnosis of this condition. dextrose would elevate glucose levels

41
Q

A patient diagnosed with HHNKS id most at risk for the development of:

  1. infection
  2. confusion
  3. dehydration
  4. skin breakdown
A

Ans: 3

reason:
dehydration requires immediate intervention

42
Q

The nurse is administering an IV insulin infusion for a patient diagnosed with diabetic ketoacidosis. Which outcome indicates the treatment was effective?

  1. lowered blood glucose within one hour
  2. replace fluids within 24 hours
  3. increased anion gap within 23 hours
  4. increase blood glucose levels within the first three hours
A

Ans: 2

reason:
treatment for DKA is treating blood glucose level GRADUALLY while replacing fluids within the first 24 hours. The anion gap should be decreased.
normal level for anion gap:
8-16mEq/L

43
Q

The nurse is caring for a patient with type 1 diabetes. At 3 am, the nurse find the patient disoriented, diaphoretic and complains of palpitations. What is the nurse’s priority?

  1. give 15g of carbohydrates
  2. call HCP
  3. administer glucagon
  4. check glucose level
A

Ans: 4

44
Q

A patient who has been treated for type 1 diabetes for five years reports numbness and tingling in the lower extremities. What should the nurse teach the patient?

  1. check feet daily
  2. soak feet daily
  3. keep feet elevated
  4. massage your lower extremities daily
A

Ans: 1

rationale:
keeping legs elevated is not a solution for paresthesia. Soaking feet could lead to skin breakdown, and will make you prone to getting an infection

45
Q

Patient is being screened for diabetes. Two fasting glucose results showed 132 and 146. how should these results be interpreted?

  1. normal results. no further action should be taken
  2. results show diabetes mellitus and further action should be taken
  3. fasting blood glucose test should be repeated two more times
  4. the patient should schedule an A1C
A

Ans: 2

reason:
diabetes is indicated if fasting blood glucose level is above 126.
normal level= 70-100
prediabetes=100-125

46
Q

A type 2 diabetes patient id prescribed capsaicin cream. What should the nurse include in a teaching plan for this medication?

  1. “This cream should be applied daily to treat dry skin”
  2. “this cream should be applied to open sores”
  3. “This cream should supplied to necrotic areas of ulcers to aid in debridement”
  4. “Apply cream four times daily to decrease neuropathic pain sensations”
A

Ans: 4

rationale:
this drug reduces substance p, which is involved in pain transmission

47
Q

When teaching a patient with diabetes about nutritional planning, which food choices should be considered for one serving of a health carbohydrate?

  1. one small orange
  2. 1/2 cup vanilla ice cream
  3. 2 slices of white bread
  4. 2 cups of whole-grain rice
A

Ans: 1

Rationale: ice cream is unhealthy and others are more than one serving (2 breads=2 servings; 2 cups of rice= 4 servings

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