Lewis: Ch. 52. Nursing Management: Diabetes Flashcards
The nurse is caring for a client with newly diagnosed type 2 diabetes mellitus who asks the
nurse what “type 2” means in relation to diabetes. Which of the following statements by
the nurse about type 2 diabetes is correct?
a. Insulin is not used to control blood glucose in clients with type 2 diabetes.
b. Complications of type 2 diabetes are less serious than those of type 1 diabetes.
c. Type 2 diabetes is usually diagnosed when the client is admitted with a hyperglycemic coma.
d. Changes in diet and exercise may be sufficient to control blood glucose levels in
type 2 diabetes.
d. Changes in diet and exercise may be sufficient to control blood glucose levels in
type 2 diabetes.
The nurse is assessing a client for diabetes at a clinic who has a fasting plasma glucose
level of 6.7 mmol/L. Which of the following information should the nurse include in the
plan of care?
a. Self-monitoring of blood glucose.
b. Use of low doses of regular insulin.
c. Lifestyle changes to lower blood glucose.
d. Effects of oral hypoglycemic medications.
c. Lifestyle changes to lower blood glucose.
Which of the following actions by a client with type 1 diabetes indicates that the nurse
should implement teaching about exercise and glucose control?
a. The client always carries hard candies when engaging in exercise.
b. The client goes for a vigorous walk when the glucose is 11.1 mmol/L.
c. The client has a peanut butter sandwich before going for a bicycle ride.
d. The client increases daily exercise when ketones are present in the urine.
d. The client increases daily exercise when ketones are present in the urine.
The nurse is assessing a client who is experiencing the onset of symptoms of type 1
diabetes. Which of the following questions is best for the nurse to ask?
a. “Have you lost any weight lately?”
b. “How long have you felt anorexic?”
c. “Is your urine unusually dark coloured?”
d. “Do you crave fluids containing sugar?”
a. “Have you lost any weight lately?”
To evaluate the effectiveness of treatment for a client with type 2 diabetes who is
scheduled for a follow-up visit in the clinic, which of the following tests will the nurse
plan to schedule for the client?
a. Urine dipstick for glucose
b. Oral glucose tolerance test
c. Fasting blood glucose level
d. Glycosylated hemoglobin level
d. Glycosylated hemoglobin level
The nurse is caring for a client who has just been diagnosed with type 2 diabetes and has a
nursing diagnosis of imbalanced nutrition: more than body requirements. Which of the
following client goals is most important?
a. The client will have a glycosylated hemoglobin level of less than 7%.
b. The client will have a diet and exercise plan that results in weight loss.
c. The client will choose a diet that distributes calories throughout the day.
d. The client will state the reasons for eliminating simple sugars in the diet.
a. The client will have a glycosylated hemoglobin level of less than 7%.
A client who has type 1 diabetes plans to take a swimming class daily at 1:00 P.M. Which
of the following instructions should the nurse teach to the client?
a. Check glucose level before, during, and after swimming.
b. Delay eating the noon meal until after the swimming class.
c. Increase the morning dose of neutral protamine d. Hagedorn (NPH) insulin.
Time the morning insulin injection so that the peak occurs while swimming.
a. Check glucose level before, during, and after swimming.
The nurse is caring for a client with newly diagnosed type 1 diabetes who has received diet
instruction. Which of the following client statements indicate a need for additional
instruction?
a. “I may have an occasional alcoholic drink if I include it in my meal plan.”
b. “I will need a bedtime snack because I take an evening dose of NPH insulin.”
c. “I may eat whatever I want, as long as I use enough insulin to cover the calories.”
d. “I will eat meals as scheduled, even if I am not hungry, to prevent hypoglycemia.”
c. “I may eat whatever I want, as long as I use enough insulin to cover the calories.”
Which of the following actions is most important for the nurse to take in order to assist a
client with diabetes to engage in moderate daily exercise?
a. Remind the client that exercise will improve self-esteem.
b. Determine what type of exercise activities the client enjoys.
c. Give the client a list of activities that are moderate in intensity.
d. Teach the client about the effects of exercise on glucose level.
b. Determine what type of exercise activities the client enjoys.
The nurse is teaching the client to administer a dose of 10 units of regular insulin and 28
units of NPH insulin. Which of the following statements by the client indicates a need for
additional instruction?
a. “I need to rotate injection sites among my arms, legs, and abdomen each day.”
b. “I will buy the 0.5 mL syringes because the line markings will be easier to see.”
c. “I should draw up the regular insulin first after injecting air into the NPH bottle.”
d. “I do not need to aspirate the plunger to check for blood before injecting insulin.”
a. “I need to rotate injection sites among my arms, legs, and abdomen each day.”
After the nurse has finished teaching a client about self-administration of the prescribed
aspart insulin, which of the following client actions indicate good understanding of the
teaching?
a. The client avoids injecting the insulin into the upper abdominal area.
b. The client cleans the skin with soap and water before insulin administration.
c. The client places the insulin back in the freezer after administering the prescribed
insulin dose.
d. The client pushes the plunger down and immediately removes the syringe from the
injection site.
b. The client cleans the skin with soap and water before insulin administration.
The nurse is caring for a client who received aspart insulin at 8:00 A.M. Which of the
following times is most important for the nurse to monitor for symptoms of
hypoglycemia?
a. 9:00 A.M.
b. 11:30 A.M.
c. 4:00 P.M.
d. 8:00 P.M.
a. 9:00 A.M.
Which of the following client actions indicate a good understanding of the nurse’s
teaching about the use of an insulin pump?
a. The client changes the site for the insertion site every week.
b. The client programs the pump to deliver an insulin bolus after eating.
c. The client takes the pump off at bedtime and starts it again each morning.
d. The client states that diet will be less flexible when using the insulin pump.
b. The client programs the pump to deliver an insulin bolus after eating.
The nurse is teaching about meal coverage to a client with diabetes who has just started on
intensive insulin therapy. Which of the following types of insulin should the nurse discuss
with the client?
a. Glargine
b. Lispro
c. Detemir
d. NPH
b. Lispro
Which of the following information should the nurse include when teaching a client who
has type 2 diabetes about glyburide?
a. Glyburide decreases glucagon secretion from the pancreas.
b. Glyburide stimulates insulin production and release from the pancreas.
c. Glyburide should be taken even if the morning blood glucose level is low.
d. Glyburide should not be used for 48 hours after receiving IV contrast media.
b. Glyburide stimulates insulin production and release from the pancreas.
The nurse has completed teaching a client with type 2 diabetes about taking gliclazide.
Which of the following client statements indicate a need for additional teaching?
a. “Other medications besides the gliclazide may affect my blood sugar.”
b. “If I overeat at a meal, I will still take just the usual dose of medication.”
c. “When I become ill, I may have to take insulin to control my blood sugar.”
d. “My diabetes is not as likely to cause complications as if I needed to take insulin.”
d. “My diabetes is not as likely to cause complications as if I needed to take insulin.”
A client with type 2 diabetes that is well-controlled with metformin develops an allergic
rash to an antibiotic and the health care provider prescribes prednisone. Which of the
following information should the nurse anticipate while the client is taking the prednisone?
a. A diet higher in calories
b. Administration of insulin
c. Development of acute hypoglycemia
d. Appearance of a rash caused by metformin–prednisone interactions.
b. Administration of insulin
The nurse is caring for a client with diabetes who received 34 units of NPH insulin at 7:00
A.M. and is away from the nursing unit, awaiting diagnostic testing when lunch trays are
distributed. Which of the following actions is best to prevent hypoglycemia?
a. Save the lunch tray to be provided upon the client’s return to the unit.
b. Call the diagnostic testing area and ask that a 5% dextrose IV be started.
c. Ensure that the client drinks a glass of orange juice at noon in the diagnostic
testing area.
d. Request that the client be returned to the unit to eat lunch if testing will not be completed promptly.
d. Request that the client be returned to the unit to eat lunch if testing will not be completed promptly.
The nurse is assessing a client’s technique of self-monitoring of blood glucose (SMBG) as
part of diabetes management. Which of the following actions indicate a need for further
teaching?
a. Washes the puncture site using soap and warm water.
b. Chooses a puncture site in the centre of the finger pad.
c. Hangs the arm down for a minute before puncturing the site.
d. Says the result of 6.1 mmol/L indicates good blood sugar control.
b. Chooses a puncture site in the centre of the finger pad.
Which of the following actions should the nurse take first when teaching a client who is
newly diagnosed with type 2 diabetes about home management of the disease?
a. Ask the client’s family to participate in the diabetes education program.
b. Assess the client’s perception of what it means to have diabetes mellitus.
c. Demonstrate how to check glucose using capillary blood glucose monitoring.
d. Discuss the need for the client to participate actively in diabetes management.
b. Assess the client’s perception of what it means to have diabetes mellitus.
A diagnosis of hyperglycemic hyperosmolar state (HHS) is made for a client with type 2
diabetes who is brought to the emergency department in an unresponsive state. Which of
the following actions should the nurse anticipate?
a. Give 50% dextrose as a bolus
b. Insert a large-bore IV catheter
c. Initiate oxygen by nasal cannula
d. Administer glargine insulin
b. Insert a large-bore IV catheter
A client with type 1 diabetes who is on glargine and lispro insulin has called the clinic to
report symptoms of a sore throat, cough, fever, and blood glucose level of 11.7 mmol/L.
Which of the following information should the nurse tell the client?
a. Use only the lispro insulin until the symptoms of infection are resolved.X
c. Decrease intake of carbohydrates until glycosylated hemoglobin is less than 7%.
d. Limit intake of calorie-containing liquids until the glucose is less than 6.7 mmol/L.
b. Monitor blood glucose every 4 hours and notify the clinic if it continues to rise.
The health care provider suspects the Somogyi effect in a client whose 7:00 A.M. blood
glucose is 12.2 mmol/L. Which action should the nurse plan to take?
a. Check the client’s blood glucose at 3:00 A.M.
b.Administer a larger dose of long-acting insulin.
Educate about the need to increase the rapid-acting insulin dose.
Remind the client about the need to avoid snacking at bedtime.
a. Check the client’s blood glucose at 3:00 A.M.
The nurse administers intramuscular glucagon to a client who is unresponsive for
treatment of hypoglycemia. Which of the following actions should the nurse take after the
client regains consciousness?
a. Assess the client for symptoms of hyperglycemia.
b. Give the client a snack of crackers and peanut butter.
c. Have the client drink a glass of orange juice or nonfat milk.
d. Administer a continuous infusion of 5% dextrose for 24 hours.
b. Give the client a snack of crackers and peanut butter.
