Diabetes Mellitus By Rnpedia.Com
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An agitated, confused female client arrives in the emergency department. Her history includes type 1 diabetes mellitus, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, nurse Lily teaches the client to treat hypoglycemia by ingesting:
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2 to 5 g of a simple carbohydrate.
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10 to 15 g of a simple carbohydrate.
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18 to 20 g of a simple carbohydrate.
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25 to 30 g of a simple carbohydrate.
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This quiz, titled 'Diabetes Mellitus by RNpedia. Com', assesses knowledge on managing type 1 diabetes, including recognizing and treating hypoglycemia, addressing complications, and understanding medication effectiveness. It's designed for healthcare professionals, particularly in nursing, to enhance patient care skills.
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- 2.
Nurse John is assigned to care for a postoperative male client who has diabetes mellitus. During the assessment interview, the client reports that he’s impotent and says he’s concerned about its effect on his marriage. In planning this client’s care, the most appropriate intervention would be to:
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Encourage the client to ask questions about personal sexuality.
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Provide time for privacy.
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Provide support for the spouse or significant other.
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Suggest referral to a sex counselor or other appropriate professional.
Correct Answer
A. Suggest referral to a sex counselor or other appropriate professional.Explanation
The nurse should refer this client to a sex counselor or other professional. Making appropriate referrals is a valid part of planning the client’s care. The nurse doesn’t normally provide sex counseling.Rate this question:
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- 3.
During a class on exercise for diabetic clients, a female client asks the nurse educator how often to exercise. The nurse educator advises the clients to exercise how often to meet the goals of planned exercise?
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At least once a week
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At least three times a week
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At least five times a week
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Every day
Correct Answer
A. At least three times a weekExplanation
Diabetic clients must exercise at least three times a week to meet the goals of planned exercise — lowering the blood glucose level, reducing or maintaining the proper weight, increasing the serum high-density lipoprotein level, decreasing serum triglyceride levels, reducing blood pressure, and minimizing stress. Exercising once a week wouldn’t achieve these goals. Exercising more than three times a week, although beneficial, would exceed the minimum requirement.Rate this question:
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- 4.
A male client with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, nurse Sharmaine would be most accurate in stating:
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“The test needs to be repeated following a 12-hour fast.”
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“It looks like you aren’t following the prescribed diabetic diet.”
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“It tells us about your sugar control for the last 3 months.”
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“Your insulin regimen needs to be altered significantly.”
Correct Answer
A. “It tells us about your sugar control for the last 3 months.”Explanation
The glycosylated Hb test provides an objective measure of glycemic control over a 3-month period. The test helps identify trends or practices that impair glycemic control, and it doesn’t require a fasting period before blood is drawn. The nurse can’t conclude that the result occurs from poor dietary management or inadequate insulin coverage.Rate this question:
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- 5.
A male client with type 1 diabetes mellitus asks the nurse about taking an oral antidiabetic agent. Nurse Jack explains that these medications are only effective if the client:
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Prefers to take insulin orally.
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Has type 2 diabetes.
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Has type 1 diabetes.
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Is pregnant and has type 2 diabetes.
Correct Answer
A. Has type 2 diabetes.Explanation
Oral antidiabetic agents are only effective in adult clients with type 2 diabetes. Oral antidiabetic agents aren’t effective in type 1 diabetes. Pregnant and lactating women aren’t prescribed oral antidiabetic agents because the effect on the fetus is uncertain.Rate this question:
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- 6.
When caring for a female client with a history of hypoglycemia, nurse Ruby should avoid administering a drug that may potentiate hypoglycemia. Which drug fits this description?
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Sulfisoxazole (Gantrisin)
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Mexiletine (Mexitil)
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Prednisone (Orasone)
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Lithium carbonate (Lithobid)
Correct Answer
A. Sulfisoxazole (Gantrisin)Explanation
Sulfisoxazole and other sulfonamides are chemically related to oral antidiabetic agents and may precipitate hypoglycemia. Mexiletine, an antiarrhythmic, is used to treat refractory ventricular arrhythmias; it doesn’t cause hypoglycemia. Prednisone, a corticosteroid, is associated with hyperglycemia. Lithium may cause transient hyperglycemia, not hypoglycemia.Rate this question:
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- 7.
After taking glipizide (Glucotrol) for 9 months, a male client experiences secondary failure. Which of the following would the nurse expect the physician to do?
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Initiate insulin therapy.
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Switch the client to a different oral antidiabetic agent.
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Prescribe an additional oral antidiabetic agent.
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Restrict carbohydrate intake to less than 30% of the total caloric intake.
Correct Answer
A. Switch the client to a different oral antidiabetic agent.Explanation
Many clients (25% to 60%) with secondary failure respond to a different oral antidiabetic agent. Therefore, it wouldn’t be appropriate to initiate insulin therapy at this time. However, if a new oral antidiabetic agent is unsuccessful in keeping glucose levels at an acceptable level, insulin may be used in addition to the antidiabetic agent.Rate this question:
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- 8.
Insulin inhibits the release of _______.
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Glucagon
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ADH
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Beta cells
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Somatostatin
Correct Answer
A. GlucagonExplanation
Insulin is a hormone secreted by the pancreas that helps regulate blood sugar levels. It works by promoting the uptake of glucose from the bloodstream into cells, thereby lowering blood sugar levels. Glucagon, on the other hand, is another hormone produced by the pancreas that has the opposite effect of insulin. It stimulates the release of glucose from the liver, raising blood sugar levels. Therefore, insulin inhibits the release of glucagon, as they have opposing actions in regulating blood sugar.Rate this question:
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- 9.
Which of the following is caused by insulin release?
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Increased breakdown of fats
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Increase breakdown of proteins
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Decreased blood sugar
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Causes glucose to be phosphorylated in kidney
Correct Answer
A. Decreased blood sugarExplanation
Insulin release causes decreased blood sugar levels. Insulin is a hormone produced by the pancreas that helps regulate blood sugar levels. When insulin is released, it allows glucose to enter cells, where it can be used for energy or stored for later use. This lowers the amount of glucose in the bloodstream, resulting in decreased blood sugar levels. Increased breakdown of fats and proteins are not directly caused by insulin release. The statement about glucose being phosphorylated in the kidney is unrelated to insulin release.Rate this question:
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- 10.
Glucagon causes increased blood sugar and causes slow breakdown of glycogen in the liver.
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TRUE
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FALSE
Correct Answer
A. FALSEExplanation
Glucagon actually causes the release of stored glucose from the liver, which increases blood sugar levels. It does not cause a slow breakdown of glycogen in the liver. Therefore, the statement is false.Rate this question:
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- 11.
As blood glucose decreases glucagon is inhibited.
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TRUE
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FALSE
Correct Answer
A. FALSEExplanation
Glucagon is actually released when blood glucose levels are low, not inhibited. Glucagon helps to raise blood glucose levels by stimulating the liver to release stored glucose into the bloodstream. Therefore, the given statement is false.Rate this question:
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- 12.
Glucagon increases blood levels of glucose by causing liver to breakdown glycogen.
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TRUE
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FALSE
Correct Answer
A. TRUEExplanation
Glucagon is a hormone that is released by the pancreas when blood sugar levels are low. It acts on the liver to stimulate the breakdown of glycogen, a stored form of glucose, into glucose molecules. These glucose molecules are then released into the bloodstream, increasing blood sugar levels. Therefore, the statement that glucagon increases blood levels of glucose by causing the liver to breakdown glycogen is true.Rate this question:
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- 13.
Which of the following is not true about Type I DM?
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May be linked to autoimmunity
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Onset usually prior to age 20
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Beta islet cells destroyed
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Does not require insulin injections
Correct Answer
A. Does not require insulin injectionsExplanation
Type I DM, also known as insulin-dependent diabetes mellitus, is characterized by the destruction of beta islet cells in the pancreas, leading to a lack of insulin production. This condition is usually diagnosed before the age of 20 and may be linked to autoimmunity. Since the destruction of beta islet cells results in insufficient insulin production, individuals with Type I DM require insulin injections to manage their blood sugar levels. Therefore, the statement "Does not require insulin injections" is not true about Type I DM.Rate this question:
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- 14.
Which of the following is not true about Type II DM?
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Considered adult onset diabetes
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Cause unknown may be due to genetics
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Require insulin 80% of cases
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May take a drug that sensitize cells or increase insulin release
Correct Answer
A. Require insulin 80% of casesExplanation
Type II DM, also known as adult onset diabetes, is characterized by insulin resistance and impaired insulin secretion. It is primarily caused by a combination of genetic and lifestyle factors. While it is true that some individuals with Type II DM may require insulin therapy, it is not the case for 80% of the cases. In fact, the majority of people with Type II DM can manage their condition through lifestyle modifications, oral medications, and/or injectable non-insulin medications. Insulin therapy is typically reserved for those who cannot achieve adequate blood sugar control with other treatments.Rate this question:
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- 15.
Which of the following is not an effect of diabetes?
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Small vessel occlusion
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Necrosis of extremities
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Ketone Body production
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Decreased fat metabolism
Correct Answer
A. Decreased fat metabolismExplanation
Decreased fat metabolism is not an effect of diabetes. Diabetes is a condition where the body is unable to properly regulate blood sugar levels. It can lead to various complications such as small vessel occlusion, necrosis of extremities, and ketone body production. However, decreased fat metabolism is not directly associated with diabetes. In fact, individuals with diabetes often have impaired glucose metabolism, leading to increased fat storage and weight gain.Rate this question:
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- 16.
Which of the following is not an indicator of a hypoglycemic condition?
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Fatigue
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Poor appetite
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Tachycardia
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Confusion
Correct Answer
A. Poor appetiteExplanation
Poor appetite is not an indicator of a hypoglycemic condition because hypoglycemia typically causes an increase in appetite, not a decrease. Hypoglycemia is a condition characterized by low blood sugar levels, and the body responds by releasing hormones that stimulate hunger and increase the desire for food. Therefore, poor appetite would be more likely to indicate a different condition or problem.Rate this question:
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- 17.
Which of the following is not an adverse effect of oral hypoglycemics?
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Hypoglycemia
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Headache
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Rashes
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Projectile vomiting
Correct Answer
A. Projectile vomitingExplanation
Projectile vomiting is not an adverse effect of oral hypoglycemics. Adverse effects of these medications may include hypoglycemia, headache, and rashes. Projectile vomiting, which refers to forceful expulsion of stomach contents, is not typically associated with the use of oral hypoglycemics.Rate this question:
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- 18.
Which of the following is not an adverse effect of glucagon?
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Allergic reaction
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Vomiting
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Nausea
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Fever
Correct Answer
A. FeverExplanation
Glucagon is a hormone that helps increase blood sugar levels. It is commonly used to treat severe hypoglycemia. While it can have side effects, such as allergic reactions, vomiting, and nausea, fever is not typically associated with the use of glucagon. Fever is an abnormal increase in body temperature and is not a known adverse effect of glucagon administration.Rate this question:
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- 19.
Which of the following drugs may be given as an immunosuppressant soon after onset of Type I Diabetes?
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Torsemide
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Cyclosporine
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Clofibrate
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Ceftriaxone
Correct Answer
A. CyclosporineExplanation
Cyclosporine is a drug that is commonly used as an immunosuppressant. It works by suppressing the immune system, which can be beneficial in cases of Type I Diabetes where the immune system mistakenly attacks the insulin-producing cells in the pancreas. By suppressing the immune response, cyclosporine may help to prevent further damage to the pancreas and preserve insulin production. Therefore, it may be given soon after the onset of Type I Diabetes to help manage the condition.Rate this question:
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- 20.
Which of the following is not considered an endocrine hormone?
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Renin
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Insulin
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Glucagon
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Somatostatin
Correct Answer
A. ReninExplanation
Renin is an enzyme that is produced and released by the kidneys. It plays a role in the regulation of blood pressure and fluid balance in the body, but it is not considered an endocrine hormone. Endocrine hormones are secreted directly into the bloodstream by specialized glands and have a wide range of effects on different organs and tissues in the body. Insulin, glucagon, and somatostatin are all examples of endocrine hormones that are involved in regulating blood sugar levels, metabolism, and other physiological processes.Rate this question:
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- 21.
What type of cells secrete glucagon?
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Beta cells B. C. D.
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Alpha cells
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Plasma cells
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Acinar cells
Correct Answer
A. Alpha cellsExplanation
Alpha cells are the type of cells that secrete glucagon. Glucagon is a hormone that is released by the pancreas and it helps to raise blood sugar levels by stimulating the liver to release stored glucose into the bloodstream. Beta cells, on the other hand, secrete insulin, which helps to lower blood sugar levels. Plasma cells are involved in the immune response, while acinar cells are responsible for producing digestive enzymes in the pancreas.Rate this question:
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- 22.
What type of cells secrete insulin?
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Beta cells
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Alpha cells
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Plasma cells
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Acinar cells
Correct Answer
A. Beta cellsExplanation
Beta cells are the type of cells that secrete insulin. Insulin is a hormone that regulates blood sugar levels by allowing cells to take in glucose from the bloodstream. Beta cells are found in the pancreas, specifically in the islets of Langerhans. They are responsible for producing and releasing insulin in response to high blood sugar levels. This hormone helps to lower blood sugar levels by facilitating the uptake of glucose by cells, thus maintaining glucose homeostasis in the body.Rate this question:
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- 23.
Which of the following would not be considered an acute effect of diabetes mellitus?
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Polyuria
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Weight gain
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Polydipsia
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Polyphagia
Correct Answer
A. Weight gainExplanation
Weight gain would not be considered an acute effect of diabetes mellitus because diabetes is commonly associated with weight loss rather than weight gain. Weight loss occurs due to the body's inability to properly utilize glucose for energy, leading to the breakdown of fat and muscle tissue. Therefore, weight gain is not typically a symptom or effect of diabetes mellitus.Rate this question:
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- 24.
Which of the following is not an accurate test for diabetes?
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Glucose tolerance test
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HbA
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Fasting glucagon test
Correct Answer
A. Fasting glucagon testExplanation
The fasting glucagon test is not an accurate test for diabetes because glucagon is a hormone that raises blood sugar levels, whereas diabetes is characterized by high blood sugar levels. Therefore, testing for glucagon levels during fasting would not provide accurate information about a person's diabetes status.Rate this question:
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- 25.
Which of the following is not an indicator of diabetic ketoacidosis?
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Hyperthermia
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Nausea/Vomiting
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Slow and shallow breathing
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Psychosis leading to dementia
Correct Answer
A. Slow and shallow breathingExplanation
Slow and shallow breathing is not an indicator of diabetic ketoacidosis. Diabetic ketoacidosis is a serious complication of diabetes that occurs when the body produces high levels of blood acids called ketones. Symptoms of diabetic ketoacidosis include hyperthermia (high body temperature), nausea/vomiting, and psychosis leading to dementia. However, slow and shallow breathing is not typically associated with this condition.Rate this question:
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- 26.
Which of the following is not related to a chronic diabetes mellitus condition?
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Atherosclerosis
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Neuropathy
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Glaucoma
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Hypotension
Correct Answer
A. HypotensionExplanation
Hypotension is not related to chronic diabetes mellitus because hypotension refers to low blood pressure, whereas chronic diabetes mellitus is a condition characterized by high blood sugar levels. Atherosclerosis, neuropathy, and glaucoma are all complications commonly associated with chronic diabetes mellitus.Rate this question:
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- 27.
Which of the following conditions is not linked to diabetic ketoacidosis?
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Cerebral edema
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Arrhythmias
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Peptic ulcers
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Mucormycosis
Correct Answer
A. Peptic ulcersExplanation
Diabetic ketoacidosis (DKA) is a serious complication of diabetes that occurs when the body produces high levels of blood acids called ketones. It is commonly associated with conditions such as cerebral edema, arrhythmias, and mucormycosis. However, peptic ulcers are not directly linked to DKA. Peptic ulcers are open sores that develop on the lining of the stomach or the upper part of the small intestine, and they are usually caused by an infection or long-term use of certain medications. While diabetes can increase the risk of developing peptic ulcers, they are not a direct consequence of DKA.Rate this question:
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- 28.
Acarbose (Precose), an alpha-glucosidase inhibitor, is prescribed for a female client with type 2 diabetes mellitus. During discharge planning, nurse Pauleen would be aware of the client’s need for additional teaching when the client states:
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“If I have hypoglycemia, I should eat some sugar, not dextrose.”
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“The drug makes my pancreas release more insulin.”
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“I should never take insulin while I’m taking this drug.”
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“It’s best if I take the drug with the first bite of a meal.”
Correct Answer
A. “If I have hypoglycemia, I should eat some sugar, not dextrose.”Explanation
Acarbose delays glucose absorption, so the client should take an oral form of dextrose rather than a product containing table sugar when treating hypoglycemia. The alpha-glucosidase inhibitors work by delaying the carbohydrate digestion and glucose absorption. It’s safe to be on a regimen that includes insulin and an alpha-glucosidase inhibitor. The client should take the drug at the start of a meal, not 30 minutes to an hour before.Rate this question:
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- 29.
Dr. Kennedy prescribes glipizide (Glucotrol), an oral antidiabetic agent, for a male client with type 2 diabetes mellitus who has been having trouble controlling the blood glucose level through diet and exercise. Which medication instruction should the nurse provide?
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“Be sure to take glipizide 30 minutes before meals.”
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“Glipizide may cause a low serum sodium level, so make sure you have your sodium level checked monthly.”
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“You won’t need to check your blood glucose level after you start taking glipizide.”
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“Take glipizide after a meal to prevent heartburn.”
Correct Answer
A. “Be sure to take glipizide 30 minutes before meals.”Explanation
The client should take glipizide twice a day, 30 minutes before a meal, because food decreases its absorption. The drug doesn’t cause hyponatremia and therefore doesn’t necessitate monthly serum sodium measurement. The client must continue to monitor the blood glucose level during glipizide therapy.Rate this question:
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- 30.
For a diabetic male client with a foot ulcer, the physician orders bed rest, a wet-to-dry dressing change every shift, and blood glucose monitoring before meals and bedtime. Why are wet-to-dry dressings used for this client?
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They contain exudate and provide a moist wound environment.
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They protect the wound from mechanical trauma and promote healing.
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They debride the wound and promote healing by secondary intention.
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They prevent the entrance of microorganisms and minimize wound discomfort.
Correct Answer
A. They debride the wound and promote healing by secondary intention.Explanation
For this client, wet-to-dry dressings are most appropriate because they clean the foot ulcer by debriding exudate and necrotic tissue, thus promoting healing by secondary intention. Moist, transparent dressings contain exudate and provide a moist wound environment. Hydrocolloid dressings prevent the entrance of microorganisms and minimize wound discomfort. Dry sterile dressings protect the wound from mechanical trauma and promote healing.Rate this question:
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- 31.
A male client has just been diagnosed with type 1 diabetes mellitus. When teaching the client and family how diet and exercise affect insulin requirements, Nurse Joy should include which guideline?
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“You’ll need more insulin when you exercise or increase your food intake.”
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“You’ll need less insulin when you exercise or reduce your food intake.”
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“You’ll need less insulin when you increase your food intake.”
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“You’ll need more insulin when you exercise or decrease your food intake.”
Correct Answer
A. “You’ll need less insulin when you exercise or reduce your food intake.”Explanation
Exercise, reduced food intake, hypothyroidism, and certain medications decrease the insulin requirements. Growth, pregnancy, greater food intake, stress, surgery, infection, illness, increased insulin antibodies, and certain medications increase the insulin requirements.Rate this question:
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- 32.
Nurse Noemi administers glucagon to her diabetic client, then monitors the client for adverse drug reactions and interactions. Which type of drug interacts adversely with glucagon?
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Oral anticoagulants
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Anabolic steroids
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Beta-adrenergic blockers
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Thiazide diuretics
Correct Answer
A. Oral anticoagulantsExplanation
As a normal body protein, glucagon only interacts adversely with oral anticoagulants, increasing the anticoagulant effects. It doesn’t interact adversely with anabolic steroids, beta-adrenergic blockers, or thiazide diuretics.Rate this question:
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- 33.
Which instruction about insulin administration should nurse Kate give to a client?
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“Always follow the same order when drawing the different insulins into the syringe.”
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“Shake the vials before withdrawing the insulin.”
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“Store unopened vials of insulin in the freezer at temperatures well below freezing.”
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“Discard the intermediate-acting insulin if it appears cloudy.”
Correct Answer
A. “Always follow the same order when drawing the different insulins into the syringe.”Explanation
The client should be instructed always to follow the same order when drawing the different insulins into the syringe. Insulin should never be shaken because the resulting froth prevents withdrawal of an accurate dose and may damage the insulin protein molecules. Insulin also should never be frozen because the insulin protein molecules may be damaged. Intermediate-acting insulin is normally cloudy.Rate this question:
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- 34.
Nurse Perry is caring for a female client with type 1 diabetes mellitus who exhibits confusion, light-headedness, and aberrant behavior. The client is still conscious. The nurse should first administer:
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I.M. or subcutaneous glucagon.
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I.V. bolus of dextrose 50%.
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15 to 20 g of a fast-acting carbohydrate such as orange juice.
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10 U of fast-acting insulin.
Correct Answer
A. 15 to 20 g of a fast-acting carbohydrate such as orange juice.Explanation
This client is having a hypoglycemic episode. Because the client is conscious, the nurse should first administer a fast-acting carbohydrate, such as orange juice, hard candy, or honey. If the client has lost consciousness, the nurse should administer either I.M. or subcutaneous glucagon or an I.V. bolus of dextrose 50%. The nurse shouldn’t administer insulin to a client who’s hypoglycemic; this action will further compromise the client’s condition.Rate this question:
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- 35.
The glycosylated hemoglobin of a 40-year-old client with diabetes mellitus is 2.5%. The nurse understands that:
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The client can have a higher-calorie diet.
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The client has good control of her diabetes.
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The client requires adjustment in her insulin dose.
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The client has poor control of her diabetes.
Correct Answer
A. The client has good control of her diabetes.Explanation
The client’s diabetes is well under control. Answer A is incorrect because it will lead to elevated glycosylated hemoglobin. Answer C is incorrect because the diet and insulin dose are appropriate for the client. Answer D is incorrect because the desired range for glycosylated hemoglobin in the adult client is 2.5%–5.9%Rate this question:
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- 36.
A 65-year-old female who has diabetes mellitus and has sustained a large laceration on her left wrist asks the nurse, “How long will it take for my scars to disappear?” which statement would be the nurse’s best response?
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“The contraction phase of wound healing can take 2 to 3 years.”
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“Wound healing is very individual but within 4 months the scar should fade.”
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“With your history and the type of location of the injury, it’s hard to say.”
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“If you don’t develop an infection, the wound should heal any time between 1 and 3 years from now.”
Correct Answer
A. “With your history and the type of location of the injury, it’s hard to say.”Explanation
Wound healing in a client with diabetes will be delayed. Providing the client with a time frame could give the client false information.Rate this question:
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- 37.
A nurse assigned to care for a postoperative male client who has diabetes mellitus. During the assessment interview, the client reports that he’s impotent and says that he’s concerned about its effect on his marriage. In planning this client’s care, the most appropriate intervention would be to:
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Encourage the client to ask questions about personal sexuality
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Provide time for privacy
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Provide support for the spouse or significant other
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Suggest referral to a sex counselor or other appropriate professional
Correct Answer
A. Suggest referral to a sex counselor or other appropriate professionalExplanation
The nurse should refer this client to a sex counselor or other professional. Making appropriate referrals is a valid part of planning the client’s care. The nurse doesn’t normally provide sex counseling. Therefore, providing time for privacy and providing support for the spouse or significant other are important, but not as important as referring the client to a sex counselor.Rate this question:
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- 38.
Clients with diabetes mellitus require frequent vision assessment. The nurse should instruct the client about which of the following eye problems most likely to be associated with diabetes mellitus?
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Cataracts
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Retinopathy
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Astigmatism
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Glaucoma
Correct Answer
A. RetinopathyExplanation
Diabetes mellitus is a chronic condition that affects the body's ability to regulate blood sugar levels. It can lead to damage in various organs, including the eyes. Retinopathy is a common eye problem associated with diabetes mellitus. It occurs when the blood vessels in the retina become damaged, leading to vision problems and potential blindness if left untreated. Therefore, clients with diabetes mellitus should be regularly assessed for retinopathy to prevent further complications. Cataracts, astigmatism, and glaucoma can also occur in individuals with diabetes, but retinopathy is the most likely eye problem associated with this condition.Rate this question:
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- 39.
A male client with diabetes mellitus is receiving insulin. Which statement correctly describes an insulin unit?
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It’s a common measurement in the metric system.
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It’s the basis for solids in the avoirdupois system.
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It’s the smallest measurement in the apothecary system.
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It’s a measure of effect, not a standard measure of weight or quantity.
Correct Answer
A. It’s a measure of effect, not a standard measure of weight or quantity.Explanation
An insulin unit is a measure of effect, not a standard measure of weight or quantity. Different drugs measured in units may have no relationship to one another in quality or quantity.Rate this question:
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- 40.
The nurse is performing wound care on a foot ulcer in a client with type 1 diabetes mellitus. Which technique demonstrates surgical asepsis?
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Putting on sterile gloves then opening a container of sterile saline.
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Cleaning the wound with a circular motion, moving from outer circles toward the center.
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Changing the sterile field after sterile water is spilled on it.
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Placing a sterile dressing ½” (1.3 cm) from the edge of the sterile field.
Correct Answer
A. Changing the sterile field after sterile water is spilled on it.Explanation
A sterile field is considered contaminated when it becomes wet. Moisture can act as a wick, allowing microorganisms to contaminate the field. The outside of containers, such as sterile saline bottles, aren’t sterile. The containers should be opened before sterile gloves are put on and the solution poured over the sterile dressings placed in a sterile basin. Wounds should be cleaned from the most contaminated area to the least contaminated area—for example, from the center outward. The outer inch of a sterile field shouldn’t be considered sterile.Rate this question:
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- 41.
A client has a medical history of rheumatic fever, type 1 (insulin dependent) diabetes mellitus, hypertension, pernicious anemia, and appendectomy. She’s admitted to the hospital and undergoes mitral valve replacement surgery. After discharge, the client is scheduled for a tooth extraction. Which history finding is a major risk factor for infective endocarditis?
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Appendectomy
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Pernicious anemia
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Diabetes mellitus
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Valve replacement
Correct Answer
A. Valve replacementExplanation
A heart valve prosthesis, such as a mitral valve replacement, is a major risk factor for infective endocarditis. Other risk factors include a history of heart disease (especially mitral valve prolapse), chronic debilitating disease, IV drug abuse, and immunosuppression. Although diabetes mellitus may predispose a person to cardiovascular disease, it isn’t a major risk factor for infective endocarditis, nor is an appendectomy or pernicious anemia.Rate this question:
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- 42.
A client with type 1 diabetes mellitus has been on a regimen of multiple daily injection therapy. He’s being converted to continuous subcutaneous insulin therapy. While teaching the client bout continuous subcutaneous insulin therapy, the nurse would be accurate in telling him the regimen includes the use of:
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Intermediate and long-acting insulins
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Short and long-acting insulins
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short-acting only
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Short and intermediate-acting insulins
Correct Answer
A. short-acting onlyExplanation
Continuous subcutaneous insulin regimen uses a basal rate and boluses of short-acting insulin. Multiple daily injection therapy uses a combination of short-acting and intermediate or long-acting insulins.Rate this question:
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- 43.
Patients with Type 1 diabetes mellitus may require which of the following changes to their daily routine during periods of infection?
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No changes.
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Less insulin.
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More insulin.
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Oral diabetic agents.
Correct Answer
A. More insulin.Explanation
During periods of infection or illness, patients with Type 1 diabetes may need even more insulin to compensate for increased blood glucose levels.Rate this question:
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- 44.
At a senior citizens meeting a nurse talks with a client who has diabetes mellitus Type 1. Which statement by the client during the conversation is most predictive of a potential for impaired skin integrity?
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"I give my insulin to myself in my thighs."
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"Sometimes when I put my shoes on I don't know where my toes are."
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"Here are my up and down glucose readings that I wrote on my calendar."
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"If I bathe more than once a week my skin feels too dry."
Correct Answer
A. "Sometimes when I put my shoes on I don't know where my toes are."Explanation
Peripheral neuropathy can lead to lack of sensation in the lower extremities. Clients do not feel pressure and/or pain and are at high risk for skin impairment.Rate this question:
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- 45.
A home health nurse is at the home of a client with diabetes and arthritis. The client has difficulty drawing up insulin. It would be most appropriate for the nurse to refer the client to
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A social worker from the local hospital
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An occupational therapist from the community center
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A physical therapist from the rehabilitation agency
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Another client with diabetes mellitus and takes insulin
Correct Answer
A. An occupational therapist from the community centerExplanation
An occupational therapist can assist a client to improve the fine motor skills needed to prepare an insulin injection.Rate this question:
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- 46.
A patient with a history of diabetes mellitus is in the second post-operative day following cholecystectomy. She has complained of nausea and isn't able to eat solid foods. The nurse enters the room to find the patient confused and shaky. Which of the following is the most likely explanation for the patient's symptoms?
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Anesthesia reaction.
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Hyperglycemia.
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Hypoglycemia.
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Diabetic ketoacidosis.
Correct Answer
A. Hypoglycemia.Explanation
A post-operative diabetic patient who is unable to eat is likely to be suffering from hypoglycemia. Confusion and shakiness are common symptoms. An anesthesia reaction would not occur on the second post-operative day. Hyperglycemia and ketoacidosis do not cause confusion and shakiness.Rate this question:
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- 47.
Which of the following clinical characteristics is associated with Type 1 diabetes (previously referred to as insulin-dependent diabetes mellitus [IDDM])?
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Presence of islet cell antibodies
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Obesity
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Rare ketosis
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Requirement for oral hypoglycemic agents
Correct Answer
A. Presence of islet cell antibodiesExplanation
Individuals with Type 1 diabetes often have islet cell antibodies. Individuals with Type 1 diabetes are usually thin or demonstrate recent weight loss at the time of diagnosis. Individuals with Type 1 diabetes are ketosis-prone when insulin is absent. Individuals with Type 1 diabetes need insulin to preserve life.Rate this question:
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- 48.
Which of the following clinical characteristics is associated with Type 2 diabetes (previously referred to as non-insulin-dependent diabetes mellitus [NIDDM])?
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Can control blood glucose through diet and exercise
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Usually thin at diagnosis
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Ketosis-prone
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Demonstrate islet cell antibodies
Correct Answer
A. Can control blood glucose through diet and exerciseExplanation
Oral hypoglycemic agents may improve blood glucose levels if dietary modification and exercise are unsuccessful. Individuals with Type 2 diabetes are usually obese at diagnosis. Individuals with Type 2 diabetes rarely demonstrate ketosis, except in stress or infection. Individuals with Type 2 diabetes do not demonstrate islet cell antibodies.Rate this question:
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- 49.
Of the following types of insulin, which is the most rapid acting?
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Humalog
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Regular
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NPH
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Ultralente
Correct Answer
A. HumalogExplanation
The onset of action of rapid-acting Humalog is within 10-15 minutes. The onset of action of short-acting regular insulin is 30 minutes-1 hour. The onset of action of intermediate acting NPH is 3-4 hours. The onset of action of long-acting Ultralente is 6-8 hours.Rate this question:
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Mar 21, 2023Quiz Edited by
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Feb 25, 2013Quiz Created by
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