Diabetes Mellitus By Rnpedia.Com
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The newly diagnosed diabetic patient asks the nurse why he needs to check his feet every day. The nurse's best response is....
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To prevent leg amputation.
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To check for any cuts, sores, or dry cracked skin so they can be treated early to prevent infection or gangrene.
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To see if they hurt.
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You just need to do it.
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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.
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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- 3.
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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- 4.
The nurse teaches the patient about diabetes including which of the following statements?
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Elevated blood glucose levels contribute to complications of diabetes, such as diminished vision.
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Sugar is found only in dessert foods.
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The only diet change needed in the treatment of diabetes is to stop eating sugar.
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Once insulin injections are started in the treatment of Type 2 diabetes, they can never be discontinued.
Correct Answer
A. Elevated blood glucose levels contribute to complications of diabetes, such as diminished vision.Explanation
When blood glucose levels are well controlled, the potential for complications of diabetes is reduced.Rate this question:
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- 5.
The nurse's first action upon finding a patient with mild hypoglycemia is to...
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Call the rapid response team
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Give 1 mg of glucagon
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Give 10-15 g of CHO or Orange juice
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Give insulin
Correct Answer
A. Give 10-15 g of CHO or Orange juiceExplanation
The nurse's first action upon finding a patient with mild hypoglycemia is to give 10-15 g of CHO or orange juice. This is because hypoglycemia is a state of low blood sugar, and providing a source of carbohydrates can quickly raise the blood sugar levels. CHO stands for carbohydrates, and orange juice is a commonly used source of quick-acting carbohydrates. Calling the rapid response team or giving glucagon or insulin may be necessary in more severe cases of hypoglycemia, but the initial action for mild hypoglycemia is to provide carbohydrates.Rate this question:
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- 6.
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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- 7.
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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- 8.
The nurse enters a patient's room and sees the patient breathing rapidly with a fruity breath smell. This is known as...
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Trousseau's
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Cullen's
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Kussmaul's
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Bitot's
Correct Answer
A. Kussmaul'sExplanation
Kussmaul's breathing is characterized by rapid and deep breaths, often associated with a fruity or acetone-like breath smell. This type of breathing pattern is commonly seen in patients with diabetic ketoacidosis, a condition where the body produces high levels of ketones due to a lack of insulin. The fruity breath smell is caused by the presence of ketones in the breath.Rate this question:
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- 9.
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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- 10.
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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- 11.
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.
Correct Answer
A. 10 to 15 g of a simple carbohydrate.Explanation
To reverse hypoglycemia, the American Diabetes Association recommends ingesting 10 to 15 g of a simple carbohydrate, such as three to five pieces of hard candy, two to three packets of sugar (4 to 6 tsp), or 4 oz of fruit juice. If necessary, this treatment can be repeated in 15 minutes. Ingesting only 2 to 5 g of a simple carbohydrate may not raise the blood glucose level sufficiently. Ingesting more than 15 g may raise it above normal, causing hyperglycemia.Rate this question:
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- 12.
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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- 13.
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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- 14.
A patient arrives at the ED with a blood sugar of 578, serum osmolarity of 300, pH of 7.3, severe thirst, dehydration, and confusion. The patient is breathing rapidly and has a fruity breath smell. This patient has symptoms of......
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Diabetic ketoacidosis
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Hyperosmolar hyperglycemic noketotic coma
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Hypoglycemia
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Diabetic neuropathy
Correct Answer
A. Diabetic ketoacidosisExplanation
The patient's blood sugar level of 578, along with symptoms such as severe thirst, dehydration, confusion, rapid breathing, and fruity breath smell, indicate a state of diabetic ketoacidosis. Diabetic ketoacidosis is a serious complication of diabetes that occurs when the body produces high levels of ketones due to a lack of insulin. This leads to high blood sugar levels, dehydration, and metabolic acidosis, resulting in symptoms like those described in the patient. Hyperosmolar hyperglycemic nonketotic coma is a separate condition characterized by extremely high blood sugar levels, but without the presence of ketones. Hypoglycemia refers to low blood sugar levels, which is not consistent with the patient's presentation. Diabetic neuropathy refers to nerve damage caused by diabetes and does not encompass the symptoms described.Rate this question:
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- 15.
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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- 16.
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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- 17.
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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- 18.
A urine test in an undiagnosed diabetic may show........
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Glucose and ketones in the urine
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glucose and high amounts of bilirubin in the urine
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Ketones in the urine
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ketones and adrenaline in the urine
Correct Answer
A. Glucose and ketones in the urineExplanation
In an undiagnosed diabetic, the body is unable to properly regulate blood sugar levels. This can lead to high levels of glucose in the urine, as the kidneys attempt to remove the excess sugar from the body. Additionally, the body may break down fat for energy instead of glucose, which produces ketones as a byproduct. Therefore, a urine test in an undiagnosed diabetic may show the presence of both glucose and ketones in the urine.Rate this question:
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- 19.
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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- 20.
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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- 21.
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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- 22.
The nurse enters a diabetic patient's room at 11:30 and notices that the patient is diaphoretic, tachycardic, anxious, states she is hungry, and doesn't remember where she is. This patient is most likely showing signs of what?
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Hyperglycemic
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Hypoglycemic
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Diabetic ketoacidosis
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Hyperosmolar hyperglycemic noketotic coma
Correct Answer
A. HypoglycemicExplanation
The patient's symptoms of diaphoresis, tachycardia, anxiety, hunger, and confusion are consistent with hypoglycemia, which is low blood sugar levels. Hypoglycemia can cause these symptoms due to the brain not receiving enough glucose for energy. This can be a dangerous condition and requires immediate intervention to prevent further complications.Rate this question:
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- 23.
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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- 24.
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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- 25.
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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- 26.
Patricia a 20 year old college student with diabetes mellitus requests additional information about the advantages of using a pen like insulin deliverydevices. The nurse explains that the advantages of these devices over syringes includes:
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Accurate dose delivery
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Shorter injection time
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Lower cost with reusable insulin cartridges
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Use of smaller gauge needle.
Correct Answer
A. Accurate dose deliveryExplanation
These devices are more accurate because they are easily to used and have improved adherence in insulin regimens by young people because the medication can be administered discreetly.Rate this question:
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- 27.
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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- 28.
The nurse teaches the patient about glargine (Lantus), a “peakless” basal insulin including which of the following statements?
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Do not mix the drug with other insulins
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Administer the total daily dosage in two doses.
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Draw up the drug first, then add regular insulin.
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The drug is rapidly absorbed and has a fast onset of action
Correct Answer
A. Do not mix the drug with other insulinsExplanation
Because glargine is in a suspension with a pH of 4, it cannot be mixed with other insulins because this would cause precipitation. When administering glargine (Lantus) insulin it is very important to read the label carefully and to avoid mistaking Lantus insulin for Lente insulin and vice versa.Rate this question:
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- 29.
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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- 30.
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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- 31.
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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- 32.
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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- 33.
A patient with severe hypoglycemia arrives at the ED unconscious by ambulance. The nurse would first...
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Give regular insulin by IV
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Give NPH by IV
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Give 10-15 g CHO or Orange juice
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Give 1 mg glucagon
Correct Answer
A. Give 1 mg glucagonExplanation
In the given scenario, the patient is experiencing severe hypoglycemia and is unconscious. Glucagon is the appropriate treatment in this situation as it helps to rapidly increase blood sugar levels. Glucagon stimulates the liver to convert stored glycogen into glucose, which can then be released into the bloodstream. This can quickly raise the patient's blood sugar levels and help them regain consciousness. Giving regular insulin, NPH, or orange juice would not be appropriate in this case as they do not act as rapidly as glucagon to increase blood sugar levels.Rate this question:
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- 34.
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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- 35.
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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- 36.
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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- 37.
Of the following categories of oral antidiabetic agents, which exert their primary action by directly stimulating the pancreas to secrete insulin?
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Sulfonylureas
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Thiazolidinediones
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Biguanides
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Alpha glucosidase inhibitors
Correct Answer
A. SulfonylureasExplanation
A functioning pancreas is necessary for sulfonylureas to be effective.Rate this question:
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- 38.
The diabetic patient's lab work comes back with a pH of 7.4, serum blood sugar of 950, serum osmolarity of 460, pCO2 of 35, HCO3 of 25. The patient is confused and dehydrated. This patient is showing signs and symptoms of....
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Diabetic ketoacidosis
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Hyperosmolar hyperglycemic noketotic coma
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Hypoglycemia
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Diabetic neuropathy
Correct Answer
A. Hyperosmolar hyperglycemic noketotic comaExplanation
The patient's lab results indicate a high serum blood sugar level of 950, which is consistent with hyperosmolar hyperglycemic nonketotic coma (HHNK). HHNK is a severe complication of diabetes characterized by extremely high blood sugar levels, dehydration, confusion, and altered mental status. The pH of 7.4 suggests that the patient's acid-base balance is within the normal range, ruling out diabetic ketoacidosis. Hypoglycemia is characterized by low blood sugar levels, which is not seen in this case. Diabetic neuropathy refers to nerve damage caused by diabetes and does not explain the patient's symptoms of confusion and dehydration.Rate this question:
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- 39.
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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- 40.
A client with diabetes mellitus has a prescription for Glucotrol XL (glipizide). The client should be instructed to take the medication:
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At bedtime
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With breakfast
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Before lunch
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After dinner
Correct Answer
A. With breakfastExplanation
Glucotrol XL is given once a day with breakfast. Answer A is incorrect because the client would develop hypoglycemia while sleeping. Answers C and D are incorrect because the client would develop hypoglycemia later in the day or evening.Rate this question:
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- 41.
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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- 42.
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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- 43.
The physician has prescribed Novalog insulin for a client with diabetes mellitus. Which statement indicates that the client knows when the peak action of the insulin occurs?
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"I will make sure I eat breakfast within 10 minutes of taking my insulin."
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"I will need to carry candy or some form of sugar with me all the time."
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"I will eat a snack around three o’clock each afternoon."
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"I can save my dessert from supper for a bedtime snack."
Correct Answer
A. "I will make sure I eat breakfast within 10 minutes of taking my insulin."Explanation
Novalog insulin onsets very quickly, so food should be available within 10–15 minutes of taking the insulin. Answer B does not address a particular type of insulin, so it is incorrect. NPH insulin peaks in 8–12 hours, so a snack should be eaten at the expected peak time. It may not be 3 p.m. as stated in answer C. Answer D is incorrect because there is no need to save the dessert until bedtime.Rate this question:
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- 44.
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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- 45.
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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- 46.
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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- 47.
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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- 48.
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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- 49.
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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Mar 21, 2023Quiz Edited by
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Feb 25, 2013Quiz Created by
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