Endocrine System Disorders | Diabetes Mellitus | NCLEX Quiz 103

1. The guidelines for Carbohydrate Counting as medical nutrition therapy for diabetes mellitus includes all of the following EXCEPT:

Flexibility in types and amounts of foods consumed

Unlimited intake of total fat. saturated fat and cholesterol

Including adequate servings of fruits. vegetables and the dairy group

Applicable to with either Type 1 or Type 2 diabetes mellitus

The guidelines for Carbohydrate Counting as medical nutrition therapy for diabetes mellitus includes all of the following EXCEPT option B. unlimited intake of total fat. saturated fat and cholesterol.

Explanation

The guidelines for Carbohydrate Counting as medical nutrition therapy for diabetes mellitus includes all of the following EXCEPT option B. unlimited intake of total fat. saturated fat and cholesterol.

2. Joko has recently been diagnosed with Type I diabetes and asks Nurse Jessica for help formulating a nutrition plan. Which of the following recommendations would the nurse make to help the client increase calorie consumption to offset absorption problems?

Eat small meals with two or three snacks throughout the day to keep blood glucose levels steady

Increase consumption of simple carbohydrates

Eating small meals with two or three snacks may be more helpful in maintaining blood glucose levels than three large meals.

Skip meals to help lose weight

Eating small meals with two or three snacks may be more helpful in maintaining blood glucose levels than three large meals.

Explanation

Eating small meals with two or three snacks may be more helpful in maintaining blood glucose levels than three large meals.

3. When taking a health history. the nurse screens for manifestations suggestive of Diabetes Type I. Which of the following manifestations are considered the primary manifestations of Diabetes Type I and would be most suggestive and require follow-up investigation?

Excessive intake of calories. rapid weight gain. and difficulty losing weight

An increase in three areas: thirst. intake of fluids. and hunger

Poor circulation. wound healing. and leg ulcers.

Lack of energy. weight gain. and depression

The primary manifestations of diabetes type I are polyuria (increased urine output). polydipsia (increased thirst). polyphagia (increased hunger).

Explanation

The primary manifestations of diabetes type I are polyuria (increased urine output). polydipsia (increased thirst). polyphagia (increased hunger).

4. The nurse is working with an overweight client who has a high-stress job and smokes. This client has just received a diagnosis of Type II Diabetes and has just been started on an oral hypoglycemic agent. Which of the following goals for the client which if met. would be most likely to lead to an improvement in insulin efficiency to the point the client would no longer require oral hypoglycemic agents?

Comply with medication regimen 100% for 6 months

Quit the use of any tobacco products by the end of three months

Lose a pound a week until weight is in normal range for height and exercise 30 minutes daily

Practice relaxation techniques for at least five minutes five times a day for at least five months

When Type II diabetics lose weight through diet and exercise they sometimes have an improvement in insulin efficiency sufficient to the degree they no longer require oral hypoglycemic agents.

Explanation

When Type II diabetics lose weight through diet and exercise they sometimes have an improvement in insulin efficiency sufficient to the degree they no longer require oral hypoglycemic agents.

5. Billy is being asked concerning his health in the emergency department. When obtaining a health history from a patient with acute pancreatitis. the nurse asks the patient specifically about a history of

Alcohol use.

Cigarette smoking.

Diabetes mellitus.

High-protein diet.

Alcohol use is one of the most common risk factors for pancreatitis in the United States.

Explanation

Alcohol use is one of the most common risk factors for pancreatitis in the United States.

6. The goal for pre-prandial blood glucose for those with Type 1 diabetes mellitus is:

The goal for pre-prandial blood glucose for those with Type 1 diabetes mellitus is

Explanation

The goal for pre-prandial blood glucose for those with Type 1 diabetes mellitus is

7. Harry is a diabetic patient who is experiencing a reaction of alternating periods of nocturnal hypoglycemia and hyperglycemia. The patient might be manifesting which of the following?

Uncontrolled diabetes

Somogyi phenomenon

Brittle diabetes

Diabetes insipidus

Diabetes is diagnosed at fasting blood glucose of greater than or equal to 126 mg/dl.

Explanation

Diabetes is diagnosed at fasting blood glucose of greater than or equal to 126 mg/dl.

8. At the time Cherrie Ann found out that the symptoms of diabetes were caused by high levels of blood glucose. she decided to break the habit of eating carbohydrates. With this. the nurse would be aware that the client might develop what complication?

Retinopathy

Atherosclerosis

Glycosuria

Acidosis

When a client’s carbohydrate consumption is inadequate. ketones are produced from the breakdown of fat. These ketones lower the pH of the blood. potentially causing acidosis that can lead to a diabetic coma.

Explanation

When a client’s carbohydrate consumption is inadequate. ketones are produced from the breakdown of fat. These ketones lower the pH of the blood. potentially causing acidosis that can lead to a diabetic coma.

9. During lecture. the clinical instructor tells the students that 50% to 60% of daily calories should come from carbohydrates. What should the nurse say about the types of carbohydrates that can be eaten?

Try to limit simple sugars to between 10% and 20% of daily calories.

Simple carbohydrates are absorbed more rapidly than complex carbohydrates.

Simple sugars cause rapid spike in glucose levels and should be avoided.

Simple sugars should never be consumed by someone with diabetes.

It is recommended that carbohydrates provide 50% to 60% of the daily calories. Approximately 40% to 50% should be from complex carbohydrates. The remaining 10% to 20 % of carbohydrates could be from simple sugars. Studies give no evidence that carbohydrates from simple sugars are digested and absorbed more rapidly that are complex carbohydrates. and they do not appear to affect blood sugar control.

Explanation

It is recommended that carbohydrates provide 50% to 60% of the daily calories. Approximately 40% to 50% should be from complex carbohydrates. The remaining 10% to 20 % of carbohydrates could be from simple sugars. Studies give no evidence that carbohydrates from simple sugars are digested and absorbed more rapidly that are complex carbohydrates. and they do not appear to affect blood sugar control.

10. Nurse Shey is educating a pregnant client who has gestational diabetes. Which of the following statements should the nurse make to the client? Select all that apply.

Cakes. candies. cookies. and regular soft drinks should be avoided.

Gestational diabetes increases the risk that the mother will develop diabetes later in life.

Gestational diabetes usually resolves after the baby is born.

Insulin injections may be necessary.

The baby will likely be born with diabetes

The mother should strive to gain no more weight during the pregnancy.

Gestational diabetes can occur between the 16th and 28th week of pregnancy. If not responsive to diet and exercise. insulin injections may be necessary. Concentrated sugars should be avoided. Weight gain should continue. but not in excessive amounts. Usually. gestational diabetes disappears after the infant is born. However. diabetes can develop 5 to 10 years after the pregnancy.

Explanation

Gestational diabetes can occur between the 16th and 28th week of pregnancy. If not responsive to diet and exercise. insulin injections may be necessary. Concentrated sugars should be avoided. Weight gain should continue. but not in excessive amounts. Usually. gestational diabetes disappears after the infant is born. However. diabetes can develop 5 to 10 years after the pregnancy.

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