Exam 20: Nutrition and Diabetes Mellitus

Nursing Exam Review Multiple Choice A patient with type 1 diabetes  typically needs _____doses of daily insulin injections.

Jared Joiner is a 56-year-old African American insurance agent. He is single, eats most meals at restaurants, and leads a sedentary lifestyle. He is 5'9" tall and weighs 204 pounds. Mr. Joiner has been feeling particularly fatigued lately and decided to make an appointment with his physician for a check-up. The results of his laboratory tests include a fasting blood glucose level of 121 mg/dL. What recommendation to help Mr. Joiner reduce his risk of developing diabetes is most likely to be effective?

Nursing Exam Review Multiple Choice A 12-year-old girl is diagnosed with type 1 diabetes and is placed on insulin. Her mother expresses concern that her daughter will refuse to give herself injections. The nurse reassures the mother that:

The diet for diabetes should provide less than _____ percent of saturated fat per day.

An appropriate goal for HbA_1C in adult diabetic patients is:

The leading cause of death in people with diabetes is:

The mode of action of sulfonylureas is to:

The recommended carbohydrate intake for adults with diabetes is based on a person's:

Nursing Exam Review Multiple Choice For which person would intensive insulin therapy be inappropriate?

Close monitoring of glucose levels is especially important for the pregnant woman with diabetes.

In severe cases of diabetic ketoacidosis, blood glucose levels can exceed 1000 mg/dL.

Those taking _____ should avoid excessive alcohol intake because it may interact with these drugs to cause lactic acidosis.

What food represents one 15 g portion of a carbohydrate for a diabetic patient?

It is appropriate for clients diagnosed with type 2 diabetes to take oral antidiabetic agents and forego recommended dietary changes.

Though the exact cause of metabolic syndrome is unknown, it is believed to be associated with:

Describe hyperosmolar hyperglycemic syndrome and its potential complications for the diabetic patient.

A disadvantage of intensive therapy for type 2 diabetes is:

A 60-year-old client, Mr. Hummel, has had type 2 DM for several years. Because of a change in insurance coverage, Mr. Hummel changes doctors and at his first appointment, a comprehensive medical exam and dietary history are performed. At the next few appointments, the certified diabetes educator, a registered dietitian, takes a full dietary history. Mr. Hummel works part-time in a seasonal sporting goods store, having retired last year after 35 years working for a manufacturing plant as a supervisor. He is married to a nurse who works full-time. He does most of the cooking and grocery shopping. He and his wife go for walks on weekends, but he does not exercise otherwise, except for doing chores around the house and occasional yard work or gardening. He is 5'9" tall and weighs 196  lbs., though when his diabetes was initially diagnosed, he weighed more. Mr. Hummel is interested in weight reduction, especially if it will help him manage his blood glucose, and provides the following 24-hour food recall that typifies how he usually eats: Breakfast (eats after taking morning blood glucose):   Pancakes with diet syrup or a bowl of cereal (usually corn flakes, Chex, or instant oatmeal) with Sweet 'N' Low and nonfat milk. Drinks coffee throughout the day starting at breakfast with two nondairy coffee creamer packets per cup. May or may not have 4 oz. of 100% fruit juice depending on hunger. Lunch (eats after taking afternoon blood glucose):   Sandwich (rye or wheat bread), deck of cards-size portion of lunch meat (salami, ham, bologna, turkey, or chicken) with thinly spread mayonnaise; coffee with nondairy creamers. May or may not eat a can of soup (cream of tomato, cream of chicken, or Italian wedding soup) instead of a sandwich, with two slices of buttered rye or wheat bread. Afternoon Snack:   Canned fruit or occasionally a cookie, doughnut, a piece of pizza, or a treat, depending on availability, hunger, blood sugar, and situation. Drinks coffee with nondairy coffee creamer. Usually also has a glass of ice water before dinner. Dinner (eats after taking evening blood glucose):   Roast beef, meat loaf, steak, or another red meat; occasionally eats poultry or fish-approximate amount 8 oz.; plain baked potato, au gratin potatoes, or boiled buttered potatoes; a salad with bottled salad dressing or a vegetable, such as canned green beans; and a slice of rye or wheat bread with butter. May use ketchup, steak sauce, salt, and pepper. Drinks water with dinner. Evening Snack:   Varies-may eat a few handfuls of a bagged snack food, such as Doritos; a bag of buttered microwave popcorn; or cookies. Labs are as follows: Fasting glucose: 140-150 mg/dL Glucose one to two hours after mealtime: 200 mg/dL Average bedtime glucose: 152 mg/dL Glycosylated hemoglobin (hemoglobin A _1C ): 7.5%   Which macronutrient distribution is appropriate for Mr. Hummel's daily diet?

Type 2 diabetes is most closely associated with:

The fructosamine test is used to determine: