Question 1

A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM.The clinic nurse will plan to teach the patient to

Accepted Answer

A)  check glucose level before, during, and after swimming. 
B)  delay eating the noon meal until after the swimming class. 
C)  increase the morning dose of neutral protamine Hagedorn (NPH) insulin. 
D)  time the morning insulin injection so that the peak occurs while swimming. 
A)  check glucose level before, during, and after swimming. 
B)  delay eating the noon meal until after the swimming class. 
C)  increase the morning dose of neutral protamine Hagedorn (NPH) insulin. 
D)  time the morning insulin injection so that the peak occurs while swimming.

Question 2

A patient receives aspart (NovoLog)insulin at 8:00 AM.Which time will it be most important for the nurse to monitor for symptoms of hypoglycemia?

Accepted Answer

A)  10:00 AM 
B)  12:00 AM 
C)  2:00 PM 
D)  4:00 PM 
A)  10:00 AM 
B)  12:00 AM 
C)  2:00 PM 
D)  4:00 PM

Question 3

An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS).The nurse will anticipate the need to

Accepted Answer

A)  give a bolus of 50% dextrose. 
B)  insert a large-bore IV catheter. 
C)  initiate oxygen by nasal cannula. 
D)  administer glargine (Lantus) insulin. 
A)  give a bolus of 50% dextrose. 
B)  insert a large-bore IV catheter. 
C)  initiate oxygen by nasal cannula. 
D)  administer glargine (Lantus) insulin.

Question 4

In which order will the nurse take these steps to prepare NPH 20 units and regular insulin 2 units using the same syringe? (Put a comma and a space between each answer choice [A,B,C,D,E]).
A) Rotate NPH vial.
B) Withdraw regular insulin.
C) Withdraw 20 units of NPH.
D) Inject 20 units of air into NPH vial.
E) Inject 2 units of air into regular insulin vial.

Accepted Answer

A,D,E,B,C
When mixing regular insulin wi

Question 5

The nurse is assessing a 22-year-old patient experiencing the onset of symptoms of type 1 diabetes.Which question is most appropriate for the nurse to ask?

Accepted Answer

A)  "Are you anorexic?" 
B)  "Is your urine dark colored?" 
C)  "Have you lost weight lately?" 
D)  "Do you crave sugary drinks?" 
A)  "Are you anorexic?" 
B)  "Is your urine dark colored?" 
C)  "Have you lost weight lately?" 
D)  "Do you crave sugary drinks?"

Question 6

A few weeks after an 82-year-old with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage)therapy and taught about appropriate diet and exercise,the home health nurse makes a visit.Which finding by the nurse is most important to discuss with the health care provider?

Accepted Answer

A)  Hemoglobin A?C level is 7.9%. 
B)  Last eye exam was 18 months ago. 
C)  Glomerular filtration rate is decreased. 
D)  Patient has questions about the prescribed diet. 
A)  Hemoglobin A?C level is 7.9%. 
B)  Last eye exam was 18 months ago. 
C)  Glomerular filtration rate is decreased. 
D)  Patient has questions about the prescribed diet.

Question 7

A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control.Which behavior indicates that the nurse should implement additional teaching?

Accepted Answer

A)  The patient always carries hard candies when engaging in exercise. 
B)  The patient goes for a vigorous walk when his glucose is 200 mg/dL. 
C)  The patient has a peanut butter sandwich before going for a bicycle ride. 
D)  The patient increases daily exercise when ketones are present in the urine. 
A)  The patient always carries hard candies when engaging in exercise. 
B)  The patient goes for a vigorous walk when his glucose is 200 mg/dL. 
C)  The patient has a peanut butter sandwich before going for a bicycle ride. 
D)  The patient increases daily exercise when ketones are present in the urine.

Question 8

A 32-year-old patient with diabetes is starting on intensive insulin therapy.Which type of insulin will the nurse discuss using for mealtime coverage?

Accepted Answer

A)  Lispro (Humalog) 
B)  Glargine (Lantus) 
C)  Detemir (Levemir) 
D)  NPH (Humulin N) 
A)  Lispro (Humalog) 
B)  Glargine (Lantus) 
C)  Detemir (Levemir) 
D)  NPH (Humulin N)

Question 9

The nurse has administered 4 oz of orange juice to an alert patient whose blood glucose was 62 mg/dL.Fifteen minutes later,the blood glucose is 67 mg/dL.Which action should the nurse take next?

Accepted Answer

A)  Give the patient 4 to 6 oz more orange juice. 
B)  Administer the PRN glucagon (Glucagon) 1 mg IM. 
C)  Have the patient eat some peanut butter with crackers. 
D)  Notify the health care provider about the hypoglycemia. 
A)  Give the patient 4 to 6 oz more orange juice. 
B)  Administer the PRN glucagon (Glucagon) 1 mg IM. 
C)  Have the patient eat some peanut butter with crackers. 
D)  Notify the health care provider about the hypoglycemia.

Question 10

Which statement by the patient indicates a need for additional instruction in administering insulin?

Accepted Answer

A)  "I need to rotate injection sites among my arms, legs, and abdomen each day." 
B)  "I can buy the 0.5 mL syringes because the line markings will be easier to see." 
C)  "I should draw up the regular insulin first after injecting air into the NPH bottle." 
D)  "I do not need to aspirate the plunger to check for blood before injecting insulin." 
A)  "I need to rotate injection sites among my arms, legs, and abdomen each day." 
B)  "I can buy the 0.5 mL syringes because the line markings will be easier to see." 
C)  "I should draw up the regular insulin first after injecting air into the NPH bottle." 
D)  "I do not need to aspirate the plunger to check for blood before injecting insulin."

Question 11

A 26-year-old patient with diabetes rides a bicycle to and from work every day.Which site should the nurse teach the patient to administer the morning insulin?

Accepted Answer

A)  thigh. 
B)  buttock. 
C)  abdomen. 
D)  upper arm. 
A)  thigh. 
B)  buttock. 
C)  abdomen. 
D)  upper arm.

Question 12

The health care provider suspects the Somogyi effect in a 50-year-old patient whose 6:00 AM blood glucose is 230 mg/dL.Which action will the nurse teach the patient to take?

Accepted Answer

A)  Avoid snacking at bedtime. 
B)  Increase the rapid-acting insulin dose. 
C)  Check the blood glucose during the night 
D)  Administer a larger dose of long-acting insulin. 
A)  Avoid snacking at bedtime. 
B)  Increase the rapid-acting insulin dose. 
C)  Check the blood glucose during the night 
D)  Administer a larger dose of long-acting insulin.

Question 13

Which patient action indicates good understanding of the nurse's teaching about administration of aspart (NovoLog)insulin?

Accepted Answer

A)  The patient avoids injecting the insulin into the upper abdominal area. 
B)  The patient cleans the skin with soap and water before insulin administration. 
C)  The patient stores the insulin in the freezer after administering the prescribed dose. 
D)  The patient pushes the plunger down while removing the syringe from the injection site. 
A)  The patient avoids injecting the insulin into the upper abdominal area. 
B)  The patient cleans the skin with soap and water before insulin administration. 
C)  The patient stores the insulin in the freezer after administering the prescribed dose. 
D)  The patient pushes the plunger down while removing the syringe from the injection site.

Question 14

The nurse is preparing to teach a 43-year-old man who is newly diagnosed with type 2 diabetes about home management of the disease.Which action should the nurse take first?

Accepted Answer

A)  Ask the patient's family to participate in the diabetes education program. 
B)  Assess the patient's perception of what it means to have diabetes mellitus. 
C)  Demonstrate how to check glucose using capillary blood glucose monitoring. 
D)  Discuss the need for the patient to actively participate in diabetes management. 
A)  Ask the patient's family to participate in the diabetes education program. 
B)  Assess the patient's perception of what it means to have diabetes mellitus. 
C)  Demonstrate how to check glucose using capillary blood glucose monitoring. 
D)  Discuss the need for the patient to actively participate in diabetes management.

Question 15

A 34-year-old has a new diagnosis of type 2 diabetes.The nurse will discuss the need to schedule a dilated eye exam

Accepted Answer

A)  every 2 years. 
B)  as soon as possible. 
C)  when the patient is 39 years old. 
D)  within the first year after diagnosis. 
A)  every 2 years. 
B)  as soon as possible. 
C)  when the patient is 39 years old. 
D)  within the first year after diagnosis.

Question 16

The nurse determines a need for additional instruction when the patient with newly diagnosed type 1 diabetes says which of the following?

Accepted Answer

A)  "I can have an occasional alcoholic drink if I include it in my meal plan." 
B)  "I will need a bedtime snack because I take an evening dose of NPH insulin." 
C)  "I can choose any foods, as long as I use enough insulin to cover the calories." 
D)  "I will eat something at meal times to prevent hypoglycemia, even if I am not hungry." 
A)  "I can have an occasional alcoholic drink if I include it in my meal plan." 
B)  "I will need a bedtime snack because I take an evening dose of NPH insulin." 
C)  "I can choose any foods, as long as I use enough insulin to cover the calories." 
D)  "I will eat something at meal times to prevent hypoglycemia, even if I am not hungry."

Question 17

Which information will the nurse include when teaching a 50-year-old patient who has type 2 diabetes about glyburide (Micronase,DiaBeta,Glynase)?

Accepted Answer

A)  Glyburide decreases glucagon secretion from the pancreas. 
B)  Glyburide stimulates insulin production and release from the pancreas. 
C)  Glyburide should be taken even if the morning blood glucose level is low. 
D)  Glyburide should not be used for 48 hours after receiving IV contrast media. 
A)  Glyburide decreases glucagon secretion from the pancreas. 
B)  Glyburide stimulates insulin production and release from the pancreas. 
C)  Glyburide should be taken even if the morning blood glucose level is low. 
D)  Glyburide should not be used for 48 hours after receiving IV contrast media.

Question 18

The nurse is taking a health history from a 29-year-old pregnant patient at the first prenatal visit.The patient reports no personal history of diabetes but has a parent who is diabetic.Which action will the nurse plan to take first?

Accepted Answer

A)  Teach the patient about administering regular insulin. 
B)  Schedule the patient for a fasting blood glucose level. 
C)  Discuss an oral glucose tolerance test for the twenty-fourth week of pregnancy. 
D)  Provide teaching about an increased risk for fetal problems with gestational diabetes. 
A)  Teach the patient about administering regular insulin. 
B)  Schedule the patient for a fasting blood glucose level. 
C)  Discuss an oral glucose tolerance test for the twenty-fourth week of pregnancy. 
D)  Provide teaching about an increased risk for fetal problems with gestational diabetes.

Question 19

Which laboratory value reported to the nurse by the unlicensed assistive personnel (UAP)indicates the most urgent need for the nurse's assessment of the patient?

Accepted Answer

A)  Bedtime glucose of 140 mg/dL 
B)  Noon blood glucose of 52 mg/dL 
C)  Fasting blood glucose of 130 mg/dL 
D)  2-hr postprandial glucose of 220 mg/dL 
A)  Bedtime glucose of 140 mg/dL 
B)  Noon blood glucose of 52 mg/dL 
C)  Fasting blood glucose of 130 mg/dL 
D)  2-hr postprandial glucose of 220 mg/dL

Question 20

Which action should the nurse take after a 36-year-old patient treated with intramuscular glucagon for hypoglycemia regains consciousness?

Accepted Answer

A)  Assess the patient for symptoms of hyperglycemia. 
B)  Give the patient a snack of peanut butter and crackers. 
C)  Have the patient drink a glass of orange juice or nonfat milk. 
D)  Administer a continuous infusion of 5% dextrose for 24 hours. 
A)  Assess the patient for symptoms of hyperglycemia. 
B)  Give the patient a snack of peanut butter and crackers. 
C)  Have the patient drink a glass of orange juice or nonfat milk. 
D)  Administer a continuous infusion of 5% dextrose for 24 hours.

Exam 49: Nursing Management: Diabetes Mellitus

A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM.The clinic nurse will plan to teach the patient to

A patient receives aspart (NovoLog)insulin at 8:00 AM.Which time will it be most important for the nurse to monitor for symptoms of hypoglycemia?

An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS).The nurse will anticipate the need to

The nurse is assessing a 22-year-old patient experiencing the onset of symptoms of type 1 diabetes.Which question is most appropriate for the nurse to ask?

A few weeks after an 82-year-old with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage)therapy and taught about appropriate diet and exercise,the home health nurse makes a visit.Which finding by the nurse is most important to discuss with the health care provider?

A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control.Which behavior indicates that the nurse should implement additional teaching?

A 32-year-old patient with diabetes is starting on intensive insulin therapy.Which type of insulin will the nurse discuss using for mealtime coverage?

The nurse has administered 4 oz of orange juice to an alert patient whose blood glucose was 62 mg/dL.Fifteen minutes later,the blood glucose is 67 mg/dL.Which action should the nurse take next?

Which statement by the patient indicates a need for additional instruction in administering insulin?

A 26-year-old patient with diabetes rides a bicycle to and from work every day.Which site should the nurse teach the patient to administer the morning insulin?

The health care provider suspects the Somogyi effect in a 50-year-old patient whose 6:00 AM blood glucose is 230 mg/dL.Which action will the nurse teach the patient to take?

Which patient action indicates good understanding of the nurse's teaching about administration of aspart (NovoLog)insulin?

The nurse is preparing to teach a 43-year-old man who is newly diagnosed with type 2 diabetes about home management of the disease.Which action should the nurse take first?

A 34-year-old has a new diagnosis of type 2 diabetes.The nurse will discuss the need to schedule a dilated eye exam

The nurse determines a need for additional instruction when the patient with newly diagnosed type 1 diabetes says which of the following?

Which information will the nurse include when teaching a 50-year-old patient who has type 2 diabetes about glyburide (Micronase,DiaBeta,Glynase)?

The nurse is taking a health history from a 29-year-old pregnant patient at the first prenatal visit.The patient reports no personal history of diabetes but has a parent who is diabetic.Which action will the nurse plan to take first?

Which laboratory value reported to the nurse by the unlicensed assistive personnel (UAP)indicates the most urgent need for the nurse's assessment of the patient?

Which action should the nurse take after a 36-year-old patient treated with intramuscular glucagon for hypoglycemia regains consciousness?

Professional Nursing Practice

Health Disparities and Culturally Competent Care

Health History and Physical Examination

Patient and Caregiver Teaching

Chronic Illness and Older Adults

Complementary and Alternative Therapies

Stress and Stress Management

Sleep and Sleep Disorders

Pain

Palliative Care at End of Life

Substance Abuse

Inflammation and Wound Healing

Genetics and Genomics

Altered Immune Responses, and Transplantation

Infection and Human Immunodeficiency Virus Infection

Cancer

Fluid, Electrolyte, and Acid-Base Imbalances

Nursing Management: Preoperative Care

Nursing Management: Intraoperative Care

Nursing Management: Postoperative Care

Nursing Assessment: Visual and Auditory Systems

Nursing Management: Visual and Auditory Problems

Nursing Assessment: Integumentary System

Nursing Management: Integumentary Problems

Nursing Management: Burns

Nursing Assessment: Respiratory System

Nursing Management: Upper Respiratory Problems

Nursing Management: Lower Respiratory Problems

Nursing Management: Obstructive Pulmonary Diseases

Nursing Assessment: Hematologic System

Nursing Management: Hematologic Problems

Nursing Assessment: Cardiovascular System

Nursing Management: Hypertension

Nursing Management: Coronary Artery Disease and Acute Coronary Syndrome

Nursing Management: Heart Failure

Nursing Management: Dysrhythmias

Nursing Management: Inflammatory and Structural Heart Disorders

Nursing Management: Vascular Disorders

Nursing Assessment: Gastrointestinal System

Nursing Management: Nutritional Problems

Nursing Management: Obesity

Nursing Management: Upper Gastrointestinal Problems

Nursing Management: Lower Gastrointestinal Problems

Nursing Management: Liver,Pancreas,and Biliary Tract Problems

Nursing Assessment: Urinary System

Nursing Management: Renal and Urologic Problems

Nursing Management: Acute Kidney Injury and Chronic Kidney Disease

Nursing Assessment: Endocrine System

Nursing Management: Endocrine Problems

Nursing Assessment: Reproductive System

Nursing Management: Breast Disorders

Nursing Management: Sexually Transmitted Infections

Nursing Management: Female Reproductive Problems

Nursing Management: Male Reproductive Problems

Nursing Assessment: Nervous System

Nursing Management: Acute Intracranial Problems

Nursing Management: Stroke

Nursing Management: Chronic Neurologic Problems

Nursing Management: Alzheimer's Disease,Dementia,and Delirium

Nursing Management: Peripheral Nerve and Spinal Cord Problems