Question 1

The patient has been admitted to the hospital with the diagnosis of DKA.The nurse anticipates that the patient will exhibit vital signs of:

Accepted Answer

A)  Temperature, 99° F; pulse, 62 beats/min; respirations, 16 breaths/min and shallow 
B)  Temperature, 98.6° F; pulse, 76 beats/min; respirations, 16 breaths/min and deep 
C)  Temperature, 98° F; pulse, 84 beats/min; respirations, 18 breaths/min and shallow 
D)  Temperature, 97.4° F; pulse, 100 beats/min; respirations, 20 breaths/min and deep 
A)  Temperature, 99° F; pulse, 62 beats/min; respirations, 16 breaths/min and shallow 
B)  Temperature, 98.6° F; pulse, 76 beats/min; respirations, 16 breaths/min and deep 
C)  Temperature, 98° F; pulse, 84 beats/min; respirations, 18 breaths/min and shallow 
D)  Temperature, 97.4° F; pulse, 100 beats/min; respirations, 20 breaths/min and deep

Question 2

The nurse suspects that the patient with type 1 diabetes may be experiencing the Somogyi phenomenon when the patient exhibits:

Accepted Answer

A)  Headache on awakening and enuresis 
B)  6 AM blood sugar of 58 and nausea 
C)  Abdominal pain and elevated blood pressure 
D)  Drowsiness and disorientation after eating 
A)  Headache on awakening and enuresis 
B)  6 AM blood sugar of 58 and nausea 
C)  Abdominal pain and elevated blood pressure 
D)  Drowsiness and disorientation after eating

Question 3

The nurse stresses that the patient with type 1 diabetes is at risk for cardiovascular disorders because the lack of insulin causes:

Accepted Answer

A)  High glucose levels that irritate and shrink the vessels 
B)  Inadequate metabolism of proteins, which causes ketosis 
C)  Increased fatty acid levels 
D)  Increased metabolism of ketones, which causes hypertension 
A)  High glucose levels that irritate and shrink the vessels 
B)  Inadequate metabolism of proteins, which causes ketosis 
C)  Increased fatty acid levels 
D)  Increased metabolism of ketones, which causes hypertension

Question 4

The home health care nurse is assessing a patient with type 1 diabetes who has been controlled for 6 months.The nurse is surprised and concerned about a blood glucose reading of 52.This episode of hypoglycemia is probably caused by the patient's having:

Accepted Answer

A)  Taken a new form of birth control pill this morning. 
B)  Used large amounts of sugar substitute in her tea this morning. 
C)  Had a 2-hour long exercise class at the spa this morning. 
D)  Administered an insufficient dose of insulin this morning. 
A)  Taken a new form of birth control pill this morning. 
B)  Used large amounts of sugar substitute in her tea this morning. 
C)  Had a 2-hour long exercise class at the spa this morning. 
D)  Administered an insufficient dose of insulin this morning.

Question 5

The patient with type 2 diabetes shows a blood sugar reading of 72 at 6 AM.Based on the reading of 72,the nurse should:

Accepted Answer

A)  Notify the charge nurse of the reading. 
B)  Give regular insulin per a sliding scale. 
C)  Give him   cup of milk. 
D)  Administer the oral hyperglycemic tablet. 
A)  Notify the charge nurse of the reading. 
B)  Give regular insulin per a sliding scale. 
C)  Give him   cup of milk. 
D)  Administer the oral hyperglycemic tablet.

Question 6

The patient has been admitted with hyperglycemic hyperosmolar nonketotic syndrome (HHNS).Her blood glucose level is very high (880 mg/dl)on admission.The physician believes that her condition is the result of large amounts of glucose solutions administered intravenously (IV)during kidney dialysis.The nurse anticipates that the patient would exhibit:

Accepted Answer

A)  Fruity breath and a high level of ketones in her urine 
B)  Severe dehydration and hypernatremia caused by the hyperglycemia 
C)  Exactly the same symptoms and signs as DKA 
D)  Kussmaul respirations, nausea, and vomiting 
A)  Fruity breath and a high level of ketones in her urine 
B)  Severe dehydration and hypernatremia caused by the hyperglycemia 
C)  Exactly the same symptoms and signs as DKA 
D)  Kussmaul respirations, nausea, and vomiting

Question 7

In drawing up a patient's diabetes teaching plan,the nurse needs to include the following:

Accepted Answer

A)  Develop an exercise plan, because regular exercise helps control blood glucose levels. 
B)  Monitor blood sugar levels only if not feeling well to ensure that the fingertips are not pricked too much. 
C)  If nervousness, palpitations, or hunger are experienced, take a small dose (1 to 2 U) of regular insulin and call the physician. 
D)  Use over-the-counter measures for any foot blisters, calluses, or wounds before seeking medical help. 
A)  Develop an exercise plan, because regular exercise helps control blood glucose levels. 
B)  Monitor blood sugar levels only if not feeling well to ensure that the fingertips are not pricked too much. 
C)  If nervousness, palpitations, or hunger are experienced, take a small dose (1 to 2 U) of regular insulin and call the physician. 
D)  Use over-the-counter measures for any foot blisters, calluses, or wounds before seeking medical help.

Question 8

When the patient with type 1 diabetes asks why his 7 AM insulin has been changed from NPH insulin to 70/30 premixed insulin,the nurse explains that 70/30 insulin mixture:

Accepted Answer

A)  Is absorbed more rapidly into the bloodstream. 
B)  Has no peak action time and lasts all day. 
C)  Makes insulin administration easier and safer. 
D)  Give a bolus of rapid-acting insulin to prevent hyperglycemia after breakfast. 
A)  Is absorbed more rapidly into the bloodstream. 
B)  Has no peak action time and lasts all day. 
C)  Makes insulin administration easier and safer. 
D)  Give a bolus of rapid-acting insulin to prevent hyperglycemia after breakfast.

Question 9

The nurse tells a patient that the functional causes of hypoglycemia include: (Select all that apply.)

Accepted Answer

A)  Dumping syndrome 
B)  Overdose of insulin 
C)  Addison disease 
D)  Prolonged muscular exercise 
E)  Chronic alcoholism 
A)  Dumping syndrome 
B)  Overdose of insulin 
C)  Addison disease 
D)  Prolonged muscular exercise 
E)  Chronic alcoholism

Question 10

As part of the teaching plan in preparation for discharge,the patient with type 1 diabetes needs guidelines for exercise.Which one of the following must be included?

Accepted Answer

A)  Plan exercise so that it coincides with the peak action of insulin. 
B)  Insulin should be injected into the lower extremity before exercise because that site provides the greatest absorption. 
C)  Exercise should be performed daily at the same time of day and at the same intensity. 
D)  Keep exercise at a minimum to conserve your energy. 
A)  Plan exercise so that it coincides with the peak action of insulin. 
B)  Insulin should be injected into the lower extremity before exercise because that site provides the greatest absorption. 
C)  Exercise should be performed daily at the same time of day and at the same intensity. 
D)  Keep exercise at a minimum to conserve your energy.

Exam 46: Diabetes Mellitus and Hypoglycemia

The patient has been admitted to the hospital with the diagnosis of DKA.The nurse anticipates that the patient will exhibit vital signs of:

The nurse suspects that the patient with type 1 diabetes may be experiencing the Somogyi phenomenon when the patient exhibits:

The nurse stresses that the patient with type 1 diabetes is at risk for cardiovascular disorders because the lack of insulin causes:

The home health care nurse is assessing a patient with type 1 diabetes who has been controlled for 6 months.The nurse is surprised and concerned about a blood glucose reading of 52.This episode of hypoglycemia is probably caused by the patient's having:

The patient with type 2 diabetes shows a blood sugar reading of 72 at 6 AM.Based on the reading of 72,the nurse should:

In drawing up a patient's diabetes teaching plan,the nurse needs to include the following:

When the patient with type 1 diabetes asks why his 7 AM insulin has been changed from NPH insulin to 70/30 premixed insulin,the nurse explains that 70/30 insulin mixture:

The nurse tells a patient that the functional causes of hypoglycemia include: (Select all that apply.)

As part of the teaching plan in preparation for discharge,the patient with type 1 diabetes needs guidelines for exercise.Which one of the following must be included?

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