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| In preparing the staff in-service for a presentation about diabetes the nurse includes which information | Diabetes increases the risk for the development of cardiovascular disease |
| The Client w/ diabetes asks the nurse why is it necessary to maintain glucose no lower than 74 | which is the nurses best response |
| In monitoring client w/ hypoglycemia, the nurse recognizes which action of glucagon | glucagon prevents hypoglycemia by promoting glucose release from liver storage sites |
| the nurse Correlates polyuria seen in clients with untreated diabetes w/ which physiologic response | Hyperosmolarity of the EFC secondary to hyperglycemia |
| The nurse correlates which assessment finding in the client with diabetes w/ decreasing renal function | Protein in the urine during a random UA (protein in urine is the start of renal failure) |
| A client Newly dx w type 1 diabetes who wears glasses and has myopia asks the nurse how frequently should he see the ophthalmologist, what is the nurses best response | the disease increases your risk for cataracts, glaucoma and retinal blood vessel changes so you should see the opthamologist yearly even when you do not have a new vision problem |
| During assessment of a client w/ 15 yr hx of diabetes the nurse that the client has decreased tactile sensation of both feet. Which action does the nurse take first | Examine the client’s feet for signs of injury |
| Which is the nurses best response about developing diabetes to the client who is father has type 1 dm | You have a greater susceptibility for developing diabetes 1 & 20 to 50 chance |
| To delay the onset of macrovascular and microvascular complications in the diabetic client, the nurse stresses which action | Controlling hyperglycemia |
| The nurse recognizes which client for being as greatest risk undiagnosed w/ diabetes | 45 year old native american woman |
| A client whose mother has Type 2 diabetes asks the nurse what are the chances of developing type 2 diabetes because of her mothers disease. What is the nurse’s best response | Children of people w/ type 2 have a 15% chance of developing the disease, but the environmental factors (obesity) also influence your risk |
| The nurse includes which information when teaching the newly diagnosed w/ type 1 dm about when to measure for urine ketone bodies | whenever you are ill or your blood sugar is consistently higher than 300 mg/dL |
| Client w/ type 2 is prescribed to take oral sulfonylurea agent, to control blood glucose levels, which precaution does the nurse need to include in the teaching plan r/t this medication | Avoid taking NSAIDS |
| The client w/ type 2 diabetes has been recently changed to the medication from oral antidiabetic agents Glyburide and glucophage, to the glyburide/metformin glucovance. the nurse includes which information of teaching about taking this medication | Glucovance contains a combination of glyburide and metformin |
| Which statement by the client w/ type 2 diabetes who is taking Starlix indicates understanding of this therapy | Ill take this medicine 15 minutes before I eat. |
| The client has been taking (Actose)-Proglitazone for 6 months and reports to the nurse that his urine has become darker since starting medication, which is the nurse’s first action | Review the results of the liver enzymes study's and notify the physician |
| The client w/ diabetes asks why there is more than 1 injection required each day | Which is the nurses best response |
| Which statement made by the client indicates further teaching about injection site rotation and injection site selection | The abdominal site is best because it is closest to the pancreas (it is best because of better absorption) |
| The client who has been using insulin control for 20 yrs has a spongy swelling at the site used most frequently for the site of insulin injection, which is the nurses best action | Instruct the client to use a different site |
| A client w/ diabetes is prescribed to take insulin, Glargine once daily & regular insulin 4 times daily how will the nurse teach this pt to take these medications when the 1st dose of regular insulin occurs the same time of day as insulin glargine dose | Draw up and inject the insulin glargine first and then draw up and inject the dose of regular insulin |
| The client on an intensified insulin regimen consistently has a fasting glucose between 70-80 if post prandial: below 200 & HGba1C of: 5.5%, which is the interpretation of the nurses findings | the client is demonstrating good control of blood glucose (hgba1c: 4-6%) (prandial: below 200) |
| The client w/ diabetes is visually impaired and is wondering if the syringes can be prefilled and stored later which is the nurse’s best response | yes prefilled syringes can be stored for up to 3 weeks in the refrigerator in a vertical position with the needle pointing up |
| To prevent complications of infection r/t infusion pumps what should the nurse teach the client | Change the needle every 3 days |
| Which is response from the client requires additional teaching regarding nutrition therapy | “ I should try to keep my diet free from carbohydrates” |
| Client newly diagnosed w/ type 2 diabetes tells the nurse, since increasing fiber intake I am experiencing flatulence, diarrhea, & abdominal cramping which is the nurse’s best response | Decrease your fiber now and then gradually add high fiber back into diet |
| The nurse recommends the pen type injector insulin delivery system for the type of client w. which clinical presentation | Pen type injector is best for greater accuracy w/ small doses, especially doses under 5 units, not good for ppl w/ visual/neuro impairments (answer): the client using intensive therapy who must use insulin in small frequent doses |
| The nurse teaches which action to the diabetic client who self injects insulin to prevent or limit local irritation at the injection site | Allow insulin to warm to room temp before injection (cold insulin is most common cause of irritation not infection) |
| To reduce complication w/ diabetes the nurse teaching the client w/ normal renal function to modify intake of which nutritional group | Fats- diabetes leads to hyperlipidemia= arterial sclerosis & vascular insufficiency |
| A client w diabetes has proliferative retinopathy, nephropathy and peripheral neuropathy, what should the nurse teach this client about exercise | Swimming or water aerobics 30 minutes each day would be the safest form of exercise routine for you |
| The nurse assess for which clinical manifestation in the client w/ uncontrollable diabetes and ketoacidosis | Increase rate & depth of respirations |
| The nurse determines of which of the ABG values are consistent w/ ketoacidosis in client w/ diabetes | pH 7.28, HCO3 18 mEq/L, PCO2 9mm Hg, PO2 98 mm Hg |
| Which priority intervention does the nurse take when pt has Kussmaul respirations as a result of diabetic ketoacidosis | Administration of IV insulin- will reduce this type of respiration |
| The client w/ type 1 diabetes asks whether an occasional glass of wine is allowed Which is the nurse’s best response | One glass of wine can be ingests w. a meal and can be considered as 2 fat exchanges |
| The nurse monitors which problem of which nutritional problem w/older adults w/ diabetes | Malnutrition |
| The nurse teaches the newly dx’s client w/ type 1 diabetes that insulin needs can be decreased by what action | Walking 1 mile each day |
| Which finding in the client w/ diabetes indicates that exercise should be avoided at this time | Ketone bodies in the urine |
| 2 months after a simultaneous kidney + pancreas transplantation the client is dx as being in acute organ rejection episode the client makes statement to the nurse: I was doing so well with my new organs and the thought of having to go back to living on he | you can have an acute episode, but doesn’t mean it’s failed- (answer): you should keep in mind that 1 acute rejection episode does not mean you will lose the new organs those episodes can be reversed w/ the right treatment |
| Which statement by the client getting ready for d/c after pancreas transplantation indicates the need for further teaching about the prescribed drug regimen | if i develop an infection i should stop taking my corticosteroid |
| The nurse correlates w/ which lab value w/ inadequate function of a transplanted pancreas | 50% decrease urine amylase (anything that has to do w/ urine)-decreased anything urine is the indication |
| 3 hours after surgery the nurse notes that the breath of the client w.type 1 diabetes has a fruity odor. Which is the nurses best 1st action | Testing urine for ketone bodies |
| The client w/ type 1 diabetes has a glucose level of 160 mg dL on arrival to the operating room, what is the nurses best action | Document the findings as the only action |
| The nurse teaches which intervention to prevent injury in the diabetic client who has numbness and reduced sensation secondary to peripheral neuropathy | Use a bath thermometer to test the water temperature-(examination of the feet does not PREVENT the injury. Inspecting for injury does not prevent it) |
| A client w/ a 20 yr hx of diabetes w/ severe burning pain in the feet and hands as a result of peripheral neuropathy asks the nurse why an antidepressant has been prescribed | What is the nurses best response |
| the nurse monitors for which clinical manifestation of decreased renal function in the client with a history of diabetes | A sustained increased of BP 130/84- to 50/100 |
| For the diabetic client w/ microalbuminuria teaches the client to decrease which part of their dietary intake | decreased percentage of total derived from proteins |
| Which statement by the diabetic client w/ a UTI indicates that teaching was effective regarding antibiotic therapy | even if i feel completely well, i should take the medication until it is gone |
| The home care nurse administers a ½ a cup of Oj to the pt with diabetes who is experiencing hypoglycemic episodes. The clinical manifestations have not changed after 5 mins, which is the nurses next best action | administer an additional 1/2 cup of orange juice |
| Which precaution should the nurse institute for the client receiving IM glucagon caused by hyperglycemia and is unable to swallow | position the client on his/her side |
| The nurse monitors which lab disorder in a client receiving IV insulin for hyperglycemia | serum potassium level of 2.5 |
| what instruction should the nurse emphasize when teaching the diabetic client about how to alter diabetes management during a period of illness that includes nausea and vomiting | monitor your blood glucose levels at least every 4 hours |
| The nurse recognizes the ketosis is rare in type 2 diabetes w/ hyperglycemia is r/t which reason | There is enough insulin produced by type 2 diabetes to prevent fat catabolism but not enough to prevent hyperglycemia |
| Which clinical manifestation indicates to the nurse that the therapy for the client w/hyperglycemic, hyperosmolar, nonketotic syndrome HHNS needs to be adjusted | The client’s score on the glasgow coma scale has not changed for 3 hours ago |
| The nurse administered 6 units of regular insulin and 10 of NPH @ 7am how many units did she give | |
| At what time is the client most susceptible to hypoglycemia r/t the NPH | 4pm- the peak of NPH (rationale): NPH is immediate acting w/ an onset of 1.5 hrs. and peaks between 4-12 hours, duration of 22 hours |
| Which statement by the client w/ diabetes need further teaching about wearing a medical alert bracelet | This bracelet identifies me as a diabetic in case I become unconscious |
| The nurse monitors for which clinical manifestations in the diabetic client admitted w/ DKA | Tachycardia & orthostatic hypotension |
| Which statement by the client recently dx w/type 2 indicates understanding in the importance of maintaining weight within the prescribed range | I might need to NOT need take medication if my weight is maintained |
| Which of the following statements by the client w/ type 2 diabetes indicates the need for further teaching about diabetic management and follow up care | clients with diabetes need to be seen at least annually to monitor for long term complications including visual changes microalbuminuria and lipid analysis |
| A client recently dx’s w. type 1 diabetes tell the nurse I don’t know if I will be able to stick myself w/ a needle. What is the nurses best response | Tell me about the injection that is concerning you |
| The nurse is d/c a client who has recently been dx’s w/ type 1 and refers the client to the American Diabetes Assoc. Which statement by the client indicates an understanding of the resources available fr. this organization | They can help me find a local diabetic nurse educator/instructor |
Which laboratory values should the nurse expect in a patient with diabetic ketoacidosis?
Diabetic ketoacidosis is typically characterized by hyperglycemia over 250 mg/dL, a bicarbonate level less than 18 mEq/L, and a pH less than 7.30, with ketonemia and ketonuria.
Which findings should the nurse expect in a patient with hyperosmolar hyperglycemic state HHS?
A serious complication of diabetes mellitus, hyperosmolar hyperglycemic syndrome (HHS) happens when blood sugar levels are very high for a long period of time. Symptoms of HHS can include extreme thirst, frequent urination, changes in your vision and confusion.
Which signs and symptoms would be seen in a client experiencing hypoglycemia?
Signs and symptoms of low blood glucose(happen quickly).
Feeling shaky..
Being nervous or anxious..
Sweating, chills and clamminess..
Irritability or impatience..
Confusion..
Fast heartbeat..
Feeling lightheaded or dizzy..
Hunger..
Which symptom should the nurse associate with hypoglycemia?
These include behavioral changes, confusion, dizziness, headache, fatigue, seizure, coma, and potential death if not immediately corrected. Severe hypoglycemia can cause hemophilia and aphasia, masquerading as a stroke.