Transcript Diabetes Mellitus

Diabetes Mellitus
Practice Questions

The client, an 18-year old female,
comes to the clinic with a wound on
her left lower leg that has not healed
for 2 weeks. Which disease process
would the nurse suspect that the
client developed?
A.
B.
C.
D.
Type 1 DM
Type 2 DM
Gestational DM
Secondary DM

The client diagnosed with Type 1 DM
has a glycosylated Hgb (A1C) of
8.1%. Which interpretation should the
nurse make based on this result?
A.
B.
C.
D.
This
This
This
This
result
result
result
result
is
is
is
is
below normal levels
within acceptable range
above recommended levels
dangerously high

The nurse administered 28 units of
Humulin N, an intermediate acting
insulin, to a client diagnosed with Type 1
DM at 1700. Which action should the
nurse implement?
A. Determine how much food the client ate at
lunch
B. Perform a glucometer reading at 0700
C. Ensure the client eats a bedtime snack
D. Offer the client protein after administering
insulin

The client diagnosed with Type 1 DM is
receiving Humalog, a rapid-acting insulin,
by sliding scale. The order reads blood
glucose level: <150, give 0 units; 151200, give 3 units; 201-250, give 6 units;
>251, contact MD. The client’s BS is 189
mg/dL.
– How much insulin should you
administer?_________
– What is the most important follow-up
assessment for this patient and when?
____________________

The nurse is completing an admission
assessment for a 76 year old client with
Type 2 DM that must be controlled with
70/30 combination insulin. Which
intervention should be included in the
plan of care?
A. Assess the client’s ability to read small print
B. Monitor the client’s coagulation studies
C. Teach the client how to perform a HgbA1C
test daily
D. Instruct the client to check the feet weekly.

The client with Type 2 DM controlled
with biguanide oral diabetic medication is
scheduled for a computed tomography
with contrast of the abdomen to evaluate
pancreatic function. Which intervention
should the nurse implement?
A. Provide a high fat diet 24 hours prior to test
B. Hold the biguanide medication for 48 hours
to test
C. Obtain an informed consent for the test
D. Administer pancreatic enzymes prior to test

The diabetic educator is teaching a class on diabetes
Type 1 and is discussing sick-day rules. Which
interventions should the educator include in the
discussion?
A. Take diabetic medication even if unable to eat the
client’s normal diabetic diet
B. If unable to eat, drink liquids equal to client’s normal
caloric intake
C. It is not necessary to notify health care provider if
ketones are present in urine
D. Test blood glucose levels frequently and test urine for
ketones once a day and keep a record

The client received 10 units of Humulin R, a
fast acting insulin, at 0700. At 1030, the
unlicensed nursing assistant tells the nurse the
client has a headache and is asking for his
lunch tray early because he is feeling very
hungry. Which action should the nurse
implement first?
A. Order the client’s lunch tray from the kitchen and
give it to him early
B. Have the client drink 8 ounces of orange juice
C. Go to the client’s room and assess the client for
hypoglycemia
D. Prepare to administer 1 amp of 50% Dextrose
intravenously
E. Instruct the nursing assistant to obtain a blood
glucose level

The client diagnosed with Type 1 DM is
found lying unconscious on the floor of
the bathroom. Which intervention should
the nurse implement first?
A.
B.
C.
D.
Notify the physician
Check the serum glucose level
Administer 50% dextrose IVP
Move the client to the ICU

The nurse is discussing ways to prevent
DKA with the client diagnosed with Type
1 DM. Which instruction would be most
important to discuss with the client?
A. Refer the client to American Diabetes
Association
B. Do not take any over the counter
medications
C. Take the prescribed insulin even when
unable to eat because of illness
D. Be sure to get you annual flu and pneumonia
vaccines

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
The goal of treatment with hypoglycemic agents is the
maintenance of stable blood glucose levels to prevent
the acute complications of hypoglycemia and
hyperglycemia, and the long-term complications
associated with hyperglycemia. Your patient will initially
be taking Humulin N/Humulin R 70/30 insulin
subcutaneously q a.m., a sliding-scale dose of regular
insulin subcutaneously before lunch and dinner, and
Humulin N insulin at bedtime.
Which statement made by a client indicates that she
correctly understands self-administration of insulin?
A) "My daily dose of 70/30 insulin is based on how much
I ate the day before."
B) "The amount of short-acting insulin I take every day
is based on my blood sugar readings."
C) "I should store my insulin in the refrigerator and
remove it thirty minutes before I need it."
D) "I will alternate my injection sites from leg to
abdomen each day to avoid overuse."
11.

An hour before the next dose of sliding-scale
insulin is scheduled, the client tells the nurse, "I
guess I’m really nervous about giving myself
insulin injections. Look how shaky and sweaty I
am.“
What is the priority nursing action?
A) Obtain Lara’s vital signs.
B) Check Lara’s blood glucose.
C) Assure Lara that she will be able to give
herself the injections.
D) Offer to bring Lara an orange so she can
practice giving injections.
13


After discharge, Lara is scheduled for a follow-up
evaluation at the outpatient clinic. A glycosylated Hgb
level is drawn, and the results were 11%.
Which statement by Lara reflects understanding of
glycosylated Hgb?
A) "The results of the test are probably high, because I
was not fasting before my blood was drawn this
morning."
B) "The results of my test are probably high, because I
went to a party last night and did not follow my
diet."
C) "I know that I need to check my glycosolated Hgb
before each meal and at bedtime, but I don’t always
have time."
D) "At least I won't have this done again for 3 months. I
will really work at following my diet between now
and then."
21.

Lara tells the nurse that her 15-year-old sister had a
fasting blood glucose test last week, because she felt that
she had some of the same symptoms that Lara had
before being diagnosed with diabetes. Lara states her
sister's results were 135 mg/dl.
How should the nurse respond?
A) "She needs a second test performed before a diagnosis
is made."
B) "Since her value is high, it sounds like both of you
have diabetes."
C) "Her value is low and indicates that she does not have
diabetes."
D) "She is too young to develop Type 1 diabetes. She
may have
Type 2."
•22.

Lara talks to the nurse about what to do if she gets sick.
She states, "It just doesn’t make sense to take my
insulin when I feel sick, knowing I won’t want to eat
anything."
How should the nurse respond?
A) "You are right. You should not take your insulin if you
are feeling sick."
B) "Take only sliding-scale insulin, not your regular dose,
if you are feeling sick."
C) "Being sick increases your blood sugar. Taking your
usual insulin dose is important."
D) "When you are sick, you should test your urine and
only take insulin if ketones are present."
23.


Which finding indicates that Lara is
experiencing a complication of diabetes?
A) Burning sensation in her toes.
B) Visual acuity of 60/20.
C) Lack of protein in her urine.
D) Blood pressure of 110/60.