. Which statement by a nurse to a patient newly diagnosed with type 2 diabetes is correct?
a.
Insulin is not used to control blood glucose in patients
... [Show More] with
type 2 diabetes.
b
.
Complications of type 2 diabetes are less serious than those
of type 1 diabetes.
c.
Changes in diet and exercise may control blood glucose
levels in type 2 diabetes.
d
.
Type 2 diabetes is usually diagnosed when the patient is
admitted with a hyperglycemic coma.
ANS: C
For some patients with type 2 diabetes, changes in lifestyle are sufficient to achieve blood
glucose control. Insulin is frequently used for type 2 diabetes, complications are equally severe
as for type 1 diabetes, and type 2 diabetes is usually diagnosed with routine laboratory testing or
after a patient develops complications such as frequent yeast infections.
2. A 48-year-old male patient screened for diabetes at a clinic has a fasting plasma glucose level
of 120 mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about
a. self-monitoring of blood glucose.
b
. using low doses of regular insulin.
c. lifestyle changes to lower blood glucose.
d
. effects of oral hypoglycemic medications.
ANS: C
The patient’s impaired fasting glucose indicates prediabetes, and the patient should be counseled
about lifestyle changes to prevent the development of type 2 diabetes. The patient with
prediabetes does not require insulin or oral hypoglycemics for glucose control and does not need
to self-monitor blood glucose.
3. 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.
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.
ANS: D
When the patient is ketotic, exercise may result in an increase in blood glucose level. Type 1
diabetic patients should be taught to avoid exercise when ketosis is present. The other statements
are correct.
4. 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. “Are you anorexic?”
b
. “Is your urine dark colored?”
c. “Have you lost weight lately?”
d
. “Do you crave sugary drinks?”
ANS: C
Weight loss occurs because the body is no longer able to absorb glucose and starts to break down
protein and fat for energy. The patient is thirsty but does not necessarily crave sugar-containing
fluids. Increased appetite is a classic symptom of type 1 diabetes. With the classic symptom of
polyuria, urine will be very dilute.
5. A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months
from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the
patient?
a. Urine dipstick for glucose
b
. Oral glucose tolerance test
c. Fasting blood glucose level
d
. Glycosylated hemoglobin level
ANS: D
The glycosylated hemoglobin (A1C or HbA1C) test shows the overall control of glucose over 90
to 120 days. A fasting blood level indicates only the glucose level at one time. Urine glucose
testing is not an accurate reflection of blood glucose level and does not reflect the glucose over a
prolonged time. Oral glucose tolerance testing is done to diagnose diabetes, but is not used for
monitoring glucose control once diabetes has been diagnosed.
6. A 55-year-old female patient with type 2 diabetes has a nursing diagnosis of imbalanced
nutrition: more than body requirements. Which goal is most important for this patient?
a.
The patient will reach a glycosylated hemoglobin level of
less than 7%.
b
.
The patient will follow a diet and exercise plan that results
in weight loss.
c.
The patient will choose a diet that distributes calories
throughout the day.
d
.
The patient will state the reasons for eliminating simple
sugars in the diet.
ANS: A
The complications of diabetes are related to elevated blood glucose, and the most important
patient outcome is the reduction of glucose to near-normal levels. The other outcomes also are
appropriate but are not as high in priority.
7. 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. 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.
ANS: A
The change in exercise will affect blood glucose, and the patient will need to monitor glucose
carefully to determine the need for changes in diet and insulin administration. Because exercise
tends to decrease blood glucose, patients are advised to eat before exercising. Increasing the
morning NPH or timing the insulin to peak during exercise may lead to hypoglycemia, especially
with the increased exercise.
8. The nurse determines a need for additional instruction when the patient with newly diagnosed
type 1 diabetes says which of the following?
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.”
ANS: C [Show Less]