VSIM Scenario 5 Skyler Hansen Diabetes Pretest

The nurse understands that the pathophysiology of type 1 diabetes is characterized by which of the following?

a) Destruction of pancreatic beta cells

b) Insulin resistance

c) Necrosis of pancreatic alpha cells

d) Impaired insulin production

a) Destruction of pancreatic beta cells

Rationale:Type 1 diabetes is characterized by the destruction of the pancreatic beta cells which are responsible for the secretion of insulin. Type 2 diabetes is the result of impaired insulin production or insulin resistance which may be related to necrosis of the pancreatic alpha cells.

Remediation:

Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition, p. 1458

Is the following statement true or false? Insulin regimens typically involve a combination of short-acting and long-acting insulin.

a) FALSE

b) TRUE

b) TRUE

Rationale:The normally functioning pancreas secretes insulin throughout the day in response to the blood glucose levels. Using a combination of short- and long-lasting insulin mimics this normal pattern.

Remediation:

Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition, pp. 1468-1469

For an unconscious patient who is experiencing hypoglycemia in a health care facility, the nurse would make what emergency management intervention?

a) 25 to 50 mL of dextrose 50% in water

b) 2 to 3 teaspoons of honey

c) IV bolus of 500mL D5W over 30 minutes

d) Glucagon 10 mg IM

a) 25 to 50 mL of dextrose 50% in water

Rationale:In hospitals and emergency departments, for patients who are unconscious or cannot swallow, 25 to 50 mL of dextrose 50% in water (D50W) may be administered IV.

Remediation:

Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition, p. 1482

The nurse would expect that a patient experiencing moderate hypoglycemia would exhibit which of the following sets of signs and symptoms?

a) Bradycardia, polyuria, acidosis

b) Double vision, cool dry skin

c) Hyperactivity, tachycardia, anorexia

d) Headache, light headedness, slurred speech

d) Headache, light headedness, slurred speech

Rationale:The clinical manifestations of hypoglycemia may be grouped into two categories: adrenergic symptoms and central nervous system symptoms. In moderate hypoglycemia, the drop in blood glucose affects the brain, resulting in headache, light headedness, and slurred speech, as well as other symptoms that may include loss of consciousness, hunger, tachycardia, and sweating.

Remediation:

Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition, p. 1482

The nurse knows that which of the following is a normal fasting serum glucose level for a patient 18 years of age?

a) 150 mg/dL

b) 90 mg/dL

c) 120 mg/dL

d) 60 mg/dL

b) 90 mg/dL

Rationale:A normal fasting serum glucose range for ages 2 to 18 years of age is 60 to 100 mg/dL.

Remediation:

Lippincott Advisor: Fasting plasma glucose level test: CD.978-1-58255-514-0.chapter186

The nurse understands that diabetes can lead to which of the following long-term complications? (Select all that apply.)

a) Diabetic ketoacidosis

b) Renal disease

c) Peripheral neuropathy

d) Blindness

e) Cardiovascular disease

b) Renal disease

c) Peripheral neuropathy

d) Blindness

e) Cardiovascular disease

Rationale:Atherosclerotic changes leading to cardiovascular disease develops at an earlier age in patients with diabetes. Most patients with diabetes have some degree of retinopathy after 20 years, which can lead to blindness. Nephropathy, or kidney disease secondary to microvascular changes in the kidney, is a common complication that develops over 10 to 15 years. Peripheral neuropathy increases with the age of the patient and the duration of diabetes. Diabetic ketoacidosis is an acute, short-term complication from inadequate insulin.

Remediation:

Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition, pp. 1488-1496

Glycosylated hemoglobin (HgbA1C) represents average blood glucose levels over a period of approximately 2 to 3 months. Which of the following would the nurse know to be a normal level range indicating good maintenance of blood glucose over time?

a) 1% to 2%

b) 6% to 8%

c) 3% to 4%

d) 4% to 6%

d) 4% to 6%

Rationale:The HgbA1C normal values range from 4% to 6% and indicate consistently near-normal blood glucose concentrations.

Remediation:

Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition, p. 1467

The nurse would educate the patient that which of the following factors increase the risk of developing type 2 diabetes? (Select all that apply.)

a) Hypertension

b) Obesity

c) HDL cholesterol >36mmol

d) Family history

e) Decreased triglycerides

a) Hypertension

b) Obesity

d) Family history

Rationale:Family history, obesity, race/ethnicity, age, previously impaired fasting glucose or impaired glucose tolerance, hypertension, HDL = 35, and/or triglyceride = 250, and a history of gestational diabetes are all risk factors.

Remediation:

Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition, p. 1457