Medsurg Quiz 16: DM and hypoglycemia

A nurse is reinforcing teaching about manifestations of hypoglycemia with an adolescent who has type 1 diabetes mellitus. Which of the following manifestations should the nurse include in the teaching?

Headache

A nurse is reinforcing teaching about preventing long-term complications of retinopathy and neuropathy with an older adult client who has diabetes mellitus. Which of the following actions is the most important for the nurse to include in the teaching?

"Maintain stable blood glucose levels."

A nurse is collecting data from a client who has diabetes mellitus and reports foot pain. The nurse should evaluate the client for which of the following alterations as indications that the client has an infection? (Select all that apply.)

An increase in neutrophils

Localized edema

A nurse is caring for a client who has type 1 diabetes mellitus. The nurse misread the client's morning fasting blood glucose level as 210 mg/dL instead of 120 mg/dL and administered the insulin dose appropriate for a reading over 200 mg/dL. Which of the following actions should the nurse identify as the priority?

Check the client's blood glucose level.

A nurse is reinforcing teaching with a client who has diabetes mellitus about using a glucometer to monitor her blood glucose. Which of the following actions should the nurse identify as an indication that the client understands the instructions?

Uses the side of a fingertip as the puncture site.

A nurse is reinforcing teaching with a client who is taking metformin XR for type II diabetes mellitus. Which of the following information should the nurse include in the teaching?

"Take the medication with a meal."

An adult client newly diagnosed with type 2 diabetes mellitus asks a nurse to explain how he developed the condition. Which of the following responses should the nurse make?

Your body doesn't process glucose well.

A nurse is teaching the parents of a child who has diabetes mellitus about the manifestations of hypoglycemia. Which of the following manifestations should the nurse include in the teaching?

Diaphoresis

A nurse is preparing to administer subcutaneous regular insulin to a client before he eats breakfast at 0800. Which of the following actions should the nurse take?

Give the insulin 30 min before breakfast.

A client with ketoacidosis is also showing severe heart dysrhythmias. Which expected electrolyte imbalance is a priority?

Hypokalemia

A patient has been NPO for 4 days with a daily average blood glucose of 120-138 mg/dL. The patient's family asks the nurse, "How is his blood sugar stable if he hasn't been eating anything?" Which is the best response by the nurse?

"The liver helps regulate blood sugar."

A patient has hypoglycemia and is given 4 oz of orange juice. What is the next appropriate action by the nurse?

Recheck blood sugar in 15 minutes.

Which food menu option best promotes balanced blood sugar?

Chicken sandwich with avocado.

A nurse is collecting data from a client who takes metformin. Which of the following medications is expected to raise blood sugar levels?

Prednisone

Which blood test helps differentiate between Type 1 and Type 2 Diabetes?

GAD 65

How long does it take for Humulin R 20 units to peak?

2 hours

A patient has come into the emergency department accompanied by a friend who states that the patient had been acting very strangely and seemed confused. The friend states that the patient has diabetes and takes insulin. Which signs of hypoglycemia might the nurse assess?

Irritability, anxiety, confusion, and dizziness

A patient newly diagnosed with type 2 diabetes mellitus asks the nurse why she has to take a pill instead of insulin.The nurse explains that in type 2 diabetes mellitus, the body still makes insulin. What other information is pertinent for the nurse to relay?

The cells become resistant to the action of insulin. Pills are given to increase insulin sensitivity.

Which is an appropriate snack for someone with diabetes and hyperglycemia?

Almonds

A nurse is reinforcing teaching for a client who has diabetes mellitus and has a prescription for insulin detemir injections once daily. Which of the following statements by the client indicates an understanding of the teaching?

"I can inject my insulin detemir in the evening before bedtime."

A nurse is preparing to administer morning insulin to a client who has a prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneously daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe?

42 units

A nurse is caring for a client who is prescribed 15 units of NPH insulin to be administered at 0700. Which of the following times of day is most appropriate for the nurse to plan to offer a snack?

1500

A nurse receives a new prescription from the provider that reads "Give regular insulin 14 units and NPH insulin 28 units subcutaneously at breakfast." How many syringes should the nurse prepare?

1 syringe

A nurse is collecting data from a client who has diabetes mellitus. The client is confused, flushed, and has an acetone odor on his breath. The nurse should anticipate a prescription for which of the following types of insulin to treat the client?

Regular

A young patient complains that diabetes is causing her to "have no life at all. It's too hard." What is the most helpful response by the nurse?

"It's a big change. Let's talk about what makes it so hard."

Which should the nurse include as risk factors for Type 2 diabetes? (Select all that apply)

Obesity

Family history of DM

Insulin Resistance

Latino ethnicity

A client presents with diaphoresis, palpitations, jitters, and tachycardia approximately 1 1⁄2 hours after taking his regular morning insulin. Which of the following treatments is appropriate for this client?

Check blood glucose level, and administer carbohydrates.

A 55-year-old client with type 2 diabetes is obese and hasn't been successful at controlling the condition by diet alone. The physician has prescribed sitagliptin (Januvia). The nurse knows that sitagliptin is commonly used for type 2 diabetes because it:

Stimulates the pancreas to secrete more insulin.

While taking a client's medical history, the nurse suspects that a patient with type 1 diabetes may be experiencing the Somogyi phenomenon. What reported symptom supports this suspicion?

Headache on awakening and enuresis.

A patient has a new diagnosis of type 1 diabetes mellitus. What is the main characterization of type 1 diabetes mellitus?

There is an absence of endogenous insulin.

The nurse is assisting with a staff development program in the hospital on patients with DM who have disrupted skin integrity. The nurse explains that disrupted skin integrity in patients with DM is related to:

Neurologic and circulatory changes.

How is the Whipple triad described? (Select all that apply)

-Symptoms of hypoglycemia are present.

-Low blood glucose levels are documented when symptoms are present.

-Symptoms improve when the blood glucose level rises.

The nurse reads a physician's written order for a client with diabetes mellitus that states: "Give Regular insulin, 20 units, PO BID." What is the nurse's most appropriate response?

Call the physician to clarify the order, since you know that Regular insulin is made ineffective in the gastrointestinal tract and cannot be given PO.

Mr. White is a diabetic patient being seen in the clinic today with complaints of numbness and tingling in his feet. The nurse suspects that he is experiencing ______, a pathological change in the nerve tissue related to diabetes. (one word, use all lowercase letters)

Neuropathy