Lewis Medical Surgical --Chapter 53
Diabetes Questions with Correct
Answers
Which information provided by a nurse to a patient newly diagnosed with type 2
diabetes is
Accurate?
a. Insulin is not used to control glucose in patients 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 glucose levels with type 2 diabetes.
d. Type 2 diabetes is usually diagnosed when a patient is admitted in hyperglycemic
coma. - ANSWERSANS: C
For some patients with type 2 diabetes, changes in lifestyle are sufficient to achieve
glucose
control. Insulin is frequently used for type 2 diabetes, complications are equally serious
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 infections.
A patient screened for diabetes at a clinic has a fasting plasma glucose level of 120
mg/dL
(6.7 mmol/L). Which information will the nurse plan to teach the patient?
a. Self-monitoring of glucose
b. Using small doses of regular insulin
c. Lifestyle changes to lower the glucose
d. Effects of oral hypoglycemic medications - ANSWERSANS: C
The patient's impaired fasting glucose indicates prediabetes, and the patient would 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 glucose.
A 28-yr-old male patient with type 1 diabetes reports how he manages his exercise and
glucose control. Which behavior indicates a need for the nurse to 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. -
ANSWERSANS: D
When the patient is ketotic, exercise increase the glucose level; persons with type 1
diabetes
should be taught to avoid exercise when ketosis is present. Other recommendations
include
(1) before exercise, if glucose 100 mg/dL, eat a 15-g carbohydrate snack. After 15 to 30
min,
recheck glucose levels. (2) Delay exercise if <100 mg/dL. Patients using drugs that
place them
at risk for hypoglycemia should always carry a fast-acting source of carbohydrate, such
as
glucose tablets or hard candies, when exercising. (3) Before exercise, if glucose 250
mg/dL
in a person with type 1 DM and ketones are present, delay vigorous activity until
ketones are
gone. Drink fluids.
The nurse is assessing a 22-yr-old patient experiencing the onset of symptoms of type 1
diabetes. Which finding would the nurse anticipate?
a. Anorexia
b. Weight loss
c. Dark colored urine
d. Craving sugary drinks. - ANSWERSANS: B
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.
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. Fasting blood glucose
b. Glycosylated hemoglobin
c. Oral glucose tolerance test
d. Urine dipstick for glucose and ketones - ANSWERSANS: B
The glycosylated hemoglobin (A1C) test shows the overall control of glucose over 90 to
120
days. A fasting level indicates only the glucose level at one time. Urine glucose testing
is not
an accurate reflection of 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 after diabetes has been diagnosed.
The nurse is assessing a 55-yr-old female patient with type 2 diabetes who has a body
mass
index (BMI) of 32 kg/m2. Which goal in the plan of care 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. -
ANSWERSANS: A
The complications of diabetes are related to elevated glucose and the most important
patient
outcome is the reduction of glucose to near-normal levels. A BMI of 30.9/kg/m2 or
above is
considered obese, so the other outcomes are appropriate but are not as high in priority.
A patient who has type 1 diabetes plans to swim laps for an hour daily at 1:00 PM.
Which
advice would the clinic nurse plan to give the patient?
a. Increase the morning dose of NPH insulin (Novolin N).
b. Check glucose level before, during, and after swimming.
c. Time the morning insulin injection to peak while swimming.
d. Delay eating the noon meal until after finishing the swimming. - ANSWERSANS: B
The exercise will affect 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 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.
Which statement by the person who has newly diagnosed type 1 diabetes indicates a
need for additional instruction from the nurse?
a. ―I will need a bedtime snack because I take an evening dose of NPH insulin.‖
b. ―I can choose any foods, as long as I use enough insulin to cover the calories.‖
c. ―I can have an occasional beverage with alcohol if I include it in my meal plan.‖
d. ―I will eat something at meal times to prevent hypoglycemia, even if I am not
hungry.‖ - ANSWERSANS: B
Planning to use additional insulin to ―balance out‖ unhealthy diet choices is not
effective for
glucose control or overall health. Patients who are using insulin therapy have
considerable
Diabetes Questions with Correct
Answers
Which information provided by a nurse to a patient newly diagnosed with type 2
diabetes is
Accurate?
a. Insulin is not used to control glucose in patients 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 glucose levels with type 2 diabetes.
d. Type 2 diabetes is usually diagnosed when a patient is admitted in hyperglycemic
coma. - ANSWERSANS: C
For some patients with type 2 diabetes, changes in lifestyle are sufficient to achieve
glucose
control. Insulin is frequently used for type 2 diabetes, complications are equally serious
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 infections.
A patient screened for diabetes at a clinic has a fasting plasma glucose level of 120
mg/dL
(6.7 mmol/L). Which information will the nurse plan to teach the patient?
a. Self-monitoring of glucose
b. Using small doses of regular insulin
c. Lifestyle changes to lower the glucose
d. Effects of oral hypoglycemic medications - ANSWERSANS: C
The patient's impaired fasting glucose indicates prediabetes, and the patient would 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 glucose.
A 28-yr-old male patient with type 1 diabetes reports how he manages his exercise and
glucose control. Which behavior indicates a need for the nurse to 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. -
ANSWERSANS: D
When the patient is ketotic, exercise increase the glucose level; persons with type 1
diabetes
should be taught to avoid exercise when ketosis is present. Other recommendations
include
(1) before exercise, if glucose 100 mg/dL, eat a 15-g carbohydrate snack. After 15 to 30
min,
recheck glucose levels. (2) Delay exercise if <100 mg/dL. Patients using drugs that
place them
at risk for hypoglycemia should always carry a fast-acting source of carbohydrate, such
as
glucose tablets or hard candies, when exercising. (3) Before exercise, if glucose 250
mg/dL
in a person with type 1 DM and ketones are present, delay vigorous activity until
ketones are
gone. Drink fluids.
The nurse is assessing a 22-yr-old patient experiencing the onset of symptoms of type 1
diabetes. Which finding would the nurse anticipate?
a. Anorexia
b. Weight loss
c. Dark colored urine
d. Craving sugary drinks. - ANSWERSANS: B
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.
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. Fasting blood glucose
b. Glycosylated hemoglobin
c. Oral glucose tolerance test
d. Urine dipstick for glucose and ketones - ANSWERSANS: B
The glycosylated hemoglobin (A1C) test shows the overall control of glucose over 90 to
120
days. A fasting level indicates only the glucose level at one time. Urine glucose testing
is not
an accurate reflection of 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 after diabetes has been diagnosed.
The nurse is assessing a 55-yr-old female patient with type 2 diabetes who has a body
mass
index (BMI) of 32 kg/m2. Which goal in the plan of care 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. -
ANSWERSANS: A
The complications of diabetes are related to elevated glucose and the most important
patient
outcome is the reduction of glucose to near-normal levels. A BMI of 30.9/kg/m2 or
above is
considered obese, so the other outcomes are appropriate but are not as high in priority.
A patient who has type 1 diabetes plans to swim laps for an hour daily at 1:00 PM.
Which
advice would the clinic nurse plan to give the patient?
a. Increase the morning dose of NPH insulin (Novolin N).
b. Check glucose level before, during, and after swimming.
c. Time the morning insulin injection to peak while swimming.
d. Delay eating the noon meal until after finishing the swimming. - ANSWERSANS: B
The exercise will affect 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 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.
Which statement by the person who has newly diagnosed type 1 diabetes indicates a
need for additional instruction from the nurse?
a. ―I will need a bedtime snack because I take an evening dose of NPH insulin.‖
b. ―I can choose any foods, as long as I use enough insulin to cover the calories.‖
c. ―I can have an occasional beverage with alcohol if I include it in my meal plan.‖
d. ―I will eat something at meal times to prevent hypoglycemia, even if I am not
hungry.‖ - ANSWERSANS: B
Planning to use additional insulin to ―balance out‖ unhealthy diet choices is not
effective for
glucose control or overall health. Patients who are using insulin therapy have
considerable
