A 7-year-old client with type 1 diabetes is sick with the flu. What is the most important information for the
nurse to convey regarding diabetes management during illness?
a) Children require less insulin when they are sick with the flu.
b) Urine ketones should be checked every other day during illness.
c) Blood glucose needs to be checked more frequently during illness.
d) Increase intake of fluids high in carbohydrate to prevent diarrhea
Blood sugar levels can go up during the flu; therefore, blood glucose levels should be monitored every 3 to 4
hours during flu. Because glucose levels are higher when a client has the flu, clients should continue to take
diabetes medications as ordered. If blood sugar level is over 240 mg/dL, ketones should be checked. If ketones
are present, the client should be encouraged to drink calorie-free fluids and eat small meals.
A client with diabetes begins to cry and says, “I just cannot stand the thought of having to give myself a shot
every day.” What would be the best response by the nurse?
a) "We can teach a family member to give the shots so you will not have to do it."
b) "I can arrange to have a home care nurse give you the shots every day."
c) "What is it about giving yourself the insulin shots that bothers you?"
d) "If you do not give yourself your insulin shots, you will be at greater risk for complications.”
A client with type 1 diabetes mellitus often skips his ordered dose of insulin. What priority information should
the nurse give to this client regarding the omission of insulin doses?
a) May cause hypoglycemic coma
b) May lead to pancreatitis
c) May lead to ketoacidosis
d) May cause diabetes insipidus
A client who fails to regularly take insulin is at risk for hyperglycemia, which could lead to diabetic
ketoacidosis. Hypoglycemia would not occur because the lack of insulin would lead to increased levels of sugar
in the blood. A client with chronic pancreatitis may develop diabetes, but insulin-dependent diabetes mellitus
does not lead to pancreatitis. Diabetes insipidus isn’t caused by alteration in insulin levels.
The nurse is assessing a child, with type 1 diabetes mellitus, who recently came to the emergency department
with signs and symptoms consistent with diabetic ketoacidosis. What is the nurse’s priority when planning care
for this child?
a) Monitor the child closely in the emergency department before transfer to the medical unit
b) Make a referral to the pediatric diabetes nurse
c) Teach the family about the prevention of this complication of diabetes
d) Prepare to administer intravenous fluids and insulin per order
Diabetic ketoacidosis, the most complete state of insulin deficiency, is a life-threatening condition. The child
should be admitted to an intensive care unit for management. Treatment would consist of rapid assessment,
adequate insulin to reduce the elevated blood glucose level, fluids to overcome dehydration, and electrolyte
replacement. Education would be a priority after the child has stabilized.
A client with diabetes comes to the clinic for a follow-up visit. During the visit, the client, who is Jewish, tells
the nurse that a holiday will be coming up next week that requires the client to fast for the day. The client takes
an oral antidiabetic medication daily and checks blood glucose levels twice a day. Which response by the nurse
would be most appropriate?
a) “Take your medication, but check your glucose every four hours.”
b) “Tell me more about what is involved so we can plan for this better.”
c) “Omit your medication on the day that you must fast.”
d) “You should not fast because it will cause your diabetes to go out of control.”
, A client with type 1 diabetes tells a nurse in the clinic, "I sometimes skip my insulin dose in the morning so I
won't gain back any of the weight I've lost." Which response would be appropriate for the nurse to make to this
client?
a) "You are worried about your weight? There are safer ways to prevent weight gain."
b) "Guess there is a good side to having diabetes!"
c) "Why bother to take any insulin? Hold off on it until you lose all the weight that you want."
d) "Oh, I didn't realize that holding off on insulin would keep the weight off!"
The nurse is teaching the client about home blood glucose monitoring. Which blood glucose measurement
indicates hypoglycemia?
a) 75 mg/dL (4.2 mmol/L)
b) 59 mg/dL (3.3 mmol/L)
c) 108 mg/dL (6.0 mmol/L)
d) 119 mg/dL (6.6 mmol/L)
An 8-year-old with diabetes is placed on an intermediate acting insulin and regular insulin before breakfast and
before dinner. She will receive a snack of milk and cereal at bedtime. The snack will:
a) prevent late night hypoglycemia.
b) provide carbohydrates for immediate use.
c) help her regain lost weight.
d) help her stay on her diet.
The nurse is caring for a neonate weighing 4,536 g (10 lb) who was born via cesarean section 1 hour ago to a
mother with insulin-dependent diabetes. She asks the nurse, “Why is my baby in the neonatal intensive care
unit?” The nurse bases a response on the understanding that neonates of mothers with diabetes commonly
develop which condition?
a) hemolytic disease
b) hypoglycemia
c) persistent pulmonary hypertension
d) anemia
A client with type 1 diabetes mellitus has influenza. The nurse should instruct the client to:
a) take half of the normal dose of insulin.
b) discontinue that dose of insulin if unable to eat.
c) reduce food intake to diminish nausea.
d) increase the frequency of self-monitoring (blood glucose testing).
A 14-year-old adolescent with type 1 diabetes checks his blood glucose level at 9:00 p.m. (2100) before going
to bed. It has been 4 hours since his dinner and his regular insulin dose. His blood glucose level is 60 mg/dl (3.3
mmol/L), and he states that he feels a little shaky. What should the nurse suggest?
a) A bedtime snack of an 8-oz (240 mL) glass of milk and graham crackers with peanut butter
b) Taking a dose of glucagon
c) Going to sleep to decrease the metabolic demands on the body
d) Doing nothing because the glucose level is unreliable because the adolescent measured it himself
What should the nurse teach a client receiving vitamin D therapy for hypoparathyroidism?
a) Vitamin D will cure hypoparathyroidism.
b) Vitamin D is taken to increase absorption of calcium.
c) Vitamin A and C will increase absorption of calcium.
nurse to convey regarding diabetes management during illness?
a) Children require less insulin when they are sick with the flu.
b) Urine ketones should be checked every other day during illness.
c) Blood glucose needs to be checked more frequently during illness.
d) Increase intake of fluids high in carbohydrate to prevent diarrhea
Blood sugar levels can go up during the flu; therefore, blood glucose levels should be monitored every 3 to 4
hours during flu. Because glucose levels are higher when a client has the flu, clients should continue to take
diabetes medications as ordered. If blood sugar level is over 240 mg/dL, ketones should be checked. If ketones
are present, the client should be encouraged to drink calorie-free fluids and eat small meals.
A client with diabetes begins to cry and says, “I just cannot stand the thought of having to give myself a shot
every day.” What would be the best response by the nurse?
a) "We can teach a family member to give the shots so you will not have to do it."
b) "I can arrange to have a home care nurse give you the shots every day."
c) "What is it about giving yourself the insulin shots that bothers you?"
d) "If you do not give yourself your insulin shots, you will be at greater risk for complications.”
A client with type 1 diabetes mellitus often skips his ordered dose of insulin. What priority information should
the nurse give to this client regarding the omission of insulin doses?
a) May cause hypoglycemic coma
b) May lead to pancreatitis
c) May lead to ketoacidosis
d) May cause diabetes insipidus
A client who fails to regularly take insulin is at risk for hyperglycemia, which could lead to diabetic
ketoacidosis. Hypoglycemia would not occur because the lack of insulin would lead to increased levels of sugar
in the blood. A client with chronic pancreatitis may develop diabetes, but insulin-dependent diabetes mellitus
does not lead to pancreatitis. Diabetes insipidus isn’t caused by alteration in insulin levels.
The nurse is assessing a child, with type 1 diabetes mellitus, who recently came to the emergency department
with signs and symptoms consistent with diabetic ketoacidosis. What is the nurse’s priority when planning care
for this child?
a) Monitor the child closely in the emergency department before transfer to the medical unit
b) Make a referral to the pediatric diabetes nurse
c) Teach the family about the prevention of this complication of diabetes
d) Prepare to administer intravenous fluids and insulin per order
Diabetic ketoacidosis, the most complete state of insulin deficiency, is a life-threatening condition. The child
should be admitted to an intensive care unit for management. Treatment would consist of rapid assessment,
adequate insulin to reduce the elevated blood glucose level, fluids to overcome dehydration, and electrolyte
replacement. Education would be a priority after the child has stabilized.
A client with diabetes comes to the clinic for a follow-up visit. During the visit, the client, who is Jewish, tells
the nurse that a holiday will be coming up next week that requires the client to fast for the day. The client takes
an oral antidiabetic medication daily and checks blood glucose levels twice a day. Which response by the nurse
would be most appropriate?
a) “Take your medication, but check your glucose every four hours.”
b) “Tell me more about what is involved so we can plan for this better.”
c) “Omit your medication on the day that you must fast.”
d) “You should not fast because it will cause your diabetes to go out of control.”
, A client with type 1 diabetes tells a nurse in the clinic, "I sometimes skip my insulin dose in the morning so I
won't gain back any of the weight I've lost." Which response would be appropriate for the nurse to make to this
client?
a) "You are worried about your weight? There are safer ways to prevent weight gain."
b) "Guess there is a good side to having diabetes!"
c) "Why bother to take any insulin? Hold off on it until you lose all the weight that you want."
d) "Oh, I didn't realize that holding off on insulin would keep the weight off!"
The nurse is teaching the client about home blood glucose monitoring. Which blood glucose measurement
indicates hypoglycemia?
a) 75 mg/dL (4.2 mmol/L)
b) 59 mg/dL (3.3 mmol/L)
c) 108 mg/dL (6.0 mmol/L)
d) 119 mg/dL (6.6 mmol/L)
An 8-year-old with diabetes is placed on an intermediate acting insulin and regular insulin before breakfast and
before dinner. She will receive a snack of milk and cereal at bedtime. The snack will:
a) prevent late night hypoglycemia.
b) provide carbohydrates for immediate use.
c) help her regain lost weight.
d) help her stay on her diet.
The nurse is caring for a neonate weighing 4,536 g (10 lb) who was born via cesarean section 1 hour ago to a
mother with insulin-dependent diabetes. She asks the nurse, “Why is my baby in the neonatal intensive care
unit?” The nurse bases a response on the understanding that neonates of mothers with diabetes commonly
develop which condition?
a) hemolytic disease
b) hypoglycemia
c) persistent pulmonary hypertension
d) anemia
A client with type 1 diabetes mellitus has influenza. The nurse should instruct the client to:
a) take half of the normal dose of insulin.
b) discontinue that dose of insulin if unable to eat.
c) reduce food intake to diminish nausea.
d) increase the frequency of self-monitoring (blood glucose testing).
A 14-year-old adolescent with type 1 diabetes checks his blood glucose level at 9:00 p.m. (2100) before going
to bed. It has been 4 hours since his dinner and his regular insulin dose. His blood glucose level is 60 mg/dl (3.3
mmol/L), and he states that he feels a little shaky. What should the nurse suggest?
a) A bedtime snack of an 8-oz (240 mL) glass of milk and graham crackers with peanut butter
b) Taking a dose of glucagon
c) Going to sleep to decrease the metabolic demands on the body
d) Doing nothing because the glucose level is unreliable because the adolescent measured it himself
What should the nurse teach a client receiving vitamin D therapy for hypoparathyroidism?
a) Vitamin D will cure hypoparathyroidism.
b) Vitamin D is taken to increase absorption of calcium.
c) Vitamin A and C will increase absorption of calcium.
