Nursing School Test Banks
Chapter 64: Care of Patients with Diabetes M
Chapter 64: Care of Patients with Diabetes Mellitus
Ignatavicius: Medical-Surgical Nursing, 8th Edition
MULTIPLE CHOICE
1.A nurse is teaching a client with diabetes mellitus who asks, “Why is it necessary to maintain m
cose levels no lower than about 60 mg/dL?” How should the nurse respond?
a. “Glucose is the only fuel used by the body to produce the energy that it needs.”
b. “Your brain needs a constant supply of glucose because it cannot store it.”
c. “Without a minimum level of glucose, your body does not make red blood cells.”
d. “Glucose in the blood prevents the formation of lactic acid and prevents acidosis.”
ANS: B
Because the brain cannot synthesize or store significant amounts of glucose, a continuous supp
body’s circulation is needed to meet the fuel demands of the central nervous system. The nurse
educate the client to prevent hypoglycemia. The body can use other sources of fuel, including f
and glucose is not involved in the production of red blood cells. Glucose in the blood will encou
metabolism but is not directly responsible for lactic acid formation.
DIF:Remembering/KnowledgeREF:1301
KEY: Diabetes mellitus| hypoglycemia MSC: Integrated Process: Teaching/Learning
,2.A nurse reviews laboratory results for a client with diabetes mellitus who presents with polyu
and a blood glucose of 560 mg/dL. Which laboratory result should the nurse correlate with the
polyuria?
a. Serum sodium: 163 mEq/L
b. Serum creatinine: 1.6 mg/dL
c. Presence of urine ketone bodies
d. Serum osmolarity: 375 mOsm/kg
ANS: D
Hyperglycemia causes hyperosmolarity of extracellular fluid. This leads to polyuria from an osm
The client’s serum osmolarity is high. The client’s sodium would be expected to be high owing t
Serum creatinine and urine ketone bodies are not related to the polyuria.
DIF:Applying/ApplicationREF:1302
KEY:Diabetes mellitus| hyperglycemia
MSC:Integrated Process: Nursing Process: Analysis
NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential
3.After teaching a young adult client who is newly diagnosed with type 1 diabetes mellitus, the n
the client’s understanding. Which statement made by the client indicates a correct understandi
for eye examinations?
a. “At my age, I should continue seeing the ophthalmologist as I usually do.”
b. “I will see the eye doctor when I have a vision problem and yearly after age 40.”
c. “My vision will change quickly. I should see the ophthalmologist twice a year.”
d. “Diabetes can cause blindness, so I should see the ophthalmologist yearly.”
,age, should be examined by an ophthalmologist (rather than an optometrist or optician) at diag
least yearly thereafter.
DIF:Applying/ApplicationREF:1303
KEY: Diabetes mellitus| health screening MSC: Integrated Process: Teaching/Learning
NOT:Client Needs Category: Health Promotion
4.A nurse assesses a client who has a 15-year history of diabetes and notes decreased tactile se
feet. Which action should the nurse take first?
a. Document the finding in the client’s chart.
b. Assess tactile sensation in the client’s hands.
c. Examine the client’s feet for signs of injury.
d. Notify the health care provider.
ANS: C
Diabetic neuropathy is common when the disease is of long duration. The client is at great risk
area with decreased sensation because he or she is less able to feel injurious events. Feet are c
tions for neuropathy and injury, so the nurse should inspect them for any signs of injury. After
nurse should document findings in the client’s chart. Testing sensory perception in the hands m
be needed. The health care provider can be notified after assessment and documentation have
completed.
DIF:Applying/ApplicationREF:1321
KEY:Diabetes mellitus| neuropathy
MSC:Integrated Process: Nursing Process: Analysis
NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential
, a. “Your risk of diabetes is higher than the general population, but it may not occur.”
b. “No genetic risk is associated with the development of type 1 diabetes mellitus.”
c. “The risk for becoming a diabetic is 50% because of how it is inherited.”
d. “Female children do not inherit diabetes mellitus, but male children will.”
ANS: A
Risk for type 1 diabetes is determined by inheritance of genes coding for HLA-DR and HLA-DQ t
Clients who have one parent with type 1 diabetes are at increased risk for its development. Dia
seems to require interaction between inherited risk and environmental factors, so not everyon
genes develops diabetes. The other statements are not accurate.
DIF:Understanding/ComprehensionREF:1307
KEY: Diabetes mellitus| genetics MSC: Integrated Process: Teaching/Learning
NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care
6.A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement should the
in this client’s plan of care to delay the onset of microvascular and macrovascular complication
a. “Maintain tight glycemic control and prevent hyperglycemia.”
b. “Restrict your fluid intake to no more than 2 liters a day.”
c. “Prevent hypoglycemia by eating a bedtime snack.”
d. “Limit your intake of protein to prevent ketoacidosis.”
ANS: A
Hyperglycemia is a critical factor in the pathogenesis of long-term diabetic complications. Main
glycemic control will help delay the onset of complications. Restricting fluid intake is not part of
plan for clients with diabetes. Preventing hypoglycemia and ketosis, although important, are no
as maintaining daily glycemic control.
Chapter 64: Care of Patients with Diabetes M
Chapter 64: Care of Patients with Diabetes Mellitus
Ignatavicius: Medical-Surgical Nursing, 8th Edition
MULTIPLE CHOICE
1.A nurse is teaching a client with diabetes mellitus who asks, “Why is it necessary to maintain m
cose levels no lower than about 60 mg/dL?” How should the nurse respond?
a. “Glucose is the only fuel used by the body to produce the energy that it needs.”
b. “Your brain needs a constant supply of glucose because it cannot store it.”
c. “Without a minimum level of glucose, your body does not make red blood cells.”
d. “Glucose in the blood prevents the formation of lactic acid and prevents acidosis.”
ANS: B
Because the brain cannot synthesize or store significant amounts of glucose, a continuous supp
body’s circulation is needed to meet the fuel demands of the central nervous system. The nurse
educate the client to prevent hypoglycemia. The body can use other sources of fuel, including f
and glucose is not involved in the production of red blood cells. Glucose in the blood will encou
metabolism but is not directly responsible for lactic acid formation.
DIF:Remembering/KnowledgeREF:1301
KEY: Diabetes mellitus| hypoglycemia MSC: Integrated Process: Teaching/Learning
,2.A nurse reviews laboratory results for a client with diabetes mellitus who presents with polyu
and a blood glucose of 560 mg/dL. Which laboratory result should the nurse correlate with the
polyuria?
a. Serum sodium: 163 mEq/L
b. Serum creatinine: 1.6 mg/dL
c. Presence of urine ketone bodies
d. Serum osmolarity: 375 mOsm/kg
ANS: D
Hyperglycemia causes hyperosmolarity of extracellular fluid. This leads to polyuria from an osm
The client’s serum osmolarity is high. The client’s sodium would be expected to be high owing t
Serum creatinine and urine ketone bodies are not related to the polyuria.
DIF:Applying/ApplicationREF:1302
KEY:Diabetes mellitus| hyperglycemia
MSC:Integrated Process: Nursing Process: Analysis
NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential
3.After teaching a young adult client who is newly diagnosed with type 1 diabetes mellitus, the n
the client’s understanding. Which statement made by the client indicates a correct understandi
for eye examinations?
a. “At my age, I should continue seeing the ophthalmologist as I usually do.”
b. “I will see the eye doctor when I have a vision problem and yearly after age 40.”
c. “My vision will change quickly. I should see the ophthalmologist twice a year.”
d. “Diabetes can cause blindness, so I should see the ophthalmologist yearly.”
,age, should be examined by an ophthalmologist (rather than an optometrist or optician) at diag
least yearly thereafter.
DIF:Applying/ApplicationREF:1303
KEY: Diabetes mellitus| health screening MSC: Integrated Process: Teaching/Learning
NOT:Client Needs Category: Health Promotion
4.A nurse assesses a client who has a 15-year history of diabetes and notes decreased tactile se
feet. Which action should the nurse take first?
a. Document the finding in the client’s chart.
b. Assess tactile sensation in the client’s hands.
c. Examine the client’s feet for signs of injury.
d. Notify the health care provider.
ANS: C
Diabetic neuropathy is common when the disease is of long duration. The client is at great risk
area with decreased sensation because he or she is less able to feel injurious events. Feet are c
tions for neuropathy and injury, so the nurse should inspect them for any signs of injury. After
nurse should document findings in the client’s chart. Testing sensory perception in the hands m
be needed. The health care provider can be notified after assessment and documentation have
completed.
DIF:Applying/ApplicationREF:1321
KEY:Diabetes mellitus| neuropathy
MSC:Integrated Process: Nursing Process: Analysis
NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential
, a. “Your risk of diabetes is higher than the general population, but it may not occur.”
b. “No genetic risk is associated with the development of type 1 diabetes mellitus.”
c. “The risk for becoming a diabetic is 50% because of how it is inherited.”
d. “Female children do not inherit diabetes mellitus, but male children will.”
ANS: A
Risk for type 1 diabetes is determined by inheritance of genes coding for HLA-DR and HLA-DQ t
Clients who have one parent with type 1 diabetes are at increased risk for its development. Dia
seems to require interaction between inherited risk and environmental factors, so not everyon
genes develops diabetes. The other statements are not accurate.
DIF:Understanding/ComprehensionREF:1307
KEY: Diabetes mellitus| genetics MSC: Integrated Process: Teaching/Learning
NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care
6.A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement should the
in this client’s plan of care to delay the onset of microvascular and macrovascular complication
a. “Maintain tight glycemic control and prevent hyperglycemia.”
b. “Restrict your fluid intake to no more than 2 liters a day.”
c. “Prevent hypoglycemia by eating a bedtime snack.”
d. “Limit your intake of protein to prevent ketoacidosis.”
ANS: A
Hyperglycemia is a critical factor in the pathogenesis of long-term diabetic complications. Main
glycemic control will help delay the onset of complications. Restricting fluid intake is not part of
plan for clients with diabetes. Preventing hypoglycemia and ketosis, although important, are no
as maintaining daily glycemic control.
