The Client with Diabetes Mellitus
19. The nurse is teaching a diabetic client using
an empowerment approach. The nurse should initiate
teaching by asking which of the following?
1. “How much does your family need to be
involved in learning about your condition?”
2. “What is required for your family to manage
your symptoms?”
3. “What activities are most important for you to
be able to maintain control of your diabetes?”
4. “What do you know about your medications
and condition?”
20. A nurse is participating in a diabetes screening
program. Who of the following is (are) at risk for
developing type 2 diabetes? Select all that apply.
1. A 32-year-old female who delivered a 9½-lb
infant.
2. A 44-year-old Native American Indian who
has a body mass index (BMI) of 32.
3. An 18-year-old Hispanic who jogs four times
a week.
4. A 55-year-old Asian American who has hypertension
and two siblings with type 2 diabetes.
5. A 12-year-old who is overweight.
21. A 57-year-old with diabetes insipidus is hospitalized
for care. Which fi nding should the nurse
report to the physician?
1. Urine output of 350 mL in 8 hours.
2. Urine specifi c gravity of 1.001.
3. Potassium of 4.0 mEq.
4. Weight gain.
22. The nurse is checking the laboratory results
on a 52-year-old client with type 1 diabetes (see
chart). What laboratory result indicates a problem
that should be managed?
1. Blood glucose.
2. Total cholesterol.
3. Hemoglobin.
4. Low-density lipoprotein (LDL) cholesterol.
Laboratory Results
Test Result
Blood glucose 192 mg/dL
Total cholesterol 250
mg/dL Hemoglobin 12.3
mg/dL
Low-density lipoprotein cholesterol 125 mg/dL
23. A client with type 1 diabetes mellitus has
diabetic ketoacidosis. Which of the following fi ndings
has the greatest effect on fl uid loss?
1. Hypotension.
2. Decreased serum potassium level.
3. Rapid, deep respirations.
4. Warm, dry skin.
24. A client is to receive glargine (Lantus) insulin
,in addition to a dose of aspart (NovoLog). When the
nurse checks the blood glucose level at the bedside,
it is greater than 200 mg/dL. How should the nurse
administer the insulins?
1. Put air into the glargine insulin vial, and then
air into the aspart insulin vial, and draw up
the correct dose of aspart insulin fi rst.
2. Roll the glargine insulin vial, then roll the
aspart insulin vial. Draw up the longer-acting
glargine insulin fi rst.
3. Shake both vials of insulin before drawing up
each dose in separate insulin syringes.
4. Put air into the glargine insulin vial, and
draw up the correct dose in an insulin
syringe; then, with a different insulin syringe,
put air into the aspart vial and draw up the
correct dose.
25. An adult client with type 2 diabetes is taking
metformin (Glucophage) 1,000 mg two times every
day. After the nurse provides instructions regarding
the interaction of alcohol and metformin, the nurse
evaluates that the client understands the instructions
when the client says:
1. “If I know I’ll be having alcohol, I must
not take metformin; I could develop lactic
acidosis.”
2. “If my physician approves, I may drink alcohol
with my metformin.”
3. “Adverse effects I should watch for are feeling
excessively energetic, unusual muscle stiffness,
low back pain, and a rapid heartbeat.”
4. “If I feel bloated, I should call my physician.”
26. A client has recently been diagnosed with
type 2 diabetes mellitus and is to take tolbutamide
(Orinase). When teaching the client about the drug,
the nurse explains that tolbutamide is believed to
lower the blood glucose level by which of the following
actions?
1. Potentiating the action of insulin.
2. Lowering the renal threshold of glucose.
3. Stimulating insulin release from functioning
beta cells in the pancreas.
4. Combining with glucose to render it inert.
27. Which information should the nurse include
when developing a teaching plan for a client newly
diagnosed with type 2 diabetes mellitus. Select all
that apply.
1. A major risk factor for complications is obesity
and central abdominal obesity.
2. Supplemental insulin is mandatory for controlling
the disease.
3. Exercise increases insulin resistance.
4. The primary nutritional source requiring
monitoring in the diet is carbohydrates.
, 5. Annual eye and foot examinations are recommended
by the American Diabetes Association
(ADA).
28. When teaching the diabetic client about
foot care, the nurse should instruct the client to
do which of the following?
1. Avoid going barefoot.
2. Buy shoes a half size larger.
3. Cut toenails at angles.
4. Use heating pads for sore feet.
29. A client with diabetes mellitus asks the nurse
to recommend something to remove corns from his
toes. The nurse should advise the client to:
1. Apply a high-quality corn plaster to the area.
2. Consult a physician or podiatrist about
removing the corns.
3. Apply iodine to the corns before peeling them
off.
4. Soak the feet in borax solution to peel off the
corns.
30. A client with diabetes mellitus comes to the
clinic for a regular 3-month follow-up appointment.
The nurse notes several small bandages covering
cuts on the client’s hands. The client says, “I’m so
clumsy. I’m always cutting my fi nger cooking or
burning myself on the iron.” Which of the following
responses by the nurse would be most appropriate?
1. “Wash all wounds in isopropyl alcohol.”
2. “Keep all cuts clean and covered.”
3. “Why don’t you have your children do the
cooking and ironing?”
4. “You really should be fi ne as long as you take
your daily medication.”
31. The client with diabetes mellitus says, “If I
could just avoid what you call carbohydrates in my
diet, I guess I would be okay.” The nurse should
base the response to this comment on the knowledge
that diabetes affects metabolism of which of
the following?
1. Carbohydrates only.
2. Fats and carbohydrates only.
3. Protein and carbohydrates only.
4. Proteins, fats, and carbohydrates.
32. A client with type 1 diabetes mellitus is
admitted to the emergency department. Which of
the following respiratory patterns requires immediate
action?
1. Deep, rapid respirations with long
expirations.
2. Shallow respirations alternating with long
expirations.
3. Regular depth of respirations with frequent
19. The nurse is teaching a diabetic client using
an empowerment approach. The nurse should initiate
teaching by asking which of the following?
1. “How much does your family need to be
involved in learning about your condition?”
2. “What is required for your family to manage
your symptoms?”
3. “What activities are most important for you to
be able to maintain control of your diabetes?”
4. “What do you know about your medications
and condition?”
20. A nurse is participating in a diabetes screening
program. Who of the following is (are) at risk for
developing type 2 diabetes? Select all that apply.
1. A 32-year-old female who delivered a 9½-lb
infant.
2. A 44-year-old Native American Indian who
has a body mass index (BMI) of 32.
3. An 18-year-old Hispanic who jogs four times
a week.
4. A 55-year-old Asian American who has hypertension
and two siblings with type 2 diabetes.
5. A 12-year-old who is overweight.
21. A 57-year-old with diabetes insipidus is hospitalized
for care. Which fi nding should the nurse
report to the physician?
1. Urine output of 350 mL in 8 hours.
2. Urine specifi c gravity of 1.001.
3. Potassium of 4.0 mEq.
4. Weight gain.
22. The nurse is checking the laboratory results
on a 52-year-old client with type 1 diabetes (see
chart). What laboratory result indicates a problem
that should be managed?
1. Blood glucose.
2. Total cholesterol.
3. Hemoglobin.
4. Low-density lipoprotein (LDL) cholesterol.
Laboratory Results
Test Result
Blood glucose 192 mg/dL
Total cholesterol 250
mg/dL Hemoglobin 12.3
mg/dL
Low-density lipoprotein cholesterol 125 mg/dL
23. A client with type 1 diabetes mellitus has
diabetic ketoacidosis. Which of the following fi ndings
has the greatest effect on fl uid loss?
1. Hypotension.
2. Decreased serum potassium level.
3. Rapid, deep respirations.
4. Warm, dry skin.
24. A client is to receive glargine (Lantus) insulin
,in addition to a dose of aspart (NovoLog). When the
nurse checks the blood glucose level at the bedside,
it is greater than 200 mg/dL. How should the nurse
administer the insulins?
1. Put air into the glargine insulin vial, and then
air into the aspart insulin vial, and draw up
the correct dose of aspart insulin fi rst.
2. Roll the glargine insulin vial, then roll the
aspart insulin vial. Draw up the longer-acting
glargine insulin fi rst.
3. Shake both vials of insulin before drawing up
each dose in separate insulin syringes.
4. Put air into the glargine insulin vial, and
draw up the correct dose in an insulin
syringe; then, with a different insulin syringe,
put air into the aspart vial and draw up the
correct dose.
25. An adult client with type 2 diabetes is taking
metformin (Glucophage) 1,000 mg two times every
day. After the nurse provides instructions regarding
the interaction of alcohol and metformin, the nurse
evaluates that the client understands the instructions
when the client says:
1. “If I know I’ll be having alcohol, I must
not take metformin; I could develop lactic
acidosis.”
2. “If my physician approves, I may drink alcohol
with my metformin.”
3. “Adverse effects I should watch for are feeling
excessively energetic, unusual muscle stiffness,
low back pain, and a rapid heartbeat.”
4. “If I feel bloated, I should call my physician.”
26. A client has recently been diagnosed with
type 2 diabetes mellitus and is to take tolbutamide
(Orinase). When teaching the client about the drug,
the nurse explains that tolbutamide is believed to
lower the blood glucose level by which of the following
actions?
1. Potentiating the action of insulin.
2. Lowering the renal threshold of glucose.
3. Stimulating insulin release from functioning
beta cells in the pancreas.
4. Combining with glucose to render it inert.
27. Which information should the nurse include
when developing a teaching plan for a client newly
diagnosed with type 2 diabetes mellitus. Select all
that apply.
1. A major risk factor for complications is obesity
and central abdominal obesity.
2. Supplemental insulin is mandatory for controlling
the disease.
3. Exercise increases insulin resistance.
4. The primary nutritional source requiring
monitoring in the diet is carbohydrates.
, 5. Annual eye and foot examinations are recommended
by the American Diabetes Association
(ADA).
28. When teaching the diabetic client about
foot care, the nurse should instruct the client to
do which of the following?
1. Avoid going barefoot.
2. Buy shoes a half size larger.
3. Cut toenails at angles.
4. Use heating pads for sore feet.
29. A client with diabetes mellitus asks the nurse
to recommend something to remove corns from his
toes. The nurse should advise the client to:
1. Apply a high-quality corn plaster to the area.
2. Consult a physician or podiatrist about
removing the corns.
3. Apply iodine to the corns before peeling them
off.
4. Soak the feet in borax solution to peel off the
corns.
30. A client with diabetes mellitus comes to the
clinic for a regular 3-month follow-up appointment.
The nurse notes several small bandages covering
cuts on the client’s hands. The client says, “I’m so
clumsy. I’m always cutting my fi nger cooking or
burning myself on the iron.” Which of the following
responses by the nurse would be most appropriate?
1. “Wash all wounds in isopropyl alcohol.”
2. “Keep all cuts clean and covered.”
3. “Why don’t you have your children do the
cooking and ironing?”
4. “You really should be fi ne as long as you take
your daily medication.”
31. The client with diabetes mellitus says, “If I
could just avoid what you call carbohydrates in my
diet, I guess I would be okay.” The nurse should
base the response to this comment on the knowledge
that diabetes affects metabolism of which of
the following?
1. Carbohydrates only.
2. Fats and carbohydrates only.
3. Protein and carbohydrates only.
4. Proteins, fats, and carbohydrates.
32. A client with type 1 diabetes mellitus is
admitted to the emergency department. Which of
the following respiratory patterns requires immediate
action?
1. Deep, rapid respirations with long
expirations.
2. Shallow respirations alternating with long
expirations.
3. Regular depth of respirations with frequent
