NCLEX Questions – Diabetes
1. A nurse is preparing a teaching plan for a client with diabetes mellitus regarding proper foot
care. Which instruction is included in the plan?
a. Soak feet in hot water
b. Avoid using a mild soap on the feet
c. Apply a moisturizing lotion to dry feet but not between the toes
d. Always have a podiatrist cut you toenails; never cut them yourself
Answer: C
Rationale: The client is instructed to used a moisturizing lotion on the feet and to avoid applying the
lotion between the toes. The client should be instructed not to soak the feet and should avoid hot water
to prevent burns. The client may cut the toenails straight across and even with the toe itself and would
consult a podiatrist if the toenails were thick or hard to cut or if vision were poor. The client should be
instructed to wash the feet daily with a mild soap.
2. A client is brought to the emergency room in an unresponsive state, and a diagnosis of
hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is made. The nurse would
immediately prepare to initiate which of the following anticipated physician’s order?
a. Endotracheal intubation
b. 100 units of NPH insulin
c. Intravenous infusion of normal saline
d. Intravenous infusion of sodium bicarbonate
Answer: C
Rationale: The primary goal of treatment in hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is
to rehydrate the client to restore fluid volume and to correct electrolyte deficiency. Intravenous fluid
replacement is similar to that administered in diabetic ketoacidosis (DKA) and begins with IV infusion of
normal saline. Regular insulin, not NPH insulin, would be administered. The use of sodium bicarbonate
to correct acidosis is avoided because it can precipitate a further drop in serum potassium levels.
Intubation and mechanical ventilation are not required to treat HHNS
3. An external insulin pump is prescribed for a client with diabetes mellitus and the client asks
the nurse about the functioning of the pump. The nurse bases the response on the
information that the pump.
a. Is timed to release programmed doses of regular or NPH insulin into the
bloodstream while regularly monitoring blood glucose levels
b. Continuously infuses small amounts of NPH insulin into the bloodstream while
regularly monitoring blood glucose levels
c. Is surgically attached to the pancreas and infuses regular insulin into the pancreas,
which in turn releases the insulin into the bloodstream
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, d. Gives a small continuous dose of regular insulin subcutaneously and the client can
self-administer a bolus with an additional dose from the pump before each meal
Answer: D
Rationale: An insulin pump provides a small continuous dose of regular insulin subcutaneously
throughout the day and night, and the client can self-administer a bolus with an additional dose from the
pump before each meal as needed. Regular insulin is used in an insulin pump. An external pump is not
attached surgically to the pancreas.
4. A client newly diagnosed with diabetes mellitus has been stabilized with daily insulin
injections. A nurse prepares a discharge teaching plan regarding the insulin and plans to
reinforce which of the following concepts?
a. Always keep insulin vials refrigerated
b. Ketones in the urine signify a need for less insulin
c. Increase the amount of insulin before unusual exercise
d. Systematically rotate insulin injections within one anatomic site
Answer: D
Rationale: Insulin doses should not be adjusted nor increased before unusual exercise. If ketones are
found in the urine, it possibly may indicate the need for additional insulin. To minimize the discomfort
associated with insulin injections, insulin should be administered at room temperature. Injection sites
should be rotated systematically within one anatomic site.
5. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in an emergency
room. Which finding would a nurse expect to note as confirming this diagnosis?
a. Comatose state
b. Decreased urine output
c. Increased respirations and an increase in pH
d. Elevated blood glucose level and low plasma bicarbonate level
Answer: D
Rationale: In DKA, the arterial pH is lower than 7.35, plasma bicarbonate is lower than 15 mEq/L, the
blood glucose level is higher than 250 mg/dL, and ketones are present in the blood and urine. The client
would be experiencing polyuria, and Kussmaul’s respirations would be present. A comatose state may
occur if DKA is not treated, but coma would not confirm the diagnosis.
6. A nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia
and ketoacidosis. The client demonstrates an understanding of the teaching by stating that
glucose will be taken if which of the following symptoms develops?
a. Polyuria
b. Shakiness
c. Blurred vision
This study source was downloaded by 100000869267694 from CourseHero.com on 08-02-2023 16:13:28 GMT -05:00
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1. A nurse is preparing a teaching plan for a client with diabetes mellitus regarding proper foot
care. Which instruction is included in the plan?
a. Soak feet in hot water
b. Avoid using a mild soap on the feet
c. Apply a moisturizing lotion to dry feet but not between the toes
d. Always have a podiatrist cut you toenails; never cut them yourself
Answer: C
Rationale: The client is instructed to used a moisturizing lotion on the feet and to avoid applying the
lotion between the toes. The client should be instructed not to soak the feet and should avoid hot water
to prevent burns. The client may cut the toenails straight across and even with the toe itself and would
consult a podiatrist if the toenails were thick or hard to cut or if vision were poor. The client should be
instructed to wash the feet daily with a mild soap.
2. A client is brought to the emergency room in an unresponsive state, and a diagnosis of
hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is made. The nurse would
immediately prepare to initiate which of the following anticipated physician’s order?
a. Endotracheal intubation
b. 100 units of NPH insulin
c. Intravenous infusion of normal saline
d. Intravenous infusion of sodium bicarbonate
Answer: C
Rationale: The primary goal of treatment in hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is
to rehydrate the client to restore fluid volume and to correct electrolyte deficiency. Intravenous fluid
replacement is similar to that administered in diabetic ketoacidosis (DKA) and begins with IV infusion of
normal saline. Regular insulin, not NPH insulin, would be administered. The use of sodium bicarbonate
to correct acidosis is avoided because it can precipitate a further drop in serum potassium levels.
Intubation and mechanical ventilation are not required to treat HHNS
3. An external insulin pump is prescribed for a client with diabetes mellitus and the client asks
the nurse about the functioning of the pump. The nurse bases the response on the
information that the pump.
a. Is timed to release programmed doses of regular or NPH insulin into the
bloodstream while regularly monitoring blood glucose levels
b. Continuously infuses small amounts of NPH insulin into the bloodstream while
regularly monitoring blood glucose levels
c. Is surgically attached to the pancreas and infuses regular insulin into the pancreas,
which in turn releases the insulin into the bloodstream
This study source was downloaded by 100000869267694 from CourseHero.com on 08-02-2023 16:13:28 GMT -05:00
https://www.coursehero.com/file/43894993/52459198-Diabetes-NCLEX-Questions-2-Anwsers-1docx/
, d. Gives a small continuous dose of regular insulin subcutaneously and the client can
self-administer a bolus with an additional dose from the pump before each meal
Answer: D
Rationale: An insulin pump provides a small continuous dose of regular insulin subcutaneously
throughout the day and night, and the client can self-administer a bolus with an additional dose from the
pump before each meal as needed. Regular insulin is used in an insulin pump. An external pump is not
attached surgically to the pancreas.
4. A client newly diagnosed with diabetes mellitus has been stabilized with daily insulin
injections. A nurse prepares a discharge teaching plan regarding the insulin and plans to
reinforce which of the following concepts?
a. Always keep insulin vials refrigerated
b. Ketones in the urine signify a need for less insulin
c. Increase the amount of insulin before unusual exercise
d. Systematically rotate insulin injections within one anatomic site
Answer: D
Rationale: Insulin doses should not be adjusted nor increased before unusual exercise. If ketones are
found in the urine, it possibly may indicate the need for additional insulin. To minimize the discomfort
associated with insulin injections, insulin should be administered at room temperature. Injection sites
should be rotated systematically within one anatomic site.
5. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in an emergency
room. Which finding would a nurse expect to note as confirming this diagnosis?
a. Comatose state
b. Decreased urine output
c. Increased respirations and an increase in pH
d. Elevated blood glucose level and low plasma bicarbonate level
Answer: D
Rationale: In DKA, the arterial pH is lower than 7.35, plasma bicarbonate is lower than 15 mEq/L, the
blood glucose level is higher than 250 mg/dL, and ketones are present in the blood and urine. The client
would be experiencing polyuria, and Kussmaul’s respirations would be present. A comatose state may
occur if DKA is not treated, but coma would not confirm the diagnosis.
6. A nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia
and ketoacidosis. The client demonstrates an understanding of the teaching by stating that
glucose will be taken if which of the following symptoms develops?
a. Polyuria
b. Shakiness
c. Blurred vision
This study source was downloaded by 100000869267694 from CourseHero.com on 08-02-2023 16:13:28 GMT -05:00
https://www.coursehero.com/file/43894993/52459198-Diabetes-NCLEX-Questions-2-Anwsers-1docx/
