Chapter 50: Diabetes and Hypoglycemia
Linton: Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. A patient has come to the physician’s office after finding out that her blood glucose level
was 135 mg/dL: She states that she had not eaten before the test and was told to come and
see her physician: She asks the nurse if she has diabetes: What is the most accurate
nursing response?
a. “Having a fasting serum glucose that high certainly indicates diabetes:”
b. “That test indicates that we need to perform more tests that are specific for
diabetes:”
c. “How do you feel? Do you have any other signs of diabetes?”
d. “Do you have a family history of diabetes, stroke, or heart disease? We need to
know before making a diagnosis:”
ANS: B
The nurse needs to answer the patient’s question in a way that gives information and
is not misleading: Although 135 mg/dL is high, a nonpathologic explanation may be
found: More tests should be performed to evaluate the patient:
DIF: Cognitive Level: Comprehension REF: p: 975 OBJ: 9
TOP: Laboratory Tests for Diabetes KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
2. A nurse is formulating a teaching plan for a 22-year-old woman taking rosiglitazone
(Avandia): What should the nurse include information about in this plan to caution this
patient?
a. Decreased effectiveness of her birth control pills
b. Excessive exposure to the sun
c. Sudden drop in blood pressure with dizziness
, d. Possible severe diarrhea
ANS: A
Avandia causes some birth control pills to be less effective:
DIF: Cognitive Level: Application REF: p: 982 OBJ: 10
TOP: Side Effects of Avandia KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
3. A patient with type 1 diabetes has an insulin order for NPH insulin, 35 U, to be given at
0700: the patient has also been instructed not to take anything by mouth (NPO) in
preparation for laboratory work that will not be drawn until 1000: What action should the
nurse implement?
a. Give the insulin as ordered:
b. Give the insulin with a small snack:
c. Inform the charge nurse:
d. Hold the insulin until after the blood draw:
ANS: D
Holding the insulin to adhere to the NPO order is appropriate: the patient will not be
getting food until after the laboratory work; consequently, the insulin will not be
needed until then: Giving the insulin as ordered will create a possibility of
hypoglycemia before the blood is drawn: Giving a snack to a patient who is NPO is
inappropriate:
DIF: Cognitive Level: Application REF: p: 986 OBJ: 8
TOP: Insulin with NPO Order KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
4. A patient comes to the diabetes clinic and confides to the nurse that she does not follow
the diet exchange program that she was given: What is the best response by the nurse?
a. “The exchange program is a carefully developed and very important program that
allows you to take control of your disease:”
Linton: Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. A patient has come to the physician’s office after finding out that her blood glucose level
was 135 mg/dL: She states that she had not eaten before the test and was told to come and
see her physician: She asks the nurse if she has diabetes: What is the most accurate
nursing response?
a. “Having a fasting serum glucose that high certainly indicates diabetes:”
b. “That test indicates that we need to perform more tests that are specific for
diabetes:”
c. “How do you feel? Do you have any other signs of diabetes?”
d. “Do you have a family history of diabetes, stroke, or heart disease? We need to
know before making a diagnosis:”
ANS: B
The nurse needs to answer the patient’s question in a way that gives information and
is not misleading: Although 135 mg/dL is high, a nonpathologic explanation may be
found: More tests should be performed to evaluate the patient:
DIF: Cognitive Level: Comprehension REF: p: 975 OBJ: 9
TOP: Laboratory Tests for Diabetes KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
2. A nurse is formulating a teaching plan for a 22-year-old woman taking rosiglitazone
(Avandia): What should the nurse include information about in this plan to caution this
patient?
a. Decreased effectiveness of her birth control pills
b. Excessive exposure to the sun
c. Sudden drop in blood pressure with dizziness
, d. Possible severe diarrhea
ANS: A
Avandia causes some birth control pills to be less effective:
DIF: Cognitive Level: Application REF: p: 982 OBJ: 10
TOP: Side Effects of Avandia KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
3. A patient with type 1 diabetes has an insulin order for NPH insulin, 35 U, to be given at
0700: the patient has also been instructed not to take anything by mouth (NPO) in
preparation for laboratory work that will not be drawn until 1000: What action should the
nurse implement?
a. Give the insulin as ordered:
b. Give the insulin with a small snack:
c. Inform the charge nurse:
d. Hold the insulin until after the blood draw:
ANS: D
Holding the insulin to adhere to the NPO order is appropriate: the patient will not be
getting food until after the laboratory work; consequently, the insulin will not be
needed until then: Giving the insulin as ordered will create a possibility of
hypoglycemia before the blood is drawn: Giving a snack to a patient who is NPO is
inappropriate:
DIF: Cognitive Level: Application REF: p: 986 OBJ: 8
TOP: Insulin with NPO Order KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
4. A patient comes to the diabetes clinic and confides to the nurse that she does not follow
the diet exchange program that she was given: What is the best response by the nurse?
a. “The exchange program is a carefully developed and very important program that
allows you to take control of your disease:”
