Lewis Medical Surgical --Chapter 53 Diabetes Exam Practice Questions and Answers

Lewis Medical Surgical --Chapter 53 Diabetes Exam Practice Questions and Answers Which information provided by a nurse to a patient newly diagnosed with type 2 diabetes is Accurate? a. Insulin is not used to control glucose in patients with type 2 diabetes. b. Complications of type 2 diabetes are less serious than those of type 1 diabetes. c. Changes in diet and exercise may control glucose levels with type 2 diabetes. d. Type 2 diabetes is usually diagnosed when a patient is admitted in hyperglycemic coma. - Ans:-ANS: C For some patients with type 2 diabetes, changes in lifestyle are sufficient to achieve glucose control. Insulin is frequently used for type 2 diabetes, complications are equally serious as for type 1 diabetes, and type 2 diabetes is usually diagnosed with routine laboratory testing or ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 2/36 after a patient develops complications such as frequent infections. A patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L). Which information will the nurse plan to teach the patient? a. Self-monitoring of glucose b. Using small doses of regular insulin c. Lifestyle changes to lower the glucose d. Effects of oral hypoglycemic medications - Ans:-ANS: C The patient's impaired fasting glucose indicates prediabetes, and the patient would be counseled about lifestyle changes to prevent the development of type 2 diabetes. The patient with prediabetes does not require insulin or oral hypoglycemics for glucose control and does not need to self-monitor glucose. A 28-yr-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates a need for the nurse to implement additional teaching? a. The patient always carries hard candies when engaging in exercise. ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 3/36 b. The patient goes for a vigorous walk when his glucose is 200 mg/dL. c. The patient has a peanut butter sandwich before going for a bicycle ride. d. The patient increases daily exercise when ketones are present in the urine. - Ans:-ANS: D When the patient is ketotic, exercise increase the glucose level; persons with type 1 diabetes should be taught to avoid exercise when ketosis is present. Other recommendations include (1) before exercise, if glucose 100 mg/dL, eat a 15-g carbohydrate snack. After 15 to 30 min, recheck glucose levels. (2) Delay exercise if 100 mg/dL. Patients using drugs that place them at risk for hypoglycemia should always carry a fast-acting source of carbohydrate, such as glucose tablets or hard candies, when exercising. (3) Before exercise, if glucose 250 mg/dL in a person with type 1 DM and ketones are present, delay vigorous activity until ketones are gone. Drink fluids. The nurse is assessing a 22-yr-old patient experiencing the onset of symptoms of type 1 diabetes. Which finding would the nurse anticipate? a. Anorexia ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 4/36 b. Weight loss c. Dark colored urine d. Craving sugary drinks. - Ans:-ANS: B Weight loss occurs because the body is no longer able to absorb glucose and starts to break down protein and fat for energy. The patient is thirsty but does not necessarily crave sugar-containing fluids. Increased appetite is a classic symptom of type 1 diabetes. With the classic symptom of polyuria, urine will be very dilute. A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the Patient? a. Fasting blood glucose b. Glycosylated hemoglobin c. Oral glucose tolerance test d. Urine dipstick for glucose and ketones - Ans:-ANS: B ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 5/36 The glycosylated hemoglobin (A1C) test shows the overall control of glucose over 90 to 120 days. A fasting level indicates only the glucose level at one time. Urine glucose testing is not an accurate reflection of glucose level and does not reflect the glucose over a prolonged time. Oral glucose tolerance testing is done to diagnose diabetes but is not used for monitoring glucose control after diabetes has been diagnosed. The nurse is assessing a 55-yr-old female patient with type 2 diabetes who has a body mass index (BMI) of 32 kg/m2. Which goal in the plan of care is most important for this patient? a. The patient will reach a glycosylated hemoglobin level of less than 7%. b. The patient will follow a diet and exercise plan that results in weight loss. c. The patient will choose a diet that distributes calories throughout the day. d. The patient will state the reasons for eliminating simple sugars in the diet. - Ans:-ANS: A The complications of diabetes are related to elevated glucose and the most important patient outcome is the reduction of glucose to near-normal levels. A BMI of 30.9/kg/m2 or above is considered obese, so the other outcomes are appropriate but are not as high in priority. ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 6/36 A patient who has type 1 diabetes plans to swim laps for an hour daily at 1:00 PM. Which advice would the clinic nurse plan to give the patient? a. Increase the morning dose of NPH insulin (Novolin N). b. Check glucose level before, during, and after swimming. c. Time the morning insulin injection to peak while swimming. d. Delay eating the noon meal until after finishing the swimming. - Ans:-ANS: B The exercise will affect glucose, and the patient will need to monitor glucose carefully to determine the need for changes in diet and insulin administration. Because exercise tends to decrease glucose, patients are advised to eat before exercising. Increasing the morning NPH or timing the insulin to peak during exercise may lead to hypoglycemia, especially with