MEDICAL SURGICAL NURSING 9TH EDITION IGNATAVICIUS TEST BANK
Test Bank - Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care 9e 527
Chapter 64: Care of Patients with Diabetes Mellitus
MULTIPLE CHOICE
1.A nurse is teaching a client with diabetes mellitus who asks, Why is it necessary to maintain my blood
glucose 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 supply from the
bodys circulation is needed to meet the fuel demands of the central nervous system. The nurse would want to
educate the client to prevent hypoglycemia. The body can use other sources of fuel, including fat and protein,
and glucose is not involved in the production of red blood cells. Glucose in the blood will encourage glucose
metabolism but is not directly responsible for lactic acid formation.
DIF:Remembering/Knowledge REF: 1281
KEY: Diabetes mellitus| hypoglycemia MSC: Integrated Process: Teaching/Learning
NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation
2.A nurse reviews laboratory results for a client with diabetes mellitus who presents with polyuria, lethargy,
and a blood glucose of 560 mg/dL. Which laboratory result should the nurse correlate with the clients
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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 osmotic diuresis.
The clients serum osmolarity is high. The clients sodium would be expected to be high owing to dehydration.
Serum creatinine and urine ketone bodies are not related to the polyuria.
DIF:Applying/Application REF: 1282
KEYiabetes 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 nurse assesses
the clients understanding. Which statement made by the client indicates a correct understanding of the need 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
NURSINGTB.COM
, MEDICAL SURGICAL NURSING 9TH EDITION IGNATAVICIUS TEST BANK
Test Bank - Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care 9e 528
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.
ANS: D
Diabetic retinopathy is a leading cause of blindness in North America. All clients with diabetes, regardless of
age, should be examined by an ophthalmologist (rather than an optometrist or optician) at diagnosis and at
least yearly thereafter.
DIF:Applying/Application REF: 1283
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 sensation in both
feet. Which action should the nurse take first?
a. Document the finding in the clients chart.
b. Assess tactile sensation in the clients
hands.
c. Examine the clients 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 for injury in any
NURSINGTB.COM
area with decreased sensation because he or she is less able to feel injurious events. Feet are common locations
for neuropathy and injury, so the nurse should inspect them for any signs of injury. After assessment, the nurse
should document findings in the clients chart. Testing sensory perception in the hands may or may not be
needed. The health care provider can be notified after assessment and documentation have been completed.
DIF:Applying/Application REF: 1301
KEYiabetes mellitus| neuropathy
MSC:Integrated Process: Nursing Process: Analysis
NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential
5.A nurse cares for a client who has a family history of diabetes mellitus. The client states, My father has type
1 diabetes mellitus. Will I develop this disease as well? How should the nurse respond?
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 tissue types.
Clients who have one parent with type 1 diabetes are at increased risk for its development. Diabetes (type 1)
seems to require interaction between inherited risk and environmental factors, so not everyone with these genes
develops diabetes. The other statements are not accurate.
NURSINGTB.COM
, MEDICAL SURGICAL NURSING 9TH EDITION IGNATAVICIUS TEST BANK
Test Bank - Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care 9e 529
DIF:Understanding/Comprehension REF: 1287
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 nurse include
in this clients plan of care to delay the onset of microvascular and macrovascular complications?
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. Maintaining tight
glycemic control will help delay the onset of complications. Restricting fluid intake is not part of the treatment
plan for clients with diabetes. Preventing hypoglycemia and ketosis, although important, are not as important
as maintaining daily glycemic control.
DIF:Applying/Application REF: 1281
KEY: Diabetes mellitus| hyperglycemia MSC: Integrated Process: Teaching/Learning
NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential
7.A nurse assesses clients who are at risk for diabetes mellitus. Which client is at greatest risk?
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a. A 29-year-old Caucasian
b. A 32-year-old African-
American
c. A 44-year-old Asian
d. A 48-year-old American Indian
ANS: D
Diabetes is a particular problem among African Americans, Hispanics, and American Indians. The incidence
of diabetes increases in all races and ethnic groups with age. Being both an American Indian and middle-aged
places this client at highest risk.
DIF:Understanding/Comprehension REF: 1287
KEYiabetes mellitus| health screening
MSC:Integrated Process: Nursing Process: Assessment
NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care
8.A nurse teaches a client about self-monitoring of blood glucose levels. Which statement should the nurse
include in this clients teaching to prevent bloodborne infections?
a. Wash your hands after completing each test.
b. Do not share your monitoring equipment.
c. Blot excess blood from the strip with a cotton
ball.
NURSINGTB.COM
Test Bank - Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care 9e 527
Chapter 64: Care of Patients with Diabetes Mellitus
MULTIPLE CHOICE
1.A nurse is teaching a client with diabetes mellitus who asks, Why is it necessary to maintain my blood
glucose 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 supply from the
bodys circulation is needed to meet the fuel demands of the central nervous system. The nurse would want to
educate the client to prevent hypoglycemia. The body can use other sources of fuel, including fat and protein,
and glucose is not involved in the production of red blood cells. Glucose in the blood will encourage glucose
metabolism but is not directly responsible for lactic acid formation.
DIF:Remembering/Knowledge REF: 1281
KEY: Diabetes mellitus| hypoglycemia MSC: Integrated Process: Teaching/Learning
NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation
2.A nurse reviews laboratory results for a client with diabetes mellitus who presents with polyuria, lethargy,
and a blood glucose of 560 mg/dL. Which laboratory result should the nurse correlate with the clients
NURSINGTB.COM
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 osmotic diuresis.
The clients serum osmolarity is high. The clients sodium would be expected to be high owing to dehydration.
Serum creatinine and urine ketone bodies are not related to the polyuria.
DIF:Applying/Application REF: 1282
KEYiabetes 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 nurse assesses
the clients understanding. Which statement made by the client indicates a correct understanding of the need 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
NURSINGTB.COM
, MEDICAL SURGICAL NURSING 9TH EDITION IGNATAVICIUS TEST BANK
Test Bank - Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care 9e 528
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.
ANS: D
Diabetic retinopathy is a leading cause of blindness in North America. All clients with diabetes, regardless of
age, should be examined by an ophthalmologist (rather than an optometrist or optician) at diagnosis and at
least yearly thereafter.
DIF:Applying/Application REF: 1283
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 sensation in both
feet. Which action should the nurse take first?
a. Document the finding in the clients chart.
b. Assess tactile sensation in the clients
hands.
c. Examine the clients 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 for injury in any
NURSINGTB.COM
area with decreased sensation because he or she is less able to feel injurious events. Feet are common locations
for neuropathy and injury, so the nurse should inspect them for any signs of injury. After assessment, the nurse
should document findings in the clients chart. Testing sensory perception in the hands may or may not be
needed. The health care provider can be notified after assessment and documentation have been completed.
DIF:Applying/Application REF: 1301
KEYiabetes mellitus| neuropathy
MSC:Integrated Process: Nursing Process: Analysis
NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential
5.A nurse cares for a client who has a family history of diabetes mellitus. The client states, My father has type
1 diabetes mellitus. Will I develop this disease as well? How should the nurse respond?
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 tissue types.
Clients who have one parent with type 1 diabetes are at increased risk for its development. Diabetes (type 1)
seems to require interaction between inherited risk and environmental factors, so not everyone with these genes
develops diabetes. The other statements are not accurate.
NURSINGTB.COM
, MEDICAL SURGICAL NURSING 9TH EDITION IGNATAVICIUS TEST BANK
Test Bank - Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care 9e 529
DIF:Understanding/Comprehension REF: 1287
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 nurse include
in this clients plan of care to delay the onset of microvascular and macrovascular complications?
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. Maintaining tight
glycemic control will help delay the onset of complications. Restricting fluid intake is not part of the treatment
plan for clients with diabetes. Preventing hypoglycemia and ketosis, although important, are not as important
as maintaining daily glycemic control.
DIF:Applying/Application REF: 1281
KEY: Diabetes mellitus| hyperglycemia MSC: Integrated Process: Teaching/Learning
NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential
7.A nurse assesses clients who are at risk for diabetes mellitus. Which client is at greatest risk?
NURSINGTB.COM
a. A 29-year-old Caucasian
b. A 32-year-old African-
American
c. A 44-year-old Asian
d. A 48-year-old American Indian
ANS: D
Diabetes is a particular problem among African Americans, Hispanics, and American Indians. The incidence
of diabetes increases in all races and ethnic groups with age. Being both an American Indian and middle-aged
places this client at highest risk.
DIF:Understanding/Comprehension REF: 1287
KEYiabetes mellitus| health screening
MSC:Integrated Process: Nursing Process: Assessment
NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care
8.A nurse teaches a client about self-monitoring of blood glucose levels. Which statement should the nurse
include in this clients teaching to prevent bloodborne infections?
a. Wash your hands after completing each test.
b. Do not share your monitoring equipment.
c. Blot excess blood from the strip with a cotton
ball.
NURSINGTB.COM
