NCLEX Exam-Diabetes Mellitus -Sections 1,2,3

NCLEX Exam: Diabetes Mellitus -Sections 1,2,3 1. Knowing that gluconeogenesis helps to maintain blood levels, a nurse should: A. Protect the patient from sources of infection because of decreased cellular protein deposits B. Evaluate the patient’s sensitivity to low room temperatures because of decreased adipose tissue insulation C. Document weight changes because of fatty acid mobilization D. Do all of the above 2. Clinical manifestations associated with a diagnosis of type 1 DM include all of the following except: A. KHypoglycemia B. Ketonuria C. Hyponatremia D. Polyphagia 3.. The lowest fasting plasma glucose level suggestive of a diagnosis of DM is: A. 90mg/dl B. 115mg/dl C. 126mg/dl D. 180mg/dl 4. Rotation sites for insulin injection should be separated from one another by 2.5 cm (1 inch) and should be used only every: A. Third day B. Week C. 2-3 weeks D. 2-4 weeks Clients with type 1 diabetes may require which of the following changes to their daily routine during periods of infection? 5. A clinical feature that distinguishes a hypoglycemic reaction from a ketoacidosis reaction is: A. Blurred vision B. Diaphoresing C. Nausea D. Weakness 6. Clinical nursing assessment for a patient with microangiopathy who has manifested impaired peripheral arterial circulation includes all of the following except: A. Integumentary inspection for the presence of brown spots on the lower extremities B. Observation for paleness of the lower extremities C. Observation for blanching of the feet after the legs are elevated for 60 seconds D. Palpation for increased pulse volume in the arteries of the lower extremities 7. The nurse expects that a type 1 diabetic may receive ____ of his or her morning dose of insulin preoperatively: A. 25-40% B. 10-20% C. 50-60% D. 85-90% 8. Albert, a 35-year-old insulin dependent diabetic, is admitted to the hospital with a diagnosis of pneumonia. He has been febrile since admission. His daily insulin requirement is 24 units of NPH. Every morning Albert is given NPH insulin at 0730. Meals are served at 0830, 1230, and 1830. The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of: A. 1130 and 1330 B. 1330 and 1930 C. 1530 and 2130 D. 1730 and 2330 9. A bedtime snack is provided for Albert. This is based on the knowledge that intermediate-acting insulins are effective for an approximate duration of: A. 6-8 hours B. 10-14 hours C. 16-20 hours D. 24-28 hours 10. Albert refuses his bedtime snack. This should alert the nurse to assess for: A. Elevated serum bicarbonate and a decreased blood pH. B. Signs of hypoglycemia earlier than expected. C. Symptoms of hyperglycemia during the peak time of NPH insulin. D. Sugar in the urine 11. A client is taking NPH insulin daily every morning. The nurse instructs the client that the most likely time for a hypoglycemic reaction to occur is: