Chapter 38: Care of Patients with Diabetes and Hypoglycemia ( book questions)

A 30 y.o. woman is admitted for urinary tract infection. A urinalysis reveals presence of ketones, glucose, and nitrates. Which question would the nurse ask to further assess possible diabetes mellitus?
Have you been thirstier than usual? DO you find you urinate more now?

Which teaching technique would be most useful for the older diabetic patient?
Set a time for the teaching session that is agreeable to the patient
Allow time for the patient to jot down important points
Repeat key concepts frequently; if the patient doesn’t understand, try rephrasing the concept

A patient newly diagnosed with diabetes is given diet instructions. What should the nurse do to effectively motivate the patient to comply with dietary recommendations?
Emphasize good food choices
Apply diet prescriptions to patient preferred foods
Focus on the benefits of diet compliance
Involve meal preparers in diet teaching

A 50 y.o. woman was recently diagnosed with type 2 diabetes mellitus and desires to start a healthy lifestyle to control her disease. What is the initial recommendation that the nurse should make?
Ensure Adequate Glucose Control

The nurse is supervising and nursing student who is performing foot care for a diabetic patient. The nurse would intervene if the student:
Places a protective cover between a heating pad and feet and uses the lowest setting

A patient who works as a personal trainer is diagnosed with insulin-dependent diabetes. What should the nurse teach regarding self administration of regular insulin?
Use the abdomen as an insulin injection site

The home health nurse is visiting an elderly patient who has successfully managed her type 2 diabetes for years. During the visit, the nurse notes that the patient has severe arthritis, poor vision, and several dry, red areas on the lower extremities. What is the priority nursing diagnosis?
Risk for ineffective self-health management related to aging

The nursing assistant informs the nurse that the diabetic patient’s blood glucose reading is 750 mg/dL. What is the nurse’s priority action?
Assess the patient for responsiveness and ketoacidosis

The nursing assistant tells you that a known diabetic patient has a blood glucose level of 60 mg/dL. What symptoms would the nurse be most likely to observe with this glucose level?
Confusion, tremulousness, pallor, sweating, and ketoacidosis

During a routine checkup, the healthcare provider tells the diabetic patient that tests results reveal microalbuminuria. Which long-term complication is specific to this test result?
Nephropathy

A patient with diabetes mellitus has been maintained on metformin (Glucophage) for regulation of her blood glucose levels. What should be included in this patient’s teaching?
Report changes in voiding patterns.

A patient with diabetes experiences the Somogyi effect. To prevent this complication, the nurse should instruct the patient to:
eat a protein and carbohydrate snack before retiring.

A patient with diabetes is taking Lantus insulin. The nurse is aware that this insulin will most likely be administered:
at night

A patient presents in the emergency room with polydipsia, polyuria, and polyphagia related to his diabetes. The nurse should expect these symptoms are related to:
hyperglycemia.

Which laboratory test is best used to determine level of compliancy in the patient with diabetes mellitus?
Hb A1c

A patient has just been diagnosed with diabetes and is admitted for insulin regulation. He asks the nurse, “Why do I need to be stuck so many times a day?” Which statement best explains the rationale for the frequent checks of his blood glucose level?
Blood glucose levels are checked so that your insulin doses can be adjusted.”

A patient with diabetes asks her nurse why she should use a diaphragm for contraception instead of birth control pills. The best explanation for the patient is that:
a diaphragm is noninvasive and will not affect her blood glucose levels.

A patient with diabetes phones the clinic stating, “I have a terrible cold and I don’t know what to do about taking my insulin.” Regarding her insulin needs, what should be included in the information given to this patient?
Infections cause alterations and increase insulin needs, so she should check her blood glucose levels and urine ketones at least every 4 hours.

A 28-year-old primigravida with gestational diabetes visits the clinic at 16 weeks’ gestation. Which statement indicates she understands the health teaching regarding her insulin needs during pregnancy?
“Changes in my hormones will make my body more resistant to insulin, so I will need more insulin as my pregnancy goes on.”

A patient newly diagnosed with diabetes is learning to administer his injections of NPH and regular insulin. Which statement indicates that the patient understands the nurse’s teaching regarding proper insulin administration?
“I will draw up the regular insulin before the NPH.”

A patient recently diagnosed as having hypoglycemia says, “Hypoglycemia! I can’t live with that. My neighbor, Joseph, had that and he acted crazy!” Which response by the nurse is most appropriate?
“Hypoglycemia has been successfully treated by diet modifications.”

Diabetes mellitus is best defined as a(n):
disturbance in utilization of glucose.

Which statement generally describes individuals diagnosed with type 1 diabetes mellitus?
They usually have a lack of insulin.

In discussing diabetes mellitus with a patient, it is important to base the discussion on the fact that diabetes mellitus:
can often be controlled by diet and regular exercise.

A patient is diagnosed as having diabetes mellitus and is started on 22 units of NPH insulin and an 1800-calorie American Diabetic Association (ADA) diet. While the LPN/LVN is teaching the patient that she should have a mid-afternoon snack, the patient asks why that is necessary. The nurse should reply that:
it helps prevent a hypoglycemic reaction.

A patient with type 1 diabetes mellitus plays tennis and asks if she will be able to continue with that sport. The LPN/LVN should tell her that:
she can play tennis, but she will need to eat more before she plays.

When teaching a patient with type 1 diabetes about home care, the LPN/LVN assures her that she can recognize the early signs of diabetic ketoacidosis, which are:
thirst, dry mucous membranes, and dry skin.

A patient who is undergoing surgery will have an intravenous solution to which insulin will be added. Which of these types of insulin must be used?
Regular

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