Question 1

What does the nurse teach the patient with type 1 diabetes mellitus to do in advance of playing tennis?

Accepted Answer

Before engaging in physical activity such as playing tennis, it is crucial for a patient with type 1 diabetes mellitus to measure their blood glucose level. This helps in determining if any adjustments to food, insulin, or both are needed to maintain blood glucose within a safe range during and after the activity.

Question 2

A patient with type 1 diabetes mellitus will be self-monitoring blood glucose levels at home. What is the minimum number of measurements that this patient should make each day?

Accepted Answer

Patients with type 1 diabetes mellitus are generally advised to monitor their blood glucose levels at least four times a day. This typically includes measurements before meals and at bedtime to effectively manage their insulin dosing and maintain glycemic control.

Question 3

The nurse correlates which assessment findings to a patient experiencing diabetic ketoacidosis?

Accepted Answer

Deep rapid respirations, known as Kussmaul respirations, are a classic sign of diabetic ketoacidosis (DKA), as the body attempts to compensate for the acidosis by expelling more carbon dioxide through the lungs.

Question 4

A patient with a 20-year history of type 1 diabetes is admitted to the emergency department with changes in level of consciousness. Serum electrolytes and arterial blood gases (ABGs) are obtained. The ABG results are as follows: pH 7.28 PaO₂ 92 PaCO₂ 30 HCO₃ 19 O₂ Sat 95% The nurse documents these results as:

Accepted Answer

The ABG results indicate a low pH (7.28), which suggests acidosis. The low bicarbonate (HCO3-) level (19) points towards a metabolic cause. The PaCO2 is also low (30), indicating a compensatory respiratory response. However, since the pH is not within the normal range, the condition is partially compensated metabolic acidosis.

Question 5

An older adult patient diagnosed with type 1 diabetes mellitus has poor oral intake. The nurse takes which action to ensure adequate blood glucose control?

Accepted Answer

Administering prandial and correctional insulin together helps manage blood glucose levels effectively, even with poor oral intake, by addressing both meal-related and existing high blood sugar levels.

Question 6

Which patient statement indicates to the nurse the need for further teaching regarding the new diagnosis of type 1 diabetes mellitus (DM)?

Accepted Answer

Type 1 diabetes mellitus requires lifelong insulin therapy because the pancreas produces little to no insulin. Oral medications are typically used for type 2 diabetes, not type 1, indicating a misunderstanding that needs to be addressed.

Question 7

A 40-year old patient is surprised to learn of the diagnosis of type 1 diabetes mellitus. What is the nurse's best response?

Accepted Answer

Type 1 diabetes mellitus, although commonly diagnosed in childhood, can indeed occur at any age. This form of diabetes results from an autoimmune destruction of insulin-producing beta cells in the pancreas, leading to insulin deficiency. It is not limited to children and can be diagnosed in adults as well, a condition sometimes referred to as latent autoimmune diabetes in adults (LADA).

Question 8

A patient is newly diagnosed with type 2 diabetes mellitus. The nurse correlates which medication classification's mechanism of action as decreasing glucose production in the liver?

Accepted Answer

Biguanides, specifically metformin, work by decreasing glucose production in the liver, making them a common first-line treatment for type 2 diabetes mellitus.

Question 9

A patient is prescribed regular insulin 5 units subcutaneous injection now. Which syringe should the nurse use for this dose if all are readily available?

Accepted Answer

The answer of A patient is prescribed regular insulin 5...

Question 10

A patient with type 2 diabetes mellitus is prescribed a glucagon-like peptide-1 agonist. The nurse teaches the patient to monitor for which side effects of this medication?

Accepted Answer

The answer of A patient with type 2 diabetes mellitus...

Question 11

Which statement best describes the pathophysiology of type 2 diabetes mellitus?

Accepted Answer

Type 2 diabetes mellitus is characterized by insulin resistance, where the body's cells do not respond effectively to insulin, making it difficult for glucose to enter cells and leading to elevated blood glucose levels.

Question 12

The nurse is reviewing the results of a patient's recent hemoglobin A1c level drawn to evaluate type 1 diabetes management. Which result indicates that treatment has been successful?

Accepted Answer

A hemoglobin A1c level of less than or equal to 6.5% is generally considered a target for good diabetes management, indicating that the patient's blood sugar levels have been well controlled over the past 2 to 3 months.

Question 13

The nurse is evaluating teaching provided to a patient with type 1 diabetes mellitus. Which patient observation indicates that medication teaching has been effective?

Accepted Answer

Rotating injection sites, such as placing a new injection an inch away from the previous site, helps prevent lipodystrophy and ensures proper insulin absorption, indicating effective teaching.

Question 14

A patient with type 1 diabetes mellitus is experiencing elevated blood glucose levels in the morning. Which action is indicated to address this complication?

Accepted Answer

Measuring blood glucose at 0200 hours helps determine if the elevated morning glucose is due to the Somogyi effect (rebound hyperglycemia after nocturnal hypoglycemia) or the dawn phenomenon (natural increase in blood glucose in the early morning).

Question 15

A patient with type 1 diabetes mellitus develops symptoms of hypoglycemia only when the blood glucose level drops to 40 mg/dL. What is the recommended action for this complication?

Accepted Answer

Raising glycemic targets is recommended to prevent hypoglycemia in patients with type 1 diabetes who do not experience symptoms until their blood glucose levels are dangerously low. This approach helps avoid such low levels by aiming for a slightly higher, safer range of blood glucose.

Question 16

A patient with type 1 diabetes mellitus is scheduled for a hemoglobin A1c level. What information does the nurse include in the patient teaching about this diagnostic test?

Accepted Answer

Hemoglobin A1c levels reflect the average blood glucose levels over the past 2 to 3 months and are not affected by fasting or the time of day the test is taken. Therefore, it can be drawn at any time during the day without special preparation.

Question 17

The nurse is reviewing type 1 diabetes mellitus with a group of patients newly diagnosed with the disorder. What should the nurse explain as the major cause for the disorder?

Accepted Answer

Type 1 diabetes mellitus is primarily caused by an autoimmune process where the body's immune system attacks and destroys the insulin-producing beta cells in the pancreas. This leads to an insulin deficiency, which is the hallmark of Type 1 diabetes.

Question 18

The nurse provides care to a patient diagnosed with type 1 diabetes mellitus (DM) whose hemoglobin A1c level remains elevated despite the use of the prescribed sliding scale insulin. The healthcare provider prescribes an insulin pump. The patient asks, "Why did my doctor prescribe a pump? " Which response by the nurse is best?

Accepted Answer

The answer of The nurse provides care to a patient...

Question 19

A patient experiencing diabetic ketoacidosis (DKA) is receiving a normal saline infusion and intravenous insulin. What additional medication does the nurse expect to be prescribed for this patient?

Accepted Answer

Potassium is often administered during treatment for diabetic ketoacidosis (DKA) because insulin therapy can cause potassium to move from the blood into the cells, potentially leading to hypokalemia (low potassium levels in the blood). Monitoring and managing potassium levels is crucial to prevent cardiac and other complications.

Question 20

Which patient statement best indicates correct understanding of the teaching regarding actions to be taken during an episode of hypoglycemia in a patient recently diagnosed with type 1 diabetes mellitus (DM)?

Accepted Answer

A cracker is a complex carbohydrate that will help to raise blood sugar levels.

Quiz 44: Coordinating Care for Patients With Diabetes Mellitus