Question 1

The nurse is providing care for a client newly diagnosed with type 2 diabetes mellitus. The health-care provider prescribes the antidiabetic noninsulin drug glipizide to be taken once daily. Which finding on the client's record causes the nurse to contact the health-care provider?

Accepted Answer

Glipizide is a sulfonylurea, and a history of an allergic reaction to sulfa drugs could indicate a potential allergy to glipizide.

Question 2

The nurse observes hyperpigmented, velvety macular lesions on the neck during the assessment of a diabetic client. Which conclusion does the nurse draw from this observation?

Accepted Answer

The hyperpigmented, velvety macular lesions on the neck are characteristic of acanthosis nigricans, which is commonly associated with insulin resistance and diabetes.

Question 3

The nurse reviews the laboratory reports of a client with diabetes mellitus and concludes that the client has diabetic nephropathy. Which finding supports the nurse's conclusion?

Accepted Answer

Albuminuria is a sign of diabetic nephropathy.

Question 4

The laboratory report of a client shows arterial blood pH of 7.6, blood glucose level of 650 mg/dL, and serum bicarbonate level of 17 mEq/L. Which conclusion does the nurse draw from these laboratory findings?

Accepted Answer

The client's laboratory report indicates hyperosmolar hyperglycemic syndrome (HHS), characterized by a high blood glucose level (650 mg/dL) and a high blood pH (7.6), suggesting a state of severe hyperglycemia without the significant ketoacidosis typically seen in diabetic ketoacidosis (DKA). The serum bicarbonate level of 17 mEq/L, while lower than normal, does not indicate the severe acidosis seen in DKA.

Question 5

The nurse is providing care for a client with diabetes mellitus. The nurse obtains a glucose blood level of 55 mg/dL. For which complication does the nurse prepare the client?

Accepted Answer

A glucose blood level of 55 mg/dL indicates hypoglycemia, which can lead to seizures if not promptly treated.

Question 6

Which diagnostic test helps in detecting the natural insulin secretion from the pancreas?

Accepted Answer

The C-peptide test measures the level of C-peptide in the blood, which is a byproduct of natural insulin production by the pancreas, thus helping in detecting the natural insulin secretion.

Question 7

While preparing a client for the oral glucose tolerance test (OGTT), the nurse asks the client to ingest soda that contains 80 g of carbohydrates. After 2 hours, the nurse measures the postprandial blood glucose level and concludes that the client has diabetes mellitus. Which blood glucose finding supports the nurse's conclusion? 1.160 mg/dL

Accepted Answer

A postprandial blood glucose level of 250 mg/dL after 2 hours indicates diabetes mellitus, as levels above 200 mg/dL are diagnostic for diabetes in the context of an OGTT.

Question 8

The nurse observes sweating, dizziness, and disorientation in the client with a known history of diabetes mellitus. Finger-stick blood glucose level is 40 mg/dL. When consulting the health-care provider, which treatment option does the nurse anticipate being most beneficial to the client?

Accepted Answer

Administering 50 mL of 50% dextrose intravenously is the most immediate and effective treatment for severe hypoglycemia, especially when the patient is disoriented and may not be able to safely consume oral glucose.

Question 9

The nurse in a maternal care clinic is performing the initial assessment on a client who just learned about being pregnant. Which finding alerts the nurse to a possibility of the client developing gestational diabetes mellitus?

Accepted Answer

A Body Mass Index (BMI) of 32 falls into the category of obesity. Obesity is a known risk factor for developing gestational diabetes mellitus during pregnancy.

Question 10

Which is the most common complication expected in clients with type 1 diabetes?

Accepted Answer

Diabetic ketoacidosis (DKA) is the most common acute complication of type 1 diabetes due to the body's inability to produce insulin, leading to high blood sugar levels and the accumulation of ketones in the blood.

Question 11

The nurse is assessing the medical records of different clients with diabetes. Which client has a reduced risk of cardiovascular disease?

Accepted Answer

The client in option C has the lowest risk of cardiovascular disease due to having optimal blood pressure (115/75 mm Hg), the lowest LDL levels (100 mg/dL), the highest HDL levels (70 mg/dL), and the lowest triglyceride levels (140 mg/dL), all of which are favorable factors for cardiovascular health.

Question 12

The nurse is assessing the blood glucose levels of a client at regular intervals. The nurse finds 55 mg/dL of blood glucose at 2:00 a.m. and 150 mg/dL at 7:00 a.m. Which mechanism does the nurse suspect behind the change in the glucose levels in the client?

Accepted Answer

The Somogyi effect is characterized by a rebound hyperglycemia following an episode of hypoglycemia, often occurring during the night, which explains the low glucose level at 2:00 a.m. and the high level at 7:00 a.m.

Question 13

The nurse is providing care for a client just diagnosed with type 1 diabetes mellitus. For which reason does the nurse anticipate a C-peptide test for the client?

Accepted Answer

A C-peptide test is used to evaluate residual pancreatic function by measuring the amount of C-peptide, which is released when insulin is produced by the pancreas.

Question 14

The nurse is reviewing the medical records of different clients. Which client does the nurse expect to have metabolic syndrome?

Accepted Answer

Metabolic syndrome is diagnosed based on a set of criteria that include abdominal obesity (waist circumference >40 inches in men and >35 inches in women) and elevated triglyceride levels (≥150 mg/dL), among others. The female client with a waist circumference of 37 inches and triglyceride levels of 160 mg/dL meets these criteria.

Question 15

The mother of an adolescent diabetic client tells the nurse, "My daughter is skipping insulin doses frequently because she is concerned about weight gain." Which condition does the nurse document for this client?

Accepted Answer

The nurse documents "insulin purging," which is when a person with diabetes deliberately skips insulin doses to lose weight, a behavior often associated with an eating disorder.

Question 16

The nurse is providing care to a diabetic client who is experiencing prolonged wound healing. Which condition does the nurse suspect in the client?

Accepted Answer

Immunosuppression is a condition in which the immune system is weakened, making the body more susceptible to infection and disease. This can lead to prolonged wound healing, as the body is less able to fight off infection and promote healing.

Question 17

The nurse reviews the laboratory reports of a client and concludes that the client has diabetes. Which finding helped the nurse to reach this conclusion?

Accepted Answer

A glycated hemoglobin (HbA1c) value of 7% or higher is a criterion for the diagnosis of diabetes, as it reflects the average blood glucose levels over the past 2 to 3 months.

Question 18

The nurse is caring for a client with immune-mediated type 1 diabetes. Which does the nurse expect to be the cause of this condition in the client?

Accepted Answer

Type 1 diabetes is caused by the autoimmune destruction of the insulin-producing beta cells in the pancreas.

Question 19

After reviewing the medical records of an adult female client, the nurse concludes the client has metabolic syndrome. Which findings helped the nurse to reach this conclusion?

Accepted Answer

The diagnosis of metabolic syndrome is based on the presence of a combination of risk factors. For this scenario, choice B is correct because it includes an HDL cholesterol level lower than 50 mg/dL for women, blood pressure equal to or higher than 130/85 mm Hg, and fasting blood glucose equal to or higher than 100 mg/dL, which are criteria for diagnosing metabolic syndrome.

Question 20

The nurse is teaching a group of staff nurses about managing hyperosmolar hyperglycemic syndrome (HHS) in clients. Which response by an attending nurse indicates effective learning?

Accepted Answer

Fluids are administered before IV insulin in HHS to correct dehydration and stabilize the patient before addressing hyperglycemia.

Quiz 25: Diabetes Mellitus and the Metabolic Syndrome