Question 1

The nurse is preparing to administer insulin to an underweight patient. Which actions should the nurse take when providing this injection?

Accepted Answer

Ensuring insulin is at room temperature helps reduce discomfort. Removing air bubbles ensures accurate dosing. Rotating injection sites prevents tissue damage and ensures better absorption.

Question 2

A patient with diabetes asks what can be done to prevent the development of corns on the feet. How should the nurse respond to this patient?

Accepted Answer

Selecting shoes that fit appropriately can help prevent corns on the feet by reducing pressure and friction on certain areas of the feet. Using corn pads or shaving off corns is not a preventive measure, and using abrasive soap can irritate the skin and increase the risk of corns.

Question 3

The nurse is teaching a patient with diabetes about the illness. The nurse knows the teaching has been effective when the patient identifies which statements as being true of pancreatic cells?

Accepted Answer

Alpha cells in the pancreas produce glucagon, which raises blood glucose levels. Beta cells secrete insulin, which lowers blood glucose levels. Delta cells produce somatostatin, which regulates the secretion of other pancreatic hormones. Cephalon cells producing creatine and epsilon cells producing erythropoietin are incorrect; these functions are not associated with pancreatic cells.

Question 4

A patient recently diagnosed with type 1 diabetes mellitus does not understand why the disease developed because the patient is thin and eats all of the time. What is the most appropriate response by the nurse?

Accepted Answer

Type 1 diabetes mellitus is characterized by the body's inability to produce insulin, which is essential for converting glucose into energy. This means that despite eating, the body cannot effectively use the food for energy, leading to symptoms such as constant hunger. This explanation helps the patient understand the relationship between their eating habits and their diagnosis.

Question 5

The nurse notes that a 41-year-old patient's fasting blood glucose level is 125 mg/dL. What should the nurse suspect is occurring with the patient?

Accepted Answer

A fasting blood glucose level of 125 mg/dL is consistent with prediabetes, as it is higher than normal but not high enough to be classified as diabetes.

Question 6

A patient with diabetes is diaphoretic, has a heart rate of 112 beats per minute, and is feeling nervous and shaky. What action should the nurse take first?

Accepted Answer

Based on the symptoms provided, it is likely that the patient is experiencing hypoglycemia. Therefore, obtaining a capillary serum glucose level reading with a glucose meter is the priority action to confirm the diagnosis and determine appropriate treatment. Administering insulin via a sliding scale dosages or providing the patient with a snack may exacerbate hypoglycemia. Contacting the laboratory to order a serum glucose level is not an immediate priority when treating hypoglycemia.

Question 7

The nurse is concerned that a patient with type 1 diabetes mellitus is at risk for developing diabetic ketoacidosis. What did the nurse assess to come to this conclusion?

Accepted Answer

A serum glucose level of 325 mg/dL is significantly elevated and puts the patient with type 1 diabetes at risk for diabetic ketoacidosis. High glucose levels can lead to an accumulation of ketones in the blood, which can cause the blood to become acidic and lead to diabetic ketoacidosis. Reports of anxiety, pale cool skin, and a plantar foot ulcer may be important findings for the nurse to consider, but are not directly related to the patient's risk for diabetic ketoacidosis.

Question 8

A patient with diabetes mellitus and poor circulation has thick and ingrown toenails. What should the nurse instruct the patient to do?

Accepted Answer

Patients with diabetes and poor circulation are at risk for complications from ingrown toenails, including infection and tissue damage. Therefore, it is important for them to see a podiatrist who can properly trim the nails and provide ongoing foot care guidance. Soaking the feet in Epsom salts or using a razor blade to trim the nails can increase the risk of injury and infection. Cutting the nails prior to bathing may also increase the risk of injury if the patient has poor circulation and decreased sensation in their feet.

Question 9

A patient beginning insulin for type 2 diabetes is experiencing blurred vision and is concerned about becoming blind. What response by the nurse is most appropriate?

Accepted Answer

Initiating insulin therapy can lead to temporary shifts in fluid balance, which may cause refractive changes in the eyes, leading to blurred vision. This is usually temporary and should resolve as the body adjusts to the insulin.

Question 10

The nurse is reviewing data collected from a patient with a predisposition to developing insulin resistance. Which medications should the nurse identify as potentially causing this patient to develop diabetes?

Accepted Answer

The answer of The nurse is reviewing data collected from...

Question 11

The nurse is conducting an educational session with a patient who is newly diagnosed with diabetes. The nurse knows further education is needed when the patient states, "In the U.S.:

Accepted Answer

The correct statistics, according to the Centers for Disease Control and Prevention (CDC) and other reputable sources, indicate that approximately 1.5 million Americans are diagnosed with diabetes each year, not 6 million. The other options (B, C, D) reflect more accurate estimates of the total number of people living with diagnosed and undiagnosed diabetes in the U.S.

Question 12

The nurse is assessing a patient who has a family history of type 2 diabetes mellitus. Which finding would require follow-up by the nurse?

Accepted Answer

Family history of type 2 diabetes mellitus is a risk factor for the development of diabetes. A new prescription for levothyroxine (Synthroid) for hypothyroidism is not related to diabetes and does not require follow-up for this reason. Decreased waist-to-hip ratio through dietary changes and a fasting blood glucose level of 89 mg/dL are both positive findings and would not require follow-up. Delivery of a baby that weighed 8 pounds and 12 ounces is a risk factor for gestational diabetes, but the question does not specify if the patient had gestational diabetes or not; therefore, this finding alone would not require follow-up.

Question 13

A patient recently diagnosed with diabetes wants to check the urine for glucose instead of using capillary blood because of the cost. Which response should the nurse make to the patient?

Accepted Answer

Urine testing for glucose is not as accurate or reliable as blood glucose testing. It is best used in conjunction with blood tests to provide a more comprehensive view of glucose levels.

Question 14

A 78-year-old patient without polyuria, polydipsia, or polyphagia has a serum glucose level of 130 mg/dL. What should the nurse conclude about this patient?

Accepted Answer

The patient's glucose level is elevated, but without classic symptoms of diabetes, further assessment is needed to determine if they have diabetes or another condition affecting glucose levels.

Question 15

The nurse is reviewing data collected for a patient's health history. Which factor should the nurse identify as increasing the patient's risk of developing type 2 diabetes mellitus?

Accepted Answer

Physical inactivity is a significant risk factor for developing type 2 diabetes mellitus. Maintaining a healthy body weight, blood pressure, and waist-to-hip ratio can reduce the risk, but physical activity is crucial in preventing the disease. A BMI of 23 kg/m2 is within a healthy range, while a lower waist-to-hip ratio is also desirable for reducing diabetes risk. However, these factors alone do not increase a person's risk of developing diabetes.

Question 16

A nurse is conducting an educational session for a group of patients regarding the incidence and prevalence of diabetes. The nurse explains that approximately 25.8 million people have been diagnosed with the disorder, but 7 million people have not. Statistically, what is the percentage of people who have undiagnosed diabetes?

Accepted Answer

The answer of A nurse is conducting an educational session...

Question 17

A patient at risk for the development of type 2 diabetes mellitus asks why weight loss will reduce risk of the condition. Which response by the nurse is most accurate?

Accepted Answer

Excess body weight can lead to insulin resistance, which impairs the body's release of insulin, and increases the risk of developing type 2 diabetes. Weight loss can improve insulin sensitivity and reduce the risk of diabetes development. The other options are not accurate explanations for the relationship between weight loss and diabetes risk.

Question 18

The nurse is caring for a healthy patient who has a serum glucose level of 60 mg/dL. The nurse anticipates which counterregulatory serum hormonal changes to occur in this patient?

Accepted Answer

When serum glucose levels drop, the body responds by increasing levels of hormones that raise blood sugar, such as epinephrine and growth hormone. Insulin levels would decrease to stop further lowering of blood glucose, while changes in thyroxine and glucocorticoids are not the immediate counterregulatory responses to hypoglycemia.

Question 19

A patient with type 1 diabetes mellitus who had one episode of vomiting in the past 2 hours asks if the routine insulin injection should be taken. What action by the nurse is best at this time?

Accepted Answer

Patients with type 1 diabetes mellitus require insulin even if they are not eating or are vomiting because their bodies do not produce insulin. Skipping insulin can lead to diabetic ketoacidosis, a serious complication. Therefore, it is important to explain the need to take insulin to manage their blood glucose levels effectively.

Question 20

The manager observes a graduate nurse teaching a 5-year-old patient with diabetes mellitus. The manager determines that content being instructed is appropriate when the nurse states, "Insulin acts like:

Accepted Answer

Insulin is a hormone that helps transport glucose (sugar) from the bloodstream into the cells of the body where it can be used for energy. Comparing insulin to a wagon that carries sugar into the cells is an appropriate analogy that a 5-year-old can understand. Choices A, C, and D are incorrect and can be misleading or confusing for the patient.

Quiz 20: Nursing Care of Patients With Diabetes Mellitus