Quiz
Critical Care Questions Chapter 46
Questions in this quiz (39)
1A client with type 1 diabetes has told the nurse that the client’s most recent urine test for ketones was positive. What is the nurse's most plausible conclusion based on this assessment finding?
- AThe client should withhold the next scheduled dose of insulin.
- BThe client should promptly eat some protein and carbohydrates.
- CThe client's insulin levels are inadequate.
- DThe client would benefit from a dose of metformin.
2A client presents to the clinic reporting symptoms that suggest diabetes. What criteria would support checking blood levels for the diagnosis of diabetes?
- AFasting plasma glucose greater than or equal to 126 mg/dL (7.0 mmol/L)
- BRandom plasma glucose greater than 150 mg/dL (8.3 mmol/L)
- CFasting plasma glucose greater than 116 mg/dL (6.4 mmol/L) on two separate occasions
- DRandom plasma glucose greater than 126 mg/dL (7.0 mmol/L)
3A client newly diagnosed with type 2 diabetes is attending a nutrition class. What general guideline should the nurse teach the clients at this class?
- ALow fat generally indicates low sugar.
- BProtein should constitute 30% to 40% of caloric intake.
- CMost calories should be derived from carbohydrates.
- DAnimal fats should be eliminated from the diet.
4A nurse is providing health education to a teenage client newly diagnosed with type 1 diabetes mellitus, as well as the client’s family. The nurse teaches the client and family nonpharmacologic measures that will decrease the body's need for insulin. What measure provides the greatest impact on glucose reduction?
- AAdequate sleep
- BLow stimulation
- CExercise
- DLow-fat diet
5A nurse is caring for a client with type 1 diabetes. The client's medication administration record includes the administration of regular insulin three times daily. Knowing that the client's lunch tray will arrive at 11:45 AM, when should the nurse administer the client's insulin?
- A10:45 AM
- B11:30 AM
- C11:45 AM
- D11:50 AM
6A client has just been diagnosed with type 2 diabetes. The health care provider has prescribed an oral antidiabetic agent that will inhibit the production of glucose by the liver and thereby aid in the control of blood glucose. What type of oral antidiabetic agent did the health care provider prescribe for this client?
- AA sulfonylurea
- BA biguanide
- CA thiazolidinedione
- DAn alpha-glucosidase inhibitor
7A diabetes nurse educator is teaching a group of clients with type 1 diabetes about "sick day rules." What guideline applies to periods of illness in a diabetic client?
- ADo not eliminate insulin when nauseated and vomiting.
- BReport elevated glucose levels greater than 150 mg/dL (8.3 mmol/L).
- CEat three substantial meals a day, if possible.
- DReduce food intake and insulin doses in times of illness.
8The nurse is discussing macrovascular complications of diabetes with a client. The nurse would address what topic during this dialogue?
- AThe need for frequent eye examinations for clients with diabetes
- BThe fact that clients with diabetes have an elevated risk of myocardial infarction
- CThe relationship between kidney function and blood glucose levels
- DThe need to monitor urine for the presence of albumin
9A school nurse is teaching a group of high school students about risk factors for diabetes. What action has the greatest potential to reduce an individual's risk for developing diabetes?
- AHave blood glucose levels checked annually.
- BStop using tobacco in any form.
- CUndergo eye examinations regularly.
- DLose weight, if obese.
10A teenage client is brought to the emergency department with symptoms of hyperglycemia. Based on the fact that the pancreatic beta cells are being destroyed, the client would be diagnosed with what type of diabetes?
- AType 1 diabetes
- BType 2 diabetes
- CNon–insulin-dependent diabetes
- DPrediabetes
11A client newly diagnosed with type 2 diabetes has been told by their family that they can no longer consume alcohol. The client asks the nurse if abstaining from all alcohol is necessary. What is the nurse’s best response?
- A“You should stop all alcohol intake. Alcohol is absorbed by your body before other important nutrients and may lead to very high blood glucose levels.”
- B"You do not need to give up alcohol entirely but there are potential side effects specific to clients with diabetes that you should consider.”
- C“You should no longer consume alcohol since it causes immediate low blood glucose levels in diabetic clients.”
- D“You can still consume alcohol, but limit your consumption to no more than 3 glasses of wine or beer daily because of the high sugar content of alcohol.”
12An occupational health nurse is screening a group of workers for diabetes. What statement should the nurse interpret as being suggestive of diabetes?
- A"I've always been a fan of sweet foods, but lately I'm turned off by them."
- B"Lately, I drink and drink and can't seem to quench my thirst."
- C"No matter how much sleep I get, it seems to take me hours to wake up."
- D"When I went to the washroom the last few days, my urine smelled odd."
13A diabetes educator is teaching a client about type 2 diabetes. The educator recognizes that the client understands the primary treatment for type 2 diabetes when the client states:
- A"I read that a pancreas transplant will provide a cure for my diabetes."
- B"I will take my oral antidiabetic agents when my morning blood sugar is high."
- C"I will make sure to follow the weight loss plan designed by the dietitian."
- D"I will make sure I call the diabetes educator when I have questions about my insulin."
14A diabetes nurse educator is presenting current recommendations for levels of caloric intake. What are the current recommendations that the nurse would describe?
- A10% of calories from carbohydrates, 50% from fat, and the remaining 40% from protein
- B10% to 20% of calories from carbohydrates, 20% to 30% from fat, and the remaining 50% to 60% from protein
- C20% to 30% of calories from carbohydrates, 50% to 60% from fat, and the remaining 10% to 20% from protein
- D50% to 60% of calories from carbohydrates, 20% to 30% from fat, and the remaining 10% to 20% from protein
15An older adult client with type 2 diabetes is brought to the emergency department by the client’s daughter. The client is found to have a blood glucose level of 600 mg/dL (33.3 mmol/L). The client's daughter reports that the client recently had a gastrointestinal virus and has been confused for the last 3 hours. The diagnosis of hyperglycemic hyperosmolar syndrome (HHS) is made. What nursing action would be a priority?
- AAdministration of antihypertensive medications
- BAdministering sodium bicarbonate intravenously
- CReversing acidosis by administering insulin
- DFluid and electrolyte replacement
16A nurse is caring for a client with type 1 diabetes who is being discharged home tomorrow. What is the best way to assess the client's ability to prepare and self-administer insulin?
- AAsk the client to describe the process in detail.
- BObserve the client drawing up and administering the insulin.
- CProvide a health education session reviewing the main points of insulin delivery.
- DReview the client's first hemoglobin A1C result after discharge.
17The nurse reviews foot care with an older adult client. Why would the nurse feel that foot care is so important to this client?
- AAn older adult client with foot ulcers experiences severe foot pain due to the diabetic polyneuropathy.
- BAvoiding foot ulcers may mean the difference between institutionalization and continued independent living.
- CHypoglycemia is linked with a risk for falls; this risk is elevated in older adults with diabetes.
- DOral antihyperglycemics have the possible adverse effect of decreased circulation to the lower extremities.
18A diabetic educator is discussing "sick day rules" with a newly diagnosed type 1 diabetic. The educator is aware that the client will require further teaching when the client states what?
- A"I will not take my insulin on the days when I am sick, but I will certainly check my blood sugar every 2 hours."
- B"If I cannot eat a meal, I will eat a soft food such as soup, gelatin, or pudding six to eight times a day."
- C"I will call the doctor if I am not able to keep liquids in my body due to vomiting or diarrhea."
- D"I will call the doctor if my blood sugar is over 300 mg/dL (16.6 mmol/L) or if I have ketones in my urine."
19Which of the following clients with type 1 diabetes is most likely to experience adequate glucose control?
- AA client who skips breakfast when the glucose reading is greater than 220 mg/dL (12.3 mmol/L)
- BA client who never deviates from the prescribed dose of insulin
- CA client who adheres closely to a meal plan and meal schedule
- DA client who eliminates carbohydrates from the daily intake
20A pregnant client has been diagnosed with gestational diabetes. The client is shocked by the diagnosis, stating that they are conscientious about their health, and asks the nurse what causes gestational diabetes. The nurse should explain that gestational diabetes is a result of what etiologic factor?
- AIncreased caloric intake during the first trimester
- BChanges in osmolality and fluid balance
- CThe effects of hormonal changes during pregnancy
- DOverconsumption of carbohydrates during the first two trimesters
21A medical nurse is aware of the need to screen specific clients for their risk of hyperglycemic hyperosmolar syndrome (HHS). In what client population does this syndrome most often occur?
- AClients who are obese and who have no known history of diabetes
- BClients with type 1 diabetes and poor dietary control
- CAdolescents with type 2 diabetes and sporadic use of antihyperglycemics
- DMiddle-aged or older people with either type 2 diabetes or no known history of diabetes
22A nurse is caring for a client newly diagnosed with type 1 diabetes. The nurse is educating the client about self-administration of insulin in the home setting. The nurse should teach the client to do what action?
- AAvoid using the same injection site more than once in 2 to 3 weeks.
- BAvoid mixing more than one type of insulin in a syringe.
- CCleanse the injection site thoroughly with alcohol prior to injecting.
- DInject at a 45-degree angle.
23A client with type 2 diabetes normally achieves adequate glycemic control through diet and exercise. Upon being admitted to the hospital for a cholecystectomy, however, the client has required insulin injections on two occasions. The nurse would identify what factor most likely caused this short-term change in treatment?
- AAlterations in bile metabolism and release have likely caused hyperglycemia.
- BStress has likely caused an increase in the client's blood sugar levels.
- CThe client’s efforts did not control the diabetes using nonpharmacologic measures.
- DThe client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars.
24The health care provider has explained to a client that the client has developed diabetic neuropathy in the right foot. Later that day, the client asks the nurse what causes diabetic neuropathy. What would be the nurse's best response?
- A"Research has shown that diabetic neuropathy is caused by fluctuations in blood sugar that have gone on for years."
- B"The cause is not known for sure but it is thought to have something to do with ketoacidosis."
- C"The cause is not known for sure but it is thought to involve elevated blood glucose levels over a period of years."
- D"Research has shown that diabetic neuropathy is caused by a combination of elevated glucose and ketone levels."
25A client with type 2 diabetes has been managing his blood glucose levels using diet and metformin. Following an ordered increase in the client's daily dose of metformin, the nurse should prioritize which of the following assessments?
- AMonitoring the client's neutrophil levels
- BAssessing the client for signs of impaired liver function
- CMonitoring the client's level of consciousness and behavior
- DReviewing the client's creatinine and BUN levels
26A client with a long-standing diagnosis of type 1 diabetes has a history of poor glycemic control. The nurse recognizes the need to assess the client for signs and symptoms of peripheral neuropathy. Peripheral neuropathy constitutes a risk for what nursing diagnosis?
- AInfection
- BAcute pain
- CAcute confusion
- DImpaired urinary elimination
27A client has been brought to the emergency department by paramedics after being found unconscious. The client's MedicAlert bracelet indicates that the client has type 1 diabetes and the client's blood glucose is 22 mg/dL (1.2 mmol/L). The nurse should anticipate what intervention?
- AIV administration of 50% dextrose in water
- BSubcutaneous administration of 10 units of Humalog
- CSubcutaneous administration of 12 to 15 units of regular insulin
- DIV bolus of 5% dextrose in 0.45% NaCl
28A nurse is working for the summer at a camp for adolescents with diabetes. When providing information on the prevention and management of hypoglycemia, what action should the nurse promote?
- AAlways carry a form of fast-acting sugar.
- BPerform exercise prior to eating whenever possible.
- CEat a meal or snack every 8 hours.
- DCheck blood sugar at least every 24 hours.
29A nurse is teaching basic "survival skills" to a client newly diagnosed with type 1 diabetes. What topic should the nurse address?
- ASigns and symptoms of diabetic nephropathy
- BManagement of diabetic ketoacidosis
- CEffects of surgery and pregnancy on blood sugar levels
- DRecognition of hypoglycemia and hyperglycemia
30A nurse is conducting a class on how to self-manage insulin regimens. A client asks how long a vial of insulin can be stored at room temperature before it "goes bad." What would be the nurse's best answer?
- A"If you are going to use up the vial within 1 month, it can be kept at room temperature."
- B"If a vial of insulin will be used up within 21 days, it may be kept at room temperature."
- C"If a vial of insulin will be used up within 2 weeks, it may be kept at room temperature."
- D"If a vial of insulin will be used up within 1 week, it may be kept at room temperature."
31A client has received a diagnosis of type 2 diabetes. The diabetes nurse has made contact with the client and will implement a program of health education. What is the nurse's priority action?
- AEnsure that the client understands the basic pathophysiology of diabetes.
- BIdentify the client's body mass index.
- CTeach the client "survival skills" for diabetes.
- DAssess the client's readiness to learn.
32A student with diabetes reports feeling nervous and hungry. The school nurse assesses the student and finds the child has tachycardia and is diaphoretic with a blood glucose level of 50 mg/dL (2.8 mmol/L). What should the school nurse administer?
- AA combination of protein and carbohydrates, such as a small cup of yogurt
- BTwo teaspoons of sugar dissolved in a cup of apple juice
- CHalf of a cup of juice, followed by cheese and crackers
- DHalf a sandwich with a protein-based filling
33A client with a history of type 1 diabetes has just been admitted to the critical care unit (CCU) for diabetic ketoacidosis. The CCU nurse should prioritize what assessment during the client's initial phase of treatment?
- AMonitoring the client for dysrhythmias
- BMaintaining and monitoring the client's fluid balance
- CAssessing the client's level of consciousness
- DAssessing the client for signs and symptoms of venous thromboembolism
34A client has been living with type 2 diabetes for several years, and the nurse realizes that the client is likely to have minimal contact with the health care system. In order to ensure that the client maintains adequate blood sugar control over the long term, what should the nurse recommend?
- AParticipation in a support group for persons with diabetes
- BRegular consultation of websites that address diabetes management
- CWeekly telephone "check-ins" with an endocrinologist
- DParticipation in clinical trials relating to antihyperglycemics
35A client with type 1 diabetes mellitus is seeing the nurse to review foot care. What would be a priority instruction for the nurse to give the client?
- AExamine feet weekly for redness, blisters, and abrasions.
- BAvoid the use of moisturizing lotions.
- CAvoid hot-water bottles and heating pads.
- DDry feet vigorously after each bath.
36The most recent blood work of a client with a long-standing diagnosis of type 1 diabetes has shown the presence of microalbuminuria. What is the nurse's most appropriate action?
- ATeach the client about actions to slow the progression of nephropathy.
- BEnsure that the client receives a comprehensive assessment of liver function.
- CDetermine whether the client has been using expired insulin.
- DAdminister a fluid challenge and have the test repeated.
37A nurse is assessing a client who has diabetes for the presence of peripheral neuropathy. The nurse should question the client about what sign or symptom that would suggest the possible development of peripheral neuropathy?
- APersistently cold feet
- BPain that does not respond to analgesia
- CAcute pain, unrelieved by rest
- DThe presence of a tingling sensation
38A client with diabetes is asking the nurse what causes diabetic ketoacidosis (DKA). Which of the following is a correct statement by the nurse?
- A"DKA can be caused by taking too much insulin.”
- B"DKA can be caused by taking too little insulin."
- C"DKA can happen without a cause."
- D"DKA will not happen with type 1 diabetes."
39A client is brought to the emergency department. The client is a type 2 diabetic and is experiencing hyperglycemic hyperosmolar syndrome (HHS). The nurse should identify what components of HHS? Select all that apply.
- ALeukocytosis
- BGlycosuria
- CDehydration
- DHypernatremia
- EHyperglycemia
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- Management of Patients with Diabetes
- Author
- Donut Docks-Mii
- Language
- English
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