Chapter 44; Coordinating Care for Patients with Diabetes Mellitus Flashcards

A 40-year old patient is surprised to learn of the diagnosis of type 1 diabetes mellitus. What is the nurse's best response?
a. "It is odd because it is usually a disease of childhood."
b. "It means that something has destroyed your pancreas."
c. "Type 1 diabetes mellitus can occur at any stage of life."
d. "It usually means that another disease process is present."

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?
a. Autoimmune process
b. Cancer of the pancreas
c. Alteration in lipid and protein utilization
d. Malfunction of carbohydrate metabolism

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?
a. "You need to schedule this test for first thing in the morning."
b. "You can have this test drawn at any time during the day."
c. "Avoid eating and drinking anything after midnight the day before the test."
d. "Restrict the intake of red meat for 3 days before having the test."

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?
a. Less than or equal to 8%
b. Less than or equal to 6.5%
c. Greater than or equal to 6.5%
d. Greater than or equal to 8.5%

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?
a. U-30
b. U-50
c. U-100
d. U-500

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?
a. "The pump is worn continuously."
b. "The pump is more convenient for you."
c. "The pump provides more precise dosages of insulin."
d. "The pump provides better control of your blood sugar."

A patient with type 1 diabetes mellitus will be self-monitoring blood glucose levels at home. What the minimum number of measurements that this patient should make each day?
a. 1
b. 3
c. 4
d. 8

The nurse correlates which assessment findings to a patient experiencing diabetic ketoacidosis?
a. Slow heart rate
b. Deep rapid respirations
c. Decreased urine output
d. Increased blood pressure

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?
a. Diuretic
b. Calcium
c. Antibiotic
d. Potassium

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?
a. Raise glycemic targets.
b. Cut the insulin dose in half.
c. Add an extra snack to the meal plan.
d. Eliminate the evening dose of insulin.

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)?
a. "I will eat a cracker."
b. "I will drink a diet soda."
c. "I will eat some ice cream."
d. "I will drink a cup of whole milk."

A patient with type 1 diabetes mellitus is experiencing elevated blood glucose levels in the morning. Which action is indicated to address this complication?
a. Change the evening insulin dose.
b. Restrict oral fluids after 1800 hours.
c. Measure blood glucose at 0200 hours.
d. Limit carbohydrate intake to 45 g with evening meal.

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:

a. Partially compensated metabolic acidosis
b. Fully compensated metabolic acidosis
c. Partially compensated respiratory alkalosis
d. Fully compensated respiratory alkalosis

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?
a. Holding all prandial doses
b. Considering increasing longer-acting insulin
c. Increasing the frequency of correctional doses
d. Administering prandial and correctional insulin together

The nurse is evaluating teaching provided to a patient with type 1 diabetes mellitus. Which patient observation indicates that medication teaching has been effective?
a. Uses a 1 mL syringe to measure insulin dose
b. Places a new injection an inch away from previous injection site
c. Inserts the needle at a 25-degree angle before injecting the medication
d. Provides an injection in the thigh after an abdominal injection in the morning

Which patient statement indicates to the nurse the need for further teaching regarding the new diagnosis of type 1 diabetes mellitus (DM)?
a. "I will need to take medication by mouth until my blood sugar is within normal
limits again."
b. "The things that I eat may impact the dose of my medication used to control my
blood glucose."
c. "If I get the flu, the dose of my insulin may need to be altered to control my blood
glucose."
d. "I will monitor my blood glucose to help determine whether my medication is
working as anticipated."

Which statement best describes the pathophysiology of type 2 diabetes mellitus?
a. There is an absolute lack of insulin.
b. The cells resist glucose from entering.
c. Pancreatic cells stop producing insulin.
d. An autoimmune disorder damages pancreatic cells.

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?
a. Nausea
b. Diarrhea
c. Dry mouth
d. Decreased appetite

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?
a. Biguanides
b. Meglitinides
c. Sulfonylureas
d. Alpha-glucosidase inhibitors

What does the nurse teach the patient with type 1 diabetes mellitus to do in advance of playing tennis?
a. Drink 1 L of fluid.
b. Measure blood glucose level.
c. Eat one serving of carbohydrate.
d. Take a dose of prescribed medication.

A patient with type 2 diabetes mellitus is being evaluated for hyperosmolar hyperglycemic state (HHS). The nurse correlates which finding with this medical diagnosis?
a. pH 7.31
b. Diaphoresis
c. Blood glucose 250 mg/dL
d. Serum bicarbonate 28 mEq/L

The nurse correlates which clinical manifestation in a patient with type 2 diabetes mellitus (DM) with macrovascular complications?
a. Chest pain
b. Sight impairment
c. Gingival hyperplasia
d. Chronic kidney failure

The nurse suspects that a patient with type 2 diabetes mellitus is experiencing autonomic neuropathy. What did the nurse assess to make this clinical determination?
a. Bloating
b. Foot pain
c. Tingling of the fingers
d. Numbness of the lower legs

During a home visit by the nurse with a patient with type 2 diabetes mellitus, which observation of the patient indicates the need for further teaching?
a. Exercising with a treadmill
b. Walking barefoot in the backyard
c. Eating one-half apple and cheese for a snack
d. Stated a weight loss of 2 lbs. over the last month

The nurse monitors for which clinical manifestations in the patient diagnosed with type 1 diabetes mellitus? Select all that apply.
a. Weight gain
b. Sweating
c. Extreme hunger
d. Excessive thirst
e. Large volume of urine output

A patient is having testing to diagnose type 1 diabetes mellitus. Which diagnostic tests might be prescribed for this patient? Select all that apply.
a. Hemoglobin A1c
b. 2-hour postprandial
c. Serum triglycerides
d. Fasting blood glucose
e. Random blood glucose

The nurse provides education to a patient who is diagnosed with type 1 diabetes mellitus (DM). Which patient statements indicate the need for additional teaching regarding self-monitoring of blood glucose? Select all that apply.

a. "I will check my blood glucose daily before meals and at bedtime."
b. "I will monitor my blood glucose levels more frequently when I have the flu."
c. "I don't need to document the results of my blood glucose if it is within the normal limits."
d. "Because I am using an insulin pump, I don't need to check my blood glucose as often as before."
e. "Because my fasting blood glucose levels are consistent with my A1c, I don't need to increase the frequency of monitoring my glucose."

The nurse correlates which assessment findings as modifiable risk factors for developing type 2 diabetes mellitus? Select all that apply.
a. Serum triglycerides 200 mg/dL
b. Sedentary lifestyle
c. Body mass index 29
d. Blood pressure 140/90 mm Hg
e. HDL less than 25 mg/dL

The nurse monitors for which clinical manifestations in the patient diagnosed with type 2 diabetes mellitus? Select all that apply.
a. Fatigue
b. Muscle cramps
c. Visual disturbances
d. Poor wound healing
e. Recurrent infections

The nurse understands that type 1 DM is caused by which of the following conditions? (Select all that apply.)
A. Gestational diabetes
B. A history of mumps or rubella
C. Family history of autoimmune disorders
D. Autoimmune destruction of the beta cells of the pancreas
E. Obesity

The nurse monitors for which clinical manifestations in the patient newly diagnosed with type 1 DM? (Select all that apply.)
A. Polyuria
B. Fatigue
C. Weight loss
D. Polyphagia
E Decreased appetite