The nurse is providing instructions about foot care for a client with diabetes mellitus. What should the nurse include in the instructions? . Select all that apply.
- Wear shoes when out of bed.
- Soak the feet in warm water daily.
- Dry between the toes after bathing.
- Remove corns as soon as they appear.
- Use a heating pad when the feet feel cold.
A. Wear shoes when out of bed.
C. Dry between the toes after bathing.
Which statement by a client with type 2 diabetes indicates to the nurse that additional dietary teaching is needed?
- "I can eat as much dietetic fruit as I want."
- "I can have a lettuce salad whenever I want it."
- "I know that half of my diet should be carbohydrates."
- "I need to reduce the amounts of saturated fats in my diet."
A. "I can eat as much dietetic fruit as I want."
The nurse is caring for a client newly diagnosed with diabetes. What symptom of hypoglycemia is most common and should be taught to the client?
- Kussmaul respirations
While obtaining the client’s health history, which factor does the nurse identify that predisposes the client to type 2 diabetes?
- Having diabetes insipidus
- Eating low-cholesterol foods
- Being 20 pounds (9 kilograms) overweight
- Drinking a daily alcoholic beverage
C. Being 20 pounds (9 kilograms) overweight
A client with type 2 diabetes has been receiving insulin in the hospital while being treated for sepsis. The client's infection is resolving, and the primary healthcare provider writes a prescription to discontinue the 7:00 AM dose of insulin and to administer glyburide 5 mg twice daily (8:00 AM and 8:00 PM). The nurse on the day shift (8:00 AM to 4:00 PM) administers the glyburide at 8:30 AM. When recording its administration in the client's record, the nurse sees that the insulin had already been administered at 7:00 AM. What initial action should the nurse take?
- Measure the vital signs.
- Notify the primary healthcare provider.
- Assess for signs of ketoacidosis.
- Check blood glucose for hypoglycemia.
D. Check blood glucose for hypoglycemia.
The nurse is counseling a client with type 1 diabetes about the client's favorite foods that are lowest in carbohydrates (CHO). Which food choice picked by the client determines that teaching was effective?
- Skim milk
- Apple juice
- Nonfat yogurt
- Fresh orange juice
A. Skim milk
A nurse is caring for two clients newly diagnosed with diabetes. One client has type 1 diabetes, and the other client has type 2 diabetes. When determining the main difference between type 1 and type 2 diabetes, the nurse recognizes what clinical presentation about type 1?
- Onset of the disease is slow.
- Excessive weight is a contributing factor.
- Complications are not present at the time of diagnosis.
- Treatment involves diet, exercise, and oral medications.
C. Complications are not present at the time of diagnosis.
A nurse is caring for an older client who had non-insulin dependent diabetes for 15 years that progressed to insulin-dependent diabetes 2 years ago. What common complications of diabetes should the nurse assess for when examining this client? Select all that apply.
- Leg ulcers
- Loss of visual acuity
- Increased creatinine clearance
- Prolonged capillary refill in the toes
- Decreased sensation in the lower extremities
A. Leg ulcers
B. Loss of visual acuity
D. Prolonged capillary refill in the toes
E. Decreased sensation in the lower extremities
A nurse is caring for a client who has a 20-year history of type 2 diabetes. The nurse should assess for what physiologic changes associated with a long history of diabetes?
- Blurry, spotty, or hazy vision
- Arthritic changes in the hands
- Hyperactive knee and ankle jerk reflexes
- Dependent pallor of the feet and lower legs
A. Blurry, spotty, or hazy vision
A nurse is formulating a teaching plan for a client recently diagnosed with type 2 diabetes. What interventions should the nurse include to decrease the risk of complications? . Select all that apply.
- Examine the feet daily
- Wear well-fitting shoes
- Perform regular exercise
- Powder the feet after showering
- Visit the primary healthcare provider weekly
- Test bathwater with the toes before bathing
A. Examine the feet daily
B. Wear well-fitting shoes
C. Wear well-fitting shoes
The health care provider prescribes one tube of glucose gel for the client with type 1 diabetes. The nurse recognizes that this is for treatment of which diabetes complication?
- Diabetic acidosis
- Hyperinsulin secretion
- Insulin-induced hypoglycemia
- Idiosyncratic reactions to insulin
C. Insulin-induced hypoglycemia
The nurse knows that the newborns of mothers with diabetes often exhibit tremors, periods of apnea, cyanosis, and poor suckling ability. With which complication are these signs associated?
- Central nervous system edema
- Congenital depression of the islets of Langerhans
The nurse is explaining insulin needs to a client with gestational diabetes who is in her second trimester of pregnancy. Which information should the nurse give to this client?
- Insulin needs will increase during the second trimester.
- Insulin needs will decrease during the second trimester.
- Insulin needs will not change during the second trimester.
- Insulin will be switched to an oral antidiabetic medication during the second trimester.
A. Insulin needs will increase during the second trimester.
A client is diagnosed with type 2 diabetes, and the health care provider prescribes an oral hypoglycemic. For what side effect should the nurse teach this client to monitor?
- Weight loss
- Low blood sugar
D. Low blood sugar
A client with diabetes mellitus complains of difficulty seeing. What would the nurse suspect as the causative factor?
- Lack of glucose in the retina
- The growth of new retina blood vessels or “neovascularization”
- Inadequate glucose supply to rods and cones
- Destructive effect of ketones on retinal metabolism
B. The growth of new retina blood vessels or “neovascularization”
A client with type 1 diabetes has an above-the-knee amputation because of severe lower extremity arterial disease. What is the nurse's primary responsibility two days after surgery when preparing the client to eat dinner?
- Checking the client's serum glucose level
- Assisting the client out of bed into a chair
- Placing the client in the high-Fowler position
- Ensuring the client's residual limb is elevated
A. Checking the client's serum glucose level
A 14-year-old adolescent with diabetes has been self-administering insulin twice a day. This morning the parents found their child lethargic and confused. After the adolescent’s admission to the emergency department, laboratory testing reveals a hemoglobin A1c level of 10% and a blood glucose level of 200 mg/dL (11.1 mmol/L). What does the nurse suspect as the most likely cause of this client’s condition?
- Somogyi effect
- Uncontrolled blood glucose level
- Noncompliance with the prescribed insulin regimen
C. Uncontrolled blood glucose level
A 10-year-old child with recently diagnosed type 2 diabetes attends the Center for Diabetic Teaching with the parents. The nurse interviews the child before the class begins. What is the priority concern diabetic children usually have?
- How much school might be missed
- Whether the diabetes can be controlled
- How the parents will react to the diagnosis
- Whether having diabetes means future sterility
A. How much school might be missed
During a diabetes mellitus campaign, the community nurse is assessing different clients. Which client should be treated first?
- Client A – A1C% 5.6; Fasting Plasma GL 100 mg/dL; Two Hour Plasma GL 150 mg/dL
- Client B – A1C% 6.8; Fasting Plasma GL 130 mg/dL; Two Hour Plasma GL 200 mg/dL
- Client C – A1C% 6.0; Fasting Plasma GL 120 mg/dL; Two Hour Plasma GL 130 mg/dL
- Client D – A1C% 6.1; Fasting Plasma GL 100 mg/dL; Two Hour Plasma GL 140 mg/dL
B. Client B – A1C% 6.8; Fasting Plasma GL 130 mg/dL; Two Hour Plasma GL 200 mg/dL
The nurse develops a teaching plan for a client with diabetes who has been diagnosed with lower extremity arterial disease (LEAD). What measures should the nurse include to increase arterial blood flow to the extremities?
- Exercises that promote muscular activity
- Meticulous care of minor skin breakdown
- Elevation of the legs above the level of the heart
- Soaking the feet in hot water each day
A. Exercises that promote muscular activity