Chapter 67: Care of Patients with Diabetes Mellitus

Chapter 67: Care of Patients with Diabetes Mellitus

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. In preparing a staff in-service presentation about diabetes mellitus, the nurse includes which information?

a.	Diabetes increases the risk for development of epilepsy.
b.	The cure for diabetes is the administration of insulin.
c.	Diabetes increases the risk for development of cardiovascular disease.
d.	Carbohydrate metabolism is altered in diabetes, but protein metabolism is normal.

 

 

ANS:  C

Diabetes mellitus is a major risk factor for morbidity and mortality caused by coronary artery disease, cerebrovascular disease, and peripheral vascular disease. Insulin is a lifelong treatment for some diabetic clients. Because insulin regulates the metabolism of carbohydrates, fats, and protein, abnormalities in insulin production or use alter their metabolism.

 

DIF:    Cognitive Level: Knowledge/Remembering                       REF:   p. 1411

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Nursing Process (Assessment)

 

2. A client with diabetes asks the nurse why it is necessary to maintain blood glucose levels no lower than about 60 mg/dL. Which is the nurse’s best response?

a.	“Glucose is the only fuel used by the body to produce the energy that it needs.”
b.	“Your brain needs a constant supply of glucose because it cannot store it.”
c.	“Without a minimum level of glucose, your body does not make red blood cells.”
d.	“Glucose in the blood prevents the formation of lactic acid and prevents acidosis.”

 

 

ANS:  B

Because the brain cannot synthesize or store significant amounts of glucose, a continuous supply from the body’s circulation is needed to meet the fuel demands of the central nervous system. The other statements are not accurate.

 

DIF:    Cognitive Level: Comprehension/Understanding               REF:   p. 1411

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Teaching/Learning

 

3. The nurse is monitoring a client with hypoglycemia. Glucagon provides which function?

a.	It enhances the activity of insulin, restoring blood glucose levels to normal more quickly after a high-calorie meal.
b.	It is a storage form of glucose and can be broken down for energy when blood glucose levels are low.
c.	It converts excess glucose into glycogen, lowering blood glucose levels in times of excess.
d.	It prevents hypoglycemia by promoting release of glucose from liver storage sites.

 

 

ANS:  D

Glycogen is a counterregulatory hormone secreted by the alpha cells of the pancreas when blood glucose levels are low. The actions of glycogen that raise blood glucose levels include stimulating the liver to break down glycogen (glycogenolysis) and forming new glucose from protein breakdown (gluconeogenesis). The other statements are not accurate descriptions of the actions of glucagon.

 

DIF:    Cognitive Level: Knowledge/Remembering                       REF:   p. 1412

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Nursing Process (Analysis)

 

4. A client with untreated diabetes mellitus has polyuria, is lethargic, and has a blood glucose of 560 mg/dL. The nurse correlates the polyuria with which finding?

a.	Serum sodium, 163 mEq/L
b.	Serum creatinine, 1.6 mg/dL
c.	Presence of urine ketone bodies
d.	Serum osmolarity, 375 mOsm/kg

 

 

ANS:  D

Hyperglycemia causes hyperosmolarity of extracellular fluid. This leads to polyuria from an osmotic diuresis. The client’s serum osmolarity is high. The client’s sodium would be expected to be high owing to dehydration. Urine ketone bodies and serum creatinine are not related to the polyuria.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Nursing Process (Analysis)