Chapter 41: Assessment and Management of Patients with Diabetes Mellitus

Chapter 41: Assessment and Management of Patients with Diabetes Mellitus

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Multiple Choice

1. The nursing instructor is discussing diabetes mellitus with the junior nursing class. What would the instructor tell the class may develop in the patient when ketone bodies accumulate in excessive amounts?
2. A) Hypovolemia
3. B) Polyuria
4. C) Diabetic ketoacidosis
5. D) Blurred vision

Ans:  C

Chapter:  41

Client Needs:  D-4

Cognitive Level:  Comprehension

Difficulty:  Easy

Integrated Process:  Teaching/Learning

Objective:  9

Page and Header:  1199, Diabetes

Feedback:  Ketone bodies are acids that disturb the acid-base balance of the body when they accumulate in excessive amounts.  This will result in diabetic ketoacidosis.  Signs and symptoms are abdominal pain, nausea, vomiting hyperventilation, fruity odor of breath, and if left untreated, possible death. Excessive amounts of ketone bodies do not cause hypovolemia, polyuria or blurred vision.

2. A patient presents to the clinic complaining of symptoms that suggest diabetes mellitus. What criteria would support checking blood levels for the diagnosis of diabetes mellitus?
3. A) Fasting plasma glucose greater than or equal to 126 mg/dL
4. B) Random plasma glucose greater than 150 mg/dL
5. C) Fasting plasma glucose greater than 100 mg/dL
6. D) Random plasma glucose greater than 126 mg/dL

Ans:  A

Chapter:  41

Client Needs:  D-4

Cognitive Level:  Analysis

Difficulty:  Difficult

Integrated Process:  Nursing Process

Objective:  4

Page and Header:  1200, Diabetes

Feedback:  Criteria for the diagnosis of diabetes mellitus include symptoms of diabetes plus random plasma glucose greater than or equal to 200 mg/dL, or a fasting plasma glucose greater than or equal to 126 mg/dL. Therefore options B, C, and D are incorrect.

3. A patient newly diagnosed with type 2 diabetes is attending a nutrition class specifically designed for type 2 diabetics. What general guideline would it be important to teach the patients at this class?
4. A) Low fat generally indicates low sugar.
5. B) Protein should constitute 35% of dietary intake.
6. C) Control calorie intake to attain a reasonable body weight.
7. D) Dietary fat should be eliminated from the diet.

Ans:  C

Chapter:  41

Client Needs:  B

Cognitive Level:  Application

Difficulty:  Moderate

Integrated Process:  Teaching/Learning

Objective:  5

Page and Header:  1202, Diabetes

Feedback:  In general, calorie distribution recommended is higher in carbohydrates than in fat and protein, and all carbohydrates should be eaten in moderation to avoid high postprandial blood glucose levels. The most important objective in the dietary management of diabetes is control of total calorie intake to attain or maintain reasonable body weight. Low fat does not automatically mean low sugar. Dietary fat does not need to be eliminated from the diet. Protein intake needs to keep calories within a reasonable amount.

4. The nurse is doing patient teaching with an adolescent newly diagnosed with type 1 diabetes mellitus and her family. The nurse teaches the patient and family that what will decrease the body’s need for insulin?
5. A) Sleep
6. B) Stress
7. C) Exercise
8. D) Low-fat diet

Ans:  C

Chapter:  41

Client Needs:  B

Cognitive Level:  Application

Difficulty:  Moderate

Integrated Process:  Teaching/Learning

Objective:  6

Page and Header:  1205, Diabetes

Feedback:  Exercise lowers blood glucose, increases levels of HDLs, and decreases total cholesterol and triglyceride levels.  Stress increases the need for insulin. Insulin is generally taken to cover what is eaten at each meal. Sleep impacts the need for insulin because many patients forget to take their insulin dose prior to going to sleep.

5. The nurse is teaching a newly diagnosed diabetic about his insulin regimen. When administering Humalog insulin the nurse should teach the patient what?
6. A) Have the patient’s meal tray available.
7. B) Have the patient begin the meal tray 30 minutes following the injection.
8. C) Feed the patient prior to administering the dose of insulin.
9. D) Watch for symptoms of hyperglycemia.

Ans:  A

Chapter:  41

Client Needs:  D-2

Cognitive Level:  Analysis

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  7

Page and Header:  1209, Diabetes

Feedback:  Humalog’s onset of action is 10 to 15 minutes. Because of its rapid action, patients should be instructed not to wait the usual 30 minutes after injection to eat. You do not feed a patient before administering insulin. You always assess for symptoms of hyperglycemia