Chapter 49: Nursing Management: Diabetes Mellitus

Chapter 49: Nursing Management: Diabetes Mellitus

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. A patient with newly diagnosed type 2 diabetes mellitus asks the nurse what “type 2”
means in relation to diabetes. Which statement by the nurse about type 2 diabetes is
correct?
a. Insulin is not used to control blood glucose in patients with type 2 diabetes.
b. Complications of type 2 diabetes are less serious than those of type 1 diabetes.
c. Type 2 diabetes is usually diagnosed when the patient is admitted with a
hyperglycemic coma.
d. Changes in diet and exercise may be sufficient to control blood glucose levels in
type 2 diabetes.
ANS: D
For some patients, changes in lifestyle are sufficient for blood glucose control. Insulin is
frequently used for type 2 diabetes, complications are equally severe as for type 1
diabetes, and type 2 diabetes is usually diagnosed with routine laboratory testing or after
a patient develops complications such as frequent yeast infections.
DIF: Cognitive Level: Comprehension REF: 1221-1222
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
2. A patient screened for diabetes at a clinic has a fasting plasma glucose level of 120
mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about
a. self-monitoring of blood glucose.
b. use of low doses of regular insulin.
c. lifestyle changes to lower blood glucose.
d. effects of oral hypoglycemic medications.
ANS: C
The patient’s impaired fasting glucose indicates prediabetes and the patient should be
counseled about lifestyle changes to prevent the development of type 2 diabetes. The
patient with prediabetes does not require insulin or the oral hypoglycemics for glucose
control and does not need to self-monitor blood glucose.
DIF: Cognitive Level: Application REF: 1221 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
3. Which action by a type 1 diabetic patient indicates that the nurse should implement
teaching about exercise and glucose control?
a. The patient always carries hard candies when engaging in exercise.
b. The patient goes for a vigorous walk when the glucose is 200 mg/dL.
Test Bank 49-2
c. The patient has a peanut butter sandwich before going for a bicycle ride.
d. The patient increases daily exercise when ketones are present in the urine.
ANS: D
When the patient is ketotic, exercise may result in an increase in blood glucose level.
Type 1 diabetic patients should be taught to avoid exercise when ketosis is present. The
other statements are correct.
DIF: Cognitive Level: Application REF: 1233
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
4. When assessing the patient experiencing the onset of symptoms of type 1 diabetes, which
question is most appropriate for the nurse to ask?
a. “Have you lost any weight lately?”
b. “How long have you felt anorexic?”
c. “Is your urine unusually dark colored?”
d. “Do you crave fluids containing sugar?”
ANS: A
Weight loss occurs because the body is no longer able to absorb glucose and starts to
break down protein and fat for energy. The patient is thirsty but does not necessarily
crave sugar-containing fluids. Increased appetite is a classic symptom of type 1 diabetes.
With the classic symptom of polyuria, urine will be very dilute.
DIF: Cognitive Level: Application REF: 1222
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
5. To evaluate the effectiveness of treatment for a patient with type 2 diabetes who is
scheduled for a follow-up visit in the clinic, which test will the nurse plan to schedule for
the patient?
a. Urine dipstick for glucose
b. Oral glucose tolerance test
c. Fasting blood glucose level
d. Glycosylated hemoglobin level
ANS: D
The glycosylated hemoglobin (Hb A1C) test shows the overall control of glucose over 90
to 120 days. A fasting blood level indicates only the glucose level at one time. Urine
glucose testing is not an accurate reflection of blood glucose level and does not reflect the
glucose over a prolonged time. Oral glucose tolerance testing is done to diagnose
diabetes, but is not used for monitoring glucose control once diabetes has been
diagnosed.
DIF: Cognitive Level: Application REF: 1223 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity