MED-SURG EXAM 1 (DIABETES)
EXAM QUESTIONS ANSWERS
1.8nAn8n18-year-old8nfemale8nclient,8n5′4′
′8ntall,8nweighing8n1138nkg,8ncomes8nto8nthe8nclinic8nfor8na8nnonhealing8nwound8non8n
her8nlower8nleg,8nwhich8nshe8nhas8nhad8nfor8ntwo8n(2)8nweeks.8nWhich8ndisease8npro
cess8nshould8nthe8nnurse8nsuspect8nthe8nclient8nhas8ndeveloped?
1.8nType8n18ndiabetes.
2.8nType8n28ndiabetes.
3.8nGestational8ndiabetes.
4.8nAcanthosis8nnigricans.8n-8nANSWERS--2.8nCORRECT8n-
8nType8n28ndiabetes8nis8na8ndisorder8nusually8noccurring8n
8naround8nthe8nage8nof8n40,8nbut8nit8nis8nnow8nbeing8ndetected8nin8nchildren8nand8nyo
ung8nadults8nas8na8nresult8nof8nobesity8nand8nsedentary8nlifestyles.8nNonhealing8nwo
unds8nare8na8nhallmark8nsign8nof8ntype8n28ndiabetes.8nThis8nclient8nweighs8n248.68np
ounds8nand8nis8nshort.
1.8nINCORRECT8n-
8nType8n18ndiabetes8nusually8noccurs8nin8nyoung8nclients8nwho8nare8nunderweight.8nI
n8nthis8ndisease,8nthere8nis8nno8nproduction8nof8ninsulin8nfrom8nthe8nbeta8ncells8nin8nt
he8npancreas.8nPeople8nwith8ntype8n18ndiabetes8nare8ninsulin8ndependent8nwith8na8nr
apid8nonset8nof8nsymptoms,8nincluding8npolyuria,8npolydipsia,8nand8npolyphagia.
3.8nINCORRECT8n-8nGestational8ndiabetes8noccurs8nduring8npregnancy.
4.8nINCORRECT8n-
8nAcanthosis8nnigricans8n(AN),8ndark8npigmentation8nand8nskin8ncreases8nin8nthe8nne
ck,8nis8na8nsign8nof8nhyperinsulinemia.8nThe8npancreas8nis8nsecreting8nexcess8namou
nts8nof8ninsulin8nas8na8nresult8nof8nexcessive8ncaloric8nintake.8nIt8nis8nidentified8nin8ny
oung8nchildren8nand8nis8na8nprecursor8nto8nthe8ndevelopment8nof8ntype8n28ndiabetes.
TEST-
TAKING8nHINT:8nThe8ntest8ntaker8nmust8nbe8naware8nof8nkilograms8nand8npounds.8n
The8nstem8nis8nasking8nabout8na8ndisease8nprocess8nand8nacanthosis8nnigricans8nis8n
a8nclinical8nmanifestation8nof8na8ndisease,8nnot8na8ndisease8nitself.8nTherefore,8nthe8nt
est8ntaker8nshould8nnot8nselect8nthis8nas8na
correct8nanswer.
2.8nThe8nclient8ndiagnosed8nwith8ntype8n18ndiabetes8nhas8na8nglycosylated8nhemoglo
bin8n(A1c)8nof8n8.1%.8nWhich8ninterpretation8nshould8nthe8nnurse8nmake8nbased8non8
nthis8nresult?
1.8nThis8nresult8nis8nbelow8nnormal8nlevels.
2.8nThis8nresult8nis8nwithin8nacceptable8nlevels.
3.8nThis8nresult8nis8nabove8nrecommended8nlevels.
,4.8nThis8nresult8nis8ndangerously8nhigh.8n-8nANSWERS--3.8nCORRECT8n-
8nThis8nresult8nparallels8na8nserum8nblood8nglucose8nlevel8nof8napproximately8n1808nt
o
2008nmg/
dL.8nAn8nA1c8nis8na8nblood8ntest8nreflecting8naverage8nblood8nglucose8nlevels8nover8n
a8nperiod8nof8nthree8n(3)8nmonths;8nclients8nwith
elevated8nblood8nglucose8nlevels8nare8nat8nrisk8nfor8ndeveloping8nlong-
term8ncomplications.
1.8nINCORRECT8n-
8nThe8nacceptable8nlevel8nfor8nan8nA1c8nfor8na8nclient8nwith8ndiabetes8nis8nbetween8n
6%8nand8n7%,8nwhich8ncorresponds8nto8na8n120-8nto8n140-mg/
dL8naverage8nblood8nglucose8nlevel.
2.8nINCORRECT8n-
8nThis8nresult8nis8nnot8nwithin8nacceptable8nlevels8nfor8nthe8nclient8nwith8ndiabetes,8nw
hich8nis8n6%8nto8n7%.
4.8nINCORRECT8n-8nAn8nA1c8nof8n13%8nis8ndangerously8nhigh;8nit8nreflects8na8n300-
mg/dL8naverage8nblood8nglucose8nlevel8nover8nthe8npast8n38nmonths.
TEST-
TAKING8nHINT:8nThe8ntest8ntaker8nmust8nknow8nnormal8nand8nabnormal8ndiagnostic8
nlaboratory8nvalues.8nLaboratory8nvalues8nvary
depending8non8nwhich8nlaboratory8nperforms8nthe8ntest.
3.8nThe8nnurse8nadministered8n288nunits8nof8nHumulin8nN,8nan8nintermediate-
acting8ninsulin,8nto8na8nclient8ndiagnosed8nwith8ntype8n18ndiabetes8nat8n1600.8nWhich8
nintervention8nshould8nthe8nnurse8nimplement?
1.8nEnsure8nthe8nclient8neats8nthe8nbedtime8nsnack.
2.8nDetermine8nhow8nmuch8nfood8nthe8nclient8nate8nat8nlunch.
3.8nPerform8na8nglucometer8nreading8nat8n0700.
4.8nOffer8nthe8nclient8nprotein8nafter8nadministering8ninsulin.8n-8nANSWERS--
1.8nCORRECT8n-
8nHumulin8nN8npeaks8nin8n68nto8n88nhours,8nmaking8nthe8nclient8nat8nrisk8nfor8nhypogl
ycemia8naround8nmidnight,8nwhich8nis8nwhy8nthe8nclient8nshould8nreceive8na8nbedtime
8nsnack.
This8nsnack8nwill8nprevent8nnighttime
hypoglycemia.
2.8nINCORRECT8n-
8nThe8nfood8nintake8nat8nlunch8nwill8nnot8naffect8nthe8nclient's8nblood8nglucose8nlevel8n
at8nmidnight.
3.8nINCORRECT8n-
8nThe8nclient's8nglucometer8nreading8nshould8nbe8ndone8naround8n21008nto8nassess8n
the8neffectiveness8nof8ninsulin8nat8n1600.
, 4.8nINCORRECT8n-8nOnset8nof8nHumulin8nN,8nan8nintermediate-
acting8ninsulin,8nis8n28nto8n48nhours8nbut8nit8ndoes8nnot8npeak8nuntil8n68nto8n88nhours.
TEST-
TAKING8nHINT:8nRemember8nto8nlook8nat8nthe8nadjective8nor8ndescriptor.8nIntermedi
ateacting8ninsulin8nprovides8nthe8nreader8na8nclue:8nanything8nwith8nintermediate8nact
ion,8ninstead8nof8nlonger8nacting,8nis8nincorrect.
4.8nThe8nclient8ndiagnosed8nwith8ntype8n18ndiabetes8nis8nreceiving8nHumalog,8na8nrap
id-
acting8ninsulin,8nby8nsliding8nscale.8nThe8norder8nreads8nblood8nglucose8nlevel:8n<150
,8nzero8n(0)8nunits;8n1518nto8n200,8nthree8n(3)8nunits;8n2018nto8n250,8nsix8n(6)8nunits;8n
>251,8ncontact8nhealth-
care8nprovider.8nThe8nunlicensed8nassistive8npersonnel8n(UAP)8nreports8nto8nthe8nnur
se8nthe8nclient's8nglucometer8nreading8nis8n189.8nHow8nmuch8ninsulin8nshould8nthe8nn
urse8nadminister8nto8nthe8nclient?8n-8nANSWERS--
Three8n(3)8nunits.8nThe8nclient's8nresult8nis8n189,8nwhich8nis8nbetween8n1518nand8n20
0,8nso8nthe8nnurse8nshould8nadminister8n38nunits8nof8nHumalog8ninsulin8nsubcutaneou
sly.
TEST-
TAKING8nHINT:8nThe8ntest8ntaker8nmust8nbe8naware8nof8nthe8nway8nthe8nHCPs8nwrit
e8nmedication8norders.8nHCPs8norder8ninsulin8non8na8nsliding8nscale8naccording8nto8n
a8nrange8nof8nblood8nglucose8nlevels.
5.8nThe8nnurse8nis8ndiscussing8nthe8nimportance8nof8nexercising8nwith8na8nclient8ndiag
nosed8nwith8ntype8n28ndiabetes8nwhose8ndiabetes8nis8nwell8ncontrolled8nwith8ndiet8nan
d8nexercise.8nWhich8ninformation8nshould8nthe8nnurse8ninclude8nin8nthe8nteaching8nab
out8ndiabetes?
1.8nEat8na8nsimple8ncarbohydrate8nsnack8nbefore8nexercising.
2.8nCarry8npeanut8nbutter8ncrackers8nwhen8nexercising.
3.8nEncourage8nthe8nclient8nto8nwalk8n208nminutes8nthree8n(3)8ntimes8na8nweek.
4.8nPerform8nwarmup8nand8ncool-down8nexercises.8n-8nANSWERS--4.8nCORRECT8n-
8nAll8nclients8nwho8nexercise8nshould8nperform8nwarmup8nand8ncool-
down8nexercises8nto8nhelp8nprevent8nmuscle8nstrain8nand8ninjury.
1.8nINCORRECT8n-
8nThe8nclient8ndiagnosed8nwith8ntype8n28ndiabetes8nwho8nis8nnot8ntaking8ninsulin8nor8n
oral8nagents8ndoes8nnot8nneed8nextra8nfood8nbefore8nexercise.
2.8nINCORRECT8n-
8nThe8nclient8nwith8ndiabetes8nwho8nis8nat8nrisk8nfor8nhypoglycemia8nwhen8nexercisin
g8nshould8ncarry8na8nsimple8ncarbohydrate,8nbut8nthis8nclient8nis8nnot8nat8nrisk8nfor8nh
ypoglycemia.
3.8nINCORRECT8n-
8nClients8nwith8ndiabetes8ncontrolled8nby8ndiet8nand8nexercise8nmust8nexercise8ndaily8
nat8nthe8nsame8ntime8nand8nin8nthe8nsame8namount8nto8ncontrol8nthe8nglucose8nlevel.
EXAM QUESTIONS ANSWERS
1.8nAn8n18-year-old8nfemale8nclient,8n5′4′
′8ntall,8nweighing8n1138nkg,8ncomes8nto8nthe8nclinic8nfor8na8nnonhealing8nwound8non8n
her8nlower8nleg,8nwhich8nshe8nhas8nhad8nfor8ntwo8n(2)8nweeks.8nWhich8ndisease8npro
cess8nshould8nthe8nnurse8nsuspect8nthe8nclient8nhas8ndeveloped?
1.8nType8n18ndiabetes.
2.8nType8n28ndiabetes.
3.8nGestational8ndiabetes.
4.8nAcanthosis8nnigricans.8n-8nANSWERS--2.8nCORRECT8n-
8nType8n28ndiabetes8nis8na8ndisorder8nusually8noccurring8n
8naround8nthe8nage8nof8n40,8nbut8nit8nis8nnow8nbeing8ndetected8nin8nchildren8nand8nyo
ung8nadults8nas8na8nresult8nof8nobesity8nand8nsedentary8nlifestyles.8nNonhealing8nwo
unds8nare8na8nhallmark8nsign8nof8ntype8n28ndiabetes.8nThis8nclient8nweighs8n248.68np
ounds8nand8nis8nshort.
1.8nINCORRECT8n-
8nType8n18ndiabetes8nusually8noccurs8nin8nyoung8nclients8nwho8nare8nunderweight.8nI
n8nthis8ndisease,8nthere8nis8nno8nproduction8nof8ninsulin8nfrom8nthe8nbeta8ncells8nin8nt
he8npancreas.8nPeople8nwith8ntype8n18ndiabetes8nare8ninsulin8ndependent8nwith8na8nr
apid8nonset8nof8nsymptoms,8nincluding8npolyuria,8npolydipsia,8nand8npolyphagia.
3.8nINCORRECT8n-8nGestational8ndiabetes8noccurs8nduring8npregnancy.
4.8nINCORRECT8n-
8nAcanthosis8nnigricans8n(AN),8ndark8npigmentation8nand8nskin8ncreases8nin8nthe8nne
ck,8nis8na8nsign8nof8nhyperinsulinemia.8nThe8npancreas8nis8nsecreting8nexcess8namou
nts8nof8ninsulin8nas8na8nresult8nof8nexcessive8ncaloric8nintake.8nIt8nis8nidentified8nin8ny
oung8nchildren8nand8nis8na8nprecursor8nto8nthe8ndevelopment8nof8ntype8n28ndiabetes.
TEST-
TAKING8nHINT:8nThe8ntest8ntaker8nmust8nbe8naware8nof8nkilograms8nand8npounds.8n
The8nstem8nis8nasking8nabout8na8ndisease8nprocess8nand8nacanthosis8nnigricans8nis8n
a8nclinical8nmanifestation8nof8na8ndisease,8nnot8na8ndisease8nitself.8nTherefore,8nthe8nt
est8ntaker8nshould8nnot8nselect8nthis8nas8na
correct8nanswer.
2.8nThe8nclient8ndiagnosed8nwith8ntype8n18ndiabetes8nhas8na8nglycosylated8nhemoglo
bin8n(A1c)8nof8n8.1%.8nWhich8ninterpretation8nshould8nthe8nnurse8nmake8nbased8non8
nthis8nresult?
1.8nThis8nresult8nis8nbelow8nnormal8nlevels.
2.8nThis8nresult8nis8nwithin8nacceptable8nlevels.
3.8nThis8nresult8nis8nabove8nrecommended8nlevels.
,4.8nThis8nresult8nis8ndangerously8nhigh.8n-8nANSWERS--3.8nCORRECT8n-
8nThis8nresult8nparallels8na8nserum8nblood8nglucose8nlevel8nof8napproximately8n1808nt
o
2008nmg/
dL.8nAn8nA1c8nis8na8nblood8ntest8nreflecting8naverage8nblood8nglucose8nlevels8nover8n
a8nperiod8nof8nthree8n(3)8nmonths;8nclients8nwith
elevated8nblood8nglucose8nlevels8nare8nat8nrisk8nfor8ndeveloping8nlong-
term8ncomplications.
1.8nINCORRECT8n-
8nThe8nacceptable8nlevel8nfor8nan8nA1c8nfor8na8nclient8nwith8ndiabetes8nis8nbetween8n
6%8nand8n7%,8nwhich8ncorresponds8nto8na8n120-8nto8n140-mg/
dL8naverage8nblood8nglucose8nlevel.
2.8nINCORRECT8n-
8nThis8nresult8nis8nnot8nwithin8nacceptable8nlevels8nfor8nthe8nclient8nwith8ndiabetes,8nw
hich8nis8n6%8nto8n7%.
4.8nINCORRECT8n-8nAn8nA1c8nof8n13%8nis8ndangerously8nhigh;8nit8nreflects8na8n300-
mg/dL8naverage8nblood8nglucose8nlevel8nover8nthe8npast8n38nmonths.
TEST-
TAKING8nHINT:8nThe8ntest8ntaker8nmust8nknow8nnormal8nand8nabnormal8ndiagnostic8
nlaboratory8nvalues.8nLaboratory8nvalues8nvary
depending8non8nwhich8nlaboratory8nperforms8nthe8ntest.
3.8nThe8nnurse8nadministered8n288nunits8nof8nHumulin8nN,8nan8nintermediate-
acting8ninsulin,8nto8na8nclient8ndiagnosed8nwith8ntype8n18ndiabetes8nat8n1600.8nWhich8
nintervention8nshould8nthe8nnurse8nimplement?
1.8nEnsure8nthe8nclient8neats8nthe8nbedtime8nsnack.
2.8nDetermine8nhow8nmuch8nfood8nthe8nclient8nate8nat8nlunch.
3.8nPerform8na8nglucometer8nreading8nat8n0700.
4.8nOffer8nthe8nclient8nprotein8nafter8nadministering8ninsulin.8n-8nANSWERS--
1.8nCORRECT8n-
8nHumulin8nN8npeaks8nin8n68nto8n88nhours,8nmaking8nthe8nclient8nat8nrisk8nfor8nhypogl
ycemia8naround8nmidnight,8nwhich8nis8nwhy8nthe8nclient8nshould8nreceive8na8nbedtime
8nsnack.
This8nsnack8nwill8nprevent8nnighttime
hypoglycemia.
2.8nINCORRECT8n-
8nThe8nfood8nintake8nat8nlunch8nwill8nnot8naffect8nthe8nclient's8nblood8nglucose8nlevel8n
at8nmidnight.
3.8nINCORRECT8n-
8nThe8nclient's8nglucometer8nreading8nshould8nbe8ndone8naround8n21008nto8nassess8n
the8neffectiveness8nof8ninsulin8nat8n1600.
, 4.8nINCORRECT8n-8nOnset8nof8nHumulin8nN,8nan8nintermediate-
acting8ninsulin,8nis8n28nto8n48nhours8nbut8nit8ndoes8nnot8npeak8nuntil8n68nto8n88nhours.
TEST-
TAKING8nHINT:8nRemember8nto8nlook8nat8nthe8nadjective8nor8ndescriptor.8nIntermedi
ateacting8ninsulin8nprovides8nthe8nreader8na8nclue:8nanything8nwith8nintermediate8nact
ion,8ninstead8nof8nlonger8nacting,8nis8nincorrect.
4.8nThe8nclient8ndiagnosed8nwith8ntype8n18ndiabetes8nis8nreceiving8nHumalog,8na8nrap
id-
acting8ninsulin,8nby8nsliding8nscale.8nThe8norder8nreads8nblood8nglucose8nlevel:8n<150
,8nzero8n(0)8nunits;8n1518nto8n200,8nthree8n(3)8nunits;8n2018nto8n250,8nsix8n(6)8nunits;8n
>251,8ncontact8nhealth-
care8nprovider.8nThe8nunlicensed8nassistive8npersonnel8n(UAP)8nreports8nto8nthe8nnur
se8nthe8nclient's8nglucometer8nreading8nis8n189.8nHow8nmuch8ninsulin8nshould8nthe8nn
urse8nadminister8nto8nthe8nclient?8n-8nANSWERS--
Three8n(3)8nunits.8nThe8nclient's8nresult8nis8n189,8nwhich8nis8nbetween8n1518nand8n20
0,8nso8nthe8nnurse8nshould8nadminister8n38nunits8nof8nHumalog8ninsulin8nsubcutaneou
sly.
TEST-
TAKING8nHINT:8nThe8ntest8ntaker8nmust8nbe8naware8nof8nthe8nway8nthe8nHCPs8nwrit
e8nmedication8norders.8nHCPs8norder8ninsulin8non8na8nsliding8nscale8naccording8nto8n
a8nrange8nof8nblood8nglucose8nlevels.
5.8nThe8nnurse8nis8ndiscussing8nthe8nimportance8nof8nexercising8nwith8na8nclient8ndiag
nosed8nwith8ntype8n28ndiabetes8nwhose8ndiabetes8nis8nwell8ncontrolled8nwith8ndiet8nan
d8nexercise.8nWhich8ninformation8nshould8nthe8nnurse8ninclude8nin8nthe8nteaching8nab
out8ndiabetes?
1.8nEat8na8nsimple8ncarbohydrate8nsnack8nbefore8nexercising.
2.8nCarry8npeanut8nbutter8ncrackers8nwhen8nexercising.
3.8nEncourage8nthe8nclient8nto8nwalk8n208nminutes8nthree8n(3)8ntimes8na8nweek.
4.8nPerform8nwarmup8nand8ncool-down8nexercises.8n-8nANSWERS--4.8nCORRECT8n-
8nAll8nclients8nwho8nexercise8nshould8nperform8nwarmup8nand8ncool-
down8nexercises8nto8nhelp8nprevent8nmuscle8nstrain8nand8ninjury.
1.8nINCORRECT8n-
8nThe8nclient8ndiagnosed8nwith8ntype8n28ndiabetes8nwho8nis8nnot8ntaking8ninsulin8nor8n
oral8nagents8ndoes8nnot8nneed8nextra8nfood8nbefore8nexercise.
2.8nINCORRECT8n-
8nThe8nclient8nwith8ndiabetes8nwho8nis8nat8nrisk8nfor8nhypoglycemia8nwhen8nexercisin
g8nshould8ncarry8na8nsimple8ncarbohydrate,8nbut8nthis8nclient8nis8nnot8nat8nrisk8nfor8nh
ypoglycemia.
3.8nINCORRECT8n-
8nClients8nwith8ndiabetes8ncontrolled8nby8ndiet8nand8nexercise8nmust8nexercise8ndaily8
nat8nthe8nsame8ntime8nand8nin8nthe8nsame8namount8nto8ncontrol8nthe8nglucose8nlevel.
