Med Surg- Chapter 48 : Diabetes Mellitus
f9 f9 f9 f9 f9 f9
1.f9Whichf9statementf9byf9af9nursef9tof9af9patientf9newlyf9diagnosedf9withf9type
f92f9diabetesf9isf9accurate?
a.f9Insulinf9isf9notf9usedf9tof9controlf9bloodf9glucosef9inf9patientsf9withf9typef92f9
diabetes.
b.f9Complicationsf9off9typef92f9diabetesf9aref9lessf9seriousf9thanf9thosef9off9type
f91f9diabetes.
c.f9Changesf9inf9dietf9andf9exercisef9mayf9controlf9bloodf9glucosef9levelsf9inf9t
ypef92f9diabetes.
d.f9Typef92f9diabetesf9isf9usuallyf9diagnosedf9whenf9af9patientf9isf9admittedf9inf9
hyperglycemic
coma.f9-f9correctf9answer✔ ✔ ANS:f9C
Forf9somef9patientsf9withf9typef92f9diabetes,f9changesf9inf9lifestylef9aref9suffici
entf9tof9achievef9blood
glucosef9control.f9Insulinf9isf9frequentlyf9usedf9forf9typef92f9diabetes,f9compli
cationsf9aref9equally
severef9asf9forf9typef91f9diabetes,f9andf9typef92f9diabetesf9isf9usuallyf9diagnosed
f9withf9routinef9laboratory
testingf9orf9afterf9af9patientf9developsf9complicationsf9suchf9asf9frequentf9yeas
tf9infections.
2.f9Af9patientf9screenedf9forf9diabetesf9atf9af9clinicf9hasf9af9fastingf9plasmaf9glu
cosef9levelf9off9120f9mg/dL
,(6.7f9mmol/L).f9Whatf9shouldf9thef9nursef9planf9tof9teachf9thef9patient?
a.f9Self-monitoringf9off9bloodf9glucose
b.f9Usingf9lowf9dosesf9off9regularf9insulin
c.f9Lifestylef9changesf9tof9lowerf9bloodf9glucose
d.f9Effectsf9off9oralf9hypoglycemicf9medicationsf9-f9correctf9answer✔ ✔
ANS:f9C
Thef9patient'sf9impairedf9fastingf9glucosef9indicatesf9prediabetes,f9andf9thef9p
atientf9shouldf9be
counseledf9aboutf9lifestylef9changesf9tof9preventf9thef9developmentf9off9typef9
2f9diabetes.f9Thef9patient
withf9prediabetesf9doesf9notf9requiref9insulinf9orf9oralf9hypoglycemicsf9forf9gl
ucosef9controlf9andf9does
notf9needf9tof9self-monitorf9bloodf9glucose.
3.f9Af928-yr-
oldf9malef9patientf9withf9typef91f9diabetesf9reportsf9howf9hef9managesf9hisf9exe
rcisef9and
glucosef9control.f9Whichf9behaviorf9indicatesf9thatf9thef9nursef9shouldf9imple
mentf9additional
teaching?
a.f9Thef9patientf9alwaysf9carriesf9hardf9candiesf9whenf9engagingf9inf9exercise.
b.f9Thef9patientf9goesf9forf9af9vigorousf9walkf9whenf9hisf9glucosef9isf9200f9mg/
dL.
,c.f9Thef9patientf9hasf9af9peanutf9butterf9sandwichf9beforef9goingf9forf9af9bicycle
f9ride.
d.f9Thef9patientf9increasesf9dailyf9exercisef9whenf9ketonesf9aref9presentf9inf9th
ef9urine.f9-f9correctf9answer✔ ✔ ANS:f9D
Whenf9thef9patientf9isf9ketotic,f9exercisef9mayf9resultf9inf9anf9increasef9inf9bloo
df9glucosef9level.f9Patients
withf9typef91f9diabetesf9shouldf9bef9taughtf9tof9avoidf9exercisef9whenf9ketosisf9
isf9present.f9Thef9other
statementsf9aref9correct.
4.f9Thef9nursef9isf9assessingf9af922-yr-
oldf9patientf9experiencingf9thef9onsetf9off9symptomsf9off9typef91
diabetes.f9Tof9whichf9questionf9wouldf9thef9nursef9anticipatef9af9positivef9resp
onse?
a.f9"Aref9youf9anorexic?"
b.f9"Isf9yourf9urinef9darkf9colored?"
c.f9"Havef9youf9lostf9weightf9lately?"
d.f9"Dof9youf9cravef9sugaryf9drinks?"f9-f9correctf9answer✔ ✔ ANS:f9C
Weightf9lossf9occursf9becausef9thef9bodyf9isf9nof9longerf9ablef9tof9absorbf9gluc
osef9andf9startsf9tof9break
downf9proteinf9andf9fatf9forf9energy.f9Thef9patientf9isf9thirstyf9butf9doesf9notf9n
ecessarilyf9crave
, sugar-
containingf9fluids.f9Increasedf9appetitef9isf9af9classicf9symptomf9off9typef91f9di
abetes.f9Withf9the
classicf9symptomf9off9polyuria,f9urinef9willf9bef9veryf9dilute.
5.f9Af9patientf9withf9typef92f9diabetesf9isf9scheduledf9forf9af9follow-
upf9visitf9inf9thef9clinicf9severalf9months
fromf9now.f9Whichf9testf9willf9thef9nursef9schedulef9tof9evaluatef9thef9effective
nessf9off9treatmentf9forf9the
patient?
a.f9Fastingf9bloodf9glucose
b.f9Glycosylatedf9hemoglobin
c.f9Oralf9glucosef9tolerancef9test
d.f9Urinef9dipstickf9forf9glucosef9andf9ketonesf9-f9correctf9answer✔ ✔
ANS:f9B
Thef9glycosylatedf9hemoglobinf9(A1C)f9testf9showsf9thef9overallf9controlf9off9
glucosef9overf990f9tof9120
days.f9Af9fastingf9bloodf9levelf9indicatesf9onlyf9thef9glucosef9levelf9atf9onef9tim
e.f9Urinef9glucosef9testing
isf9notf9anf9accuratef9reflectionf9off9bloodf9glucosef9levelf9andf9doesf9notf9refle
ctf9thef9glucosef9overf9a
prolongedf9time.f9Oralf9glucosef9tolerancef9testingf9isf9donef9tof9diagnosef9dia
betesf9butf9isf9notf9usedf9for
monitoringf9glucosef9controlf9afterf9diabetesf9hasf9beenf9diagnosed.
f9 f9 f9 f9 f9 f9
1.f9Whichf9statementf9byf9af9nursef9tof9af9patientf9newlyf9diagnosedf9withf9type
f92f9diabetesf9isf9accurate?
a.f9Insulinf9isf9notf9usedf9tof9controlf9bloodf9glucosef9inf9patientsf9withf9typef92f9
diabetes.
b.f9Complicationsf9off9typef92f9diabetesf9aref9lessf9seriousf9thanf9thosef9off9type
f91f9diabetes.
c.f9Changesf9inf9dietf9andf9exercisef9mayf9controlf9bloodf9glucosef9levelsf9inf9t
ypef92f9diabetes.
d.f9Typef92f9diabetesf9isf9usuallyf9diagnosedf9whenf9af9patientf9isf9admittedf9inf9
hyperglycemic
coma.f9-f9correctf9answer✔ ✔ ANS:f9C
Forf9somef9patientsf9withf9typef92f9diabetes,f9changesf9inf9lifestylef9aref9suffici
entf9tof9achievef9blood
glucosef9control.f9Insulinf9isf9frequentlyf9usedf9forf9typef92f9diabetes,f9compli
cationsf9aref9equally
severef9asf9forf9typef91f9diabetes,f9andf9typef92f9diabetesf9isf9usuallyf9diagnosed
f9withf9routinef9laboratory
testingf9orf9afterf9af9patientf9developsf9complicationsf9suchf9asf9frequentf9yeas
tf9infections.
2.f9Af9patientf9screenedf9forf9diabetesf9atf9af9clinicf9hasf9af9fastingf9plasmaf9glu
cosef9levelf9off9120f9mg/dL
,(6.7f9mmol/L).f9Whatf9shouldf9thef9nursef9planf9tof9teachf9thef9patient?
a.f9Self-monitoringf9off9bloodf9glucose
b.f9Usingf9lowf9dosesf9off9regularf9insulin
c.f9Lifestylef9changesf9tof9lowerf9bloodf9glucose
d.f9Effectsf9off9oralf9hypoglycemicf9medicationsf9-f9correctf9answer✔ ✔
ANS:f9C
Thef9patient'sf9impairedf9fastingf9glucosef9indicatesf9prediabetes,f9andf9thef9p
atientf9shouldf9be
counseledf9aboutf9lifestylef9changesf9tof9preventf9thef9developmentf9off9typef9
2f9diabetes.f9Thef9patient
withf9prediabetesf9doesf9notf9requiref9insulinf9orf9oralf9hypoglycemicsf9forf9gl
ucosef9controlf9andf9does
notf9needf9tof9self-monitorf9bloodf9glucose.
3.f9Af928-yr-
oldf9malef9patientf9withf9typef91f9diabetesf9reportsf9howf9hef9managesf9hisf9exe
rcisef9and
glucosef9control.f9Whichf9behaviorf9indicatesf9thatf9thef9nursef9shouldf9imple
mentf9additional
teaching?
a.f9Thef9patientf9alwaysf9carriesf9hardf9candiesf9whenf9engagingf9inf9exercise.
b.f9Thef9patientf9goesf9forf9af9vigorousf9walkf9whenf9hisf9glucosef9isf9200f9mg/
dL.
,c.f9Thef9patientf9hasf9af9peanutf9butterf9sandwichf9beforef9goingf9forf9af9bicycle
f9ride.
d.f9Thef9patientf9increasesf9dailyf9exercisef9whenf9ketonesf9aref9presentf9inf9th
ef9urine.f9-f9correctf9answer✔ ✔ ANS:f9D
Whenf9thef9patientf9isf9ketotic,f9exercisef9mayf9resultf9inf9anf9increasef9inf9bloo
df9glucosef9level.f9Patients
withf9typef91f9diabetesf9shouldf9bef9taughtf9tof9avoidf9exercisef9whenf9ketosisf9
isf9present.f9Thef9other
statementsf9aref9correct.
4.f9Thef9nursef9isf9assessingf9af922-yr-
oldf9patientf9experiencingf9thef9onsetf9off9symptomsf9off9typef91
diabetes.f9Tof9whichf9questionf9wouldf9thef9nursef9anticipatef9af9positivef9resp
onse?
a.f9"Aref9youf9anorexic?"
b.f9"Isf9yourf9urinef9darkf9colored?"
c.f9"Havef9youf9lostf9weightf9lately?"
d.f9"Dof9youf9cravef9sugaryf9drinks?"f9-f9correctf9answer✔ ✔ ANS:f9C
Weightf9lossf9occursf9becausef9thef9bodyf9isf9nof9longerf9ablef9tof9absorbf9gluc
osef9andf9startsf9tof9break
downf9proteinf9andf9fatf9forf9energy.f9Thef9patientf9isf9thirstyf9butf9doesf9notf9n
ecessarilyf9crave
, sugar-
containingf9fluids.f9Increasedf9appetitef9isf9af9classicf9symptomf9off9typef91f9di
abetes.f9Withf9the
classicf9symptomf9off9polyuria,f9urinef9willf9bef9veryf9dilute.
5.f9Af9patientf9withf9typef92f9diabetesf9isf9scheduledf9forf9af9follow-
upf9visitf9inf9thef9clinicf9severalf9months
fromf9now.f9Whichf9testf9willf9thef9nursef9schedulef9tof9evaluatef9thef9effective
nessf9off9treatmentf9forf9the
patient?
a.f9Fastingf9bloodf9glucose
b.f9Glycosylatedf9hemoglobin
c.f9Oralf9glucosef9tolerancef9test
d.f9Urinef9dipstickf9forf9glucosef9andf9ketonesf9-f9correctf9answer✔ ✔
ANS:f9B
Thef9glycosylatedf9hemoglobinf9(A1C)f9testf9showsf9thef9overallf9controlf9off9
glucosef9overf990f9tof9120
days.f9Af9fastingf9bloodf9levelf9indicatesf9onlyf9thef9glucosef9levelf9atf9onef9tim
e.f9Urinef9glucosef9testing
isf9notf9anf9accuratef9reflectionf9off9bloodf9glucosef9levelf9andf9doesf9notf9refle
ctf9thef9glucosef9overf9a
prolongedf9time.f9Oralf9glucosef9tolerancef9testingf9isf9donef9tof9diagnosef9dia
betesf9butf9isf9notf9usedf9for
monitoringf9glucosef9controlf9afterf9diabetesf9hasf9beenf9diagnosed.
