Which laboratory value would cause the nurse to include prediabetes in the patient's plan of
care?
a. Hemoglobin A1c of 7%
d. Two-hour postprandial of 145 mg/dL
b. Fasting blood glucose of 150 mg/dL
c. Random blood glucose of 205 mg/dL
d. Two-hour postprandial of 145 mg/dL
In which patient groups may the risk of maintaining tighter glucose control outweigh the
benefits? Select all that apply.
a. School-age children c. Patients with renal disease
b. Older adult patients d. Patients with limited life expectancy
c. Patients with renal disease e. Patients with heart disease
d. Patients with limited life expectancy
e. Patients with heart disease
Which clinical manifestations should the nurse assess for when providing care to a patient
diagnosed with hyperosmolar hyperglycemic state? Select all that apply.
a. Serum osmolality of 320 mOsm/kg or greater
a. Serum osmolality of 320 mOsm/kg or greater
b. Positive urine ketones
e. Blood glucose of 600 mg/dL or greater
c. Arterial pH less than 7.3
d. Blood glucose less than 250 mg/dL
e. Blood glucose of 600 mg/dL or greater
Which statement made by a patient diagnosed with type 2 diabetes mellitus indicates correct
understanding of the prescribed foot care regimen?
a. "I will apply cream between my toes every day."
c. "I will make an appointment with a podiatrist to have my toenails clipped."
b. "I will soak my feet every day to decrease the risk for ulceration."
c. "I will make an appointment with a podiatrist to have my toenails clipped."
d. "I will increase the temperature of my hot water heater to greater than 130 degrees."
A patient is diagnosed with metabolic syndrome. Which topic should the nurse include in the
teaching session for this patient?
a. Diabetic ketoacidosis
c. Type 2 diabetes mellitus
b. Type 1 diabetes mellitus
c. Type 2 diabetes mellitus
d. Gestational diabetes mellitus
a. Triggered by an autoimmune process
d. Prescribed insulin included in the treatment plan
Type 1 DM e. Diabetic ketoacidosis (DKA) is a known complication
a. Triggered by an autoimmune process f. More common in children
b. Associated with insulin resistance
c. Treated with oral hypoglycemic agents Rationale: Type 1 DM is typically triggered by an autoimmune process in which the in-
d. Prescribed insulin included in the treatment plan sulin-producing beta cells of the pancreas are destroyed, resulting in an absolute lack of
e. Diabetic ketoacidosis (DKA) is a known complication insulin. This process is usually rapid, with a total insulin deficiency occurring within 1 year.
f. More common in children This results in the need for lifelong insulin delivered via injection or pump. Type 1 DM more
commonly occurs in children. A known complication of type 1 DM is DKA. Type 2 DM is
associated with insulin resistance and is treated with oral hypoglycemic agents.
a. Involves insulin resistance
c. Prescribed oral hypoglycemic agents included in treatment plan
Type 2 DM
d. Hyperosmolar hyperglycemic state (HHS) is a known complication
a. Involves insulin resistance
f. Prediabetes is a warning sign
b. Initially treated with prescribed insulin
Rationale: Type 2 DM involves defects at the cell membrane that prevent the normal action of
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, insulin. Even though insulin is present, the cells resist its ettorts to transport glucose into the
cell. This results in insulin resistance that requires an increased level of insulin to drive glucose
c. Prescribed oral hypoglycemic agents included in treatment plan
into the cells. Prediabetes is a warning sign of type 2 DM. Prescribed oral hypoglycemic agents
d. Hyperosmolar hyperglycemic state (HHS) is a known complication
are included in the treatment plan for a patient who is diagnosed with type 2 DM. A known
e. Diagnosed most often during the early school-age stage of development
complication for type 2 DM is HHS. While a patient diagnosed with type 2 DM may require
f. Prediabetes is a warning sign
exogenous insulin delivery to maintain normal blood glucose levels as the disease progresses,
this is not the initial treatment. Diagnosis of type 1, not type 2, DM occurs during childhood.
b. May result from increased need for insulin due to illness
e. Treatment includes insulin administration
Diabetic Ketoacidosis (DKA) f. Treatment includes correction of electrolyte imbalances
a. Often caused by a new diagnosis of type 2 DM
b. May result from increased need for insulin due to illness Rationale: With DKA, the cells lack enough insulin to obtain adequate glucose for normal
c. Increases risk for hypervolemia metabolism. It is often caused by an increased need for insulin due to illness, infection, or
d. Diagnosed when the blood glucose level is >200 mg/dL stress. Treatment includes insulin administration and correction of electrolyte imbalances,
e. Treatment includes insulin administration especially potassium and sodium. Potassium imbalances place the patient at risk for lethal
f. Treatment includes correction of electrolyte imbalances cardiac arrhythmias. A new diagnosis of type 1, not type 2, DM can also cause DKA. The patient
is at risk for hypovolemia, not hypervolemia, due to osmotic diuresis that occurs. A diagnosis
of DKA is not made until the blood glucose level is greater than 250, not 200, mg/dL.
b. Characterized by hyperglycemia and hyperosmolarity
c. Blood glucose levels can rise to extremes above 600 mg/dL
Hyperosmolar Hyperglycemic State (HHS) d. Often causes global neurological deficits
a. A more common complication for DM than DKA e. Treatment includes intravenous (IV) fluid and IV insulin
b. Characterized by hyperglycemia and hyperosmolarity
c. Blood glucose levels can rise to extremes above 600 mg/dL Rationale: HHS is a serious metabolic derangement that most commonly occurs in older
d. Often causes global neurological deficits adult patients diagnosed with type 2 DM. Clinical manifestations often include blood glucose
e. Treatment includes intravenous (IV) fluid and IV insulin levels that rise above 600 mg/dL along with global neurological deficits. Treatment for HHS
f. Characterized by dehydration and ketoacidosis includes IV fluid and IV insulin. HHS is characterized by hyperglycemia, hyperosmolarity, and
dehydration without ketoacidosis. DKA, not HHS, is the more common complication associated
with DM.
a. Administer subcutaneous insulin in the abdomen, deltoid, thigh, and buttock
c. Rotate injection sites
e. Symptoms of hypoglycemia include feeling anxious and shaky
f. Symptoms of hyperglycemia include feeling thirsty and fatigued
Patient Teaching for Type 1 DM
a. Administer subcutaneous insulin in the abdomen, deltoid, thigh, and buttock Rationale: Patients who are diagnosed with type 1 DM require specific teaching to self-man-
b. Take oral hypoglycemic agents as prescribed age the disease and avoid complications. You should teach the patient to administer insulin
c. Rotate injection sites subcutaneously in areas that provide the best absorption, including the abdomen, deltoid,
d. Larger patients should use a 45-degree angle to administer insulin thigh, and buttocks. You should also teach the patient to rotate the injection sites to decrease
e. Symptoms of hypoglycemia include feeling anxious and shaky the risk of tissue damage. It is important for the patient to know the symptoms of both
f. Symptoms of hyperglycemia include feeling thirsty and fatigued hypo- and hyperglycemia. Hypoglycemia is demonstrated with feelings of anxiety, hunger,
palpitations, circumoral paresthesia, sweating, shakiness, and irritability. Hyperglycemia, on
the other hand, is demonstrated with polyphagia, polydipsia, polyuria, fatigue, and weight
loss. Oral hypoglycemic agents are not ettective in treating type 1 DM but are ettective in the
treatment of type 2 DM.
b. Check blood glucose levels via finger stick as prescribed
Patient Teaching for Type 2 DM c. Reduce food intake and increase physical activity
a. Adjust oral hypoglycemic medication based on daily glucose level d. Distribute carbohydrates evenly throughout the day with meals
b. Check blood glucose levels via finger stick as prescribed e. Strive for a goal HgbA1c of less than 7%
c. Reduce food intake and increase physical activity f. Monitor for complications of DM
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care?
a. Hemoglobin A1c of 7%
d. Two-hour postprandial of 145 mg/dL
b. Fasting blood glucose of 150 mg/dL
c. Random blood glucose of 205 mg/dL
d. Two-hour postprandial of 145 mg/dL
In which patient groups may the risk of maintaining tighter glucose control outweigh the
benefits? Select all that apply.
a. School-age children c. Patients with renal disease
b. Older adult patients d. Patients with limited life expectancy
c. Patients with renal disease e. Patients with heart disease
d. Patients with limited life expectancy
e. Patients with heart disease
Which clinical manifestations should the nurse assess for when providing care to a patient
diagnosed with hyperosmolar hyperglycemic state? Select all that apply.
a. Serum osmolality of 320 mOsm/kg or greater
a. Serum osmolality of 320 mOsm/kg or greater
b. Positive urine ketones
e. Blood glucose of 600 mg/dL or greater
c. Arterial pH less than 7.3
d. Blood glucose less than 250 mg/dL
e. Blood glucose of 600 mg/dL or greater
Which statement made by a patient diagnosed with type 2 diabetes mellitus indicates correct
understanding of the prescribed foot care regimen?
a. "I will apply cream between my toes every day."
c. "I will make an appointment with a podiatrist to have my toenails clipped."
b. "I will soak my feet every day to decrease the risk for ulceration."
c. "I will make an appointment with a podiatrist to have my toenails clipped."
d. "I will increase the temperature of my hot water heater to greater than 130 degrees."
A patient is diagnosed with metabolic syndrome. Which topic should the nurse include in the
teaching session for this patient?
a. Diabetic ketoacidosis
c. Type 2 diabetes mellitus
b. Type 1 diabetes mellitus
c. Type 2 diabetes mellitus
d. Gestational diabetes mellitus
a. Triggered by an autoimmune process
d. Prescribed insulin included in the treatment plan
Type 1 DM e. Diabetic ketoacidosis (DKA) is a known complication
a. Triggered by an autoimmune process f. More common in children
b. Associated with insulin resistance
c. Treated with oral hypoglycemic agents Rationale: Type 1 DM is typically triggered by an autoimmune process in which the in-
d. Prescribed insulin included in the treatment plan sulin-producing beta cells of the pancreas are destroyed, resulting in an absolute lack of
e. Diabetic ketoacidosis (DKA) is a known complication insulin. This process is usually rapid, with a total insulin deficiency occurring within 1 year.
f. More common in children This results in the need for lifelong insulin delivered via injection or pump. Type 1 DM more
commonly occurs in children. A known complication of type 1 DM is DKA. Type 2 DM is
associated with insulin resistance and is treated with oral hypoglycemic agents.
a. Involves insulin resistance
c. Prescribed oral hypoglycemic agents included in treatment plan
Type 2 DM
d. Hyperosmolar hyperglycemic state (HHS) is a known complication
a. Involves insulin resistance
f. Prediabetes is a warning sign
b. Initially treated with prescribed insulin
Rationale: Type 2 DM involves defects at the cell membrane that prevent the normal action of
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, insulin. Even though insulin is present, the cells resist its ettorts to transport glucose into the
cell. This results in insulin resistance that requires an increased level of insulin to drive glucose
c. Prescribed oral hypoglycemic agents included in treatment plan
into the cells. Prediabetes is a warning sign of type 2 DM. Prescribed oral hypoglycemic agents
d. Hyperosmolar hyperglycemic state (HHS) is a known complication
are included in the treatment plan for a patient who is diagnosed with type 2 DM. A known
e. Diagnosed most often during the early school-age stage of development
complication for type 2 DM is HHS. While a patient diagnosed with type 2 DM may require
f. Prediabetes is a warning sign
exogenous insulin delivery to maintain normal blood glucose levels as the disease progresses,
this is not the initial treatment. Diagnosis of type 1, not type 2, DM occurs during childhood.
b. May result from increased need for insulin due to illness
e. Treatment includes insulin administration
Diabetic Ketoacidosis (DKA) f. Treatment includes correction of electrolyte imbalances
a. Often caused by a new diagnosis of type 2 DM
b. May result from increased need for insulin due to illness Rationale: With DKA, the cells lack enough insulin to obtain adequate glucose for normal
c. Increases risk for hypervolemia metabolism. It is often caused by an increased need for insulin due to illness, infection, or
d. Diagnosed when the blood glucose level is >200 mg/dL stress. Treatment includes insulin administration and correction of electrolyte imbalances,
e. Treatment includes insulin administration especially potassium and sodium. Potassium imbalances place the patient at risk for lethal
f. Treatment includes correction of electrolyte imbalances cardiac arrhythmias. A new diagnosis of type 1, not type 2, DM can also cause DKA. The patient
is at risk for hypovolemia, not hypervolemia, due to osmotic diuresis that occurs. A diagnosis
of DKA is not made until the blood glucose level is greater than 250, not 200, mg/dL.
b. Characterized by hyperglycemia and hyperosmolarity
c. Blood glucose levels can rise to extremes above 600 mg/dL
Hyperosmolar Hyperglycemic State (HHS) d. Often causes global neurological deficits
a. A more common complication for DM than DKA e. Treatment includes intravenous (IV) fluid and IV insulin
b. Characterized by hyperglycemia and hyperosmolarity
c. Blood glucose levels can rise to extremes above 600 mg/dL Rationale: HHS is a serious metabolic derangement that most commonly occurs in older
d. Often causes global neurological deficits adult patients diagnosed with type 2 DM. Clinical manifestations often include blood glucose
e. Treatment includes intravenous (IV) fluid and IV insulin levels that rise above 600 mg/dL along with global neurological deficits. Treatment for HHS
f. Characterized by dehydration and ketoacidosis includes IV fluid and IV insulin. HHS is characterized by hyperglycemia, hyperosmolarity, and
dehydration without ketoacidosis. DKA, not HHS, is the more common complication associated
with DM.
a. Administer subcutaneous insulin in the abdomen, deltoid, thigh, and buttock
c. Rotate injection sites
e. Symptoms of hypoglycemia include feeling anxious and shaky
f. Symptoms of hyperglycemia include feeling thirsty and fatigued
Patient Teaching for Type 1 DM
a. Administer subcutaneous insulin in the abdomen, deltoid, thigh, and buttock Rationale: Patients who are diagnosed with type 1 DM require specific teaching to self-man-
b. Take oral hypoglycemic agents as prescribed age the disease and avoid complications. You should teach the patient to administer insulin
c. Rotate injection sites subcutaneously in areas that provide the best absorption, including the abdomen, deltoid,
d. Larger patients should use a 45-degree angle to administer insulin thigh, and buttocks. You should also teach the patient to rotate the injection sites to decrease
e. Symptoms of hypoglycemia include feeling anxious and shaky the risk of tissue damage. It is important for the patient to know the symptoms of both
f. Symptoms of hyperglycemia include feeling thirsty and fatigued hypo- and hyperglycemia. Hypoglycemia is demonstrated with feelings of anxiety, hunger,
palpitations, circumoral paresthesia, sweating, shakiness, and irritability. Hyperglycemia, on
the other hand, is demonstrated with polyphagia, polydipsia, polyuria, fatigue, and weight
loss. Oral hypoglycemic agents are not ettective in treating type 1 DM but are ettective in the
treatment of type 2 DM.
b. Check blood glucose levels via finger stick as prescribed
Patient Teaching for Type 2 DM c. Reduce food intake and increase physical activity
a. Adjust oral hypoglycemic medication based on daily glucose level d. Distribute carbohydrates evenly throughout the day with meals
b. Check blood glucose levels via finger stick as prescribed e. Strive for a goal HgbA1c of less than 7%
c. Reduce food intake and increase physical activity f. Monitor for complications of DM
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