LEWIS MEDICAL-SURGICAL NURSING 10TH
EDITION CERTIFICATION EVALUATION TEST
COMPLETE QUESTIONS AND CORRECT
ANSWERS
◉ A 28-yr-old male patient with type 1 diabetes reports how he
manages his exercise and
glucose control. Which behavior indicates a need for the nurse to
implement additional teaching?
a. The patient always carries hard candies when engaging in
exercise.
b. The patient goes for a vigorous walk when his glucose is 200
mg/dL.
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.
Answer: ANS: D
When the patient is ketotic, exercise increase the glucose level;
persons with type 1 diabetes
should be taught to avoid exercise when ketosis is present. Other
recommendations include
,(1) before exercise, if glucose 100 mg/dL, eat a 15-g carbohydrate
snack. After 15 to 30 min,
recheck glucose levels. (2) Delay exercise if <100 mg/dL. Patients
using drugs that place them
at risk for hypoglycemia should always carry a fast-acting source of
carbohydrate, such as
glucose tablets or hard candies, when exercising. (3) Before exercise,
if glucose 250 mg/dL
in a person with type 1 DM and ketones are present, delay vigorous
activity until ketones are
gone. Drink fluids.
◉ The nurse is assessing a 22-yr-old patient experiencing the onset
of symptoms of type 1
diabetes. Which finding would the nurse anticipate?
a. Anorexia
b. Weight loss
c. Dark colored urine
d. Craving sugary drinks.
Answer: ANS: B
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.
◉ A patient with type 2 diabetes is scheduled for a follow-up visit in
the clinic several months
from now. Which test will the nurse schedule to evaluate the
effectiveness of treatment for the
Patient?
a. Fasting blood glucose
b. Glycosylated hemoglobin
c. Oral glucose tolerance test
d. Urine dipstick for glucose and ketones
Answer: ANS: B
The glycosylated hemoglobin (A1C) test shows the overall control of
glucose over 90 to 120
days. A fasting level indicates only the glucose level at one time.
Urine glucose testing is not
an accurate reflection of 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 after diabetes has been diagnosed.
, ◉ The nurse is assessing a 55-yr-old female patient with type 2
diabetes who has a body mass
index (BMI) of 32 kg/m2. Which goal in the plan of care is most
important for this patient?
a. The patient will reach a glycosylated hemoglobin level of less than
7%.
b. The patient will follow a diet and exercise plan that results in
weight loss.
c. The patient will choose a diet that distributes calories throughout
the day.
d. The patient will state the reasons for eliminating simple sugars in
the diet.
Answer: ANS: A
The complications of diabetes are related to elevated glucose and
the most important patient
outcome is the reduction of glucose to near-normal levels. A BMI of
30.9/kg/m2 or above is
considered obese, so the other outcomes are appropriate but are not
as high in priority.
◉ A patient who has type 1 diabetes plans to swim laps for an hour
daily at 1:00 PM. Which
advice would the clinic nurse plan to give the patient?
a. Increase the morning dose of NPH insulin (Novolin N).
EDITION CERTIFICATION EVALUATION TEST
COMPLETE QUESTIONS AND CORRECT
ANSWERS
◉ A 28-yr-old male patient with type 1 diabetes reports how he
manages his exercise and
glucose control. Which behavior indicates a need for the nurse to
implement additional teaching?
a. The patient always carries hard candies when engaging in
exercise.
b. The patient goes for a vigorous walk when his glucose is 200
mg/dL.
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.
Answer: ANS: D
When the patient is ketotic, exercise increase the glucose level;
persons with type 1 diabetes
should be taught to avoid exercise when ketosis is present. Other
recommendations include
,(1) before exercise, if glucose 100 mg/dL, eat a 15-g carbohydrate
snack. After 15 to 30 min,
recheck glucose levels. (2) Delay exercise if <100 mg/dL. Patients
using drugs that place them
at risk for hypoglycemia should always carry a fast-acting source of
carbohydrate, such as
glucose tablets or hard candies, when exercising. (3) Before exercise,
if glucose 250 mg/dL
in a person with type 1 DM and ketones are present, delay vigorous
activity until ketones are
gone. Drink fluids.
◉ The nurse is assessing a 22-yr-old patient experiencing the onset
of symptoms of type 1
diabetes. Which finding would the nurse anticipate?
a. Anorexia
b. Weight loss
c. Dark colored urine
d. Craving sugary drinks.
Answer: ANS: B
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.
◉ A patient with type 2 diabetes is scheduled for a follow-up visit in
the clinic several months
from now. Which test will the nurse schedule to evaluate the
effectiveness of treatment for the
Patient?
a. Fasting blood glucose
b. Glycosylated hemoglobin
c. Oral glucose tolerance test
d. Urine dipstick for glucose and ketones
Answer: ANS: B
The glycosylated hemoglobin (A1C) test shows the overall control of
glucose over 90 to 120
days. A fasting level indicates only the glucose level at one time.
Urine glucose testing is not
an accurate reflection of 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 after diabetes has been diagnosed.
, ◉ The nurse is assessing a 55-yr-old female patient with type 2
diabetes who has a body mass
index (BMI) of 32 kg/m2. Which goal in the plan of care is most
important for this patient?
a. The patient will reach a glycosylated hemoglobin level of less than
7%.
b. The patient will follow a diet and exercise plan that results in
weight loss.
c. The patient will choose a diet that distributes calories throughout
the day.
d. The patient will state the reasons for eliminating simple sugars in
the diet.
Answer: ANS: A
The complications of diabetes are related to elevated glucose and
the most important patient
outcome is the reduction of glucose to near-normal levels. A BMI of
30.9/kg/m2 or above is
considered obese, so the other outcomes are appropriate but are not
as high in priority.
◉ A patient who has type 1 diabetes plans to swim laps for an hour
daily at 1:00 PM. Which
advice would the clinic nurse plan to give the patient?
a. Increase the morning dose of NPH insulin (Novolin N).
