LEWIS MEDICAL SURGICAL NURSING IN
CANADA EXAM SCRIPT 2026
COMPREHENSIVE QUESTIONS SOLUTIONS
GRADED A PLUS ACUTE CARE STUDY
PACKAGE
◉ A patient screened for diabetes at a clinic has a fasting plasma
glucose level of 120 mg/dL
(6.7 mmol/L). Which information will the nurse plan to teach the
patient?
a. Self-monitoring of glucose
b. Using small doses of regular insulin
c. Lifestyle changes to lower the glucose
d. Effects of oral hypoglycemic medications
Answer: ANS: C
The patient's impaired fasting glucose indicates prediabetes, and the
patient would be
counseled about lifestyle changes to prevent the development of
type 2 diabetes. The patient
with prediabetes does not require insulin or oral hypoglycemics for
glucose control and does
not need to self-monitor glucose.
,◉ 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%.
CANADA EXAM SCRIPT 2026
COMPREHENSIVE QUESTIONS SOLUTIONS
GRADED A PLUS ACUTE CARE STUDY
PACKAGE
◉ A patient screened for diabetes at a clinic has a fasting plasma
glucose level of 120 mg/dL
(6.7 mmol/L). Which information will the nurse plan to teach the
patient?
a. Self-monitoring of glucose
b. Using small doses of regular insulin
c. Lifestyle changes to lower the glucose
d. Effects of oral hypoglycemic medications
Answer: ANS: C
The patient's impaired fasting glucose indicates prediabetes, and the
patient would be
counseled about lifestyle changes to prevent the development of
type 2 diabetes. The patient
with prediabetes does not require insulin or oral hypoglycemics for
glucose control and does
not need to self-monitor glucose.
,◉ 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%.
