NCLEX Diabetes Questions and Answers

NCLEX Diabetes Questions and Answers A 54-year-old patient admitted with type 2 diabetes asks the nurse what "type 2" means. What is the most appropriate response by the nurse? a. "With type 2 diabetes, the body of the pancreas becomes inflamed." b. "With type 2 diabetes, insulin secretion is decreased, and insulin resistance is increased." c. "With type 2 diabetes, the patient is totally dependent on an outside source of insulin." d. "With type 2 diabetes, the body produces autoantibodies that destroy β-cells in the pancreas." - ANS ️️ B - In type 2 diabetes mellitus, the secretion of insulin by the pancreas is reduced, and/or the cells of the body become resistant to insulin. The pancreas becomes inflamed with pancreatitis. The patient is totally dependent on exogenous insulin and may have had autoantibodies destroy the β-cells in the pancreas with type 1 diabetes mellitus. The nurse caring for a patient hospitalized with diabetes mellitus would look for which laboratory test result to obtain information on the patient's past glucose control? a. prealbumin level b. urine ketone level c. fasting glucose level d. glycosylated hemoglobin level - ANS ️️ D - A glycosylated hemoglobin level detects the amount of glucose that is bound to red blood cells (RBCs). When circulating glucose levels are high, glucose attaches to the RBCs and remains there for the life of the blood cell, which is approximately 120 days. Thus the test can give an indication of glycemic control over approximately 2 to 3 months. The prealbumin level is used to establish nutritional status and is unrelated to past glucose control. The urine ketone level will only show that hyperglycemia or starvation is probably currently occurring. The fasting glucose level only indicates current glucose control. The nurse has been teaching a patient with diabetes mellitus how to perform self- monitoring of blood glucose (SMBG). During evaluation of the patient's technique, the nurse identifies a need for additional teaching when the patient does what? a. chooses a puncture site in the center of the finger pad. b. washes hands with soap and water to cleanse the site to be used. c. warms the finger before puncturing the finger to obtain a drop of blood. d. tells the nurse that the result of 110 mg/dL indicates good control of diabetes. - ANS ️️ A - The patient should select a site on the sides of the fingertips, not on the center of the finger pad as this area contains many nerve endings and would be unnecessarily painful. Washing hands, warming the finger, and knowing the results that indicate good control all show understanding of the teaching. The nurse is assigned to the care of a 64-year-old patient diagnosed with type 2 diabetes. In formulating a teaching plan that encourages the patient to actively participate in management of the diabetes, what should be the nurse's initial intervention? a. assess patient's perception of what it means to have diabetes. b. ask the patient to write down current knowledge about diabetes. c. set goals for the patient to actively participate in managing his diabetes. d. assume responsibility for all of the patient's care to decrease stress level. - ANS ️️ A - In order for teaching to be effective, the first step is to assess the patient. Teaching can be individualized once the nurse is aware of what a diagnosis of diabetes means to the patient. After the initial assessment, current knowledge can be assessed, and goals should be set with the patient. Assuming responsibility for all of the patient's care will not facilitate the patient's health. The nurse is beginning to teach a diabetic patient about vascular complications of diabetes. What information is appropriate for the nurse to include? a. macroangiopathy does not occur in type 1 diabetes but rather in type 2 diabetics who have severe disease. b. microangiopathy is specific to diabetes and most commonly affects the capillary membranes of the eyes, kidneys, and skin. c. renal damage resulting from changes in large- and medium-sized blood vessels can be prevented by careful glucose control. d. macroangiopathy causes slowed gastric emptying and the sexual impotency experienced by a majority of patients with diabetes. - ANS ️️ B - Microangiopathy occurs in diabetes mellitus. When it affects the eyes, it is called diabetic retinopathy. When the kidneys are affected, the patient has nephropathy. When the skin is affected, it can lead to diabetic foot ulcers. Macroangiopathy can occur in either type 1 or type 2 diabetes and contributes to cere