Test Bank For Lewis's Medical-Surgical Nursing, 12th Edition by Mariann M.
Harding, Jeffrey Kwong, Debra Hagler Chapter 1-69
A patient who has type 1 diabetes plans to swim laps for an hour
daily at 1:00 PM. What
advice should the clinic nurse plan to give the patient?
a. Increase the morning dose of NPH insulin (Novolin N).
b. Check glucose level before, during, and after swimming.
c. Time the morning insulin injection to peak while swimming.
d. Delay eating the noon meal until after finishing the swimming -
ANS-ANS: B
The change in exercise will affect blood glucose, and the patient
will need to monitor glucose
carefully to determine the need for changes in diet and insulin
administration. Because
exercise tends to decrease blood glucose, patients are advised to
eat before exercising.
Increasing the morning NPH or timing the insulin to peak during
exercise may lead to
hypoglycemia, especially with the increased exercise.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
,Which statement by a nurse to a patient newly diagnosed with
type 2 diabetes is accurate?
a. Insulin is not used to control blood glucose in patients with
type 2 diabetes.
b. Complications of type 2 diabetes are less serious than those of
type 1 diabetes.
,c. Changes in diet and exercise may control blood glucose levels
in type 2 diabetes.
d. Type 2 diabetes is usually diagnosed when a patient is
admitted in hyperglycemic
coma. - ANS-ANS: C
For some patients with type 2 diabetes, changes in lifestyle are
sufficient to achieve blood
glucose control. Insulin is frequently used for type 2 diabetes,
complications are equally
severe as for type 1 diabetes, and type 2 diabetes is usually
diagnosed with routine laboratory
testing or after a patient develops complications such as frequent
yeast infections.
DIF: Cognitive Level: Understand (comprehension)
TOP: Nursing Process: Implementation MSC: NCLEX:
Physiological Integrity
A patient screened for diabetes at a clinic has a fasting plasma
glucose level of 120 mg/dL
(6.7 mmol/L). What should the nurse plan to teach the patient?
a. Self-monitoring of blood glucose
b. Using low doses of regular insulin
c. Lifestyle changes to lower blood glucose
d. Effects of oral hypoglycemic medications - ANS-ANS: C
The patient's impaired fasting glucose indicates prediabetes, and
the patient should 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 blood glucose.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
A 28-yr-old male patient with type 1 diabetes reports how he
manages his exercise and
glucose control. Which behavior indicates that the nurse should
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. - ANS-ANS: D
When the patient is ketotic, exercise may result in an increase in
blood glucose level. Patients
with type 1 diabetes should be taught to avoid exercise when
ketosis is present. The other
statements are correct.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological
Integrity
Harding, Jeffrey Kwong, Debra Hagler Chapter 1-69
A patient who has type 1 diabetes plans to swim laps for an hour
daily at 1:00 PM. What
advice should the clinic nurse plan to give the patient?
a. Increase the morning dose of NPH insulin (Novolin N).
b. Check glucose level before, during, and after swimming.
c. Time the morning insulin injection to peak while swimming.
d. Delay eating the noon meal until after finishing the swimming -
ANS-ANS: B
The change in exercise will affect blood glucose, and the patient
will need to monitor glucose
carefully to determine the need for changes in diet and insulin
administration. Because
exercise tends to decrease blood glucose, patients are advised to
eat before exercising.
Increasing the morning NPH or timing the insulin to peak during
exercise may lead to
hypoglycemia, especially with the increased exercise.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
,Which statement by a nurse to a patient newly diagnosed with
type 2 diabetes is accurate?
a. Insulin is not used to control blood glucose in patients with
type 2 diabetes.
b. Complications of type 2 diabetes are less serious than those of
type 1 diabetes.
,c. Changes in diet and exercise may control blood glucose levels
in type 2 diabetes.
d. Type 2 diabetes is usually diagnosed when a patient is
admitted in hyperglycemic
coma. - ANS-ANS: C
For some patients with type 2 diabetes, changes in lifestyle are
sufficient to achieve blood
glucose control. Insulin is frequently used for type 2 diabetes,
complications are equally
severe as for type 1 diabetes, and type 2 diabetes is usually
diagnosed with routine laboratory
testing or after a patient develops complications such as frequent
yeast infections.
DIF: Cognitive Level: Understand (comprehension)
TOP: Nursing Process: Implementation MSC: NCLEX:
Physiological Integrity
A patient screened for diabetes at a clinic has a fasting plasma
glucose level of 120 mg/dL
(6.7 mmol/L). What should the nurse plan to teach the patient?
a. Self-monitoring of blood glucose
b. Using low doses of regular insulin
c. Lifestyle changes to lower blood glucose
d. Effects of oral hypoglycemic medications - ANS-ANS: C
The patient's impaired fasting glucose indicates prediabetes, and
the patient should 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 blood glucose.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
A 28-yr-old male patient with type 1 diabetes reports how he
manages his exercise and
glucose control. Which behavior indicates that the nurse should
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. - ANS-ANS: D
When the patient is ketotic, exercise may result in an increase in
blood glucose level. Patients
with type 1 diabetes should be taught to avoid exercise when
ketosis is present. The other
statements are correct.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological
Integrity
