NUR 445: Exam 1 Review (Testbank UPDATED ACTUAL Questions and CORRECT
Answers
A 40-year-old patient is surprised to learn 3. "Type 1 diabetes mellitus can occur at any stage of life."
of the diagnosis of type 1 diabetes mellitus.
What is the nurse's best response?
1. "It is odd because it is usually a disease of
childhood."
2. "It means that something has destroyed
your pancreas."
3. "Type 1 diabetes mellitus can occur at
any stage of life."
4. "It usually means that another disease
process is present."
The nurse is reviewing type 1 diabetes 1. Autoimmune process
mellitus with a group of patients newly
diagnosed with the disorder. What should Rationale: Type 1 diabetes mellitus (DM) is typically triggered by an autoimmune
the nurse explain as the major cause for the processing which the insulin-producing beta cells of the pancreas are destroyed,
disorder? resulting in an absolute lack of insulin.
1. Autoimmune process
2. Cancer of the pancreas
3. Alteration in lipid and protein utilization
4. Malfunction of carbohydrate metabolism
,A patient with type 1 diabetes mellitus is 2. "You can have this test drawn at any time during the day."
scheduled for a hemoglobin A1c level.
What information does the nurse include in Rationale: On the day the hemoglobin A1c (HgbA1c) sample is collected, eating,
the patient teaching about this diagnostic physical activity, or acute stresses do not affect the result, and the test can be done
test? at any time of day and does not require fasting.
1. "You need to schedule this test for first
thing in the morning."
2. "You can have this test drawn at any time
during the day."
3. "Avoid eating and drinking anything after
midnight the day before the test."
4. "Restrict the intake of red meat for 3 days
before having the test."
The nurse is reviewing the results of a 2. Less than or equal to 6.5%
patient's recent hemoglobin A1c level
drawn to evaluate type 1 diabetes Rationale: A hemoglobin A1c result less than or equal to 6.5% indicates good
management. Which result indicates that glycemic control.
treatment has been successful?
1. Less than or equal to 8%
2. Less than or equal to 6.5%
3. Greater than or equal to 6.5%
4. Greater than or equal to 8.5%
The nurse provides care to a patient 4. "The pump provides better control of your blood sugar."
diagnosed with type 1 diabetes mellitus
(DM) whose hemoglobin A1c level remains Rationale: The use of the subcutaneous insulin pump has been found to provide
elevated despite the use of the prescribed better glycemic control, especially in patients with higher hemoglobin A1c levels,
sliding scale insulin. The healthcare indicating poor glycemic control with traditional methods. This is the best response
provider prescribes an insulin pump. The because this patient has an elevated A1c level despite the implementation of a sliding
patient asks, "Why did my doctor prescribe scale insulin prescription.
a pump?" Which response by the nurse is
best?
1. "The pump is worn continuously."
2. "The pump is more convenient for you."
3. "The pump provides more precise
dosages of insulin."
4. "The pump provides better control of
your blood sugar."
A patient with type 1 diabetes mellitus will 3. 4
be self-monitoring blood glucose levels at
home. What is the minimum number of Rationale: Generally, patients with type 1 diabetes are advised to check their blood
measurements that this patient should make glucose a minimum of before meals and at bedtime or four times a day.
each day?
1. 1
2. 3
3. 4
4. 8
, The nurse correlates which assessment 2. Deep rapid respirations
findings to a patient experiencing diabetic
ketoacidosis? Rationale: The patient develops Kussmaul's respirations, which are rapid, deep
respirations that occur as a compensatory mechanism for the acidosis.
1. Slow heart rate
2. Deep rapid respirations
3. Decreased urine output
4. Increased blood pressure
A patient experiencing diabetic 4. Potassium
ketoacidosis (DKA) is receiving a normal
saline infusion and intravenous insulin. What Rationale: Care must be taken to monitor potassium levels before treating the
additional medication does the nurse hyperglycemia with insulin. As insulin is administered to decrease hyperglycemia,
expect to be prescribed for this patient? potassium will also move back into the cell, worsening hypokalemia. If hypokalemia
is present, potassium replacement is a priority.
1. Diuretic
2. Calcium
3. Antibiotic
4. Potassium
A patient with type 1 diabetes mellitus 1. Raise glycemic targets.
develops symptoms of hypoglycemia only
when the blood glucose level drops to 40 Rationale: If patients have "hypoglycemia unawareness," they will not experience
mg/dL. What is the recommended action symptoms of low blood glucose until their blood glucose levels fall to the point
for this complication? where they are at risk for neurological symptoms, such as confusion or loss of
consciousness. Individuals with hypoglycemia unawareness should be advised to
1. Raise glycemic targets. raise their glycemic targets to strictly avoid further hypoglycemia for at least several
2. Cut the insulin dose in half. weeks to partially reverse hypoglycemia unawareness and reduce risk of further
3. Add an extra snack to the meal plan. episodes.
4. Eliminate the evening dose of insulin.
Which patient statement best indicates 1. "I will eat a cracker."
correct understanding of the teaching
regarding actions to be taken during an Rationale: Oral glucose (15-20 g) administration is the preferred treatment for the
episode of hypoglycemia in a patient conscious individual with hypoglycemia, although any form of carbohydrate that
recently diagnosed with type 1 diabetes contains glucose may be used. Juice, soda, bread, or crackers work well. This
mellitus (DM)? statement indicates understanding of the priority action taken during episodes of
hypoglycemia.
1. "I will eat a cracker."
2. "I will drink a diet soda."
3. "I will eat some ice cream."
4. "I will drink a cup of whole milk."
A patient with type 1 diabetes mellitus is 3. Measure blood glucose at 0200 hours.
experiencing elevated blood glucose
levels in the morning. Which action is Rationale: The cause of elevated glucose levels needs to be determined. To
indicated to address this complication? determine what is causing the increased blood glucose levels in the morning, the
blood glucose levels need to be checked in the early morning hours, 2 or 3 a.m., for
1. Change the evening insulin dose. several nights. If the blood glucose level is low at that early morning time, the high
2. Restrict oral fluids after 1800 hours. glucose levels later in the morning most likely are due to the Somogyi effect. If the
3. Measure blood glucose at 0200 hours. blood glucose level is high or normal at that early morning hour, the increased levels
4. Limit carbohydrate intake to 45 g with later in the morning most likely are due to the dawn phenomenon.
evening meal.
Answers
A 40-year-old patient is surprised to learn 3. "Type 1 diabetes mellitus can occur at any stage of life."
of the diagnosis of type 1 diabetes mellitus.
What is the nurse's best response?
1. "It is odd because it is usually a disease of
childhood."
2. "It means that something has destroyed
your pancreas."
3. "Type 1 diabetes mellitus can occur at
any stage of life."
4. "It usually means that another disease
process is present."
The nurse is reviewing type 1 diabetes 1. Autoimmune process
mellitus with a group of patients newly
diagnosed with the disorder. What should Rationale: Type 1 diabetes mellitus (DM) is typically triggered by an autoimmune
the nurse explain as the major cause for the processing which the insulin-producing beta cells of the pancreas are destroyed,
disorder? resulting in an absolute lack of insulin.
1. Autoimmune process
2. Cancer of the pancreas
3. Alteration in lipid and protein utilization
4. Malfunction of carbohydrate metabolism
,A patient with type 1 diabetes mellitus is 2. "You can have this test drawn at any time during the day."
scheduled for a hemoglobin A1c level.
What information does the nurse include in Rationale: On the day the hemoglobin A1c (HgbA1c) sample is collected, eating,
the patient teaching about this diagnostic physical activity, or acute stresses do not affect the result, and the test can be done
test? at any time of day and does not require fasting.
1. "You need to schedule this test for first
thing in the morning."
2. "You can have this test drawn at any time
during the day."
3. "Avoid eating and drinking anything after
midnight the day before the test."
4. "Restrict the intake of red meat for 3 days
before having the test."
The nurse is reviewing the results of a 2. Less than or equal to 6.5%
patient's recent hemoglobin A1c level
drawn to evaluate type 1 diabetes Rationale: A hemoglobin A1c result less than or equal to 6.5% indicates good
management. Which result indicates that glycemic control.
treatment has been successful?
1. Less than or equal to 8%
2. Less than or equal to 6.5%
3. Greater than or equal to 6.5%
4. Greater than or equal to 8.5%
The nurse provides care to a patient 4. "The pump provides better control of your blood sugar."
diagnosed with type 1 diabetes mellitus
(DM) whose hemoglobin A1c level remains Rationale: The use of the subcutaneous insulin pump has been found to provide
elevated despite the use of the prescribed better glycemic control, especially in patients with higher hemoglobin A1c levels,
sliding scale insulin. The healthcare indicating poor glycemic control with traditional methods. This is the best response
provider prescribes an insulin pump. The because this patient has an elevated A1c level despite the implementation of a sliding
patient asks, "Why did my doctor prescribe scale insulin prescription.
a pump?" Which response by the nurse is
best?
1. "The pump is worn continuously."
2. "The pump is more convenient for you."
3. "The pump provides more precise
dosages of insulin."
4. "The pump provides better control of
your blood sugar."
A patient with type 1 diabetes mellitus will 3. 4
be self-monitoring blood glucose levels at
home. What is the minimum number of Rationale: Generally, patients with type 1 diabetes are advised to check their blood
measurements that this patient should make glucose a minimum of before meals and at bedtime or four times a day.
each day?
1. 1
2. 3
3. 4
4. 8
, The nurse correlates which assessment 2. Deep rapid respirations
findings to a patient experiencing diabetic
ketoacidosis? Rationale: The patient develops Kussmaul's respirations, which are rapid, deep
respirations that occur as a compensatory mechanism for the acidosis.
1. Slow heart rate
2. Deep rapid respirations
3. Decreased urine output
4. Increased blood pressure
A patient experiencing diabetic 4. Potassium
ketoacidosis (DKA) is receiving a normal
saline infusion and intravenous insulin. What Rationale: Care must be taken to monitor potassium levels before treating the
additional medication does the nurse hyperglycemia with insulin. As insulin is administered to decrease hyperglycemia,
expect to be prescribed for this patient? potassium will also move back into the cell, worsening hypokalemia. If hypokalemia
is present, potassium replacement is a priority.
1. Diuretic
2. Calcium
3. Antibiotic
4. Potassium
A patient with type 1 diabetes mellitus 1. Raise glycemic targets.
develops symptoms of hypoglycemia only
when the blood glucose level drops to 40 Rationale: If patients have "hypoglycemia unawareness," they will not experience
mg/dL. What is the recommended action symptoms of low blood glucose until their blood glucose levels fall to the point
for this complication? where they are at risk for neurological symptoms, such as confusion or loss of
consciousness. Individuals with hypoglycemia unawareness should be advised to
1. Raise glycemic targets. raise their glycemic targets to strictly avoid further hypoglycemia for at least several
2. Cut the insulin dose in half. weeks to partially reverse hypoglycemia unawareness and reduce risk of further
3. Add an extra snack to the meal plan. episodes.
4. Eliminate the evening dose of insulin.
Which patient statement best indicates 1. "I will eat a cracker."
correct understanding of the teaching
regarding actions to be taken during an Rationale: Oral glucose (15-20 g) administration is the preferred treatment for the
episode of hypoglycemia in a patient conscious individual with hypoglycemia, although any form of carbohydrate that
recently diagnosed with type 1 diabetes contains glucose may be used. Juice, soda, bread, or crackers work well. This
mellitus (DM)? statement indicates understanding of the priority action taken during episodes of
hypoglycemia.
1. "I will eat a cracker."
2. "I will drink a diet soda."
3. "I will eat some ice cream."
4. "I will drink a cup of whole milk."
A patient with type 1 diabetes mellitus is 3. Measure blood glucose at 0200 hours.
experiencing elevated blood glucose
levels in the morning. Which action is Rationale: The cause of elevated glucose levels needs to be determined. To
indicated to address this complication? determine what is causing the increased blood glucose levels in the morning, the
blood glucose levels need to be checked in the early morning hours, 2 or 3 a.m., for
1. Change the evening insulin dose. several nights. If the blood glucose level is low at that early morning time, the high
2. Restrict oral fluids after 1800 hours. glucose levels later in the morning most likely are due to the Somogyi effect. If the
3. Measure blood glucose at 0200 hours. blood glucose level is high or normal at that early morning hour, the increased levels
4. Limit carbohydrate intake to 45 g with later in the morning most likely are due to the dawn phenomenon.
evening meal.
