ITEMS ACCURATE MARKING
◉ 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?
1. Self-monitoring of glucose
2. Using small doses of regular insulin
3. Lifestyle changes to lower the glucose
4. Effects of oral hypoglycemic medications. Answer: 3. Lifestyle
changes to lower the glucose
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?
,1. The patient always carries hard candies when engaging in
exercise.
2. The patient goes for a vigorous walk when his glucose is 200
mg/dL.
3. The patient has a peanut butter sandwich before going for a
bicycle ride.
4. The patient increases daily exercise when ketones are present in
the urine.. Answer: 4. The patient increases daily exercise when
ketones are present in the urine.
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?
,1. Anorexia
2. Weight loss
3. Dark colored urine
4. Craving sugary drinks. Answer: 2. Weight loss
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?
1. Fasting blood glucose
2. Glycosylated hemoglobin
3. Oral glucose tolerance test
4. Urine dipstick for glucose and ketones. Answer: 2. Glycosylated
hemoglobin
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?
1. The patient will reach a glycosylated hemoglobin level of less than
7%.
2. The patient will follow a diet and exercise plan that results in
weight loss.
3. The patient will choose a diet that distributes calories throughout
the day.
4. The patient will state the reasons for eliminating simple sugars in
the diet.. Answer: 1. The patient will reach a glycosylated
hemoglobin level of less than 7%.
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.