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NUR 257 CHRONIC ILLNESS AND NURSING MANAGEMENT EXAM 3 | QUESTIONS & UPDATED CORRECT ANSWERS | LATEST UPDATE

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NUR 257 CHRONIC ILLNESS AND NURSING MANAGEMENT EXAM 3 | QUESTIONS & UPDATED CORRECT ANSWERS | LATEST UPDATE

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,1. The nurse is teaching a 75-year-old client with diabetes mellitus about nutrition
therapy while taking antidiabetic medications. Which client statement indicates
that further teaching is needed regarding dietary management and medication
effectiveness?

A 75-year-old client with type 2 diabetes mellitus has recently started taking oral
antidiabetic medication. During a follow-up education session, the nurse reinforces
the importance of nutrition therapy, meal consistency, and lifestyle modifications to
promote optimal blood glucose control and reduce the risk of complications. Which
of the following client statements indicates that the client requires additional
teaching?

A. “I will eat the same amount and quality of food every day.”

B. “Eating meals and snacks at the same time every day is important.”

C. “I should stick to the food allowed on my diet except for special occasions.”

D. “I will consult with a dietitian for meal planning and preparation.”

Rationale:
The statement about following the diet "except for special occasions" indicates a
misunderstanding because diabetes management requires consistent meal planning
and portion control even during holidays, celebrations, and social events. Occasional
indulgences may be incorporated into a meal plan with appropriate planning, but
routinely making exceptions can lead to significant fluctuations in blood glucose
levels and decrease the effectiveness of antidiabetic medications. Ongoing nutritional
consistency is essential to prevent both hyperglycemia and hypoglycemia while
promoting long-term glycemic control.



2. The home health nurse is caring for an 85-year-old client who was recently
diagnosed with type 2 diabetes mellitus and prescribed metformin. Which nursing
action is the priority?

,An 85-year-old client has recently been diagnosed with type 2 diabetes mellitus and
discharged home with a new prescription for metformin. During the first home
health visit, the client expresses uncertainty regarding dietary recommendations,
exercise, medication administration, and lifestyle changes needed to manage
diabetes successfully. Which nursing intervention should the nurse perform first?

A. Contact the primary care provider regarding the most recent orders.

B. Perform a comprehensive assessment and answer all of the client's questions.

C. Perform an assessment and document all findings.

D. Contact the dietitian and physical therapist regarding orders.

Rationale:
The nursing process always begins with assessment. By first assessing the client's
physical condition, knowledge level, learning needs, and concerns, the nurse can
provide individualized education that addresses knowledge deficits while
determining whether additional referrals or provider notification are necessary.
Answering the client's questions immediately after assessment promotes
understanding, improves medication adherence, reduces anxiety, and supports safe
self-management of diabetes before implementing additional interventions.



3. The nurse is caring for an older adult who is suspected of having type 2 diabetes
mellitus. Which factor commonly contributes to a delayed diagnosis in the older
adult population?

A nurse is evaluating an 80-year-old client who reports increasing fatigue, mild
blurred vision, and occasional urinary frequency over several months. The healthcare
provider suspects type 2 diabetes mellitus. The nurse understands that diagnosis in
older adults is frequently delayed because of which reason?

A. There are usually few, if any, symptoms until severe organ damage has occurred.

B. Older adults tend to avoid complaining of not feeling well because they fear the
unknown.

, C. The primary care provider hesitates to make the diagnosis to preserve quality of
life.

D. The symptoms develop so rapidly that attention is directed toward other body
systems first.

Rationale:
Older adults with type 2 diabetes often present with subtle, nonspecific, or absent
symptoms, allowing chronic hyperglycemia to progress unnoticed for extended
periods. As a result, many individuals are diagnosed only after complications such as
neuropathy, nephropathy, retinopathy, or cardiovascular disease have already
developed. This delayed presentation emphasizes the importance of routine
screening and early recognition of risk factors in the older adult population.



4. The nurse is developing a care plan for an older adult with type 2 diabetes
mellitus. Which combination of nursing interventions should be included to
promote effective long-term diabetes self-management?

A 78-year-old client with recently diagnosed type 2 diabetes mellitus is receiving
education before discharge. The nurse develops a comprehensive care plan that
focuses on preventing complications, promoting healthy lifestyle behaviors, and
improving the client's ability to manage diabetes independently. Which combination
of interventions should the nurse include in the teaching plan?

1. Teach strategies to prevent hypoglycemia.

2. Emphasize the role of regular physical exercise.
3. Review the manifestations of acute and chronic complications.

4. Stress the importance of avoiding carbohydrates.

5. Instruct the client in self-monitoring of blood glucose levels.

A. 1, 3, 4, 5

B. 1, 2, 4, 5

C. 1, 2, 3, 5

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