LEWIS MEDICAL SURGICAL NURSING IN
CANADA FINAL PAPER 2026 COMPLETE
ANSWERS CLINICAL DECISION MAKING
PRACTICE RESOURCE
◉ A patient who has type 1 diabetes plans to swim laps for an hour
daily at 1:00 PM. Which
advice would 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.
Answer: ANS: B
The exercise will affect 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 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.
,◉ Which statement by the person who has newly diagnosed type 1
diabetes indicates a need for additional instruction from the nurse?
a. ―I will need a bedtime snack because I take an evening dose of
NPH insulin.‖
b. ―I can choose any foods, as long as I use enough insulin to cover
the calories.‖
c. ―I can have an occasional beverage with alcohol if I include it in
my meal plan.‖
d. ―I will eat something at meal times to prevent hypoglycemia, even
if I am not
hungry.‖
Answer: ANS: B
Planning to use additional insulin to ―balance out‖ unhealthy diet
choices is not effective for
glucose control or overall health. Patients who are using insulin
therapy have considerable
flexibility in diet choices and can plan occasional alcohol beverages
in their diet. Planning
snacks and meal intake to coordinate with insulin doses indicates
good understanding of the
diet instruction.
, ◉ Which nursing action is most important in assisting an older
patient who has diabetes to
engage in moderate daily exercise?
a. Determine what types of activities the patient enjoys.
b. Remind the patient that exercise improves self-esteem.
c. Teach the patient about the effects of exercise on glucose level.
d. Give the patient a list of activities that are moderate in intensity.
Answer: ANS: A
Because consistency with exercise is important, assessment for the
types of exercise that the
patient finds enjoyable is the most important action by the nurse in
ensuring adherence to an
exercise program. Reminding about the benefits of exercise, teaching
about exercise effects on
glucose, and identifying moderate intensity exercises may be helpful
but are not the most
important in improving adherence.
◉ Which patient statement to the nurse indicates a need for
additional instruction in
administering insulin?
a. ―I should inject the insulin into a muscle that I plan to exercise
vigorously.‖
CANADA FINAL PAPER 2026 COMPLETE
ANSWERS CLINICAL DECISION MAKING
PRACTICE RESOURCE
◉ A patient who has type 1 diabetes plans to swim laps for an hour
daily at 1:00 PM. Which
advice would 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.
Answer: ANS: B
The exercise will affect 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 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.
,◉ Which statement by the person who has newly diagnosed type 1
diabetes indicates a need for additional instruction from the nurse?
a. ―I will need a bedtime snack because I take an evening dose of
NPH insulin.‖
b. ―I can choose any foods, as long as I use enough insulin to cover
the calories.‖
c. ―I can have an occasional beverage with alcohol if I include it in
my meal plan.‖
d. ―I will eat something at meal times to prevent hypoglycemia, even
if I am not
hungry.‖
Answer: ANS: B
Planning to use additional insulin to ―balance out‖ unhealthy diet
choices is not effective for
glucose control or overall health. Patients who are using insulin
therapy have considerable
flexibility in diet choices and can plan occasional alcohol beverages
in their diet. Planning
snacks and meal intake to coordinate with insulin doses indicates
good understanding of the
diet instruction.
, ◉ Which nursing action is most important in assisting an older
patient who has diabetes to
engage in moderate daily exercise?
a. Determine what types of activities the patient enjoys.
b. Remind the patient that exercise improves self-esteem.
c. Teach the patient about the effects of exercise on glucose level.
d. Give the patient a list of activities that are moderate in intensity.
Answer: ANS: A
Because consistency with exercise is important, assessment for the
types of exercise that the
patient finds enjoyable is the most important action by the nurse in
ensuring adherence to an
exercise program. Reminding about the benefits of exercise, teaching
about exercise effects on
glucose, and identifying moderate intensity exercises may be helpful
but are not the most
important in improving adherence.
◉ Which patient statement to the nurse indicates a need for
additional instruction in
administering insulin?
a. ―I should inject the insulin into a muscle that I plan to exercise
vigorously.‖
