Chapter 48: Diabetes Mellitus Lewis: Medical-Surgical Nursing, 10th Edition

Chapter 48: Diabetes Mellitus
Lewis: Medical-Surgical Nursing, 10th
Edition
1. 41. A 30-yr-old patient has a new diagnosis of type 2 diabetes. The
nurse will discuss the need to schedule a dilated eye examination

a. every 2 years.

b. as soon as possible.

c. when the patient is 39 years old.

d. within the first year after diagnosis.: ANS: B

Because many patients have some diabetic retinopathy when they are
first diag- nosed with type 2 diabetes, a dilated eye examination is
recommended at the time of diagnosis and annually thereafter.
Patients with type 1 diabetes should have dilated eye examinations
starting 5 years after they are diagnosed and then annually.

DIF: Cognitive Level: Apply
(application) TOP: Nursing
Process: Planning
REF: 1149
MSC: NCLEX: Physiological Integrity
2. 1. Which statement by a nurse to a patient newly diagnosed with
type 2 diabetes is correct?
a. Insulin is not used to control blood glucose in patients with type 2
dia- betes.

1/

,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 the patient is admitted with
a hyperglycemic coma.: 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.




2/

, Chapter 48: Diabetes Mellitus
Lewis: Medical-Surgical Nursing, 10th
Edition
DIF: Cognitive Level: Understand (comprehension) REF: 1134
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological
Integrity
3. 4. The nurse is assessing a 22-yr-old patient experiencing the onset of
symptoms of type 1 diabetes. To which question would the nurse
anticipate a positive response?
a. "Are you anorexic?"
b. "Is your urine dark colored?"
c. "Have you lost weight lately?"
d. "Do you crave sugary drinks?": ANS: C
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.


DIF: Cognitive Level: Apply
(application) TOP: Nursing
Process: Assessment

REF: 1121
MSC: NCLEX: Physiological Integrity
4. 5. 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?

a. Fasting blood glucose
b. Oral glucose tolerance
c Glycosylated hemoglobin
d. Urine dipstick for glucose: _ANS: C
The glycosylated hemoglobin (A1C) test shows the overall control of
glucose over 90 to 120 days. A fasting blood level indicates only the
glucose level at one time. Urine glucose testing is not an accurate
reflection of blood glucose level and does not reflect the glucose over

DIF: Cognitive Level: Apply
(application) TOP: Nursing
Process: Planning
3/

, Chapter 48: Diabetes Mellitus
Lewis: Medical-Surgical Nursing, 10th
Edition
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.




DIF: Cognitive Level: Apply
(application) TOP: Nursing
Process: Planning
4/