Chapter 49 - Diabetes Mellitus Exam with
complete solutions
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 diabetes.
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. -
correct answer-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.
A 48-year-old male patient screened for diabetes at a clinic has a fasting plasma glucose level of 120
mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about
a. self-monitoring of blood glucose.
b. using low doses of regular insulin.
c. lifestyle changes to lower blood glucose.
d. effects of oral hypoglycemic medications. - correct answer-ANS: C
The patient's impaired fasting glucose indicates prediabetes, and the patient should 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 blood
glucose
A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose
control. Which behavior indicates that the nurse should implement additional teaching?
,a. The patient always carries hard candies when engaging in exercise.
b. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
c. The patient has a peanut butter sandwich before going for a bicycle ride.
d. The patient increases daily exercise when ketones are present in the urine. - correct answer-ANS: D
When the patient is ketotic, exercise may result in an increase in blood glucose level. Type 1 diabetic
patients should be taught to avoid exercise when ketosis is present. The other statements are correct
The nurse is assessing a 22-year-old patient experiencing the onset of symptoms of type 1 diabetes.
Which question is most appropriate for the nurse to ask?
a. "Are you anorexic?"
b. "Is your urine dark colored?"
c. "Have you lost weight lately?"
d. "Do you crave sugary drinks?" - correct answer-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
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. Urine dipstick for glucose
b. Oral glucose tolerance test
c. Fasting blood glucose level
d. Glycosylated hemoglobin level - correct answer-ANS: D
The glycosylated hemoglobin (A1C or HbA1C) 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 a prolonged time. Oral
glucose tolerance testing is done to diagnose diabetes, but is not used for monitoring glucose control
once diabetes has been diagnosed
, A 55-year-old female patient with type 2 diabetes has a nursing diagnosis of imbalanced nutrition: more
than body requirements. Which goal is most important for this patient?
a. The patient will reach a glycosylated hemoglobin level of less than 7%.
b. The patient will follow a diet and exercise plan that results in weight loss.
c. The patient will choose a diet that distributes calories throughout the day.
d. The patient will state the reasons for eliminating simple sugars in the diet. - correct answer-ANS: A
The complications of diabetes are related to elevated blood glucose, and the most important patient
outcome is the reduction of glucose to near-normal levels. The other outcomes also are appropriate but
are not as high in priority
A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM. The clinic nurse will
plan to teach the patient to
a. check glucose level before, during, and after swimming.
b. delay eating the noon meal until after the swimming class.
c. increase the morning dose of neutral protamine Hagedorn (NPH) insulin.
d. time the morning insulin injection so that the peak occurs while swimming. - correct answer-ANS: A
The change in exercise will affect blood 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
blood 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
The nurse determines a need for additional instruction when the patient with newly diagnosed type 1
diabetes says which of the following?
a. "I can have an occasional alcoholic drink if I include it in my meal plan."
b. "I will need a bedtime snack because I take an evening dose of NPH insulin."
c. "I can choose any foods, as long as I use enough insulin to cover the calories."
d. "I will eat something at meal times to prevent hypoglycemia, even if I am not hungry." - correct
answer-ANS: C
complete solutions
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 diabetes.
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. -
correct answer-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.
A 48-year-old male patient screened for diabetes at a clinic has a fasting plasma glucose level of 120
mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about
a. self-monitoring of blood glucose.
b. using low doses of regular insulin.
c. lifestyle changes to lower blood glucose.
d. effects of oral hypoglycemic medications. - correct answer-ANS: C
The patient's impaired fasting glucose indicates prediabetes, and the patient should 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 blood
glucose
A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose
control. Which behavior indicates that the nurse should implement additional teaching?
,a. The patient always carries hard candies when engaging in exercise.
b. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
c. The patient has a peanut butter sandwich before going for a bicycle ride.
d. The patient increases daily exercise when ketones are present in the urine. - correct answer-ANS: D
When the patient is ketotic, exercise may result in an increase in blood glucose level. Type 1 diabetic
patients should be taught to avoid exercise when ketosis is present. The other statements are correct
The nurse is assessing a 22-year-old patient experiencing the onset of symptoms of type 1 diabetes.
Which question is most appropriate for the nurse to ask?
a. "Are you anorexic?"
b. "Is your urine dark colored?"
c. "Have you lost weight lately?"
d. "Do you crave sugary drinks?" - correct answer-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
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. Urine dipstick for glucose
b. Oral glucose tolerance test
c. Fasting blood glucose level
d. Glycosylated hemoglobin level - correct answer-ANS: D
The glycosylated hemoglobin (A1C or HbA1C) 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 a prolonged time. Oral
glucose tolerance testing is done to diagnose diabetes, but is not used for monitoring glucose control
once diabetes has been diagnosed
, A 55-year-old female patient with type 2 diabetes has a nursing diagnosis of imbalanced nutrition: more
than body requirements. Which goal is most important for this patient?
a. The patient will reach a glycosylated hemoglobin level of less than 7%.
b. The patient will follow a diet and exercise plan that results in weight loss.
c. The patient will choose a diet that distributes calories throughout the day.
d. The patient will state the reasons for eliminating simple sugars in the diet. - correct answer-ANS: A
The complications of diabetes are related to elevated blood glucose, and the most important patient
outcome is the reduction of glucose to near-normal levels. The other outcomes also are appropriate but
are not as high in priority
A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM. The clinic nurse will
plan to teach the patient to
a. check glucose level before, during, and after swimming.
b. delay eating the noon meal until after the swimming class.
c. increase the morning dose of neutral protamine Hagedorn (NPH) insulin.
d. time the morning insulin injection so that the peak occurs while swimming. - correct answer-ANS: A
The change in exercise will affect blood 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
blood 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
The nurse determines a need for additional instruction when the patient with newly diagnosed type 1
diabetes says which of the following?
a. "I can have an occasional alcoholic drink if I include it in my meal plan."
b. "I will need a bedtime snack because I take an evening dose of NPH insulin."
c. "I can choose any foods, as long as I use enough insulin to cover the calories."
d. "I will eat something at meal times to prevent hypoglycemia, even if I am not hungry." - correct
answer-ANS: C
