N172 week 3 evolve quiz DM Questions With Complete
Solutions
A client who is 60 pounds (27.2 kg) more than the ideal body
weight is admitted to the hospital with a diagnosis of type 1
diabetes. Which concept would the nurse include in teaching
about diabetes when discussing strategies to lose weight?
Obesity leads to insulin resistance.
Surplus fat causes excretion of insulin.
Fat cells absorb insulin and prevent its circulation to other cells.
Lipids accumulate in the pancreas and interfere with insulin
production. Correct Answers Obesity leads to insulin
resistance.
Rationale
Excess fat alters glucose metabolism, causing cells to become
insulin resistant. Fat cells have no relationship to the function of
the kidneys. Fat cells do not absorb insulin and therefore do not
prevent the circulation of insulin to other cells. Clients with type
1 diabetes do not produce insulin. If lipids should accumulate in
the pancreas of a healthy adult, they do not interfere with insulin
production.
A client with type 1 diabetes for 25 years states, "I have been
really bad for the past 15 years. I have not paid attention to my
diet and have done little to control my diabetes." Which
common complications of diabetes might the nurse expect to
,identify when assessing this client? Select all that apply. One,
some, or all responses may be correct.
Leg ulcers
Loss of visual acuity
Thick, yellow toenails
Increased growth of body hair
Decreased sensation in the feet Correct Answers Leg ulcers
Loss of visual acuity
command
Thick, yellow toenails
Decreased sensation in the feet
Rationale
Leg ulcers are a common response to the microvascular and
macrovascular changes associated with diabetes. Retinopathy,
damage to the microvascular system of the retina (e.g., edema,
exudate, and local hemorrhage), occurs as a result of the
occlusion of the small vessels in the eyes, causing
microaneurysms in the capillary walls. Thick, yellow toenails
result from prolonged inadequate arterial circulation to the feet.
Pedal pulses diminish, which can result in gangrene,
necessitating amputation. Diabetic neuropathies affect 60% to
70% of people with diabetes. It is theorized that consistent
hyperglycemia causes a buildup of sorbitol and fructose in the
nerves that results in impairment via an unknown process.
Inadequate arterial circulation to hair follicles results in a lack of
hair on the feet and ankles. The skin becomes dry and cracks,
predisposing it to leg ulcers and infection.
, A client with type 1 diabetes has dry, hot, flushed skin; a fruity
odor to the breath; and is having Kussmaul respirations. Which
complication does the nurse suspect that the client is
experiencing?
Ketoacidosis
Somogyi phenomenon
Hypoglycemic reaction
Hyperosmolar nonketotic coma Correct Answers Ketoacidosis
Rationale
Ketoacidosis occurs when insulin is lacking and carbohydrates
cannot be used for energy; this increases the breakdown of
protein and fat, causing deep, rapid respirations (Kussmaul
respirations), decreased alertness, decreased circulatory volume,
metabolic acidosis, and an acetone breath. The Somogyi
phenomenon is a rebound hyperglycemia induced by severe
hypoglycemia; there are not enough data to determine whether
this occurred. Hypoglycemia is manifested by cool, moist skin,
not hot, dry skin; Kussmaul respirations do not occur with
hypoglycemia. Hyperosmolar nonketotic coma usually occurs in
clients with type 2 diabetes because available insulin prevents
the breakdown of fat.
A client's fasting plasma glucose levels are being evaluated. The
nurse identifies that the client is considered to be diabetic if the
results are within which range?
40 to 60 mg/dL (2.2-3.3 mmol/L)
• 80 to 99 mg/dL (4.5-5.5 mmol/L)
• 100 to 125 mg/dL (5.6-6.9 mmol/L)
Solutions
A client who is 60 pounds (27.2 kg) more than the ideal body
weight is admitted to the hospital with a diagnosis of type 1
diabetes. Which concept would the nurse include in teaching
about diabetes when discussing strategies to lose weight?
Obesity leads to insulin resistance.
Surplus fat causes excretion of insulin.
Fat cells absorb insulin and prevent its circulation to other cells.
Lipids accumulate in the pancreas and interfere with insulin
production. Correct Answers Obesity leads to insulin
resistance.
Rationale
Excess fat alters glucose metabolism, causing cells to become
insulin resistant. Fat cells have no relationship to the function of
the kidneys. Fat cells do not absorb insulin and therefore do not
prevent the circulation of insulin to other cells. Clients with type
1 diabetes do not produce insulin. If lipids should accumulate in
the pancreas of a healthy adult, they do not interfere with insulin
production.
A client with type 1 diabetes for 25 years states, "I have been
really bad for the past 15 years. I have not paid attention to my
diet and have done little to control my diabetes." Which
common complications of diabetes might the nurse expect to
,identify when assessing this client? Select all that apply. One,
some, or all responses may be correct.
Leg ulcers
Loss of visual acuity
Thick, yellow toenails
Increased growth of body hair
Decreased sensation in the feet Correct Answers Leg ulcers
Loss of visual acuity
command
Thick, yellow toenails
Decreased sensation in the feet
Rationale
Leg ulcers are a common response to the microvascular and
macrovascular changes associated with diabetes. Retinopathy,
damage to the microvascular system of the retina (e.g., edema,
exudate, and local hemorrhage), occurs as a result of the
occlusion of the small vessels in the eyes, causing
microaneurysms in the capillary walls. Thick, yellow toenails
result from prolonged inadequate arterial circulation to the feet.
Pedal pulses diminish, which can result in gangrene,
necessitating amputation. Diabetic neuropathies affect 60% to
70% of people with diabetes. It is theorized that consistent
hyperglycemia causes a buildup of sorbitol and fructose in the
nerves that results in impairment via an unknown process.
Inadequate arterial circulation to hair follicles results in a lack of
hair on the feet and ankles. The skin becomes dry and cracks,
predisposing it to leg ulcers and infection.
, A client with type 1 diabetes has dry, hot, flushed skin; a fruity
odor to the breath; and is having Kussmaul respirations. Which
complication does the nurse suspect that the client is
experiencing?
Ketoacidosis
Somogyi phenomenon
Hypoglycemic reaction
Hyperosmolar nonketotic coma Correct Answers Ketoacidosis
Rationale
Ketoacidosis occurs when insulin is lacking and carbohydrates
cannot be used for energy; this increases the breakdown of
protein and fat, causing deep, rapid respirations (Kussmaul
respirations), decreased alertness, decreased circulatory volume,
metabolic acidosis, and an acetone breath. The Somogyi
phenomenon is a rebound hyperglycemia induced by severe
hypoglycemia; there are not enough data to determine whether
this occurred. Hypoglycemia is manifested by cool, moist skin,
not hot, dry skin; Kussmaul respirations do not occur with
hypoglycemia. Hyperosmolar nonketotic coma usually occurs in
clients with type 2 diabetes because available insulin prevents
the breakdown of fat.
A client's fasting plasma glucose levels are being evaluated. The
nurse identifies that the client is considered to be diabetic if the
results are within which range?
40 to 60 mg/dL (2.2-3.3 mmol/L)
• 80 to 99 mg/dL (4.5-5.5 mmol/L)
• 100 to 125 mg/dL (5.6-6.9 mmol/L)
