NR 505 Chapter 51, Assessment and Management of Patients with Diabetes Final Exam Complete Key Questions with 100% Correct Solutions||UPDATED 2025/2026 A+ GRADED!!! BRAND NEW VERSION

NR 505 Chapter 51, Assessment and Management of Patients with Diabetes Final Exam Complete Key Questions with 100% Correct Solutions||UPDATED 2025/2026 A+ GRADED!!! BRAND NEW VERSION 1. A nurse educates a group of clients with diabetes mellitus on the prevention of diabetic nephropathy. Which of the following suggestions would be most important? 1. Take the antidiabetic drugs regularly. 2. Drink plenty of fluids. 3. Control blood glucose levels. 4. Eat a high-fiber diet. - ANSWER 3. Control blood glucose levels. 2. Controlling blood glucose levels and any hypertension can prevent or delay the development of diabetic nephropathy. Drinking plenty of fluids does not prevent diabetic nephropathy. Taking antidiabetic drugs regularly may help to control blood glucose levels, but it is the control of these levels that is most important. A high-fiber diet is unrelated to the development of diabetic nephropathy. 3. A client with diabetes is receiving an oral antidiabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer? 1. Repaglinide 2. Glipizide 3. Metformin 4. Glyburide - ANSWER 3. Metformin 4. Metformin is a biguanide and along with the thiazolidinediones (rosiglitazone and pioglitazone) are categorized as insulin sensitizers; they help tissues use available insulin more efficiently. Glyburide and glipizide which are sulfonylureas, and repaglinide, a meglitinide, are described as being insulin releasers because they stimulate the pancreas to secrete more insulin. 5. The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action? 1. It decreases the intestinal absorption of glucose. 2. It aids in the process of gluconeogenesis. 3. It stimulates the pancreatic beta cells. 4. It carries glucose into body cells. - ANSWER 4. It carries glucose into body cells. 6. Insulin carries glucose into body cells as their preferred source of energy. Besides, it promotes the liver's storage of glucose as glycogen and inhibits the breakdown of glycogen back into glucose. Insulin does not aid in gluconeogenesis but inhibits the breakdown of glycogen back into glucose. Insulin does not have an effect on the intestinal absorption of glucose. 7. Which statement is true regarding gestational diabetes? 1. It occurs in most pregnancies. 2. There is a low risk for perinatal complications. 3. A glucose challenge test should be performed between 24 and 28 weeks. 4. Onset usually occurs in the first trimester. - ANSWER 3. A glucose challenge test should be performed between 24 and 28 weeks. 8. A glucose challenge test should be performed between 24 and 48 weeks in women at average risk. It occurs in 2% to 5% of all pregnancies. Onset usually occurs in the second or third trimester. There is an above-normal risk for perinatal complications. 9. An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting: 1. 2 to 5 g of a simple carbohydrate. 2. 25 to 30 g of a simple carbohydrate. 3. 10 to 15 g of a simple carbohydrate. 4. 18 to 20 g of a simple carbohydrate. - ANSWER 3. 10 to 15 g of a simple carbohydrate. 10. To reverse hypoglycemia, the American Diabetes Association recommends ingesting 10 to 15 g of a simple carbohydrate, such as three to five pieces of hard candy, two to three packets of sugar (4 to 6 tsp), or 4 oz of fruit juice. Then the client should check his blood glucose after 15 minutes. If necessary, this treatment may be repeated in 15 minutes. Ingesting only 2 to 5 g of a simple carbohydrate may not raise the blood glucose level sufficiently. Ingesting more than 15 g may raise it above normal, causing hyperglycemia. 11. A client with diabetes mellitus must learn how to self-administer insulin. The physician has ordered 10 units of U-100 regular insulin and 35 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction? 1. "Inject insulin into healthy tissue with large blood vessels and nerves." 2. "Administer insulin into sites above muscles that you plan to exercise heavily later that day." 3. "Administer insulin into areas of scar tissue or hypertrophy whenever possible." 4. "Rotate injection sites within the same anatomic region, not among different regions." - ANSWER 4. "Rotate injection sites within the same anatomic region, not among different regions." 12. The nurse should instruct the client to rotate injection sites within the same anatomic region. Rotating sites among different regions may cause excessive day-to-day variations in the blood glucose level; also, insulin absorption differs from one region to the next. Insulin should be injected only into healthy tissue lacking large blood vessels, nerves, or scar tissue or other deviations. Injecting insulin into areas of hypertrophy may delay absorption. The client shouldn't inject insulin into areas of lipodystrophy (such as hypertrophy or atrophy); to prevent lipodystrophy, the client should rotate injection sites systematically. Exercise speeds drug absorption, so the client shouldn't inject insulin into sites above muscles that will be exercised heavily. 13. A client with type 1 diabetes has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse is most accurate in stating: 1. "The test must be repeated following a 12-hour fast." 2. "Your insulin regimen must be altered significantly." 3. "It looks like you aren't following the ordered diabetic diet." 4. "It tells us about your sugar control for the last 3 months." - ANSWER 4. "It tells us about your sugar control for the last 3 months." 14. The nurse is providing accurate information to the client when she states that the glycosylated Hb test provides an objective measure of glycemic control over a 3-month period. The test helps identify trends or practices that impair glycemic control, and it doesn't require a fasting period before blood is drawn. The nurse can't conclude that the result occurs from poor dietary management or inadequate insulin coverage.