TEST-BANK-for-nutritional-foundations-and-clinical-applications-7th-edition-by-grodner-chapter-15-

TEST-BANK-for-nutritional-foundations-and-clinical-applications-7th-edition-by-grodner-chapter-15- Chapter 15: Nutrition for Diabetes Mellitus Grodner and Escott-Stump: Nutritional Foundations and Clinical Application: A Nursing Approach, 7th Edition MULTIPLE CHOICE 1. At a routine physical examination, a 50-year-old man has a fasting blood glucose level of 160 mg/dL. The next step in diagnosis and treatment would be a. referral to a diabetes clinic. b. prescribing an oral hypoglycemic agent. c. rechecking fasting blood glucose level. d. evaluating cardiovascular risk factors. ANS: C Type 2 diabetes mellitus is diagnosed when the fasting blood glucose level exceeds 126 mg/dL on at least two occasions; therefore, the first step in care would be to recheck his fasting blood glucose level. If the diagnosis is confirmed, referral to a diabetes clinic, use of an oral hypoglycemic agent, and evaluation of cardiovascular risk factors may be warranted. DIF: Cognitive Level: Applying REF: Page 322 TOP: Nursing Process: Diagnosis MSC: Client Needs: Physiological integrity 2. If a patient with type 2 diabetes shows early signs of kidney disease, the first priority in nutrition management is a. restricting dietary protein intake. b. normalizing blood glucose levels. c. limiting dietary sodium intake. d. increasing fluid intake. ANS: B If a patient with diabetes begins to develop any kind of complications, the priority in treatment is always normalizing blood glucose levels. Avoiding excessive intakes of protein and sodium and maintaining adequate protein intake may be beneficial but are not the first steps. DIF: Cognitive Level: Analyzing REF: Pages 322-324 TOP: Nursing Process: Planning MSC: Client Needs: Physiological integrity 3. If a patient with type 1 diabetes is unable to maintain good blood glucose control through insulin injections, the physician may recommend a. an oral hypoglycemic agent. b. using an insulin pump. c. more frequent self-monitoring of blood glucose. d. a daily exercise routine. ANS: B An insulin pump is likely to result in better blood glucose management. Oral hypoglycemic agents cannot be used to treat type 1 diabetes. More frequent self-monitoring of blood glucose and daily exercise may be helpful but are not as beneficial as an insulin pump. A daily exercise routine has definite health benefits, especially for patients with diabetes, but it would not necessarily help normalize blood glucose level. DIF: Cognitive Level: Analyzing REF: Pages 328-329 TOP: Nursing Process: Planning MSC: Client Needs: Physiological integrity 4. If a 15-year-old student who runs cross-country and long-distance track events starts to lose weight and is continually thirsty and hungry, he or she may have a. type 1 diabetes. b. type 2 diabetes. c. acquired immunodeficiency syndrome (AIDS). d. hepatitis virus infection. ANS: A Polyphagia, polydipsia, and weight loss are hallmarks of untreated type 1 diabetes mellitus. Type 2 diabetes is associated with overweight and inactivity. AIDS and hepatitis may result in weight loss but are accompanied by loss of appetite rather than increased appetite. DIF: Cognitive Level: Applying REF: Page 325 | Page 329 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 5. The cause of type 1 diabetes mellitus is a. excessive intake of simple sugars. b. destruction of pancreatic beta cells. c. inability of cells to respond to insulin in the bloodstream. d. inability of the pancreas to keep up with the body’s demands for insulin. ANS: B Type 1 diabetes mellitus is caused by autoimmune destruction of pancreatic beta cells. Excessive sugar intake does not cause any kind of diabetes mellitus. Type 2 diabetes is caused by inability of cells to respond to insulin in the bloodstream. In type 1 diabetes, the pancreas is not able to keep up with the body’s demands for insulin, but the cause of this is destruction of beta cells. DIF: Cognitive Level: Remembering REF: Page 325 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological integrity 6. The two strongest risk factors for type 2 diabetes are a. obesity and family history. b. recurrent viral infections and stress. c. male gender and upper body obesity. d. preference for sweet foods and sedentary lifestyle. ANS: A The two strongest risk factors for type 2 diabetes are obesity and family history. Upper body obesity and sedentary lifestyle may also contribute to the risk for the disease. Male gender, preference for sweet foods, recurrent viral infections, and stress are not risk factors for type 2 diabetes. DIF: Cognitive Level: Understanding REF: Page 326 | Page 329 TOP: Nursing Process: Assessment MSC: Client Needs: Health promotion and maintenance