Diabetes Harding: Lewis Medical-Surgical Nursing, 12th Edition

Test Bank for Lewis Medical Surgical Nursing 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra Hagler (Chapters 1 to 69) 100% verified Correct Answers| Graded A+. A 26-yr-old female who has type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and reports a glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. Which action would the nurse advise the patient to take? a. Use only the lispro insulin until the symptoms are resolved. b. Limit intake of calories until the glucose is less than 120 mg/dL. c. Monitor blood glucose every 4 hours and contact the clinic if it rises. d. Decrease carbohydrates until glycosylated hemoglobin is less than 7%. - C A 27-yr-old patient admitted with diabetic ketoacidosis (DKA) has a serum glucose level of 732 mg/dL and serum potassium level of 3.1 mEq/L. Which action prescribed by the health care provider would the nurse implement first? a. Place the patient on a cardiac monitor. b. Administer IV potassium supplements. c. Ask the patient about home insulin doses. d. Start an insulin infusion at 0.1 units/kg/hr. - A A 28-yr-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates a need for the nurse to 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. - D A 30-yr-old patient has a new diagnosis of type 2 diabetes. When would the nurse recommend the patient schedule a dilated eye examination? a. Every 2 years b. Every 6 months c. As soon as available d. At the age of 39 years - C A female patient is scheduled for an oral glucose tolerance test. Which information from the patient's health history is important for the nurse to communicate to the health care provider regarding interpreting the result of this test? a. The patient uses oral contraceptives. b. The patient runs several days a week. c. The patient has been pregnant three times. d. The patient has a family history of diabetes. - A A few weeks after an 82-yr-old patient with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage) therapy, the home health nurse makes a visit. Which finding would the nurse promptly discuss with the health care provider? a. Hemoglobin A1C level is 7.9%. b. Glomerular filtration rate is decreased. c. Last eye examination was 18 months ago. d. Patient has questions about the prescribed diet. - B A hospitalized patient who has diabetes received 38 U of NPH insulin at 7:00 AM. At 1:00 PM, the patient has been away from the nursing unit for 2 hours, missing the lunch delivery while awaiting a chest x-ray. Which nursing action would be the best way to prevent the patient from experiencing hypoglycemia? a. Plan to decrease the evening dose of insulin. b. Save the lunch tray for the later return. c. Request that if testing is further delayed, the patient must eat lunch first. d. Send a glass of orange juice to the patient in the diagnostic testing area. - C A patient receives as part (NovoLog) insulin at 8:00 AM. At which time would the nurse anticipate the highest risk for hypoglycemia? a. 10:00 AM b. 12:00 AM c. 2:00 PM d. 4:00 PM - A A patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L). Which information will the nurse plan to teach the patient? a. Self-monitoring of glucose b. Using small doses of regular insulin c. Lifestyle changes to lower the glucose d. Effects of oral hypoglycemic medications - C A patient who has diabetes and reports burning foot pain at night receives a new prescription. Which information would the nurse teach the patient about the purpose of amitriptyline? a. Amitriptyline decreases the depression caused by your foot pain. b. Amitriptyline helps prevent transmission of pain impulses to the brain. c. Amitriptyline corrects some of the blood vessel changes that cause pain. d. Amitriptyline improves sleep and makes you less aware of nighttime pain. - B A patient who has diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse explain for mealtime coverage? a. Lispro (Humalog) b. Glargine (Lantus) c. Detemir (Levemir) d. NPH (Humulin N) - A A patient who has type 1 diabetes plans to swim laps for an hour daily at 1:00 PM. Which advice would the clinic nurse plan to give the patient? a. Increase the morning dose of NPH insulin (Novolin N). b. Check glucose level before, during, and after swimming. c. Time the morning insulin injection to peak while swimming. d. Delay eating the noon meal until after finishing the swimming. - B A patient who has type 2 diabetes is being prepared for an elective coronary angiogram. Which information would the nurse anticipate might lead to rescheduling the test? a. The patient's glucose is 128 mg/dL. b. The patient's most recent A1C was 7.5%. c. The patient took the prescribed metformin today. d. The patient took the prescribed enalapril 4 hours ago. - C A patient who takes metformin (Glucophage) to manage type 2 diabetes developed an allergic rash from an unknown cause and the health care provider prescribed prednisone. Which change in the plan of care at would the nurse anticipate? a. The patient may need a diet higher in calories while receiving prednisone.