EXAM2 REVIEW FOR MEDICAL-SURGICAL NURSING I
WITH CORRECT QUESTIONS AND VERIFIED
ANSWERS GRADED A+.
Type 1 Diabetes - ANSWERS-need insulin, Islets of Langerhans beta cells are
destroyed and no insulin production
Type 2 Diabetes - ANSWERS-insulin receptors are damaged, controlled by 1) diet and
exercise, 2) OHA meds, 3) insulin
Fasting blood glucose - ANSWERS-range 70-100, to determine level of circulating
glucose; requires fasting venous blood sample
2 hr. postprandial blood glucose - ANSWERS-to determine need for change in diabetes
therapy; blood drawn 2 hr. after meal
Glucose tolerance test - ANSWERS-to detect abnormal glucose metabolism; blood
drawn 10-12 hrs. after fasting, drawn at 30min intervals for 2 hrs.
Hemoglobin A1C - ANSWERS-good diabetic control <6%, to determine diabetic control
of blood sugar over 2-3 mo.
Nutrition and Exercise - ANSWERS-Reduce fat intake, carb counting, simplified meal
plans, healthy food choices, individualized meal planning strategies.
Exercise Plan - ANSWERS-Exercise should not be planned until blood glucose is under
control, exercise plan should be 3 times a week.
Insulin Types - ANSWERS-Rapid-acting, short-acting, intermediate-acting, and long-
acting.
Insulin-to-Carbohydrate Ratio - ANSWERS-1 unit of insulin per 15g carbohydrate.
, Insulin Verification - ANSWERS-Draw up must be verified by another nurse every time.
Sliding Scale Insulin - ANSWERS-Sliding scale of insulin based on glucose check
before meals and rapid-acting is given.
Footcare - ANSWERS-Inspect feet daily, dry between toes after washing, do not soak
feet, wear clean socks each day, break in shoes gradually, never wear open sandals or with
straps between toes, use sock or blankets to warm feet, test temperature of bath water,
elevate feet.
Travel Care - ANSWERS-Carry twice the medication or insulin, always carry fast-acting
sugars (candy) and long-acting foods (peanut butter crackers), pack dried fruits, nuts, and
seeds for snacks, check blood sugar frequently, seek medical attention immediately when
feeling ill, stick to prescribed meal plans, obtain sufficient rest and avoid stressful situations,
travel with someone familiar with diabetes and treatments, obtain usual amount of exercise
or adjust food and medication accordingly, drink a glass of water every 2 hours, protect
insulin from extreme temperatures, eat something every 4 hours.
Sick Days - ANSWERS-Take insulin and oral meds as prescribed, do not skip doses,
nausea and vomiting replace diet with liquids containing sugar, drink 1 cup water each hour,
test blood sugar every 4 hours, check every 2 hours when really sick, notify provider:
vomiting, abdominal pain, temp 100.2; blood sugar >200 and doesn't decrease with extra
insulin.
Hypoglycemia Symptoms - ANSWERS-Cool and clammy, need some candy; weak,
shaky; hungry; tachycardia; blurred vision.
Hyperglycemia Symptoms - ANSWERS-Hot and dry, sugar's high; dry mucus
membranes; polyuria; polyphagia; polydipsia.
Dawn Phenomenon - ANSWERS-Blood glucose elevated in early morning (0500 and
0900); treatment is intermediate-acting insulin at night.
Somogyi Effect - ANSWERS-Rebound hyperglycemia in response to hypoglycemia.
Diabetic Ketoacidosis (DKA) - ANSWERS-Type 1; S/S: polyuria, FVD, acidosis,
ketones (fruity breath/urine), high blood sugar, hyperkalemia, Kussmaul's breathing;
treatment: IVFs, insulin drip (monitor accu-checks), bicarbs, ECG.
WITH CORRECT QUESTIONS AND VERIFIED
ANSWERS GRADED A+.
Type 1 Diabetes - ANSWERS-need insulin, Islets of Langerhans beta cells are
destroyed and no insulin production
Type 2 Diabetes - ANSWERS-insulin receptors are damaged, controlled by 1) diet and
exercise, 2) OHA meds, 3) insulin
Fasting blood glucose - ANSWERS-range 70-100, to determine level of circulating
glucose; requires fasting venous blood sample
2 hr. postprandial blood glucose - ANSWERS-to determine need for change in diabetes
therapy; blood drawn 2 hr. after meal
Glucose tolerance test - ANSWERS-to detect abnormal glucose metabolism; blood
drawn 10-12 hrs. after fasting, drawn at 30min intervals for 2 hrs.
Hemoglobin A1C - ANSWERS-good diabetic control <6%, to determine diabetic control
of blood sugar over 2-3 mo.
Nutrition and Exercise - ANSWERS-Reduce fat intake, carb counting, simplified meal
plans, healthy food choices, individualized meal planning strategies.
Exercise Plan - ANSWERS-Exercise should not be planned until blood glucose is under
control, exercise plan should be 3 times a week.
Insulin Types - ANSWERS-Rapid-acting, short-acting, intermediate-acting, and long-
acting.
Insulin-to-Carbohydrate Ratio - ANSWERS-1 unit of insulin per 15g carbohydrate.
, Insulin Verification - ANSWERS-Draw up must be verified by another nurse every time.
Sliding Scale Insulin - ANSWERS-Sliding scale of insulin based on glucose check
before meals and rapid-acting is given.
Footcare - ANSWERS-Inspect feet daily, dry between toes after washing, do not soak
feet, wear clean socks each day, break in shoes gradually, never wear open sandals or with
straps between toes, use sock or blankets to warm feet, test temperature of bath water,
elevate feet.
Travel Care - ANSWERS-Carry twice the medication or insulin, always carry fast-acting
sugars (candy) and long-acting foods (peanut butter crackers), pack dried fruits, nuts, and
seeds for snacks, check blood sugar frequently, seek medical attention immediately when
feeling ill, stick to prescribed meal plans, obtain sufficient rest and avoid stressful situations,
travel with someone familiar with diabetes and treatments, obtain usual amount of exercise
or adjust food and medication accordingly, drink a glass of water every 2 hours, protect
insulin from extreme temperatures, eat something every 4 hours.
Sick Days - ANSWERS-Take insulin and oral meds as prescribed, do not skip doses,
nausea and vomiting replace diet with liquids containing sugar, drink 1 cup water each hour,
test blood sugar every 4 hours, check every 2 hours when really sick, notify provider:
vomiting, abdominal pain, temp 100.2; blood sugar >200 and doesn't decrease with extra
insulin.
Hypoglycemia Symptoms - ANSWERS-Cool and clammy, need some candy; weak,
shaky; hungry; tachycardia; blurred vision.
Hyperglycemia Symptoms - ANSWERS-Hot and dry, sugar's high; dry mucus
membranes; polyuria; polyphagia; polydipsia.
Dawn Phenomenon - ANSWERS-Blood glucose elevated in early morning (0500 and
0900); treatment is intermediate-acting insulin at night.
Somogyi Effect - ANSWERS-Rebound hyperglycemia in response to hypoglycemia.
Diabetic Ketoacidosis (DKA) - ANSWERS-Type 1; S/S: polyuria, FVD, acidosis,
ketones (fruity breath/urine), high blood sugar, hyperkalemia, Kussmaul's breathing;
treatment: IVFs, insulin drip (monitor accu-checks), bicarbs, ECG.
