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Lewis Medical Surgical --Chapter 53 Diabetes EXAM QUESTIONS AND CORRECT ANSWER
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Lewis Medical Surgical --Chapter 53 Diabetes EXAM QUESTIONS AND CORRECT ANSWER
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Lewis Medical Surgical --Chapter 53 Diabetes EXAM 2024-2025 QUESTIONS AND CORRECT ANSWER
A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months
from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the
Patient?
a. Fasting blood glucose
b. Glycosylated hemoglobin
c. Oral glucose tolerance test
d. Urine dipstick for glucose and ketones - answer>>>ANS: B
The glycosylated hemoglobin (A1C) test shows the overall control of glucose over 90 to 120
days. A fasting level indicates only the glucose level at one time. Urine glucose testing is not
an accurate reflection of glucose level and does not reflect the glucose over a prolonged time.
Oral glucose tolerance testing is done to diagnose diabetes but is not used for monitoring
glucose control after diabetes has been diagnosed.
Which question during the assessment of a patient who has diabetes will help the nurse
identify autonomic neuropathy?
a. ―Do you feel bloated after eating?‖
b. ―Have you seen any skin changes?‖
c. ―Do you need to increase your insulin dosage when you are stressed?‖
d. ―Have you noticed any painful new ulcerations or sores on your feet?‖ - answer>>>ANS: A
Autonomic neuropathy can cause delayed gastric emptying, which results in a bloated feeling
for the patient. Asking about skin changes, insulin dosages, and foot lesions would not help in
identifying autonomic neuropathy.
Which information would the nurse include in teaching a patient who has peripheral arterial
disease, type 2 diabetes, and sensory neuropathy of the feet and legs?
,a. Choose flat-soled leather shoes.
b. Set heating pads on a low temperature.
c. Use a callus remover for corns or calluses.
d. Soak feet in warm water for an hour each day. - answer>>>ANS: A
The patient is taught to avoid open-toe, open-heel, and high-heel shoes. Leather shoes are
preferred to plastic ones. The feet should be washed, but not soaked, in warm water daily.
Heating pad use should be avoided. Commercial callus and corn removers should be avoided.
The patient should see a specialist to treat these problems.
Which finding indicates a need to contact the health care provider before the nurse administers
metformin (Glucophage)?
a. The patient's glucose level is 174 mg/dL.
b. The patient is scheduled for a chest x-ray in an hour.
c. The patient has gained 2 lb (0.9 kg) in the past 24 hours.
d. The patient's estimated glomerular filtration rate is 42 mL/min. - answer>>>ANS: D
The glomerular filtration rate indicates possible renal impairment, and metformin should not
be used in patients with significant renal impairment. The other findings are not
contraindications to the use of metformin.
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. - answer>>>. ANS:
B
Tricyclic antidepressants (TCAs) decrease the transmission of pain impulses to the spinal cord
and brain. TCAs also improve sleep quality and are used for depression, but that is not the
, major purpose for their use in diabetic neuropathy. TCAs do not affect the blood vessel
changes that contribute to neuropathy.
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. - answer>>>ANS: C
To avoid lactic acidosis, metformin should be discontinued a day or 2 before the coronary
angiogram and should not be used for 48 hours after IV contrast media are administered. The
other patient data do not indicate any need to reschedule the procedure.
Which action by a patient indicates that the home health nurse's teaching about glargine and
regular insulin has been successful?
a. The patient administers the glargine 30 minutes before each meal.
b. The patient's family prefills the syringes with the mix of insulins weekly.
c. The patient discards the open vials of glargine and regular insulin after 4 weeks.
d. The patient draws up the regular insulin and then the glargine in the same syringe. -
answer>>>ANS: C
Insulin can be stored at room temperature for 4 weeks. Glargine should not be mixed with
other insulins or prefilled and stored. Short-acting regular insulin is administered before
meals, and glargine is given once daily.
. A patient with diabetes rides a bicycle to and from work every day. Which site would the
nurse teach the patient to use to administer the morning insulin?
a. Thigh
b. Buttock
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