CNA 101 Diabetes Mellitus Exam 3 Questions and Answers- North Seattle Community College
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CNA 101
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CNA 101
CNA 101 Diabetes Mellitus Exam 3 Questions and Answers- North Seattle Community College/CNA 101 Diabetes Mellitus Exam 3 Questions and Answers- North Seattle Community College/CNA 101 Diabetes Mellitus Exam 3 Questions and Answers- North Seattle Community College/CNA 101 Diabetes Mellitus Exam 3 Qu...
cna 101 diabetes mellitus exam 3 questions and answers north seattle community collegecna 101 diabetes mellitus exam 3 questions and answers north seattle community collegecna 101 diabetes mellitu
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A nurse is teaching a client with diabetes mellitus who asks, "Why is it necessary to maintain my blood glucose
levels no lower than about 60 mg/dL?" How should the nurse respond?
a."Glucose is the only fuel used by the body to produce the energy that it needs."
b."Your brain needs a constant supply of glucose because it cannot store it."
c."Without a minimum level of glucose, your body does not make red blood cells."
d."Glucose in the blood prevents the formation of lactic acid and prevents acidosis."
ANS: B
Because the brain cannot synthesize or store significant amounts of glucose, a continuous supply from the
body's circulation is needed to meet the fuel demands of the central nervous system. The nurse would want to
educate the client to prevent hypoglycemia. The body can use other sources of fuel, including fat and protein,
and glucose is not involved in the production of red blood cells. Glucose in the blood will encourage glucose
metabolism but is not directly responsible for lactic acid formation.
A nurse reviews laboratory results for a client with diabetes mellitus who presents with polyuria, lethargy, and a
blood glucose of 560 mg/dL. Which laboratory result should the nurse correlate with the client's polyuria?
Hyperglycemia causes hyperosmolarity of extracellular fluid. This leads to polyuria from an osmotic diuresis.
The client's serum osmolarity is high. The client's sodium would be expected to be high owing to dehydration.
Serum creatinine and urine ketone bodies are not related to the polyuria.
After teaching a young adult client who is newly diagnosed with type 1 diabetes mellitus, the nurse assesses the
client's understanding. Which statement made by the client indicates a correct understanding of the need for eye
examinations?
a."At my age, I should continue seeing the ophthalmologist as I usually do."
b."I will see the eye doctor when I have a vision problem and yearly after age 40."
c."My vision will change quickly. I should see the ophthalmologist twice a year."
d."Diabetes can cause blindness, so I should see the ophthalmologist yearly."
ANS: D
Diabetic retinopathy is a leading cause of blindness in North America. All clients with diabetes, regardless of
age, should be examined by an ophthalmologist (rather than an optometrist or optician) at diagnosis and at least
yearly thereafter.
A nurse assesses a client who has a 15-year history of diabetes and notes decreased tactile sensation in both feet.
Which action should the nurse take first?
a.Document the finding in the client's chart.
b.Assess tactile sensation in the client's hands.
c.Examine the client's feet for signs of injury.
d.Notify the health care provider.
,ANS: C
Diabetic neuropathy is common when the disease is of long duration. The client is at great risk for injury in any
area with decreased sensation because he or she is less able to feel injurious events. Feet are common locations
for neuropathy and injury, so the nurse should inspect them for any signs of injury. After assessment, the nurse
should document findings in the client's chart. Testing sensory perception in the hands may or may not be
needed. The health care provider can be notified after assessment and documentation have been completed.
A nurse cares for a client who has a family history of diabetes mellitus. The client states, "My father has type 1
diabetes mellitus. Will I develop this disease as well?" How should the nurse respond?
a."Your risk of diabetes is higher than the general population, but it may not occur."
b."No genetic risk is associated with the development of type 1 diabetes mellitus."
c."The risk for becoming a diabetic is 50% because of how it is inherited."
d."Female children do not inherit diabetes mellitus, but male children will."
ANS: A
Risk for type 1 diabetes is determined by inheritance of genes coding for HLA-DR and HLA-DQ tissue types.
Clients who have one parent with type 1 diabetes are at increased risk for its development. Diabetes (type 1)
seems to require interaction between inherited risk and environmental factors, so not everyone with these genes
develops diabetes. The other statements are not accurate.
A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement should the nurse include in
this client's plan of care to delay the onset of microvascular and macrovascular complications?
a."Maintain tight glycemic control and prevent hyperglycemia."
b."Restrict your fluid intake to no more than 2 liters a day."
c."Prevent hypoglycemia by eating a bedtime snack."
d."Limit your intake of protein to prevent ketoacidosis."
ANS: A
Hyperglycemia is a critical factor in the pathogenesis of long-term diabetic complications. Maintaining tight
glycemic control will help delay the onset of complications. Restricting fluid intake is not part of the treatment
plan for clients with diabetes. Preventing hypoglycemia and ketosis, although important, are not as important as
maintaining daily glycemic control.
A nurse assesses clients who are at risk for diabetes mellitus. Which client is at greatest risk?
a.A 29-year-old Caucasian
b.A 32-year-old African-American
c.A 44-year-old Asian
d.A 48-year-old American Indian
ANS: D
Diabetes is a particular problem among African Americans, Hispanics, and American Indians. The incidence of
diabetes increases in all races and ethnic groups with age. Being both an American Indian and middle-aged
places this client at highest risk.
,A nurse teaches a client about self-monitoring of blood glucose levels. Which statement should the nurse
include in this client's teaching to prevent bloodborne infections?
a."Wash your hands after completing each test."
b."Do not share your monitoring equipment."
c."Blot excess blood from the strip with a cotton ball."
d."Use gloves when monitoring your blood glucose."
ANS: B
Small particles of blood can adhere to the monitoring device, and infection can be transported from one user to
another. Hepatitis B in particular can survive in a dried state for about a week. The client should be taught to
avoid sharing any equipment, including the lancet holder. The client should be taught to wash his or her hands
before testing. The client would not need to blot excess blood away from the strip or wear gloves.
A nurse teaches a client with type 2 diabetes mellitus who is prescribed glipizide (Glucotrol). Which statement
should the nurse include in this client's teaching?
a."Change positions slowly when you get out of bed."
b."Avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs)."
c."If you miss a dose of this drug, you can double the next dose."
d."Discontinue the medication if you develop a urinary infection."
ANS: B
NSAIDs potentiate the hypoglycemic effects of sulfonylurea agents. Glipizide is a sulfonylurea. The other
statements are not applicable to glipizide.
After teaching a client with type 2 diabetes mellitus who is prescribed nateglinide (Starlix), the nurse assesses
the client's understanding. Which statement made by the client indicates a correct understanding of the
prescribed therapy?
a."I'll take this medicine during each of my meals."
b."I must take this medicine in the morning when I wake."
c."I will take this medicine before I go to bed."
d."I will take this medicine immediately before I eat
ANS: D
Nateglinide is an insulin secretagogue that is designed to increase meal-related insulin secretion. It should be
taken immediately before each meal. The medication should not be taken without eating as it will decrease the
client's blood glucose levels. The medication should be taken before meals instead of during meals.
A nurse cares for a client who is prescribed pioglitazone (Actos). After 6 months of therapy, the client reports
that his urine has become darker since starting the medication. Which action should the nurse take?
a.Assess for pain or burning with urination.
b.Review the client's liver function study results.
c.Instruct the client to increase water intake.
d.Test a sample of urine for occult blood.
, ANS: B
Thiazolidinediones (including pioglitazone) can affect liver function; liver function should be assessed at the
start of therapy and at regular intervals while the client continues to take these drugs. Dark urine is one indicator
of liver impairment because bilirubin is increased in the blood and is excreted in the urine. The nurse should
check the client's most recent liver function studies. The nurse does not need to assess for pain or burning with
urination and does not need to check the urine for occult blood. The client does not need to be told to increase
water intake.
A nurse cares for a client with diabetes mellitus who asks, "Why do I need to administer more than one injection
of insulin each day?" How should the nurse respond?
a."You need to start with multiple injections until you become more proficient at self-injection."
b."A single dose of insulin each day would not match your blood insulin levels and your food intake patterns."
c."A regimen of a single dose of insulin injected each day would require that you eat fewer carbohydrates."
d."A single dose of insulin would be too large to be absorbed, predictably putting you at risk for insulin shock."
ANS: B
Even when a single injection of insulin contains a combined dose of different-acting insulin types, the timing of
the actions and the timing of food intake may not match well enough to prevent wide variations in blood
glucose levels. One dose of insulin would not be appropriate even if the client decreased carbohydrate intake.
Additional injections are not required to allow the client practice with injections, nor will one dose increase the
client's risk of insulin shock.
After teaching a client with diabetes mellitus to inject insulin, the nurse assesses the client's understanding.
Which statement made by the client indicates a need for additional teaching?
a."The lower abdomen is the best location because it is closest to the pancreas."
b."I can reach my thigh the best, so I will use the different areas of my thighs."
c."By rotating the sites in one area, my chance of having a reaction is decreased."
d."Changing injection sites from the thigh to the arm will change absorption rates."
ANS: A
The abdominal site has the fastest rate of absorption because of blood vessels in the area, not because of its
proximity to the pancreas. The other statements are accurate assessments of insulin administration.
A nurse assesses a client with diabetes mellitus and notes the client only responds to a sternal rub by moaning,
has capillary blood glucose of 33 g/dL, and has an intravenous line that is infiltrated with 0.45% normal saline.
Which action should the nurse take first?
a.Administer 1 mg of intramuscular glucagon.
b.Encourage the client to drink orange juice.
c.Insert a new intravenous access line.
d.Administer 25 mL dextrose 50% (D50) IV push.
ANS: A
The client's blood glucose level is dangerously low. The nurse needs to administer glucagon IM immediately to
increase the client's blood glucose level. The nurse should insert a new IV after administering the glucagon and
can use the new IV site for future doses of D50 if the client's blood glucose level does not rise. Once the client
is awake, orange juice may be administered orally along with a form of protein such as a peanut butter.
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