NURS 334 EXAM 3 STUDY QUESTIONS AND CORRECT ANSWERS
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Course
NUR 334
Institution
NUR 334
1. After a thorough evaluation, a nurse concludes that the efforts of a client with type 2 diabetes mellitus (DM) to control blood glucose levels have been highly effective over the last 3 months. Which finding supports the nurse's conclusion? a. Hemoglobin A1C level of 5% b. No incidence of diabet...
NURS 334 EXAM 3 STUDY QUESTIONS
AND CORRECT ANSWERS
1. After a thorough evaluation, a nurse concludes that the efforts of a client with type 2
diabetes mellitus (DM) to control blood glucose levels have been highly effective over
the last 3 months. Which finding supports the nurse's conclusion?
a. Hemoglobin A1C level of 5%
b. No incidence of diabetic ketoacidosis (DKA)
c. No ketones in the urine
d. Negative oral glucose tolerance test (OGTT) ✅A.
1. A clinic nurse is evaluating a client with type 1 diabetes who intends to enroll in a
tennis class. Which statement made by the client indicates that the client understands
the effects of exercise on insulin demand?
a. "I will carry a high-fat, high-calorie food, such as a cookie."
b. "I will administer 1 unit of lispro insulin prior to playing tennis."
c. "I will eat a 15-gram carbohydrate snack before playing tennis."
d. "I will decrease the meal prior to the class by 15-grams of carbohydrates." ✅C.
1. A nurse administers 15 units of glargine (Lantus) insulin at 2100 hours to a Hispanic
client when the client's fingerstick blood glucose reading was 110mg/dL. At 2300 hours,
a nursing assistant reports to the nurse that an evening snack was not given because
the client was sleeping. Which instruction by the nurse is most appropriate?
a. "You will need to wake he client to check he blood glucose and then give a snack. All
diabetics get a snack at bedtime."
b. "It is not necessary for this client to have a snack because glargine is absorbed very
slowly over 24 hours and doesn't have a peak."
c. "The next time the client wakes up, check a blood glucose level and then give a
snack."
d. "I will need to notify the physician because a snack at this time will affect the client's
blood glucose level and he next dose of glargine insulin." ✅B.
1. A nurse is teaching a client who has been newly diagnosed with type 2 diabetes
mellitus (DM). Which teaching point should the nurse emphasize?
a. Use the arm when self-administering NPH insulin
b. Exercise for 30 minutes daily, preferably after a meal
c. Consume 30% of the daily calorie intake from protein foods
d. Eat a 30-gram carbohydrate snack prior to strenuous activity ✅B.
1. A home-health nurse is planning the first home visit for a 60-year-old client newly
diagnosed with type 2 diabetes mellitus. The client has been instructed to take 70/30
combination insulin in the morning and at suppertime. Which interventions should be
,included in the client's plan of care for diabetics? SELECT ALL THAT APPLY. CREDIT
GIVEN ONLY FOR ALL CORRECT ANSWERS.
a. Instruct the client to inspect the feet daily
b. Ensure that the client eats a bedtime snack
c. Assess the clients ability to read small print
d. Teach the client to perform a hemoglobin A1c test daily ✅A, B, C
1. A client is scheduled for a preprandial blood sugar check. The blood sugar is 224
mg/dl. According to the sliding scale insulin schedule, the client is to receive 4 units of
Regular insulin for a blood sugar from 201-250 mg/dl. You, the nurse prepare the insulin
as ordered. Upon taking the insulin into the client's room, the client is vomiting and
refuses to eat lunch. What would be an appropriate nursing action?
a. Give the 4 units of Regular insulin and recheck the blood sugar in 30 minutes
b. Give only 2 units of the Regular insulin because the client is vomiting
c. Hold the 4 units of Regular insulin and notify the physician of client vomiting
d. Hold the 4 units of Regular insulin and wait until the client is able to eat and drink and
then give the insulin ✅C.
1. A client is having their blood sugar checked in the clinic where you work. The client
states their fasting blood sugar is 118 mg/dl. The client wants to know why the physician
instructed them to watch their diet and exercise to prevent diabetes. Your explanation to
the client is based on the knowledge that prediabetes:
a. will always lead to a diagnosis of diabetes.
b. can be prevented or delayed with proper diet and exercise.
c. have fasting blood sugar levels between 130 and 150
d. have less incidence of developing complications of diabetes ✅B.
1. A client is scheduled for surgery the following morning and calls you, the nurse, who
works for the client's primary care physician. The client wonders if he should take his
scheduled insulin dosage before surgery the next morning. Your response is:
a. "Yes, you may take your scheduled dose of insulin before surgery and we will check
your blood sugar when you arrive at the ambulatory care center."
b. "No, do not take any insulin before surgery because you will not eat or drink anything
after midnight to prepare you for surgery."
c. "I will check with your physician about if or how much insulin he/she would like you to
take before surgery."
d. "Check your blood sugar tomorrow morning before surgery and if it is >120mg/dl,
take one half of the prescribed dose of your insulin." ✅C.
1. The home care nurse is visiting a child newly diagnosed with DM. The nurse is
instructing the child and parents regarding actions to take if hypoglycemic reactions
occur. The nurse tells the child to:
A. Drink 8 ounces of diet cola at the first sign of weakness
B. Report to the ER if the blood glucose is 60mg/dL
C. Carry hard candies whenever leaving home in case of hypoglycemic reaction occurs
D. Administer glucagon immediately if shakiness is felt ✅C.
,1. A diabetic client who is taking insulin lispro (Humalog) injections would be advised to
eat:
A. Within 30 minutes after the injection
B. 1 hour after the injection
C. At anytime, because timing of meals with lispro injections is unnecessary
D. 2 hours before the injection ✅A.
Match the following characteristics as they relate to complications of diabetes (answers
may be used more than once)
1. Microvascular
2. Macrovascular
3. Autonomic Neuropathy
4. Sensory Neuropathy
_____a. Urinary retention
_____b. Damage to small vessels that supply the renal glomeruli
___ _ c. Related to altered lipid metabolism of diabetes
____d. Microaneurysms and destruction of retinal capillaries
_____e. Atrophy of small muscles of the hands and feet
_____f. Capillary and arteriole membrane thickening specific to diabetes
____ g. Pain and paresthesia of the legs
_____ h. Ulceration and amputation of the lower extremities
___4__i. Foot ulcers without patient feeling pain
_____j. Nausea and or vomiting
_____k. Ischemic heart disease
_____l. Painless myocardial infarction
_____m. Male impotence ✅___3__a. Urinary retention
___1__b. Damage to small vessels that supply the renal glomeruli
___2 _ c. Related to altered lipid metabolism of diabetes
___1__d. Microaneurysms and destruction of retinal capillaries
___4__e. Atrophy of small muscles of the hands and feet
___1__f. Capillary and arteriole membrane thickening specific to diabetes
___4_ g. Pain and paresthesia of the legs
___2__ h. Ulceration and amputation of the lower extremities
___4__i. Foot ulcers without patient feeling pain
___3__j. Nausea and or vomiting
___2__k. Ischemic heart disease
___3__l. Painless myocardial infarction
___3__m. Male impotence
Metabolism ✅the processes of biochemical reactions occurring in the body's cells that
are necessary to produce energy, repair, and facilitate the growth of cells, and maintain
life.
, Diabetes Melitus ✅a chronic multisystem disease characterized by hyperglycemia
related to abnormal insulin production, impaired insulin utilization, or both Affects 29.1
million peopleSeventh leading cause of death
Etiology and Pathophysiology of DM ✅*Combination of causative factors
-Genetic,
-Autoimmune
-Environmental- viruses, obesity
*Absent/insufficient insulin and/or poor utilization of insulin
*Normal glucose and insulin metabolism
-Produced by b-cells in islets of Langerhans
-Released continuously into bloodstream in small increments with larger amounts
released after food
-Stabilizes glucose level in range of 70 to 110 mg/dL
*Insulin:
-promotes glucose transport from the bloodstream across the cell membrane to the
cytoplasm of the cell
-Cells break down glucose to make energy
-Liver and muscle cells store excess glucose as glycogen
-Skeletal muscle and adipose tissue are considered insulin-dependent tissues
*Counter regulatory hormones
-Glucagon, epinephrine, growth hormone, cortisol
-Oppose effects of insulin
-Stimulates glucose production and release by the liver
-Decrease movement of glucose into cells
-Help maintain normal blood glucose levels
Type 1 Diabetes Mellitus ✅-Formerly known as juvenile-onset or insulin-dependent
diabetes
-Generally affects people under age 40
-Can occur at any age
-Autoimmune disorder
-Body develops antibodies against insulin and/or pancreatic β cells that produce
insulin=not enough insulin to survive
-Genetic link
-Idiopathic diabetes
-Autoantibodies are present for months to years before symptoms occur
-Pancreas can no longer produce insulinNecessitates insulin
-Rapid onset with ketoacidosis
-Patient may have temporary remission after initial treatment
Type 2 Diabetes Mellitus ✅-Formerly known as adult-onset diabetes (AODM) or non-
insulin-dependent diabetes (NIDDM)
-Most prevalent type (90% to 95%)
-Many risk factors: -Overweight, obesity, advanced age, family Hx
-Increasing prevalence in children
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