RNSG 1533 Exam 3 - Acid base & Metabolism Questions And Answers Rated 100% Correct!!
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RNSG 1533 - Acid base & Metabolism
Institution
RNSG 1533 - Acid Base & Metabolism
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. Urine dipstick for glucose
b. Oral glucose tolerance test
c. Fasting blood glucose level
d....
RNSG 1533 Exam 3 - Acid base &
Metabolism
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. Urine dipstick for glucose
b. Oral glucose tolerance test
c. Fasting blood glucose level
d. Glycosylated hemoglobin level - ✔️✔️ANS: D
The glycosylated hemoglobin (A1C or HbA1C) test shows the overall control of glucose
over 90 to 120 days. A fasting blood level indicates only the glucose level at one time.
Urine glucose testing is not an accurate reflection of blood 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 once diabetes has
been diagnosed.
A 48-year-old male patient screened for diabetes at a clinic has a fasting plasma
glucose level of 120 mg/dL(6.7 mmol/L). The nurse will plan to teach the patient about
a. self-monitoring of blood glucose.
b. using low doses of regular insulin.
c. lifestyle changes to lower blood glucose.
d. effects of oral hypoglycemic medications. - ✔️✔️ANS: C
The patients impaired fasting glucose indicates prediabetes, and the patient should be
counseled about lifestylechanges to prevent the development of type 2 diabetes. The
patient with prediabetes does not require insulin ororal hypoglycemics for glucose
control and does not need to self-monitor blood glucose.
Which statement by a nurse to a patient newly diagnosed with type 2 diabetes is
correct?
a. Insulin is not used to control blood glucose in patients with type 2 diabetes.
b. Complications of type 2 diabetes are less serious than those of type 1 diabetes.
c. Changes in diet and exercise may control blood glucose levels in type 2 diabetes.
d. Type 2 diabetes is usually diagnosed when the patient is admitted with a
hyperglycemic coma. - ✔️✔️ANS: C
For some patients with type 2 diabetes, changes in lifestyle are sufficient to achieve
blood glucose control.Insulin is frequently used for type 2 diabetes, complications are
equally severe as for type 1 diabetes, and type2 diabetes is usually diagnosed with
routine laboratory testing or after a patient develops complications such asfrequent
yeast infections
,A 28-year-old male patient with type 1 diabetes reports how he manages his exercise
and glucose control.Which behavior indicates that the nurse should 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. -
✔️✔️ANS: D
When the patient is ketotic, exercise may result in an increase in blood glucose level.
Type 1 diabetic patientsshould be taught to avoid exercise when ketosis is present. The
other statements are correct.
The nurse is assessing a 22-year-old patient experiencing the onset of symptoms of
type 1 diabetes. Which question is most appropriate for the nurse to ask?
a. Are you anorexic?
b. Is your urine dark colored?
c. Have you lost weight lately?
d. Do you crave sugary drinks? - ✔️✔️ANS: C
Weight loss occurs because the body is no longer able to absorb glucose and starts to
break down protein and fat for energy. The patient is thirsty but does not necessarily
crave sugar-containing fluids. Increased appetite is a classic symptom of type 1
diabetes. With the classic symptom of polyuria, urine will be very dilute.
A 55-year-old female patient with type 2 diabetes has a nursing diagnosis of imbalanced
nutrition: more than body requirements. Which goal is most important for this patient?
a. The patient will reach a glycosylated hemoglobin level of less than 7%.
b. The patient will follow a diet and exercise plan that results in weight loss.
c. The patient will choose a diet that distributes calories throughout the day.
d. The patient will state the reasons for eliminating simple sugars in the diet. -
✔️✔️ANS: A
The complications of diabetes are related to elevated blood glucose, and the most
important patient outcome is the reduction of glucose to near-normal levels. The other
outcomes also are appropriate but are not as high in priority.
A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM. The
clinic nurse will plan to teach the patient to
a. check glucose level before, during, and after swimming.
b. delay eating the noon meal until after the swimming class.
c. increase the morning dose of neutral protamine Hagedorn (NPH) insulin.
d. time the morning insulin injection so that the peak occurs while swimming -
✔️✔️ANS: A
The change in exercise will affect blood glucose, and the patient will need to monitor
glucose carefully to determine the need for changes in diet and insulin administration.
Because exercise tends to decrease blood glucose, patients are advised to eat before
exercising. Increasing the morning NPH or timing the insulin to peak during exercise
may lead to hypoglycemia, especially with the increased exercise.
,The nurse determines a need for additional instruction when the patient with newly
diagnosed type 1diabetes says which of the following?
a. I can have an occasional alcoholic drink if I include it in my meal plan.
b. I will need a bedtime snack because I take an evening dose of NPH insulin.
c. I can choose any foods, as long as I use enough insulin to cover the calories.
d. I will eat something at meal times to prevent hypoglycemia, even if I am not hungry -
✔️✔️ANS: C
Most patients with type 1 diabetes need to plan diet choices very carefully. Patients who
are using intensified insulin therapy have considerable flexibility in diet choices but still
should restrict dietary intake of items such as fat, protein, and alcohol. The other patient
statements are correct and indicate good understanding of the diet instruction.
In order to assist an older diabetic patient to engage in moderate daily exercise, which
action is most important for the nurse to take?
a. Determine what type of activities the patient enjoys.
b. Remind the patient that exercise will improve self-esteem.
c. Teach the patient about the effects of exercise on glucose level.
d. Give the patient a list of activities that are moderate in intensity. - ✔️✔️ANS: A
Because consistency with exercise is important, assessment for the types of exercise
that the patient finds enjoyable is the most important action by the nurse in ensuring
adherence to an exercise program. The other actions will also be implemented but are
not the most important in improving compliance.
Which statement by the patient indicates a need for additional instruction in
administering insulin?
a. I need to rotate injection sites among my arms, legs, and abdomen each day.
b. I can buy the 0.5 mL syringes because the line markings will be easier to see.
c. I should draw up the regular insulin first after injecting air into the NPH bottle.
d. I do not need to aspirate the plunger to check for blood before injecting insulin. -
✔️✔️ANS: A
Rotating sites is no longer recommended because there is more consistent insulin
absorption when the same site is used consistently. The other patient statements are
accurate and indicate that no additional instruction is needed
Which patient action indicates good understanding of the nurses teaching about
administration of aspart(NovoLog) insulin?
a. The patient avoids injecting the insulin into the upper abdominal area.
b. The patient cleans the skin with soap and water before insulin administration.
c. The patient stores the insulin in the freezer after administering the prescribed dose.
d. The patient pushes the plunger down while removing the syringe from the injection
site. - ✔️✔️ANS: B
Cleaning the skin with soap and water or with alcohol is acceptable. Insulin should not
be frozen. The patient should leave the syringe in place for about 5 seconds after
injection to be sure that all the insulin has been injected. The upper abdominal area is
one of the preferred areas for insulin injection.
, A patient receives aspart (NovoLog) insulin at 8:00 AM. Which time will it be most
important for the nurse to monitor for symptoms of hypoglycemia?
a. 10:00 AM
b. 12:00 AM
c. 2:00 PM
d. 4:00 PM - ✔️✔️ANS: A
The rapid-acting insulins peak in 1 to 3 hours. The patient is not at a high risk for
hypoglycemia at the other listed times, although hypoglycemia may occur.
Which patient action indicates a good understanding of the nurses teaching about the
use of an insulin pump?
a. The patient programs the pump for an insulin bolus after eating.
b. The patient changes the location of the insertion site every week.
c. The patient takes the pump off at bedtime and starts it again each morning.
d. The patient plans for a diet that is less flexible when using the insulin pump. -
✔️✔️ANS: A
In addition to the basal rate of insulin infusion, the patient will adjust the pump to
administer a bolus after each meal, with the dosage depending on the oral intake. The
insertion site should be changed every 2 or 3 days.There is more flexibility in diet and
exercise when an insulin pump is used. The pump will deliver a basal insulin rate 24
hours a day.
A 32-year-old patient with diabetes is starting on intensive insulin therapy. Which type of
insulin will thenurse discuss using for mealtime coverage?
a. Lispro (Humalog)
b. Glargine (Lantus)
c. Detemir (Levemir)
d. NPH (Humulin N) - ✔️✔️ANS: A
Rapid- or short-acting insulin is used for mealtime coverage for patients receiving
intensive insulin therapy.NPH, glargine, or detemir will be used as the basal insulin.
Which information will the nurse include when teaching a 50-year-old patient who has
type 2 diabetes about glyburide (Micronase, DiaBeta, Glynase)?
a. Glyburide decreases glucagon secretion from the pancreas.
b. Glyburide stimulates insulin production and release from the pancreas.
c. Glyburide should be taken even if the morning blood glucose level is low.
d. Glyburide should not be used for 48 hours after receiving IV contrast media. -
✔️✔️ANS: B
The sulfonylureas stimulate the production and release of insulin from the pancreas. If
the glucose level is low,the patient should contact the health care provider before taking
the glyburide, because hypoglycemia can occur with this class of medication. Metformin
should be held for 48 hours after administration of IV contrast media, but this is not
necessary for glyburide. Glucagon secretion is not affected by glyburide.
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