N4 test Chapter 47 Diabetes Mellitus

Med Surg
1. The polydipsia and polyuria related to diabetes mellitus are primarily caused by
A. the release of ketones from cells during fat metabolism.
B. fluid shifts resulting from the osmotic effect of hyperglycemia.
C. damage to the kidneys from exposure to high levels of glucose.
D.changes in RBCs resulting from attachment of excessive glucose to hemoglobin.

2. When a patient with type 2 diabetes mellitus is admitted to the hospital with pneumonia, the nurse recognizes that the patient
A. must receive insulin therapy to prevent the development of ketoacidosis.
B. has islet cell antibodies that have destroyed the ability of the pancreas to produce insulin.
C. has minimal or absent endogenous insulin secretion and requires daily insulin injections.
D. may have sufficient endogenous insulin to prevent ketosis but is at risk for development of hyperosmolar hyperglycemic nonketotic syndrome.

3. Effective collaborative management of diabetes includes
A. using insulin with all patients to achieve glycemic goals.
B. relying on the health care provider as the central figure in the program for good control.
C. relying solely on nutritional therapy as the initial treatment modality for all patients with diabetes.
D. aiming for a balance of diet, activity, and medications together with appropriate monitoring and patient and family teaching.

4.
The nurse assists the patient with nutritional therapy of diabetes with the knowledge that a “diabetic diet” is designed
A. to be used only for type 1 diabetes.
B. for use during periods of high stress.
C. to normalize blood glucose by elimination of sugar.
D. to help normalize blood glucose through a balanced diet.

5. In teaching a newly diagnosed type 1 diabetic “survival skills,” the nurse includes information about
A. weight loss measures.
B. elimination of sugar from diet.
C. need to reduce physical activity.
D. self-monitoring of blood glucose.

6. An appropriate teaching measure for the patient with diabetes mellitus related to care of the feet is to
A. use heat to increase blood supply.
B. avoid softening lotions and creams.
C. inspect all surfaces of the feet daily.
D. use iodine to disinfect cuts and abrasions.

7. A diabetic patient has a serum glucose level of 824 mg/dl (45.7 mmol/L) and is unresponsive. Following assessment of the patient, the nurse suspects diabetic ketoacidosis rather than hyperosmolar hyperglycemic nonketotic syndrome based on the finding of
A. polyuria.
B. severe dehydration.
C. rapid, deep respirations.
D. decreased serum potassium.

8. Which of the following is not an appropriate therapy for patients with diabetes mellitus?
A. Use of diuretics to treat renal problems
B. Use of ACE inhibitors to treat renal problems
C. Use of laser photocoagulation to treat retinopathy
D. Use of regular insulin for a patient with type 2 diabetes during the intraoperative period