A patient with newly diagnosed type 2 diabetes mellitus asks the nurse what type 2 means in relation to diabetes. Which statement by the nurse about 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 ...
NUR 325 Exam 3 Study Questions and
Answers
A patient with newly diagnosed type 2 diabetes mellitus asks the nurse what type 2
means in relation to diabetes. Which statement by the nurse about 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. Type 2 diabetes is usually diagnosed when the patient is admitted with a
hyperglycemic coma.
d. Changes in diet and exercise may be sufficient to control blood glucose levels in type
2 diabetes. ✅ANS: D
For some patients, changes in lifestyle are sufficient for blood glucose control. Insulin is
frequently used for type 2 diabetes, complications are equally severe as for type 1
diabetes, and type 2 diabetes is usually diagnosed with routine laboratory testing or
after a patient develops complications such as frequent yeast infections.
A 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. use of 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 lifestyle changes to prevent the development of type 2 diabetes. The
patient with prediabetes does not require insulin or the oral hypoglycemics for glucose
control and does not need to self-monitor blood glucose.
Which action by a type 1 diabetic patient indicates that the nurse should implement
teaching about exercise and glucose control?
a. The patient always carries hard candies when engaging in exercise.
b. The patient goes for a vigorous walk when the 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 patients should be taught to avoid exercise when ketosis is present. The
other statements are correct.
When assessing the patient experiencing the onset of symptoms of type 1 diabetes,
which question is most appropriate for the nurse to ask?
a. Have you lost any weight lately?
b. How long have you felt anorexic?
c. Is your urine unusually dark colored?
,d. Do you crave fluids containing sugar? ✅ANS: A
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.
To evaluate the effectiveness of treatment for a patient with type 2 diabetes who is
scheduled for a follow-up visit in the clinic, which test will the nurse plan to schedule 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 (Hb A1C) 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 patient who has just been diagnosed with type 2 diabetes has a nursing diagnosis of
imbalanced nutrition: more than body requirements. Which patient goal is most
important for this patient?
a. The patient will have a glycosylated hemoglobin level of less than 7%.
b. The patient will have 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 nurse is teaching a patient relaxation techniques to decreases stress. Which finding
will support the nurse's evaluation that the therapy is effective?
a) Dilated pupils
b) Increased blood sugar
c) Decreased heart rate
d) Elevated blood pressure ✅c) Decreased heart rate
Which action will help the nurse determine whether a new patient's confusion is caused
by dementia or delirium?
a) Ask about a family history of dementia.
b) Administer the Mini-Mental Status Exam.
c) Use the Confusion Assessment Method tool.
d) Obtain a list of the patient's usual medications. ✅c) Use the Confusion Assessment
Method tool.
,A nurse is developing a plan of care for an older client with diabetic neuropathy of the
lower extremities resulting from type 2 diabetes mellitus. Which problem does the nurse
recognize as the highest priority for this client?
a) Change in body image
b) Increased risk for injury
c) Increased risk of depression
d) Lower level of physical activity ✅b) Increased risk for injury
A nurse is planning dietary measures for an older client who is experiencing dysphagia.
Which action should the nurse include in the plan of care?
a) Encouraging the client to feed herself
b) Ensuring that most of the diet consists of liquids
c) Monitoring the client during meals to ensure that food is swallowed
d) Consulting with the health care provider regarding feeding through an enteral tube
✅d) Consulting with the health care provider regarding feeding through an enteral tube
A patient who has type 1 diabetes plans to take a swimming class 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.
An 18-year-old with newly diagnosed type 1 diabetes has received diet instruction. The
nurse determines a need for additional instruction when the patient says,
a. I may 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 may eat whatever I want, as long as I use enough insulin to cover the calories.
d. I will eat meals as scheduled, even if I am not hungry, to prevent hypoglycemia.
✅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.
Which action is most important for the nurse to take in order to assist a diabetic patient
to engage in moderate daily exercise?
a. Remind the patient that exercise will improve self-esteem.
b. Determine what type of exercise activities the patient enjoys.
c. Give the patient a list of activities that are moderate in intensity.
d. Teach the patient about the effects of exercise on glucose level. ✅ANS: B
, Since 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 also will be implemented, but are
not the most important in improving compliance.
The nurse has been teaching the patient to administer a dose of 10 units of regular
insulin and 28 units of NPH insulin. The statement by the patient that indicates a need
for additional instruction is,
a. I need to rotate injection sites among my arms, legs, and abdomen each day.
b. I will 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.
After the nurse has finished teaching a patient about self-administration of the
prescribed aspart (NovoLog) insulin, which patient action indicates good understanding
of the teaching?
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 places the insulin back in the freezer after administering the prescribed
insulin dose.
d. The patient pushes the plunger down and immediately removes 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. 9:00 AM
b. 11:30 AM
c. 4:00 PM
d. 8:00 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 changes the site for the insertion site every week.
b. The patient programs the pump to deliver an insulin bolus after eating.
c. The patient takes the pump off at bedtime and starts it again each morning.
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