NUR 229 Final Exam Questions and
Complete Solutions
Type 1 Insulin Pathophysiology ✅(Juvenile) Pancreas does not produce insulin
May have sudden weight loss
Type 2 Insulin Pathophysiology ✅Body produces insulin but it either isn't enough, or
the body is insulin resistant
Gestational Diabetes ✅Occurs during pregnancy
Main function of insulin ✅Transports glucose to body cells to be used for energy
Too much glucose in the blood stream leads to thickened vessel walls
Clinical Manifestations of Hyperglycemia ✅Polyuria, polydipsia, polyphagia
Fatigue weakness, vision changes, numbness/tingling in hands/feet
What labs are used to diagnose Diabetes? ✅Fasting plasma glucose: Should never be
above 126
Blood Glucose 2 hours after eating shouldn't be above 200
A1C should be below 6.5%
5 Components of Diabetes Management ✅Nutritional therapy, exercise, monitoring,
Pharmacologic therapy, Education
3 Goals of Dietary Management for diabetic PTs ✅Control total caloric intake to
maintain reasonable body weight
Control glucose levels
Normalize lipid levels and BP
Effect of exercise on blood glucose ✅Lowers blood glucose
PT on insulin should eat a 15 gram carbohydrate snack prior to exercise and insulin
may be adjusted
What should the nurse obtain before giving insulin ✅PT current insulin levels
When is it ok for the nurse to leave a hypoglycemic or hyperglycemic PT? ✅When
their glucose levels have stabilized
,What should the nurse do if a PT is alert, oriented, and hypoglycemic? ✅Give a 15-20
gram carbohydrate snack
What should the nurse do if a PT is hypoglycemic and unconscious or can't swallow
✅If the PT has an IV, give Dextrose (results should be seen in 1.5 minutes)
If the PT doesn't have an IV, give Glucagon IM injection
Normal Blood Glucose range ✅Hypoglycemia: <70
Hyperglycemia: >180
Oral antidiabetic agents are used for which type of diabetes? ✅Type 2 only
Clinical Manifestations of Hypoglycemia ✅Sweating, tremors, tachycardia, palpitations,
hunger, confusion/disoriented, HA, slurred speech
Severe Hypoglycemia: Disorientation, seizures, loss of consciousness, death
Nursing Interventions for Hypoglycemic PT ✅Give 15g of carbohydrates (3 or 4
glucose tablets, or 4-6oz of juice or soda)
Retest BG in 15 minutes
Peripheral Neuropathy Pathophysiology ✅Blood vessels in the feet become thickened
resulting in feet not receiving enough nutrients due to lack of circulation
Makes wound healing much more difficult
PT Teaching for Peripheral Neuropathy ✅Inspect and wash feet everyday
Wear shoes and socks at all times
Protect feet from hot and cold
Keep blood flowing to feet (elevate feet, wiggle toes, don't cross legs)
Sick Day Rules for Diabetic PTs ✅Take insulin or antibiotics as usual
If unable to retain oral fluids you may require hospitalization
Substitute soft foods and take liquids
Take Glucose Q3-4H and report elevated levels
What is the diagnosing criteria for HTN? ✅2 BP readings at least 4 weeks apart
>140 / >90
, What are the symptoms of elevated BP? ✅There aren't any symptoms usually
Late symptoms: Organ damage (retinal/eye changes, renal damage, MI, cardiac
hypertrophy, stroke)
What are the lifestyle modifications HTN Pts should make? ✅Weight Reduction
DASH (low sodium) diet
Physical Activity
Reduced Alcohol (2 drinks/week)
What foods are included in the DASH diet? ✅Fruits, vegetables, grains, seeds, nuts,
legumes
What is the recommended sodium intake range? ✅2000-2300mg
What is the ideal BP for HTN PTs? ✅Under 140/90
Always compare it to their baseline
PT Education when taking anti-hypertensives ✅Continue taking meds even if BP is
improved
Rebound HTN is worse
*Diabetics on beta-blockers don't show symptoms of hypoglycemia*
What should the nurse do first if a PT has a high BP? ✅Retake manually and obtain all
other vitals
What BP is considered a hypertensive emergency?
What should you do for the PT during a HTN Emergency? ✅>180/120
Lower the PT immediately to prevent damage to target organs
What is Hypertensive Urgency? ✅BP is very elevated but there is no evidence of
immediate or progressive target organ damage
Goals for PT during HTN Emergency ✅Reduce BP 20-25% in first hour
Reduce BP to 160/100 in 6 hours
Bring BP to normal levels in a few days
What should the nurse monitor for a PT with HTN ✅I&O
What is the Virchow Triad? ✅The causes of a DVT
Complete Solutions
Type 1 Insulin Pathophysiology ✅(Juvenile) Pancreas does not produce insulin
May have sudden weight loss
Type 2 Insulin Pathophysiology ✅Body produces insulin but it either isn't enough, or
the body is insulin resistant
Gestational Diabetes ✅Occurs during pregnancy
Main function of insulin ✅Transports glucose to body cells to be used for energy
Too much glucose in the blood stream leads to thickened vessel walls
Clinical Manifestations of Hyperglycemia ✅Polyuria, polydipsia, polyphagia
Fatigue weakness, vision changes, numbness/tingling in hands/feet
What labs are used to diagnose Diabetes? ✅Fasting plasma glucose: Should never be
above 126
Blood Glucose 2 hours after eating shouldn't be above 200
A1C should be below 6.5%
5 Components of Diabetes Management ✅Nutritional therapy, exercise, monitoring,
Pharmacologic therapy, Education
3 Goals of Dietary Management for diabetic PTs ✅Control total caloric intake to
maintain reasonable body weight
Control glucose levels
Normalize lipid levels and BP
Effect of exercise on blood glucose ✅Lowers blood glucose
PT on insulin should eat a 15 gram carbohydrate snack prior to exercise and insulin
may be adjusted
What should the nurse obtain before giving insulin ✅PT current insulin levels
When is it ok for the nurse to leave a hypoglycemic or hyperglycemic PT? ✅When
their glucose levels have stabilized
,What should the nurse do if a PT is alert, oriented, and hypoglycemic? ✅Give a 15-20
gram carbohydrate snack
What should the nurse do if a PT is hypoglycemic and unconscious or can't swallow
✅If the PT has an IV, give Dextrose (results should be seen in 1.5 minutes)
If the PT doesn't have an IV, give Glucagon IM injection
Normal Blood Glucose range ✅Hypoglycemia: <70
Hyperglycemia: >180
Oral antidiabetic agents are used for which type of diabetes? ✅Type 2 only
Clinical Manifestations of Hypoglycemia ✅Sweating, tremors, tachycardia, palpitations,
hunger, confusion/disoriented, HA, slurred speech
Severe Hypoglycemia: Disorientation, seizures, loss of consciousness, death
Nursing Interventions for Hypoglycemic PT ✅Give 15g of carbohydrates (3 or 4
glucose tablets, or 4-6oz of juice or soda)
Retest BG in 15 minutes
Peripheral Neuropathy Pathophysiology ✅Blood vessels in the feet become thickened
resulting in feet not receiving enough nutrients due to lack of circulation
Makes wound healing much more difficult
PT Teaching for Peripheral Neuropathy ✅Inspect and wash feet everyday
Wear shoes and socks at all times
Protect feet from hot and cold
Keep blood flowing to feet (elevate feet, wiggle toes, don't cross legs)
Sick Day Rules for Diabetic PTs ✅Take insulin or antibiotics as usual
If unable to retain oral fluids you may require hospitalization
Substitute soft foods and take liquids
Take Glucose Q3-4H and report elevated levels
What is the diagnosing criteria for HTN? ✅2 BP readings at least 4 weeks apart
>140 / >90
, What are the symptoms of elevated BP? ✅There aren't any symptoms usually
Late symptoms: Organ damage (retinal/eye changes, renal damage, MI, cardiac
hypertrophy, stroke)
What are the lifestyle modifications HTN Pts should make? ✅Weight Reduction
DASH (low sodium) diet
Physical Activity
Reduced Alcohol (2 drinks/week)
What foods are included in the DASH diet? ✅Fruits, vegetables, grains, seeds, nuts,
legumes
What is the recommended sodium intake range? ✅2000-2300mg
What is the ideal BP for HTN PTs? ✅Under 140/90
Always compare it to their baseline
PT Education when taking anti-hypertensives ✅Continue taking meds even if BP is
improved
Rebound HTN is worse
*Diabetics on beta-blockers don't show symptoms of hypoglycemia*
What should the nurse do first if a PT has a high BP? ✅Retake manually and obtain all
other vitals
What BP is considered a hypertensive emergency?
What should you do for the PT during a HTN Emergency? ✅>180/120
Lower the PT immediately to prevent damage to target organs
What is Hypertensive Urgency? ✅BP is very elevated but there is no evidence of
immediate or progressive target organ damage
Goals for PT during HTN Emergency ✅Reduce BP 20-25% in first hour
Reduce BP to 160/100 in 6 hours
Bring BP to normal levels in a few days
What should the nurse monitor for a PT with HTN ✅I&O
What is the Virchow Triad? ✅The causes of a DVT
