LCCW GIGU: Diabetes, Diabetes GIGU, Lewis's Medical Surgical
Nursing 11th Edition Harding Test Bank, Chapter 48: Diabetes
Mellitus Lewis: Medical-Surgical Nursing, 10th Edition,
diabetes nclex review 2024- 2025
1. To monitor for complications in a patient with type 2 diabetes, which tests will the nurse in
the diabetic clinic schedule at least annually (select all that apply)?
a. Chest x-ray
b. Blood pressure
c. Serum creatinine
d. Urine for microalbuminuria
e. Complete blood count (CBC)
f. Monofilament testing of the foot - answer>>>ANS: B, C, D, F
Blood pressure, serum creatinine, urine testing for microalbuminuria, and monofilament
testing of the foot are recommended at least annually to screen for possible microvascular
and macrovascular complications of diabetes. Chest x-ray and CBC might be ordered if the
patient with diabetes presents with symptoms of respiratory or infectious problems but are
not routinely included in screening.
2. 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. use of low doses of regular insulin.
b. self-monitoring of blood glucose.
,c. oral hypoglycemic medications.
d. maintenance of a healthy weight. - answer>>>D
Rationale: The patient's 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.
Cognitive Level: Application Text Reference: p. 1255
Nursing Process: Planning NCLEX: Physiological Integrity
3. During a diabetes screening program, a patient tells the nurse, "My mother died of
complications of type 2 diabetes. Can I inherit diabetes?" The nurse explains that
a. as long as the patient maintains normal weight and exercises, type 2 diabetes can be
prevented.
b. the patient is at a higher than normal risk for type 2 diabetes and should have periodic blood
glucose level testing.
c. there is a greater risk for children developing type 2 diabetes when the father has type 2
diabetes.
d. although there is a tendency for children of people with type 2 diabetes to develop diabetes,
the risk is higher for those with type 1 diabetes. - answer>>>B
Rationale: Offspring of people with type 2 diabetes are at higher risk for developing type 2
diabetes. The risk can be decreased, but not prevented, by maintenance of normal weight
and exercising. The risk for children of a person with type 1 diabetes to develop diabetes is
higher when it is the father who has the disease. Offspring of people with type 2 diabetes are
more likely to develop diabetes than offspring of those with type 1 diabetes.
Cognitive Level: Application Text Reference: p. 1256
Nursing Process: Implementation NCLEX: Physiological Integrity
,4. A program of weight loss and exercise is recommended for a patient with impaired fasting
glucose (IFG). When teaching the patient about the reason for these lifestyle changes, the nurse
will tell the patient that
a. the high insulin levels associated with this syndrome damage the lining of blood vessels,
leading to vascular disease.
b. although the fasting plasma glucose levels do not currently indicate diabetes, the
glycosylated hemoglobin will be elevated.
c. the liver is producing excessive glucose, which will eventually exhaust the ability of the
pancreas to produce insulin, and exercise will normalize glucose production.
d. the onset of diabetes and the associated cardiovascular risks can be delayed or prevented by
weight loss and exercise. - answer>>>D
Rationale: The patient with IFG is at risk for developing type 2 diabetes, but this risk can be
decreased with lifestyle changes. Glycosylated hemoglobin levels will not be elevated in IFG
and the Hb A1C test is not included in prediabetes testing. Elevated insulin levels do not cause
the damage to blood vessels that can occur with IFG. The liver does not produce increased
levels of glucose in IFG.
Cognitive Level: Application Text Reference: p. 1255
Nursing Process: Implementation NCLEX: Physiological Integrity
5. When assessing the patient experiencing the onset of symptoms of type 1 diabetes, which
question should the nurse ask?
a. "Have you lost any weight lately?"
b. "Do you crave fluids containing sugar?"
c. "How long have you felt anorexic?"
d. "Is your urine unusually dark-colored?" - answer>>>A
Rationale: 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.
Cognitive Level: Application Text Reference: pp. 1255, 1258
6. During a clinic visit 3 months following a diagnosis of type 2 diabetes, the patient reports
following a reduced-calorie diet. The patient has not lost any weight and did not bring the
glucose-monitoring record. The nurse will plan to obtain a(n)
a. fasting blood glucose level.
b. urine dipstick for glucose.
c. glycosylated hemoglobin level.
d. oral glucose tolerance test. - answer>>>C
Rationale: 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.
Cognitive Level: Application Text Reference: pp. 1258-1259
Nursing Process: Planning NCLEX: Physiological Integrity
7. A patient who has just been diagnosed with type 2 diabetes is 5 ft 4 in (160 cm) tall and
weighs 182 pounds (82 kg). A nursing diagnosis of imbalanced nutrition: more than body
requirements is developed. Which patient outcome is most important for this patient?
a. The patient will have a diet and exercise plan that results in weight loss.
b. The patient will state the reasons for eliminating simple sugars in the diet.
c. The patient will have a glycosylated hemoglobin level of less than 7%.
d. The patient will choose a diet that distributes calories throughout the day. - answer>>>C
Rationale: 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 are also appropriate but are not as high in priority.
Cognitive Level: Application Text Reference: p. 1273
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