NRSNG DIABETES NCLEX
EXAM STUDY SET
1) A nurse is counseling a patient who has hypertension and type 2 diabetes. During the
initial assessment, the nurse notes that the patient has a blood pressure of 148/92
mmHg, a BMI of 28, and a blood glucose level of 161 mg/dL. Which of the following
information about lifestyle changes would be most beneficial to help control this
patients state of health? - Answer - Help the patient understand how to lose weight to
get her BMI to less than 25
1) Rationale - Answer Hypertension may be associated with diabetes; a patient who
presents with an elevated blood pressure and elevated blood glucose levels can make
lifestyle changes that can improve both blood pressure and blood glucose levels. This
most likely involves managing weight and getting to a normal BMI.
2) A patient with diabetes is being seen for symptoms of DKA. What actions should the
nurse expect to be ordered as initial treatment? Select all that apply. - Answer -
Providing IV fluid with sodium chloride solution
- Administering Regular insulin
- Checking the patients potassium levels
- Assessing the patients urine for glucose and ketones
2) Rationale - Answer Diabetic ketoacidosis is a condition in which a patient presents
with a very high blood glucose level, ketones in the urine, and potential cognitive
changes. The nurse's priorities are to manage blood glucose levels by increasing the IV
rate and administering insulin; the nurse would also monitor for electrolyte changes that
could lead to significant complications. It is not necessary to encourage activity until the
patients condition has stabilized.
3) A diabetic patient is recovering after a pancreas transplant for treatment of type 1
diabetes. Based on the nurse's knowledge of this process, the nurse knows that after a
pancreas transplant: - Answer - the surgery will reduce the risks of hypo- and
hyperglycemia for the patient.
3) Rationale - Answer A pancreas transplant may be an option for some patients who
suffer from type 1 diabetes and who do not have a functioning method of creating or
secreting insulin to control blood sugar levels. Following a pancreatic transplant, the
patient will still need medications to prevent organ rejection, but the transplant should
reduce the risks of hypo- or hyperglycemia for the patient.
4) A 58-year-old patient with a diabetic foot wound needs his dressing changed by the
nurse caring for him. The nurse uses sterile technique as part of his wound dressing
, change. Which of the following techniques would be included as part of this sterile
technique? Select all that apply. - Answer - The nurse opens a dressing package and
does not allow anything to touch the inside of the package
- The nurse does not allow any of the wound debridement instruments to go below the
level of her waist
- The nurse does not turn her back on the instruments used for the dressing change
4) Rationale - Answer A nurse may perform a dressing change using sterile technique to
prevent infection. The nurse keeps the items in the package sterile before use and does
not allow any sterile items to go below the waist, nor does the nurse turn her back on
these items.
5) A diabetic patient in the care clinic is complaining of feeling anxious; the nurse notes
his skin is sweaty, he has tremors, and he is tachycardic. Which intervention would the
nurse most likely perform in response? - Answer - Provide a glass of juice for the patient
to drink
5) Rationale - Answer The patient is exhibiting symptoms of hypoglycemia: a decrease in
blood glucose levels. The first response is to bring the patients blood sugar levels up to
prevent complications. The nurse can offer a snack or drink that contains
carbohydrates, such as a small glass of juice.
6) A pregnant client is in labor to deliver her baby. The mother is 39 weeks' gestation
and has had gestational diabetes during pregnancy. The mother has missed many
prenatal appointments and admits that she has not checked her blood glucose levels or
controlled her diet well, despite her diagnosis. Which of the following are risks to the
infant as a result of uncontrolled gestational diabetes? Select all that apply. - Answer -
Large body size
- Low blood glucose after birth
- An increased risk of obesity later in life
6) Rationale - Answer Uncontrolled gestational diabetes can cause many complications
for both the pregnant mother and the unborn child. Gestational diabetes results in an
increase risk of infant macrosomia, or large body size. The infant may also have
hypoglycemia after birth when he is no longer connected to the mother's blood supply.
Finally, infants born to mothers with gestational diabetes are at greater risk of
developing obesity later in life.
7) The nurse is giving insulin to a client with diabetes for what purpose? - Answer - For
health maintenance
7) Rationale - Answer Insulin is used to control blood sugar, which is a part of health
maintenance in a diabetic. It cannot prevent diabetes nor can it cure it. It does not
change disease manifestations as there are no overt manifestations of disease in the
daily life of a diabetic.
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