RNSG 1533 Exam 3 - Acid base &
Metabolism Questions With Verified
Answers
Which statement by a nurse to a patient newly diagnosed with 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. Changes in diet and exercise may control blood glucose levels in type 2 diabetes.
d. Type 2 diabetes is usually diagnosed when the patient is admitted with a hyperglycemic
coma. - answer✔ANS: C
For some patients with type 2 diabetes, changes in lifestyle are sufficient to achieve blood
glucose control.Insulin is frequently used for type 2 diabetes, complications are equally severe
as for type 1 diabetes, and type2 diabetes is usually diagnosed with routine laboratory testing
or after a patient develops complications such asfrequent yeast infections
A 48-year-old male 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. using low doses of regular insulin.
c. lifestyle changes to lower blood glucose.
d. effects of oral hypoglycemic medications. - answer✔ANS: C
The patients impaired fasting glucose indicates prediabetes, and the patient should be
counseled about lifestylechanges to prevent the development of type 2 diabetes. The patient
with prediabetes does not require insulin ororal hypoglycemics for glucose control and does not
need to self-monitor blood glucose.
A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and
glucose control.Which behavior indicates that the nurse should implement additional teaching?
a. The patient always carries hard candies when engaging in exercise.
b. The patient goes for a vigorous walk when his 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. - answer✔ANS: D
When the patient is ketotic, exercise may result in an increase in blood glucose level. Type 1
diabetic patientsshould be taught to avoid exercise when ketosis is present. The other
statements are correct.
The nurse is assessing a 22-year-old patient experiencing the onset of symptoms of type 1
diabetes. Which question is most appropriate for the nurse to ask?
a. Are you anorexic?
b. Is your urine dark colored?
c. Have you lost weight lately?
d. Do you crave sugary drinks? - answer✔ANS: C
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.
A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months
from now.Which test will the nurse schedule to evaluate the effectiveness of treatment for the
patient?
a. Urine dipstick for glucose
b. Oral glucose tolerance test
c. Fasting blood glucose level
d. Glycosylated hemoglobin level - answer✔ANS: D
The glycosylated hemoglobin (A1C or HbA1C) 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 55-year-old female patient with type 2 diabetes has a nursing diagnosis of imbalanced
nutrition: more than body requirements. Which goal is most important for this patient?
a. The patient will reach a glycosylated hemoglobin level of less than 7%.
b. The patient will follow 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. - answer✔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 38-year-old patient who has type 1 diabetes plans to swim laps 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 - answer✔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.
The nurse determines a need for additional instruction when the patient with newly diagnosed
type 1diabetes says which of the following?
a. I can 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 can choose any foods, as long as I use enough insulin to cover the calories.
d. I will eat something at meal times to prevent hypoglycemia, even if I am not hungry -
answer✔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.
In order to assist an older diabetic patient to engage in moderate daily exercise, which action is
most important for the nurse to take?
a. Determine what type of activities the patient enjoys.
b. Remind the patient that exercise will improve self-esteem.
c. Teach the patient about the effects of exercise on glucose level.
d. Give the patient a list of activities that are moderate in intensity. - answer✔ANS: A
Because 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 will also be implemented but are not the most important in
improving compliance.
Which statement by the patient indicates a need for additional instruction in administering
insulin?
a. I need to rotate injection sites among my arms, legs, and abdomen each day.
b. I can 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. -
answer✔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
Which patient action indicates good understanding of the nurses teaching about administration
of aspart(NovoLog) insulin?
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 stores the insulin in the freezer after administering the prescribed dose.
4|Page
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Brightstars. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.49. You're not tied to anything after your purchase.
