The main purpose of giving insulin to a client with Type 1 diabetes is to: improve the functioning of the pancreas

replace the insulin not being produced by the pancreas decrease the functioning of the pancreas supplement the production of insulin by the pancreas NPH insulin is classified as an intermediate-acting insulin. The usual onset of action of NPH insulin is within: 10 - 15 minutes 30 - 60 minutes 2 - 4 hours 6 - 8 hours A diabetic client develops a sore throat, cough, and fever, then calls the nurse at the clinic to report that his blood glucose is 230mg/dl. According to the sick day rule of diabetics, the nurse should advise the client to: measure his urine output and test his urine for ketones withhold both food and insulin until his fever is relieved reduce his carbohydrate intake until his glucose level is about 130 mg/dl monitor his blood glucose every six hours and notify the clinic if it rises above 300mg/dl Signs and symptoms of diabetic ketoacidosis (DKA) include: (select all that apply); metabolic acidosis fruity breath odor cold, clammy skin Kussmaul's respirations hypoglycemia altered level of consciousness me: A client is diagnosed as having type 2 diabetes. A priority teaching goal should be, " The client will be able to: Perform foot care daily." Administer insulin as ordered." Test urine for sugar and acetone." Identify signs of both hypoglycemia and hyperglycemia." Which arterial blood gas results would the nurse expect in the client diagnosed with diabetic ketoacidosis? pH 7.34, pCO2 = 48, HCO3 = 24; PaO2 = 99 pH 7.38, pCO2= 40, HCO3 = 22; PaO2 =95 pH 7.46, pCO2= 30, HCO3 = 26; PaO2 = 85 pH 7.30 ; pCO2 = 30; HCO3 = 18; PaO2 90 Diabetic ketoacidosis and hyperglycemic hyperosmolar nonketotic (HHNK) coma are alike in that: both occur most often in insulin dependent (Type 1) diabetes

both may be caused by an infection or some other stressor metabolic acidosis is a prominent feature of both serum glucose levels are usually greater than 800 mg/dL The nurse knows that glucagon may be given in the treatment of hypoglycemia because it: Inhibits glycogenesis Stimulates release of insulin Increases blood glucose levels Provides more storage of glucose In formulating an education plan with a new Type 2 diabetic client, it is important that the nurse encourage the client to become an active participant in the managment of diabetes. The first thing the nurse should do is: set goals for the client to be an active participant in the management of diabetes ask the client's family to participate in the diabetes education program assess the client's perception of what it means to have diabetes assume the responsibility for all of the client's care to decrease the stress level A client diagnosed as having type 1 diabetes is encouraged to exercise on a regular basis primarily because exercise has been shown to: Decrease insulin sensitivity Stimulate glucagon production Improve the cellular uptake of glucose Reduce metabolic requirements for glucose Which information obtained by the nurse when caring for a patient who has diabetes insipidus (DI) is most important to report to the health care provider? The patient is confused and lethargic The patient had a recent head injury The patients urine specific gravity is 1.003 The patient has a urine output of 400 mL/hr When a client is first admitted with hyperglycemic, hyperosmolar noonketotoic syndrome (HHNS), the nurse's priority is to provide: oxygen carbohydrates fluid replacement dietary instruction When the nurse is describing the effects of insulin on the body to a patient newly diagnosed with diabetes mellitus, the best explanation is: "Insulin promotes the breakdown of fatty tissue into triglycerides, which can be used for energy." "When proteins are taken into the body, insulin promotes their breakdown and conversion to fats."

"Insulin stimulates the conversion of stored sugars into blood glucose and the conversion of proteins into glucose." "When carbohydrates, fats, and proteins are eaten, insulin promotes cellular transport and storage of all these nutrients." Glucagon is secreted by which of the following organs/glands? liver pancreas kidneys thyroid Mr. Thomas is a 50 year old who was diagnosed with diabetes type 2 five years ago. Upon his recent physical, his BUN was 45 mg/dL and his creatinine was 2.6mg/dL. Upon reviewing these findings, the nurse would be alert for further signs and symptoms of: diabetic retinopathy diabetic nephropathy peripheral neuropathy hepatic failure Which type of insulin may be administered IV? Lente Regular NPH Ultralente' The primary difference between hyperglycemia, hyperosmolar, non-ketonic syndrome (HHNK ) and ketoadicosis is that in HHNK there is: greater production of lactic acid greater production of ketones lesser production of lactic acid no production of ketones Lantus, a very long acting insulin, differs from most other insulins in that it: peaks within 2 hours peaks every other hour has no peak; is continuous has two peaks within a 24 hour period The nurse is caring for a client with diabetes mellitus who received six units of regular insulin at 0730. The nurse should monitor the client for manifestations of hypoglycemia at which of the following times? 1000 - 1100 1200 - 1400 1500 - 1700 1800 - 2000

A client is considered to be prediabetic when a fasting plasma glucose is between: 40 t0 60 mg/dL 80 to 99 mg/dL 100 to 125 mg/dL 126 - 140 mg/dL The major advantage of using an insulin pump is that: frequent blood glucose monitoring is unnecessary tight glycemic control can be maintained errors in insulin dosing are less likely to occur complications of insulin therapy are prevented The nurse teaches a client with type 2 diabetes how to provide self-care to prevent infections of the feet. The nurse recognizes that the teaching was effective when the client says, "I should: 1) Massage my feet and legs with oil or lotion." 2) Apply heat intermittently to my feet and legs." 3) Eat foods high in protein and carbohydrates." 4) Control my diabetes through diet, excercise, and medication." Complaints of pain, numbness, and tingling to the lower feet of a diabetic client are suggestive of which of the following? diabetic retinopathy Peripheral neuropathy Leg cramps macrovascular changes Identify the laboratory test that is the best indicator of the client's average blood glucose level and/or compliance to the diabetes mellitus regimen over the last 3 months. postparandial blood glucose test Oral glucose tolerance test casual blood glucose test Glycosylated hemoglobin (HgbA1c) The polydipsia and polyuria related to diabetes are caused primarily by: the release of ketones from cells during fat metabolism fluid shifts resulting from osmotic effects of hyperglycemia damage to the kidneys from exposure to high levels of glucose changes in RBCs resulting from attachmetn of excessive glucose to hemoglobin A client with untreated type 1 diabetes mellitus may lapse into a coma because of acidosis. This acidosis is directly caused by an increased concentration in the serum of : Ketones Glucose Lactic Acid Glutamic Acid

The most common cause of diabetic ketoacidosis is: Emotional stress Presence of infection Increased insulin dose Inadequate food intake Which of the following statements is correct about glucagon secretion? It is stimulated by an increase in blood glucose levels. It is stimulated by a decrease in amino acid levels. It exerts its primary effect on the pancreas. It acts to increase blood glucose levels Metformin (Glucophage) has been prescribed for a client newly diagnosed with type 2 diabetes mellitus. The nurse evaluates that the client understood medication teaching when the client states that Metformin acts in which of the following manners? Answer Decreases sensitivity of peripheral tissue to insulin Stimulates glucose production in the liver

Decreases production of glucose by the liver Stimulates glucose absorption from the GI tract Sent at 7:40 PM on Sunday me: Glucagon is used primarily to treat the client with: Answer

Diabetic ketoacidosis

insulin-induced hypoglycemia Hyperglycemic, hyperosmolar, nonketotic syndrome elevated blood glucose A client who is hospitalized and recovering from an episode of diabetic ketoacidosis calls the nurse and reports feeling anxious, nervous, and sweaty. Based on the client's report, the nurse should: Answer check the client's vital signs

administer 1 mg of glucagon SC compile a diet journal of what the client has eaten since hospital admission give the client 1 cup of milk Sent at 7:41 PM on Sunday me: Which of the following is a contributing cause of ulcers in the foot of the patient with diabetes? Answer Venous insufficiency Arterial insufficiency Gout

Hypertension Sent at 7:43 PM on Sunday me: Glyburide (Micronase, DiaBeta, Glynase) is prescribed for a patient when her type 2 diabetes has not been controlled with diet and exercise. When teaching the patient about Glyburide, the nurse explains that: Answer Glyburide is thought to stimulate insulin production and release from the pancreas. Glyburide is a substitute for insulin and acts by directly stimulating the glucose uptake into the cell. Glyburide, like all oral antidiabetes agents, does not cause the hypoglycemic reactions that may occur with insulin use. Glyburide and other sulfonylureas lower blood sugar by decreasing the rate of hepatic glucose production, preventing gluconeogenesis. Sent at 7:46 PM on Sunday me: A nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include a fasting blood glucose of 120 mg/dL, temperature of 1010 F; pulse of 88 beats /minute, respirations of 22 breaths/min, and blood pressure of 100/72 mm hg. Which finding would be of most concern to the nurse? Answer pulse respiration

temperature blood pressure Sent at 7:47 PM on Sunday me: A diabetic client with the flu asks why he should drink juices, check his fingerstidck glucose every 4 hours, and take insulin when he is not eating and is vomiting. What would be the best explanation by the nurse? Answer "You need to prevent dehydration and monitor for hyperglycemia and excessive breakdown of fats for glucose." " You need to check your blood glucose because vominting could cause hypoglycemia and drinking fluids will prevent dehydration." "Your body uses protein for energy during times of illness, causing increased ketones and hypoglycemia." "If you can substitute water for the juices to prevent dehydration , then you won't need to check your blood glucose levels so often." Sent at 7:49 PM on Sunday me: The nurse is caring for a client with type 1 diabetes mellitus. In preparing to administer insulin, the nurse would complete the following steps in what sequence? (Reorder the actions appropriattely) Answer Withdraw the dose of NPH insulin Inject air into the NPH insulin vial Withdraw the dose of regular insulin Inject air into the regular insulin vial Sent at 7:51 PM on Sunday