Nokea
A client is diagnosed with diabetes mellitus. The client reports visiting the gym regularly and is a vegetarian. Which of the following factors is important to consider when the nurse assesses the client?
- A. The client's consumption of carbohydrates
- B. History of radiographic contrast studies that used iodine
- C. The client's mental and emotional status
- D. The client's exercise routine
Correct Answer: A
Rationale: Carbohydrate consumption is critical to assess in diabetes due to its direct impact on blood sugar levels. While mental status, exercise, and past iodine contrast studies are relevant, they are secondary to carbohydrate intake in managing high blood sugar.
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A diabetic client maintains glucose control with the use of long-acting and short-acting insulin. Which nursing instruction would be considered a priority instruction for this client?
- A. Mix short-acting and long-acting insulin.
- B. Monitor blood glucose levels immediately following injection.
- C. Use stomach for nighttime injections.
- D. If using Lantus or Levemir, give in separate syringe.
Correct Answer: D
Rationale: Lantus and Levemir (long-acting insulins) must be administered in separate syringes, as mixing with other insulins can alter their action. Monitoring should occur before injections, and the stomach is not specifically preferred for nighttime doses; thighs are often used for slower absorption.
Which is the best nursing explanation for the symptom of polyuria in a client with diabetes mellitus?
- A. With diabetes, drinking more results in more urine production.
- B. Increased ketones in the urine promote the manufacturing of more urine.
- C. High sugar pulls fluid into the bloodstream, which results in more urine production.
- D. The body's requirement for fuel drives the production of urine.
Correct Answer: C
Rationale: High blood glucose levels increase blood osmolality, pulling fluid into the vascular system, which leads to increased urine production (polyuria) as the kidneys attempt to excrete excess glucose. This triggers thirst (polydipsia), not vice versa. Ketones and fuel requirements do not directly cause polyuria.
A client reports taking oral medication for control of sugar problems. Which is the best nursing interpretation of this verbal accounting?
- A. Lack of knowledge of disease process
- B. Client has type 2 diabetes mellitus.
- C. Client has prediabetes mellitus.
- D. Lack of knowledge on medication regime
Correct Answer: B
Rationale: Oral antidiabetic medications are typically prescribed for type 2 diabetes, indicating the client likely has this condition. Prediabetes is not treated with medication, and there is insufficient information to assume a lack of knowledge about the disease or medication.
Which assessment finding is most important in determining nursing care for a client with diabetes mellitus?
- A. Respirations of 12 breaths/minute
- B. Cloudy urine
- C. Blood sugar 170 mg/dL
- D. Fruity breath
Correct Answer: D
Rationale: Fruity breath indicates rising ketones and potential diabetic ketoacidosis, a life-threatening condition requiring immediate intervention to prevent complications like acidosis or renal shutdown. A blood sugar of 170 mg/dL is elevated but less critical, cloudy urine may suggest a UTI, and normal respirations are not a priority.
The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action?
- A. It carries glucose into body cells
- B. It aids in the process of gluconeogenesis.
- C. It stimulates the pancreatic hormone cells.
- D. It decreases the intestinal absorption of glucose.
Correct Answer: A
Rationale: Insulin's primary role is to facilitate glucose transport into cells for energy use and promote glycogen storage in the liver, inhibiting glycogen breakdown. It does not promote gluconeogenesis, stimulate pancreatic hormone cells, or affect intestinal glucose absorption.