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A controlled type 2 diabetic client states, 'The doctor said if my blood sugars remain stable, I may not need to take any medication.' Which response by the nurse is most appropriate?
- A. Diet, exercise, and weight loss can eliminate the need for medication.
- B. You will be placed on a strict low-sugar diet for better control.
- C. Some doctors do not treat blood sugar elevation until symptoms appear.
- D. You misunderstood the doctor. Let's ask for clarification.
Correct Answer: A
Rationale: Lifestyle interventions like diet, exercise, and weight loss can effectively manage type 2 diabetes, potentially reducing or eliminating the need for medication. A strict low-sugar diet is not typically recommended, and waiting for symptoms or assuming misunderstanding is less appropriate.
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The nurse is teaching an older client how to self-administer insulin. Which of the following would be most helpful to the client who is having difficulty drawing up the correct dosage of insulin in the syringe?
- A. Syringe magnifier
- B. Insulin pen
- C. Jet injector
- D. Insulin pump
Correct Answer: A
Rationale: A syringe magnifier is a cost-effective and simple tool to help older clients with visual or dexterity issues accurately draw insulin doses. Insulin pens require precise dialing, which may be challenging, and jet injectors and insulin pumps are more complex and costly, potentially unsuitable for older clients.
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 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.
A client with type 2 diabetes is informed of being unable to have a pancreatic transplant and asks the nurse why this is. Which reason would the nurse provide to the client?
- A. Increased risk for urologic complications
- B. Need for exocrine enzymatic drainage
- C. Underlying problem of insulin resistance
- D. Need for lifelong immunosuppressive therapy
Correct Answer: C
Rationale: Clients with type 2 diabetes have insulin resistance, which a pancreas transplant does not address, as the issue lies in tissue response rather than insulin production. Urologic complications and exocrine drainage are not primary reasons, and while immunosuppressive therapy is required, it is not specific to type 2 diabetes.
The nurse is explaining glycosylated hemoglobin testing to a diabetic client. Which of the following provides the best reason for this order?
- A. Provides best information on the body's ability to maintain normal blood functioning
- B. Best indicator for the nutritional state of the client.
- C. Is less costly than performing daily blood sugar test
- D. Reflects the amount of glucose stored in hemoglobin over past several months
Correct Answer: D
Rationale: Glycosylated hemoglobin (HbA1c) measures glucose bound to hemoglobin over its 120-day lifespan, reflecting long-term glucose control. It does not assess overall blood functioning, nutritional status, or cost relative to daily testing, which is still necessary for insulin-dependent clients.