Nokea
An occupational health nurse is screening a group of workers for diabetes. What statement should the nurse interpret as suggestive of diabetes?
- A. Ive always been a fan of sweet foods, but lately Im turned off by them.
- B. Lately, I drink and drink and cant seem to quench my thirst.
- C. No matter how much sleep I get, it seems to take me hours to wake up.
- D. When I went to the washroom the last few days, my urine smelled odd.
Correct Answer: B
Rationale: Classic clinical manifestations of diabetes include the three Ps: polyuria, polydipsia, and polyphagia. Lack of interest in sweet foods, fatigue, and foul-smelling urine are not suggestive of diabetes.
You may also like to solve these questions
A patient has received a diagnosis of type 2 diabetes. The diabetes nurse has made contact with the patient and will implement a program of health education. What is the nurses priority action?
- A. Ensure that the patient understands the basic pathophysiology of diabetes.
- B. Identify the patients body mass index.
- C. Teach the patient survival skills for diabetes.
- D. Assess the patients readiness to learn.
Correct Answer: D
Rationale: Before initiating diabetes education, the nurse assesses the patients (and familys) readiness to learn. This must precede other physiologic assessments (such as BMI) and providing health education.
A medical nurse is aware of the need to screen specific patients for their risk of hyperglycemic hyperosmolar syndrome (HHS). In what patient population does hyperosmolar nonketotic syndrome most often occur?
- A. Patients who are obese and who have no known history of diabetes
- B. Patients with type 1 diabetes and poor dietary control
- C. Adolescents with type 2 diabetes and sporadic use of antihyperglycemics
- D. Middle-aged or older people with either type 2 diabetes or no known history of diabetes
Correct Answer: D
Rationale: HHS occurs most often in older people (50 to 70 years of age) who have no known history of diabetes or who have type 2 diabetes.
A patient has been brought to the emergency department by paramedics after being found unconscious. The patients Medic Alert bracelet indicates that the patient has type 1 diabetes and the patients blood glucose is 22 mg/dL (1.2 mmol/L). The nurse should anticipate what intervention?
- A. IV administration of 50% dextrose in water
- B. Subcutaneous administration of 10 units of Humalog
- C. Subcutaneous administration of 12 to 15 units of regular insulin
- D. IV bolus of 5% dextrose in 0.45% NaCl
Correct Answer: A
Rationale: In hospitals and emergency departments, for patients who are unconscious or cannot swallow, 25 to 50 mL of 50% dextrose in water (D50W) may be administered IV for the treatment of hypoglycemia. Five percent dextrose would be inadequate and insulin would exacerbate the patients condition.
The most recent blood work of a patient with a longstanding diagnosis of type 1 diabetes has shown the presence of microalbuminuria. What is the nurses most appropriate action?
- A. Teach the patient about actions to slow the progression of nephropathy.
- B. Ensure that the patient receives a comprehensive assessment of liver function.
- C. Determine whether the patient has been using expired insulin.
- D. Administer a fluid challenge and have the test repeated.
Correct Answer: A
Rationale: Clinical nephropathy eventually develops in more than 85% of people with microalbuminuria. As such, educational interventions addressing this microvascular complication are warranted. Expired insulin does not cause nephropathy, and the patients liver function is not likely affected. There is no indication for the use of a fluid challenge.
Which of the following patients with type 1 diabetes is most likely to experience adequate glucose control?
- A. A patient who skips breakfast when his glucose reading is greater than 220 mg/dL
- B. A patient who never deviates from her prescribed dose of insulin
- C. A patient who adheres closely to a meal plan and meal schedule
- D. A patient who eliminates carbohydrates from his daily intake
Correct Answer: C
Rationale: The therapeutic goal for diabetes management is to achieve normal blood glucose levels without hypoglycemia. Therefore, diabetes management involves constant assessment and modification of the treatment plan by health professionals and daily adjustments in therapy (possibly including insulin) by patients. For patients who require insulin to help control blood glucose levels, maintaining consistency in the amount of calories and carbohydrates ingested at meals is essential. In addition, consistency in the approximate time intervals between meals, and the snacks, help maintain overall glucose control. Skipping meals is never advisable for person with type 1 diabetes.