Nokea
The client who is managing diabetes through diet and insulin control asks the nurse why exercise is important. Which is the best response by the nurse to support adding exercise to the daily routine?
- A. Increases ability for glucose to get into the cell and lowers blood sugar
- B. Creates an overall feeling of well-being and lowers risk of depression
- C. Decreases need for pancreas to produce more cells
- D. Decreases risk of developing insulin resistance and hyperglycemia
Correct Answer: A
Rationale: Exercise enhances glucose uptake by increasing transmembrane glucose transporters in muscles, lowering blood sugar levels. While it may improve well-being and reduce insulin resistance, the primary benefit for diabetes management is improved glucose transport into cells.
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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 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.
A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously?
- A. Glargine
- B. Regular
- C. NPH
- D. Lente
Correct Answer: B
Rationale: Regular insulin is used intravenously for DKA due to its rapid onset and ability to be infused continuously. Glargine, NPH, and Lente are long- or intermediate-acting insulins administered subcutaneously, unsuitable for acute DKA management.
A client with type 2 diabetes who is physically active reports recurrent symptoms of weakness and nervousness. Which is the best response from the nurse?
- A. These symptoms are related to added stress.
- B. Maybe you should eat simple carbohydrates.
- C. Sounds like high blood sugar symptoms.
- D. Exercise and activity can lower glucose levels.
Correct Answer: D
Rationale: Weakness and nervousness suggest hypoglycemia, which can be triggered by exercise lowering blood glucose levels. These are not typical of hyperglycemia, stress alone, or a need for simple carbohydrates, which could exacerbate glucose fluctuations.
The nurse is caring for a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNKS). Which assessment finding should the nurse address immediately?
- A. Hypotension
- B. Blood pH 7.38
- C. Mental changes
- D. Fever
Correct Answer: A
Rationale: Hypotension in HHNKS indicates significant fluid loss from the extracellular compartment, requiring urgent correction to prevent coma or death. A normal pH (7.38) is not a concern, and while mental changes and fever are symptoms, they are less immediately life-threatening than fluid imbalance.