Nokea
The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which characteristic would the nurse inform the group is associated with type 2 diabetes?
- A. Onset most common during adolescence
- B. Insulin resistance or insufficient insulin production
- C. Absence of insulin production by beta cells in the islets of Langerhans
- D. Little relation to prediabetes
Correct Answer: B
Rationale: Type 2 diabetes is characterized by insulin resistance or inadequate insulin production, typically seen in adults, not adolescents. Absence of insulin production is specific to type 1 diabetes, and prediabetes is a precursor to type 2 diabetes.
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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.
The nurse is admitting a client with the diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNKS) following steroid therapy. Which sign(s) and symptom(s) would the nurse likely note? Select all that apply.
- A. High blood pressure
- B. Extreme thirst
- C. Bradycardia
- D. Poor skin turgor
- E. Acidosis
- F. Hypoglycemia
Correct Answer: B,D
Rationale: HHNKS presents with extreme thirst and dehydration (poor skin turgor) due to severe hyperglycemia and fluid shifts. High blood pressure is unlikely (hypotension is more common), bradycardia is incorrect (tachycardia occurs), acidosis is not typical (unlike DKA), and hypoglycemia is not associated with HHNKS.
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.
A client with diabetes is receiving an oral antidiabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer?
- A. Metformin
- B. Glyburide
- C. Repaglinide
- D. Glipizide
Correct Answer: A
Rationale: Metformin, a biguanide, enhances insulin sensitivity in tissues, improving glucose uptake. Glyburide, glipizide (sulfonylureas), and repaglinide (meglitinide) stimulate insulin release from the pancreas, not tissue sensitivity.
On initial nursing rounds, the diabetic client reports 'not feeling well.' Later, the nurse finds the client to be diaphoretic and in a stuporous state. Which is the immediate action taken by the nurse?
- A. Call the physician.
- B. Obtain a glucometer reading.
- C. Administer fruit juice.
- D. Start an IV of dextrose.
Correct Answer: B
Rationale: A glucometer reading is critical to differentiate between hypoglycemia and diabetic ketoacidosis in a stuporous diabetic client. Administering juice or IV dextrose without confirming hypoglycemia risks worsening hyperglycemia, and calling the physician is secondary to obtaining a glucose level.