Nokea
The patient is a 20-year-old college student who has type 1 diabetes and normally walks each evening as part of an exercise regimen. The patient plans to enroll in a swimming class. Which adjustment will the nurse suggest to the patient based on this information?
- A. Time the morning insulin injection so that the peak action will occur during swimming class.
- B. Delete normal walks on swimming class days.
- C. Delay the meal before the swimming class until the session is over.
- D. Monitor glucose level before, during, and after swimming to determine the need for alterations in food or insulin.
Correct Answer: D
Rationale: Exercise can reduce insulin resistance and increase glucose uptake for as long as 72 hours, as well as reducing blood pressure and lipid levels. However, exercise can carry some risks for patients with diabetes, including hypoglycemia.
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Which diagnostic test for diabetes mellitus provides a measure of glucose levels for the previous 8 to 12 weeks?
- A. Fasting blood sugar (FBS)
- B. Oral glucose tolerance test (OGT)
- C. Glycosylated hemoglobin (HbA1c)
- D. Postprandial glucose test (PPBG)
Correct Answer: C
Rationale: Glycosylated hemoglobin (HbA1c) - This blood test measures the amount of glucose that has become incorporated into the hemoglobin within an erythrocyte. Because glycosylation occurs constantly during the 120-day lifespan of the erythrocyte, this test reveals the effectiveness of diabetes therapy for the preceding 8 to 12 weeks.
The health care provider orders an 1800-calorie diabetic diet and 40 units of NPH insulin subcutaneously daily for a patient with diabetes mellitus. For which reason will a mid-afternoon snack of milk and crackers be given?
- A. To improve nutrition.
- B. To improve carbohydrate metabolism.
- C. To prevent hypoglycemia
- D. To prevent diabetic coma.
Correct Answer: C
Rationale: NPH insulin peaks in 6-10 hours. The nurse should be alert for signs of hypoglycemia (low blood glucose) at the peak of action of whatever type of insulin the patient is receiving.
The use of radioactive iodine in the treatment of hyperthyroidism is for which purpose?
- A. stimulate the thyroid gland.
- B. depress the pituitary.
- C. destroy some of the thyroid tissue.
- D. alter the stimulus from the pituitary.
Correct Answer: C
Rationale: Radioactive iodine 131 destroys some of the hyperactive thyroid gland to produce a more normally functioning gland.
Which is a sign or symptom of hypoglycemia?
- A. Irritability
- B. Dry mouth
- C. Tremors
- D. Diaphoresis
- E. Fruity breath
- F. Deep respirations
Correct Answer: A,C,D
Rationale: Hypoglycemic reaction: rapid shallow respirations, irritability, tremors, excessive perspiration, and possibly loss of consciousness.
Which precaution(s) will the nurse take when caring for a patient who is being treated with radioactive iodine 131 (RAIU)?
- A. Initiate radioactive safety precautions.
- B. Avoid assigning any young woman to the patient.
- C. Wait 3 days after dose before assigning a pregnant nurse to care for this patient.
- D. Advise visitors to sit at least 10 ft away from the patient.
Correct Answer: C
Rationale: The dose is patient specific and at a very low level. No radioactive safety precautions are necessary and pregnant nurses can be assigned 3 days after the dose. RAIU is not harmful to nonpregnant women.