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.
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A client asks why pancreas transplantation is not an option offered to all insulin-dependent clients with diabetes. Which is the best response by the nurse?
- A. Type 1 diabetes can be managed in most clients with insulin.
- B. Pancreas transplant is becoming more common.
- C. There is a long waiting list to receive a new pancreas.
- D. For every transplant, two deceased donors are needed.
Correct Answer: A
Rationale: Type 1 diabetes is manageable with insulin, and the risks of lifelong immunosuppression from transplantation often outweigh benefits. Pancreas transplants are not increasingly common, waiting lists are not the primary issue, and only one donor is needed.
The client asks the nurse if dipstick of urine can be used for monitoring glucose levels. Which is the best response by the nurse?
- A. Yes, it is a cheaper method of monitoring glucose and ketones in the urine.
- B. This test can detect ketones but not glucose levels.
- C. The most accurate way to monitor glucose levels is by blood testing.
- D. Dipstick of urine will only indicate lower levels of glucose and ketones.
Correct Answer: C
Rationale: Blood testing via glucometer is the most accurate method for monitoring glucose levels, as urine dipsticks only detect glucose above the renal threshold, which is less precise. Urine dipsticks can detect both glucose and ketones but are not the preferred method for ongoing management.
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.
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 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.
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