LCCW GIGU: Diabetes, Diabetes GIGU, Lewis's Medical Surgical Nursing 11th Edition Harding, Exams of Nursing

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Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

IDDM- Type 1 diabetes mellitus is _____ onset occurring at what ages? - - - correct answer ✅juvenile; 8-15 years (may also be seen in adult, now seeing equal occurrences) destruction left behind from IDDM- Type 1 diabetes mellitus is called _____ - - - correct answer ✅insulitis syndrome of IDDM- Type 1 diabetes mellitus is characterized by ______ - - - correct answer ✅hyperglycemia due to impaired insulin secretion IDDM- Type 1 diabetes mellitus is caused by ______ - - - correct answer ✅immunologically mediated destruction of beta cells (genetics) IDDM- Type 1 diabetes mellitus accounts for ____ of all diabetes - -

• correct answer ✅5-10%

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

IDDM- Type 1 diabetes mellitus is associated with ______ & ____ if not treated - - - correct answer ✅acute ketoacidosis & coma S&S of IDDM- Type 1 diabetes mellitus - - - correct answer ✅1. polyphasia

2. polyuria
3. polydipsia 4.ketoacidosis
4. tiredness
5. weight loss Diagnoses for IDDM- Type 1 diabetes mellitus - - - correct answer ✅1. fasting glucose test
6. plasma glucose test 2 hrs after a challenge
7. serum glucose 150-200 beginning

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

4. 300-500 moderate
5. severe DM over 500 ketoacidosis is found in which type of diabetes? - - - correct answer ✅IDDM- Type 1 diabetes mellitus Treatment for IDDM- Type 1 diabetes mellitus - - - correct answer ✅1. insulin injection
6. constant plasma glucose monitoring after meals & at bedtime Complications of diabetes - - - correct answer ✅1. atherosclerotic coronary artery disease
7. diabetic retinopathy
8. diabetic nephropathy
9. diabetic neuropathy
10. foot ulcers

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

6. charcot's joint What does AGE stand for - - - correct answer ✅Advanced glycation end product (glucose derivative + plasma protein) NIDDM-Type 2 Diabetes Mellitus _____ onset occurring at what ages? - - - correct answer ✅adult; 40-50 y.o. NIDDM-Type 2 Diabetes Mellitus is seen in children at this point as ______ - - - correct answer ✅MODY (mature onset diabetes in young) NIDDM-Type 2 Diabetes Mellitus is associated with _____ & _____ lifestyle - - - correct answer ✅obese & sedentary

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

NIDDM-Type 2 Diabetes Mellitus is ______ with relative insulin deficiency - - - correct answer ✅insulin resistance NIDDM-Type 2 Diabetes Mellitus findings include hyper_____ & hyper_____ - - - correct answer ✅hypertension; hypertriglyceridemia S&S of NIDDM-Type 2 Diabetes Mellitus - - - correct answer ✅1. polyphasia

2. polyurua
3. polydipsia
4. ketoacidosis rare
5. nonketotic hypersmolar coma Diagnosis for NIDDM-Type 2 Diabetes Mellitus - - - correct answer ✅1. Same as type 1
6. measure c-peptide

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

3. glucose test
4. fasting >126 mg/dl
5. OGTT >200 mg/dl Treatment for NIDDM-Type 2 Diabetes Mellitus - - - correct answer ✅early stage: diet & exercise middle stage (impaired glucose tolerance): diet, exercise, and medication to increase insulin action & function late stage: insulin shots Central Diabetes insipidus is characterized by _____ due to a _____

• • • correct answer ✅excessive urination; deficiency of ADH Diabetes insipidus involves inflammation, tumor, or trauma to the _____ & _____ - - - correct answer ✅hypothalamus & pituitary

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

_______ Diabetes insipidus is a result of renal tubular unresponsiveness to ADH - - - correct answer ✅nephrogenic Diabetes insipidus may occur at what age? - - - correct answer ✅any age S&S of Diabetes insipidus - - - correct answer ✅Polyuria Polydipsia Nocturia What test is used as Diagnosis for Diabetes insipidus - - - correct answer ✅water deprivation test water deprivation test involves taking what samples & doing what in the morning? - - - correct answer ✅blood, urine sample & weighing patient

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

What must you prevent during the water deprivation test - - - correct answer ✅prevent patient from drinking water _____ is collected hourly during water deprivation test - - - correct answer ✅voided uric test stops when ______ & _____ appear, or when 5% or more of _____ has been lost - - - correct answer ✅orthostatic hypotension & postural tachycardia; initial body weight specific ______ is measured with water deprivation test - - - correct answer ✅gravity & osmolarity of uric Treatment for Diabetes insipidus - - - correct answer ✅1. hormonal therapy (desmopressin acetate, nasal spray)

2. non hormonal therapy: diuretics (thiazide) & ADH releasing drugs (chlorpropamide & carbamazepine)

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

What is diabetes mellitus? - - - correct answer ✅A chronic multisystem disease related to abnormal insulin production, impaired insulin utilization, or both What is the normal process of glucose and insulin metabolism? - - - correct answer ✅Insulin is a hormone produced by the B-cells in the Islets of Langerhans or the pancreas. Usually insulin is released into the bloodstream and than at an increased rate upon food ingestion. What is the normal glucose level? - - - correct answer ✅70- mg/dL What does insulin do? - - - correct answer ✅lowers blood glucose What are the counter-regulatory hormones? - - - correct answer ✅glucagon, epinephrine, growth hormone, and cortisol

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

How do counter-regulatory hormones work? - - - correct answer ✅Stimulating glucose production and release by the liver. Decreasing the movement of glucose into the cells What is type 1 diabetes? - - - correct answer ✅an autoimmune disease in which the body develops antibodies against insulin and/or the pancreatic beta cells that produce insulin. This patient is insulin DEPENDENT. What is the gene that makes you more susceptible to type 1 diabetes? - - - correct answer ✅The HLA (HLA-DR3 & HLA-DR4) gene. This person is exposed to a viral infection, the B-cells of the pancreas are destroyed, either directly or through an autoimmune process. What is idiopathic diabetes? - - - correct answer ✅Type 1 diabetes that is strongly inherited and not related to autoimmunity.

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

What is latent autoimmune diabetes in adults? - - - correct answer ✅A slowly progressing autoimmune form of type 1 diabetes occurs in adults, and is often mistaken for type 2 diabetes. What are the signs/symptoms of type 1 diabetes? - - - correct answer ✅polyuria (frequent urination) polydipsia (excessive thirst) polyphagia (excessive hunger) weight-loss What can a patient with type 1 diabetes develop if the disease goes untreated? - - - correct answer ✅Diabetic ketoacidosis (metabolic acidosis) what is the honey moon period related to type 1 diabetes? - - - correct answer ✅A period of remission lasts for 3-12 months after

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

initial diagnosis. The patient may require little to no insulin because B-cell insulin production remains the sufficient for healthy blood glucose levels. What is type 2 diabetes mellitus? - - - correct answer ✅Inadequate insulin secretion and insulin resistance. Endogenous insulin is present in this patient. What are some risk factors for type 2 diabetes? - - - correct answer ✅Being overweight or obese, being older, and having a family history of type 2 diabetes. What is the first factor in causing type 2 diabetes? - - - correct answer ✅Insulin resistance- body tissues do not respond to the action of insulin because insulin receptors are unresponsive, are insufficient in number or both.

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

Where are insulin receptors found? - - - correct answer ✅mainly on skeletal muscle, fat, and liver cells What can insulin resistance lead to? - - - correct answer ✅hyperinsulinemia- the pancreas produces greater amounts of insulin What is the second factor in causing type 2 diabetes? - - - correct answer ✅Decrease in the ability of the pancreas to produce insulin, as the B-cells become fatigued from the compensatory overproduction of insulin or when B-cells mass is lost. What is the third factor in causing type 2 diabetes? - - - correct answer ✅Inappropriate glucose production by the liver. The liver haphazardly releases glucose in response to blood levels. This usually does not correspond to the body's needs at the time.

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

What is the fourth factor in causing type 2 diabetes? - - - correct answer ✅Altered production of hormones and cytokines by adipose tissue (adipokines). Adipokines are thought to cause chronic inflammation, a factor involved in insulin resistance, type 2 diabetes, and cardiovascular disease. What are the two adipokines? - - - correct answer ✅adiponectin and leptin What is metabolic syndrome? - - - correct answer ✅elevated glucose levels, abdominal obesity, elevated BP, high levels of triglycerides, and decreased levels of high-density lipoproteins. How do you know if someone has metabolic syndrome? - - - correct answer ✅This must have 3 of the 5 components.

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

How would an overweight patient decrease their risk for metabolic syndrome? - - - correct answer ✅Weight loss and regular physical activity How are people usually diagnosed with type 2 diabetes? - - - correct answer ✅Patient found with elevated glucose or glycosylated hemoglobin (A1C) levels are found. What is prediabetes? - - - correct answer ✅Term used to describe condition where glucose levels are higher than normal, but not high enough to be classified as diabetes. Increased risk of type 2 diabetes How do you diagnose prediabetes? - - - correct answer ✅Impaired glucose tolerance (IGT) Impaired fasting glucose (IFG)

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

How do you diagnose impaired IGT? - - - correct answer ✅2 hour oral glucose tolerance test (OGTT) values are 140 to 199 mg/dL (7. to 11.0 mmol/L) How do you diagnose impaired IFG? - - - correct answer ✅Fasting blood glucose levels are 100 to 125 mg/dL (5.56 to 6.9 mmol/L) What should patients with prediabetes be doing? - - - correct answer ✅Rechecking their blood glucose and A1C, regularly monitoring for symptoms like (fatigue, frequent infections, or slow healing wounds). How to prevent prediabetes from turning into type 2 diabetes? - - - correct answer ✅Maintaining a healthy weight, exercising regularly, and making healthy food choices.

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

What women are at risk for gestational diabetes? - - - correct answer ✅Obese, advanced maternal age, or have a family history of diabetes Women with gestational diabetes are at risk for what? - - - correct answer ✅Cesarean delivery, and their babies have increased risk for perinatal death, birth injury, and neonatal complications. Do women with gestational diabetes blood glucose levels return to normal? - - - correct answer ✅Yes, within 6 weeks postpartum Can women with gestational diabetes develop type 2 diabetes? - - - correct answer ✅Yes, within 16 years What medical conditions can cause type 2 diabetes? - - - correct answer ✅Cushing syndrome, hyperthyroidism, recurrent pancreatitis, cystic fibrosis, hemochromatosis, and parental nutrition

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

What medications can cause type 2 diabetes? - - - correct answer ✅Corticosteriods - prednisone Thiazides Phenytoin (Dilantin) Atypical antipsychotics (Clozapine (Clozaril)) How do you treat diabetes caused by a medical condition or medication? - - - correct answer ✅Resolve when the underlying condition is treated or the medication discontinued. Visual changes are common in? - - - correct answer ✅Type 2 diabetes How to diagnosis DM? - - - correct answer ✅1. A1C of 6.5% or higher

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

2.Fasting plasma glucose (FPG) level greater than or equal to 126 mg/dL. (Fasting defined as no calorie intake in 8 hours)

3. Two-hour plasma glucose level greater than or equal to 200 mg/dL (11.1 mmol/L) during an OGTT, using a glucose load of 75 g.
4. In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose greater than or equal to 200 mg/dL (11.1 mmol/L) Repeated testing performed and criteria 1-3 are met person has diabetes What lab does not require repeated testing to confirm diagnosis? - -

• correct answer ✅Random plasma glucose greater than or equal to 200 mg/dL What factors can falsely elevate these lab results? - - - correct answer ✅Restrictions of dietary carbohydrates, acute illness, medications (contraceptives & corticosteroids), and restricted activity such as bed rest.

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

How do you find the estimated average glucose? - - - correct answer ✅eAG= 28.7 X A1C - 46. What is fructosamine? - - - correct answer ✅Another way to assess glucose levels. Reflects glycemia in the previous 1 to 3 weeks. May show a change in blood glucose levels before A1C does. What is the goal of diabetes management? - - - correct answer ✅Reduce symptoms, promote well-being, prevent acute complications related to hyper- and hypoglycemia, and prevent or delay the onset and progression of long term complications. Which statement by a nurse to a patient newly diagnosed with type 2 diabetes is accurate? a. Insulin is not used to control blood glucose in patients with type 2 diabetes.

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

b. Complications of type 2 diabetes are less serious than those of type 1 diabetes. c. Changes in diet and exercise may control blood glucose levels in type 2 diabetes. d. Type 2 diabetes is usually diagnosed when a patient is admitted in hyperglycemic coma. - - - correct answer ✅ANS: C For some patients with type 2 diabetes, changes in lifestyle are sufficient to achieve blood glucose control. Insulin is frequently used for type 2 diabetes, complications are equally severe as for type 1 diabetes, and type 2 diabetes is usually diagnosed with routine laboratory testing or after a patient develops complications such as frequent yeast infections. DIF: Cognitive Level: Understand (comprehension) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

A patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L). What should the nurse plan to teach the patient? a. Self-monitoring of blood glucose b. Using low doses of regular insulin c. Lifestyle changes to lower blood glucose d. Effects of oral hypoglycemic medications - - - correct answer ✅ANS: C The patient's impaired fasting glucose indicates prediabetes, and the patient should be counseled about lifestyle changes to prevent the development of type 2 diabetes. The patient with prediabetes does not require insulin or oral hypoglycemics for glucose control and does not need to self-monitor blood glucose.

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity A 28-yr-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching? a. The patient always carries hard candies when engaging in exercise. b. The patient goes for a vigorous walk when his glucose is 200 mg/dL. c. The patient has a peanut butter sandwich before going for a bicycle ride. d. The patient increases daily exercise when ketones are present in the urine. - - - correct answer ✅ANS: D

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

When the patient is ketotic, exercise may result in an increase in blood glucose level. Patients with type 1 diabetes should be taught to avoid exercise when ketosis is present. The other statements are correct. DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity The nurse is assessing a 22-yr-old patient experiencing the onset of symptoms of type 1 diabetes. To which question would the nurse anticipate a positive response? a. "Are you anorexic?" b. "Is your urine dark colored?" c. "Have you lost weight lately?" d. "Do you crave sugary drinks?" - - - correct answer ✅ANS: C

Lewis's Medical Surgical Nursing 11th

Edition Harding Test Bank, Chapter 48:

Diabetes Mellitus Lewis: Medical-

Surgical Nursing, 10th Edition, diabetes

nclex review Exam Questions and

Answers

Weight loss occurs because the body is no longer able to absorb glucose and starts to break down protein and fat for energy. The patient is thirsty but does not necessarily crave sugar-containing fluids. Increased appetite is a classic symptom of type 1 diabetes. With the classic symptom of polyuria, urine will be very dilute. DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient? a. Fasting blood glucose