The nurse is providing instructions about foot care for a client with diabetes mellitus. What should the nurse include in the instructions? . Select all that apply.

1. Wear shoes when out of bed.
2. Soak the feet in warm water daily.
3. Dry between the toes after bathing.
4. Remove corns as soon as they appear.
5. Use a heating pad when the feet feel cold.

A. Wear shoes when out of bed.

C. Dry between the toes after bathing.

Which statement by a client with type 2 diabetes indicates to the nurse that additional dietary teaching is needed?

1. "I can eat as much dietetic fruit as I want."
2. "I can have a lettuce salad whenever I want it."
3. "I know that half of my diet should be carbohydrates."
4. "I need to reduce the amounts of saturated fats in my diet."

A. "I can eat as much dietetic fruit as I want."

The nurse is caring for a client newly diagnosed with diabetes. What symptom of hypoglycemia is most common and should be taught to the client?

1. Kussmaul respirations
2. Tachycardia
3. Confusion
4. Anorexia

C. Confusion

While obtaining the client’s health history, which factor does the nurse identify that predisposes the client to type 2 diabetes?

1. Having diabetes insipidus
2. Eating low-cholesterol foods
3. Being 20 pounds (9 kilograms) overweight
4. Drinking a daily alcoholic beverage

C. Being 20 pounds (9 kilograms) overweight

A client with type 2 diabetes has been receiving insulin in the hospital while being treated for sepsis. The client's infection is resolving, and the primary healthcare provider writes a prescription to discontinue the 7:00 AM dose of insulin and to administer glyburide 5 mg twice daily (8:00 AM and 8:00 PM). The nurse on the day shift (8:00 AM to 4:00 PM) administers the glyburide at 8:30 AM. When recording its administration in the client's record, the nurse sees that the insulin had already been administered at 7:00 AM. What initial action should the nurse take?

1. Measure the vital signs.
2. Notify the primary healthcare provider.
3. Assess for signs of ketoacidosis.
4. Check blood glucose for hypoglycemia.

D. Check blood glucose for hypoglycemia.

The nurse is counseling a client with type 1 diabetes about the client's favorite foods that are lowest in carbohydrates (CHO). Which food choice picked by the client determines that teaching was effective?

1. Skim milk
2. Apple juice
3. Nonfat yogurt
4. Fresh orange juice

A. Skim milk

A nurse is caring for two clients newly diagnosed with diabetes. One client has type 1 diabetes, and the other client has type 2 diabetes. When determining the main difference between type 1 and type 2 diabetes, the nurse recognizes what clinical presentation about type 1?

1. Onset of the disease is slow.
2. Excessive weight is a contributing factor.
3. Complications are not present at the time of diagnosis.
4. Treatment involves diet, exercise, and oral medications.

C. Complications are not present at the time of diagnosis.

A nurse is caring for an older client who had non-insulin dependent diabetes for 15 years that progressed to insulin-dependent diabetes 2 years ago. What common complications of diabetes should the nurse assess for when examining this client? Select all that apply.

1. Leg ulcers
2. Loss of visual acuity
3. Increased creatinine clearance
4. Prolonged capillary refill in the toes
5. Decreased sensation in the lower extremities

A. Leg ulcers

B. Loss of visual acuity

D. Prolonged capillary refill in the toes

E. Decreased sensation in the lower extremities

A nurse is caring for a client who has a 20-year history of type 2 diabetes. The nurse should assess for what physiologic changes associated with a long history of diabetes?

1. Blurry, spotty, or hazy vision
2. Arthritic changes in the hands
3. Hyperactive knee and ankle jerk reflexes
4. Dependent pallor of the feet and lower legs

A. Blurry, spotty, or hazy vision

A nurse is formulating a teaching plan for a client recently diagnosed with type 2 diabetes. What interventions should the nurse include to decrease the risk of complications? . Select all that apply.

1. Examine the feet daily
2. Wear well-fitting shoes
3. Perform regular exercise
4. Powder the feet after showering
5. Visit the primary healthcare provider weekly
6. Test bathwater with the toes before bathing

A. Examine the feet daily

B. Wear well-fitting shoes

C. Wear well-fitting shoes

The health care provider prescribes one tube of glucose gel for the client with type 1 diabetes. The nurse recognizes that this is for treatment of which diabetes complication?

1. Diabetic acidosis
2. Hyperinsulin secretion
3. Insulin-induced hypoglycemia
4. Idiosyncratic reactions to insulin

C. Insulin-induced hypoglycemia

The nurse knows that the newborns of mothers with diabetes often exhibit tremors, periods of apnea, cyanosis, and poor suckling ability. With which complication are these signs associated?

1. Hypoglycemia
2. Hypercalcemia
3. Central nervous system edema
4. Congenital depression of the islets of Langerhans

A. Hypoglycemia

The nurse is explaining insulin needs to a client with gestational diabetes who is in her second trimester of pregnancy. Which information should the nurse give to this client?

1. Insulin needs will increase during the second trimester.
2. Insulin needs will decrease during the second trimester.
3. Insulin needs will not change during the second trimester.
4. Insulin will be switched to an oral antidiabetic medication during the second trimester.

A. Insulin needs will increase during the second trimester.

A client is diagnosed with type 2 diabetes, and the health care provider prescribes an oral hypoglycemic. For what side effect should the nurse teach this client to monitor?

1. Ketonuria
2. Weight loss
3. Ketoacidosis
4. Low blood sugar

D. Low blood sugar

A client with diabetes mellitus complains of difficulty seeing. What would the nurse suspect as the causative factor?

1. Lack of glucose in the retina
2. The growth of new retina blood vessels or “neovascularization”
3. Inadequate glucose supply to rods and cones
4. Destructive effect of ketones on retinal metabolism

B. The growth of new retina blood vessels or “neovascularization”

A client with type 1 diabetes has an above-the-knee amputation because of severe lower extremity arterial disease. What is the nurse's primary responsibility two days after surgery when preparing the client to eat dinner?

1. Checking the client's serum glucose level
2. Assisting the client out of bed into a chair
3. Placing the client in the high-Fowler position
4. Ensuring the client's residual limb is elevated

A. Checking the client's serum glucose level

A 14-year-old adolescent with diabetes has been self-administering insulin twice a day. This morning the parents found their child lethargic and confused. After the adolescent’s admission to the emergency department, laboratory testing reveals a hemoglobin A1c level of 10% and a blood glucose level of 200 mg/dL (11.1 mmol/L). What does the nurse suspect as the most likely cause of this client’s condition?

1. Hypoglycemia
2. Somogyi effect
3. Uncontrolled blood glucose level
4. Noncompliance with the prescribed insulin regimen

C. Uncontrolled blood glucose level

A 10-year-old child with recently diagnosed type 2 diabetes attends the Center for Diabetic Teaching with the parents. The nurse interviews the child before the class begins. What is the priority concern diabetic children usually have?

1. How much school might be missed
2. Whether the diabetes can be controlled
3. How the parents will react to the diagnosis
4. Whether having diabetes means future sterility

A. How much school might be missed

During a diabetes mellitus campaign, the community nurse is assessing different clients. Which client should be treated first?

1. Client A – A1C% 5.6; Fasting Plasma GL 100 mg/dL; Two Hour Plasma GL 150 mg/dL
2. Client B – A1C% 6.8; Fasting Plasma GL 130 mg/dL; Two Hour Plasma GL 200 mg/dL
3. Client C – A1C% 6.0; Fasting Plasma GL 120 mg/dL; Two Hour Plasma GL 130 mg/dL
4. Client D – A1C% 6.1; Fasting Plasma GL 100 mg/dL; Two Hour Plasma GL 140 mg/dL

B. Client B – A1C% 6.8; Fasting Plasma GL 130 mg/dL; Two Hour Plasma GL 200 mg/dL

The nurse develops a teaching plan for a client with diabetes who has been diagnosed with lower extremity arterial disease (LEAD). What measures should the nurse include to increase arterial blood flow to the extremities?

1. Exercises that promote muscular activity
2. Meticulous care of minor skin breakdown
3. Elevation of the legs above the level of the heart
4. Soaking the feet in hot water each day

A. Exercises that promote muscular activity