Diabetes Mellitus Reviewer and NCLEX Questions (100 Items)

Knowing that gluconeogenesis helps to maintain blood glucose levels, a nurse should:

The nurse is admitting a patient diagnosed with type 2 diabetes mellitus. The nurse should expect the following symptoms during an assessment, except:

Glycosylated hemoglobin (HbA1C) test measures the average blood glucose control of an individual over the previous three months. Which of the following values is considered a diagnosis of pre-diabetes?

Rotation sites for insulin injection should be separated from one another by 2.5 cm (1 inch) and should be used only every:

A clinical feature that distinguishes a hypoglycemic reaction from a ketoacidosis reaction is:

Clinical nursing assessment for a patient with microangiopathy who has manifested impaired peripheral arterial circulation includes all of the following, except:

The nurse expects that a type 1 diabetic may receive how much of his or her morning dose of insulin preoperatively?

Albert, a 35-year-old insulin-dependent diabetic, is admitted to the hospital with a diagnosis of pneumonia. He has been febrile since admission. His daily insulin requirement is 24 units of NPH. Every morning Albert is given NPH insulin at 0730. Meals are served at 0830, 1230, and 1830. The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of:

A male nurse is providing a bedtime snack for his patient. This is based on the knowledge that intermediate-acting insulins are effective for an approximate duration of:

A nurse went to a patient’s room to do routine vital signs monitoring and found out that the patient’s bedtime snack was not eaten. This should alert the nurse to check and assess for:

A client is taking NPH insulin daily every morning. The nurse instructs the client that the most likely time for a hypoglycemic reaction to occur is:

An external insulin pump is prescribed for a client with DM. The client asks the nurse about the functioning of the pump. The nurse bases the response on the information that the pump:

A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the ER. Which finding would a nurse expect to note as confirming this diagnosis?

A client with DM demonstrates acute anxiety when first admitted for the treatment of hyperglycemia. The most appropriate intervention to decrease the client’s anxiety would be to:

A nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The priority nursing diagnosis would be:

A nurse is caring for a client admitted to the ER with DKA. In the acute phase the priority nursing action is to prepare to:

A nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include fasting blood glucose of 120mg/dl, temperature of 101ºF, pulse of 88 bpm, respirations of 22 bpm, and a BP of 140/84 mmHg. Which finding would be of most concern to the nurse?

A client with type 1 diabetes mellitus calls the nurse to report recurrent episodes of hypoglycemia with exercise. Which statement by the client indicated an inadequate understanding of the peak action of NPH insulin and exercise?

A client with diabetes mellitus visits a health care clinic. The client’s diabetes previously had been well controlled with glyburide (Diabeta), 5 mg PO daily, but recently, the fasting blood glucose has been running 180-200 mg/dl. Which medication, if added to the clients regimen, may have contributed to the hyperglycemia?

Glucose is an important molecule in a cell because this molecule is primarily used for:

When a client is first admitted with hyperglycemic hyperosmolar nonketotic syndrome (HHNS), the nurse’s priority is to provide:

The nurse is admitting a client with hypoglycemia. Identify the signs and symptoms the nurse should expect. Select all that apply.

When a client is experiencing diabetic ketoacidosis, the insulin that would be administered is:

The nurse recognizes that additional teaching is necessary when the client who is learning alternative site testing (AST) for glucose monitoring says:

Which adaptations should the nurse caring for a client with diabetic ketoacidosis expect the client to exhibit? Select all that apply:

A client’s blood gases reflect diabetic acidosis. The nurse should expect:

The nurse knows that glucagon may be given in the treatment of hypoglycemia because it:

A client with type 1 diabetes mellitus has a fingerstick glucose level of 258mg/dl at bedtime. An order for sliding scale insulin exists. The nurse should:

The physician orders 36 units of NPH and 12 units of regular insulin. The nurse plans to administer these drugs using one (1) syringe.

Tip: Identify the steps in this procedure by listing them in priority order, simply drag and drop the choices below.

The nurse is teaching a client regarding the administration of insulin as part of the discharge plan. Which of the following insulin has the most rapid onset of action?

A client with diabetes mellitus states, “I cannot eat big meals; I prefer to snack throughout the day.” The nurse should carefully explain that:

A client with diabetes mellitus has an above-knee amputation because of severe peripheral vascular disease, Two days following surgery, when preparing the client for dinner, it is the nurse’s primary responsibility to:

Which of the following nursing interventions should be taken for a client who complains of nausea and vomits one hour after taking his glyburide (DiaBeta)?

Which of the following chronic complications is associated with diabetes?

Rotating injection sites when administering insulin prevents which of the following complications?

Which of the following methods of insulin administration would be used in the initial treatment of hyperglycemia in a client with diabetic ketoacidosis?

Insulin forces which of the following electrolytes out of the plasma and into the cells?

Which of the following causes of Hyperglycaemic Hyperosmolar Non-Ketotic Syndrome (HHNS) is most common?

A client is in diabetic ketoacidosis (DKA) secondary to infection. As the condition progresses, which of the following symptoms might the nurse see?

Clients with type 1 diabetes may require which of the following changes to their daily routine during periods of infection?

Marlisa has been diagnosed with diabetes mellitus type 1. She asks Nurse Errol what this means. What is the best response by the nurse? Select all that apply.

Dr. Shrunk orders intravenous (IV) insulin for Rita, a client with a blood sugar of 563. Nurse AJ administers insulin lispro (Humalog) intravenously (IV). What does the best evaluation of the nurse reveal? Select all that apply.

Ben injects his insulin as prescribed, but then gets busy and forgets to eat. What will the best assessment of the nurse reveal?

A clinical instructor teaches a class for the public about diabetes mellitus. Which individual does the nurse assess as being at the highest risk for developing diabetes?

A patient was recently diagnosed with type 1 diabetes mellitus and received insulin. Which laboratory test will the nurse assess?

Jansen is receiving metformin (Glucophage). What will be the best plan of the nurse with regard to patient education with this drug? Select all that apply.

Serafica who has diabetes mellitus type 1 is found unresponsive in the clinical setting. Which nursing action is a priority?

TIP: To arrange all answers in the correct order, simply drag and drop the choices below.

Serge who has diabetes mellitus is taking oral agents and is scheduled for a diagnostic test that requires him to be NPO. What is the best plan of the nurse with regard to giving the client his oral medications?

A client diagnosed with type 1 diabetes receives insulin. He asks the nurse why he can’t just take pills instead. What is the best response by the nurse?

Nurse Andy has finished teaching a client with diabetes mellitus how to administer insulin. He evaluates the learning has occurred when the client makes which statement?

Genevieve has diabetes type 1 and receives insulin for glycemic control. She tells the nurse that she likes to have a glass of wine with dinner. What will the best plan of the nurse for client education include?

Dr. Wijangco orders insulin lispro (Humalog) 10 units for Alicia, a client with diabetes mellitus. When will the nurse administer this medication?

Nurse Matt makes a home visit to the client with diabetes mellitus. During the visit, Nurse Matt notes the client’s additional insulin vials are not refrigerated. What is the best action by the nurse at this time?

During the morning rounds, Nurse AJ accompanied the physician in every patient’s room. The physician writes orders for the client with diabetes mellitus. Which order would the nurse validate with the physician?

Gary has diabetes type 2. Nurse Martha has taught him about the illness and evaluates learning has occurred when the client makes which statement?

The principal goals of therapy for older patients who have poor glycemic control are:

Which of the following is accurate pertaining to physical exercise and type 2 diabetes mellitus?

Harry is a diabetic patient who is experiencing a reaction to alternating periods of nocturnal hypoglycemia and hyperglycemia. The patient might be manifesting which of the following?

Dr. Hugo has prescribed sulfonylureas for Rebecca in the management of diabetes mellitus type 2. As a nurse, you know that the primary purpose of sulfonylureas, such as long-acting glyburide (Micronase), is to:

Rosemary has been taking glargine (Lantus) to treat her condition. One of the benefits of glargine (Lantus) insulin is its ability to:

A 50-year-old widower is admitted to the hospital with a diagnosis of diabetes mellitus and complaints of rapid-onset weight loss, elevated blood glucose levels, and polyphagia. The gerontology nurse should anticipate which of the following secondary medical diagnoses?

An older woman with diabetes mellitus visits the clinic concerning her condition. Which of the following symptoms might an older woman with diabetes mellitus complain?

Gregory is a 52-year-old man identified as high-risk for diabetes mellitus. Which laboratory test should a nurse anticipate a physician would order for him? Select all that apply.

According to the National Diabetes Statistics Report, diabetes remains one of the leading causes of death in the United States since 2010. Which of the following factors are risks for the development of diabetes mellitus? Select all that apply.

During a visit to the hospital, the student nurses are asked which of the following persons would most likely be diagnosed with diabetes mellitus. They are correct if they answered a 44-year-old:

An ailing 70-year-old woman with a diagnosis of type 2 diabetes mellitus has been ill with pneumonia. The client’s intake has been very poor, and she is admitted to the hospital for observation and management as needed. What is the most likely problem with this patient?

After suffering an acute MI, a client with a history of type 1 diabetes is prescribed metoprolol (Lopressor) I.V. Which nursing interventions are associated with I.V. administration of metoprolol? Select all that apply.

When reviewing the urinalysis report of a client with newly diagnosed diabetes mellitus, the nurse would expect which urine characteristics to be abnormal? Select all that apply.

The nurse is admitting a client with newly diagnosed diabetes mellitus and left-sided heart failure. Assessment reveals low blood pressure, increased respiratory rate and depth, drowsiness, and confusion. The client complains of headache and nausea. Based on the serum laboratory results below, how would the nurse interpret the client’s acid-base balance?

Lab Results:

pH: 7.34
HCO3-: 19 mEq/L
PaCO2: 35 mm Hg
PaO2: 88 mm Hg
Potassium: 5.3 mEq/L
Chloride: 102 mEq/L
Calcium: 10.4 mg/dl
Anion gap: 30 mEq/L

A nurse has a four-patient assignment in the medical step-down unit. When planning care for the clients, which client would have the following treatment goals: fluid replacement, vasopressin replacement, and correction of underlying intracranial pathology?

During the lecture, the clinical instructor tells the students that 50% to 60% of daily calories should come from carbohydrates. What should the nurse say about the types of carbohydrates that can be eaten?

At the time Cherrie Ann found out that the symptoms of diabetes were caused by high levels of blood glucose, she decided to break the habit of eating carbohydrates. With this, the nurse would be aware that the client might develop which of the following complications?

Joko has recently been diagnosed with type 1 Diabetes Mellitus and asks nurse Jessica for help formulating a nutrition plan. Which of the following recommendations would the nurse make to help the client increase calorie consumption to offset absorption problems?

Billy is being asked concerning his health in the emergency department. When obtaining a health history from a patient with acute pancreatitis, the nurse asks the patient specifically about the history of:

Nurse Shey is educating a pregnant client who has gestational diabetes. Which of the following statements should the nurse make to the client? Select all that apply.

The goal of preprandial blood glucose for those with type 1 diabetes mellitus is:

The guidelines for carbohydrate counting as medical nutrition therapy for diabetes mellitus includes all of the following, except:

The nurse working in the physician’s office is reviewing lab results on the clients seen that day. One of the clients who has classic diabetic symptoms had an eight-hour fasting plasma glucose (FPG) test done. The nurse realizes that diagnostic criteria developed by the American Diabetes Association for diabetes include classic diabetic symptoms plus which of the following fasting plasma glucose levels?

When taking a health history, the nurse screens for manifestations suggestive of diabetes type 1. Which of the following manifestations are considered the primary manifestations of type 1 diabetes mellitus and would be most suggestive and require follow-up investigation?

The nurse is working with an overweight client who has a high-stress job and smokes. This client has just received a diagnosis of type 2 diabetes mellitus and has just been started on an oral hypoglycemic agent. Which of the following goals for the client which if met, would be most likely to lead to an improvement in insulin efficiency to the point the client would no longer require oral hypoglycemic agents?

During a visit to a community, the nurse will recommend routine screening for diabetes when the person has one or more of seven risk criteria. Which of the following persons that the nurse comes in contact with most needs to be screened for diabetes based on the seven risk criteria?

A client was brought to the emergency room with complaints of slurring of speech, vomiting, dry mucosa, and dry skin turgor. Lab tests showing serum sodium 125 mEq/L and serum blood glucose of 350 mg/dL. Nurse Sophie will anticipate the physician to initially order which of the following intravenous solutions?

You are doing some teaching with a client who is starting on a sulfonylurea antidiabetic agent. The client mentions that he usually has a couple of beers each night and takes an aspirin each day to prevent heart attack and/or strokes. Which of the following responses would be best on the part of the nurse?

Which of the following, if stated by the nurse, is correct about Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)?

Nurse Robedee is teaching an underweight and emaciated client about the proper methods/techniques when giving insulin. Which one of the following shows a proper technique?

Nurse Pira is explaining to the client about type 2 diabetes mellitus. Risk factors of such condition include all of the following, except:

Blood sugar is well controlled when Hemoglobin A1C is:

Which of the following diabetes drugs acts by decreasing the amount of glucose produced by the liver?

A 39-year-old company driver presents with shakiness, sweating, anxiety, and palpitations and tells the nurse he has type 1 diabetes mellitus. Which of the following actions should the nurse do first?

Which insulin can be administered through continuous intravenous infusion?

A medication nurse is about to give insulin to a patient with diabetes mellitus. Upon reviewing the medications of the patient, which of the following would cause a further decrease in the blood glucose level of the patient?

Tony is a night shift nurse who is assigned to a patient whose glucose levels remain normal at bedtime but experiences hypoglycemia at 3 am and hyperglycemia at 7 am. The patient is likely experiencing what kind of complication of insulin therapy?

A nurse is caring for a client admitted with diabetic retinopathy. Which of the following would the nurse expect to note on the assessment of this client:

A patient received 6 units of regular insulin three (3) hours ago. The nurse would be MOST concerned if which of the following was observed?

Mr. Wesley is newly diagnosed with Type I DM and is being seen by the home health nurse. The doctor’s orders include: 1200 calorie ADA diet, 15 units NPH insulin before breakfast, and check blood sugar QID. When the nurse visits the patient at 5 pm, the nurse observes the man performing blood sugar analysis. The result is 50 mg/dL. The nurse would expect the patient to be:

Give Regular insulin by continuous I.V. infusion at 20 units/hr. The solution is 250 ml NS with 100 units of Regular insulin. What rate on the infusion pump will deliver the correct dose? Fill in the blank.

Your patient has had the following intake: 2 ½ cups of coffee (240 mL/cup), 11.5 oz of grape juice, ¾ qt of milk, 320 mL of diet coke, 1 ¼ L of D5W IV and 2 oz of grits. What will you record as the total intake in mL for this patient? Fill in the blank.

A health care provider prescribed ondansetron (Zofran) 8 mg p.o. T.i.d to a patient with Type 1 diabetes mellitus with complaints of vomiting.; Available stock of Zofran in a 100 ml bottle labeled 4 mg/tsp.; How many ml will the nurse administer for each dose? Fill in the blank.

Your patient has had the following intake: 8 oz glasses of iced tea, 4 oz cartons of grape juice, ¾ pt of ice cream, 32 oz of juice, 1 ½ L of D5W IV and 6 oz of cottage cheese. What will you record as the total intake in mL for this patient? Fill in the blank.

A patient was recently discharged after being hospitalized due to type 1 diabetes mellitus and was given ergocalciferol (Vitamin D) 225,000 units PO daily. The patient have on hand ergocalciferol in 50,000 unit tablets. How many tablet(s) should the patient take? Fill in the blank.