Albert refuses his bedtime snack. This should alert the nurse to assess for:

Elevated serum bicarbonate and a decreased blood pH.
Signs of hypoglycemia earlier than expected.
Symptoms of hyperglycemia during the peak time of NPH insulin.
Sugar in the urine

Solution

Signs of hypoglycemia earlier than expected.

A bedtime snack is provided for Albert. This is based on the knowledge that intermediate-acting insulins are effective for an approximate duration of:

6-8 hours
10-14 hours
16-20 hours
24-28 hours

Solution

16-20 hours

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:

1130 and 1330
1330 and 1930
1530 and 2130
1730 and 2330

Solution

1330 and 1930

The nurse expects that a type 1 diabetic may receive ____ of his or her morning dose of insulin preoperatively:

10-20%
25-40%
50-60%
85-90%

Solution

50-60%

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

Integumentary inspection for the presence of brown spots on the lower extremities
Observation for paleness of the lower extremities
Observation for blanching of the feet after the legs are elevated for 60 seconds
Palpation for increased pulse volume in the arteries of the lower extremities

Solution

Palpation for increased pulse volume in the arteries of the lower extremities

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

Blurred vision
Diaphoresis
Nausea
Weakness

Solution

Diaphoresis

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

Third day
Week
2-3 weeks
2-4 weeks

Solution

2-3 weeks

The lowest fasting plasma glucose level suggestive of a diagnosis of DM is:

90mg/dl
115mg/dl
126mg/dl
180mg/dl

Solution

126mg/dl

Clinical manifestations associated with a diagnosis of type 1 DM include all of the following except:

Hypoglycemia
Hyponatremia
Ketonuria
Polyphagia

Solution

Hypoglycemia

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

Document weight changes because of fatty acid mobilization
Evaluate the patient’s sensitivity to low room temperatures because of decreased adipose tissue insulation
Protect the patient from sources of infection because of decreased cellular protein deposits
Do all of the above

Solution

Do all of the above

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