Chapter 24 Nutritional Care and Support

Chapter 24  Nutritional Care and Support

Complete Chapter Questions And Answers
 

Sample Questions

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. The nurse is caring for a diabetic patient who requires blood glucose monitoring before meals and at bedtime. When checking the patient’s blood glucose before lunch, the nurse documents the reading as 130 mg/dL. What should the nurse do next?
A.
Continue to monitor.
B.
Notify the patient’s physician.
C.
Give the patient an injection of insulin.
D.
Administer an ampule of 50% dextrose.

____ 2. When caring for a diabetic patient, the nurse checks the morning lab values. The nurse notes that the patient’s blood glucose level is 60 mg/dL. The nurse recognizes this reading is consistent with
A.
Hypoglycemia.
B.
Hyperglycemia.
C.
A normal value.
D.
Diabetic ketoacidosis.

____ 3. When performing an initial admission assessment on a diabetic patient, the nurse checks the patient’s blood glucose level. The nurse notes that the patient’s blood glucose level is 280 mg/dL. The nurse recognizes this reading is consistent with
A.
Hypoglycemia.
B.
Diabetic coma.
C.
Hyperglycemia.
D.
A normal value.

____ 4. When providing diabetic teaching to a newly diagnosed diabetic patient, the nurse teaches that the best indicator of long-term glycemic control is obtained through measuring a patient’s
A.
Creatinine level.
B.
Urine glucose level.
C.
Blood glucose level.
D.
Glycosylated hemoglobin.

____ 5. When educating a diabetic patient about the HbA1c test, the nurse teaches that the HbA1c gives a better overall picture of glycemic control by measuring the amount of glucose present over a period of
A.
1 to 2 months.
B.
4 to 5 months.
C.
2 to 3 months.
D.
3 to 4 months.

Chapter 24. Nutritional Care and Support
Answer Section

MULTIPLE CHOICE

1. ANS: A

Feedback
A
The 2008 American Diabetic Association guidelines state a range of 90 to 130 mg/dL before meals is acceptable for existing diabetics. Therefore, since the findings are normal, the nurse should continue to monitor. Chapter Objective: Describe the nurse’s responsibilities associated with mealtimes and therapeutic diets.
B
The 2008 American Diabetic Association guidelines state a range of 90 to 130 mg/dL before meals is acceptable for existing diabetics. Notifying the patient’s physician is not warranted for a normal blood glucose level.
C
The 2008 American Diabetic Association guidelines state a range of 90 to 130 mg/dL before meals is acceptable for existing diabetics. Giving the patient an injection of insulin is not warranted.
D
The 2008 American Diabetic Association guidelines state a range of 90 to 130 mg/dL before meals is acceptable for existing diabetics. Giving the patient 50% dextrose is not warranted.

PTS: 1 REF: Chapter: 24 | Page: 504 OBJ: Chapter Objective: 24-5
KEY: Content Area: Blood Glucose | Integrated Process: Nursing Process/Evaluation | Client Need: Physiological Integrity | Cognitive Level: Analysis

2. ANS: A

Feedback
A
The 2008 American Diabetic Association guidelines state a range of 90 to 130 mg/dL before meals is acceptable for existing diabetics. A blood glucose level of 60 mg/dL is consistent with hypoglycemia. Chapter Objective: Describe the nurse’s responsibilities associated with mealtimes and therapeutic diets.
B
The 2008 American Diabetic Association guidelines state a range of 90 to 130 mg/dL before meals is acceptable for existing diabetics. A blood glucose level of 60 mg/dL is consistent with hypoglycemia.
C
The 2008 American Diabetic Association guidelines state a range of 90 to 130 mg/dL before meals is acceptable for existing diabetics. A blood glucose level of 60 mg/dL is consistent with hypoglycemia.
D
The 2008 American Diabetic Association guidelines state a range of 90 to 130 mg/dL before meals is acceptable for existing diabetics. A blood glucose level of 60 mg/dL is consistent with hypoglycemia. Diabetic ketoacidosis is associated with hyperglycemia.

PTS: 1 REF: Chapter: 24 | Page: 504 OBJ: Chapter Objective: 24-5
KEY: Content Area: Blood Glucose | Integrated Process: Nursing Process/Evaluation | Client Need: Physiological Integrity | Cognitive Level: Analysis

3. ANS: C

Feedback
A
The 2008 American Diabetic Association guidelines state a range of 90 to 130 mg/dL before meals is acceptable for existing diabetics. A blood glucose level of 280 mg/dL is consistent with hyperglycemia.
B
The 2008 American Diabetic Association guidelines state a range of 90 to 130 mg/dL before meals is acceptable for existing diabetics. A blood glucose level of 280 mg/dL is consistent with hyperglycemia. Diabetic coma is associated with hypoglycemia.
C
The 2008 American Diabetic Association guidelines state a range of 90 to 130 mg/dL before meals is acceptable for existing diabetics. A blood glucose level of 280 mg/dL is consistent with hyperglycemia. Chapter Objective: Describe the nurse’s responsibilities associated with mealtimes and therapeutic diets.
D
The 2008 American Diabetic Association guidelines state a range of 90 to 130 mg/dL before meals is acceptable for existing diabetics. A blood glucose level of 280 mg/dL is consistent with hyperglycemia.

PTS: 1 REF: Chapter: 24 | Page: 504 OBJ: Chapter Objective: 24-5
KEY: Content Area: Blood Glucose | Integrated Process: Nursing Process/Evaluation | Client Need: Physiological Integrity | Cognitive Level: Analysis

4. ANS: D

Feedback
A
A creatinine test measures the level of waste product left in the blood after the kidneys have filtered the blood, therefore, it is a test reflective of kidney function.
B
The urine level of glucose provides an indicator of a current elevated blood level of glucose, but does not reflect long-term glycemic control.
C
The blood glucose level provides information related to the current glucose level, but not to the long-term blood glucose and control.
D
Glucose in the blood freely enters red blood cells and attaches to hemoglobin molecules, directly proportional to the amount of glucose present. Health care providers evaluate a patient’s long-term glycemic control by measuring glycosylated hemoglobin, known as HbA1c. A red blood cell has an average life span of 120 days, so the HbA1c measures the amount of glucose present over a period of 2 to 3 months, giving a better overall picture of glycemic control. Chapter Objective: Describe the nurse’s responsibilities associated with mealtimes and therapeutic diets.

PTS: 1 REF: Chapter: 24 | Page: 504 OBJ: Chapter Objective: 24-5
KEY: Content Area: Glycosylated Hemoglobin | Integrated Process: Teaching and Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Analysis

5. ANS: C

Feedback
A
Glucose in the blood freely enters red blood cells and attaches to hemoglobin molecules, directly proportional to the amount of glucose present. Health care providers evaluate a patient’s long-term glycemic control by measuring glycosylated hemoglobin, known as HbA1c. A red blood cell has an average life span of 120 days, so the HbA1c measures the amount of glucose present over a period of 2 to 3 months, giving a better overall picture of glycemic control.
B
Glucose in the blood freely enters red blood cells and attaches to hemoglobin molecules, directly proportional to the amount of glucose present. Health care providers evaluate a patient’s long-term glycemic control by measuring glycosylated hemoglobin, known as HbA1c. A red blood cell has an average life span of 120 days, so the HbA1c measures the amount of glucose present over a period of 2 to 3 months, giving a better overall picture of glycemic control.
C
Glucose in the blood freely enters red blood cells and attaches to hemoglobin molecules, directly proportional to the amount of glucose present. Health care providers evaluate a patient’s long-term glycemic control by measuring glycosylated hemoglobin, known as HbA1c. A red blood cell has an average life span of 120 days, so the HbA1c measures the amount of glucose present over a period of 2 to 3 months, giving a better overall picture of glycemic control. Chapter Objective: Describe the nurse’s responsibilities associated with mealtimes and therapeutic diets.
D
Glucose in the blood freely enters red blood cells and attaches to hemoglobin molecules, directly proportional to the amount of glucose present. Health care providers evaluate a patient’s long-term glycemic control by measuring glycosylated hemoglobin, known as HbA1c. A red blood cell has an average life span of 120 days, so the HbA1c measures the amount of glucose present over a period of 2 to 3 months, giving a better overall picture of glycemic control.

PTS: 1 REF: Chapter: 24 | Page: 504 OBJ: Chapter Objective: 24-5
KEY: Content Area: Glycosylated Hemoglobin | Integrated Process: Teaching and Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Analysis