Chapter 51 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

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Chapter 51  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

1. A patient with type 1 diabetes has told the nurse that his most recent urine test for ketones was positive. What is the nurse’s most plausible conclusion based on this assessment finding?

  1. A)  The patient should withhold his next scheduled dose of insulin.
  2. B)  The patient should promptly eat some protein and carbohydrates.
  3. C)  The patient’s insulin levels are inadequate.
  4. D)  The patient would benefit from a dose of metformin (Glucophage).

Ans: C

Feedback:

Ketones in the urine signal that there is a deficiency of insulin and that control of type 1 diabetes is deteriorating. Withholding insulin or eating food would exacerbate the patient’s ketonuria. Metformin will not cause short-term resolution of hyperglycemia.

2. A patient presents to the clinic complaining of symptoms that suggest diabetes. What criteria would support checking blood levels for the diagnosis of diabetes?

  1. A)  Fasting plasma glucose greater than or equal to 126 mg/dL
  2. B)  Random plasma glucose greater than 150 mg/dL
  3. C)  Fasting plasma glucose greater than 116 mg/dL on 2 separate occasions
  4. D)  Random plasma glucose greater than 126 mg/dL

Ans: A

Feedback:

Criteria for the diagnosis of diabetes include symptoms of diabetes plus random plasma glucose greater than or equal to 200 mg/dL, or a fasting plasma glucose greater than or equal to 126 mg/dL.

3. A patient newly diagnosed with type 2 diabetes is attending a nutrition class. What general guideline would be important to teach the patients at this class?

  1. A)  Low fat generally indicates low sugar.
  2. B)  Protein should constitute 30% to 40% of caloric intake.
  3. C)  Most calories should be derived from carbohydrates.
  4. D)  Animal fats should be eliminated from the diet.

Ans: C

Feedback:

Currently, the ADA and the Academy of Nutrition and Dietetics (formerly the American Dietetic Association) recommend that for all levels of caloric intake, 50% to 60% of calories should be derived from carbohydrates, 20% to 30% from fat, and the remaining 10% to 20% from protein.Low fat does not automatically mean low sugar. Dietary animal fat does not need to be eliminated from the diet.

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4. A nurse is providing health education to an adolescent newly diagnosed with type 1 diabetes mellitus and her family. The nurse teaches the patient and family that which of the following nonpharmacologic measures will decrease the body’s need for insulin?

  1. A)  Adequate sleep
  2. B)  Low stimulation
  3. C)  Exercise
  4. D)  Low-fat diet

Ans: C

Feedback:

Exercise lowers blood glucose, increases levels of HDLs, and decreases total cholesterol and triglyceride levels. Low fat intake and low levels of stimulation do not reduce a patient’s need for insulin. Adequate sleep is beneficial in reducing stress, but does not have an effect that is pronounced as that of exercise.

5. A medical nurse is caring for a patient with type 1 diabetes. The patient’s medication administration record includes the administration of regular insulin three times daily. Knowing that the patient’s lunch tray will arrive at 11:45, when should the nurse administer the patient’s insulin?

  1. A)  10:45
  2. B)  11:15
  3. C)  11:45
  4. D)  11:50

Ans: B

Feedback:

Regular insulin is usually administered 20–30 min before a meal. Earlier administration creates a risk for hypoglycemia; later administration creates a risk for hyperglycemia.

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