Roth 10e NCLEX Chapter 17

MULTIPLE CHOICE 1. A client has recently been diagnosed with Type I diabetes and asks the nurse 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? a. Eating small meals with two or three snacks may be more helpful in maintaining blood glucose levels than three large meals. b. Eat small meals with two or three snacks throughout the day to keep blood glucose levels steady c. Increase consumption of simple carbohydrates

d. Skip meals to help lose weight

ANS: A Eating small meals with two or three snacks may be more helpful in maintaining blood glucose levels than three large meals. PTS: 1 REF: Nutrition Management

2. When a client learned that the symptoms of diabetes were caused by high levels of blood glucose the client decided to stop eating carbohydrates. In this instance, the nurse would be concerned that the client would develop what complication? a. acidosis b. atherosclerosis c. glycosuria d. retinopathy

ANS: A When a clients carbohydrate consumption is inadequate ketones are produced from the breakdown of fat. These ketones lower the pH of the blood, potentially causing acidosis that can lead to a diabetic coma. PTS: 1 REF: Symptoms

3. The doctor is interested in how well a client has controlled their blood glucose since their last visit. What lab values could the nurse evaluate to determine how well the client has controlled their blood glucose over the past three months? a. blood glucose b. glucagon c. hbgA1c d. insulin

ANS: C HbgA1c is a blood test used to determine how well blood glucose has been controlled for the last three months. PTS: 1 REF: Classification

4. A client recently decided to undertake the exchange diet, and for breakfast chooses a large (4 oz) bagel. How many starch exchanges would the nurse tell the client this bagel contains? a. one b. two c. three d. four

ANS: D One exchange is equivalent to one ounce of a bagel (Table 17-3). PTS: 1 REF: Diets Based on Exchange Lists

5. The client tells the nurse that the client really misses having sugar with tea in the morning. What is an alternative that the nurse could advise them to help sweeten their drink. a. Oatrim b. Olestra c. sucralose d. tannin

ANS: C Aspartame is the generic name for a sweetener composed of two amino acids, phenylalanine and aspartic acid. Olestra and Oatrim are fat replacers and tannin is an acid found in some foods such as tea. PTS: 1 REF: Artificial Sweeteners

6. During a teaching session, the nurse tells the client 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? a. Simple carbohydrates are absorbed more c. Simple sugars should never be consumed rapidly than complex carbohydrates. by someone with diabetes. b. Simple sugars cause a rapid spike in d. Try to limit simple sugars to between 10% glucose levels and should be avoided. and 20% of daily calories. ANS: D It is recommended that carbohydrates provide 50% to 60% of the daily calories. Approximately 40% to 50% should be from complex carbohydrates. The remaining 10% to 20% of carbohydrates could be from simple sugars. Research provides no evidence that carbohydrates from simple sugars are digested and absorbed more rapidly than are complex carbohydrates, and they do not appear to affect blood sugar control. PTS: 1 MULTIPLE RESPONSE 1. A client comes to the nurse and expresses concern that they may have diabetes. What signs and symptoms would the nurse, look for in this client? Select all that apply. a. The client complains of changes in vision d. The client exhibits weight loss despite excessive hunger and appetite b. The client complains of frequent e. The client has to go to the bathroom headaches frequently c. The client complains of frequent nausea ANS: A, B, D, E f. The client mentions that they are always thirsty REF: Nutritional Management

The inability to metabolize glucose can lead to weight loss despite an excessive appetite, or polyphagia. This inability to metabolize glucose will also lead to increased blood levels of glucose. This excessive blood glucose will pull water out of the cellular fluid leading to polyuria, or excessive urination, and polydipsia, or excessive thirst. Eventually, these changes can lead to vision problems know as retinopathy. PTS: 1 REF: Symptoms

2. The client, an otherwise healthy teenager has recently been diagnosed with type I diabetes. The client has recently started using the pump for his insulin and is worried he wont be able to eat at regular times as a result of his busy schedule. What symptoms should the nurse advise this client to look for? Select all that apply. a. blurred vision b. confusion c. fever d. headache e. tremors f. uremia

ANS: A, B, D, E When clients do not eat the prescribed diet but continue to take insulin, hypoglycemia can result. Symptoms of hypoglycemia include headache, blurred vision, tremors, confusion, poor coordination, and eventual unconsciousness. PTS: 1 REF: Insulin Reactions

3. The nurse 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. a. Cakes, candies, cookies, and regular soft d. Insulin injections may be necessary. drinks should be avoided. b. Gestational diabetes increases the risk that e. The baby will likely be born with diabetes. the mother will develop diabetes later in life. c. Gestational diabetes usually resolves after f. The mother should strive to gain no more the baby is born. weight during the pregnancy. ANS: A, B, C, D Gestational diabetes can occur between the sixteenth and twenty-eight week of pregnancy. If not responsive to diet and exercise, insulin injections may be necessary. Concentrated sugars should be avoided. Weight gain should continue, but not in excessive amounts. Usually, gestational diabetes disappears after the infant is born. However, diabetes can develop 5 to 10 years after the pregnancy. PTS: 1 REF: Classification

4. The public health nurse is giving a lecture at the local community center about risk factors for type 2 diabetes. What ethnic groups will the nurse say can predispose one to developing type 2 diabetes? a. African Americans d. Native Americans b. Hispanic Americans e. Native Hawaiians c. Latino Americans f. Pacific Islanders ANS: A, B, C, D, E, F Race and ethnicity can predispose one to type 2 diabetes. African Americans, Hispanic and Latino Americans, Native Americans, some Asian Americans, Native Hawaiians, and other pacific islanders are at a particularly high risk for type 2 diabetes/

PTS: 1

REF: Classification