Test Bank for Lewis Medical Surgical Nursing 12TH Edition by By Mariann M. Harding, Jeffrey Kwong, Debra Hagler, and Courtney Reinisch/Updated Version 2024/2025/ All Chapters Covered(Chapter 1 to Chapter 69)/100% Correct

A patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL
(6.7 mmol/L). What should the nurse plan to teach the patient?
a. Self-monitoring of blood glucose
b. Using low doses of regular insulin
c. Lifestyle changes to lower blood glucose
d. Effects of oral hypoglycemic medications - ANSWER--ANS: C
The patient's impaired fasting glucose indicates prediabetes, and the patient should be
counseled about lifestyle changes to prevent the development of type 2 diabetes. The patient
with prediabetes does not require insulin or oral hypoglycemics for glucose control and does
not need to self-monitor blood glucose.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity



For some patients with type 2 diabetes, changes in lifestyle are sufficient to achieve blood
glucose control. Insulin is frequently used for type 2 diabetes, complications are equally
severe as for type 1 diabetes, and type 2 diabetes is usually diagnosed with routine laboratory
testing or after a patient develops complications such as frequent yeast infections.
DIF: Cognitive Level: Understand (comprehension)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

A 28-yr-old male patient with type 1 diabetes reports how he manages his exercise and
glucose control. Which behavior indicates that the nurse should implement additional
teaching?
a. The patient always carries hard candies when engaging in exercise.
b. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
c. The patient has a peanut butter sandwich before going for a bicycle ride.
d. The patient increases daily exercise when ketones are present in the urine. - ANSWER--ANS: D
A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months
from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the
patient?
a. Fasting blood glucose
b. Glycosylated hemoglobin
c. Oral glucose tolerance test
d. Urine dipstick for glucose and ketones - ANSWER--ANS: B
The glycosylated hemoglobin (A1C) test shows the overall control of glucose over 90 to 120
days. A fasting blood level indicates only the glucose level at one time. Urine glucose testing
is not an accurate reflection of blood glucose level and does not reflect the glucose over a
prolonged time. Oral glucose tolerance testing is done to diagnose diabetes but is not used for
monitoring glucose control after diabetes has been diagnosed.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
When the patient is ketotic, exercise may result in an increase in blood glucose level. Patients
with type 1 diabetes should be taught to avoid exercise when ketosis is present. The other
statements are correct.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
Which statement by a nurse to a patient newly diagnosed with type 2 diabetes is accurate?
a. Insulin is not used to control blood glucose in patients with type 2 diabetes.
b. Complications of type 2 diabetes are less serious than those of type 1 diabetes.
c. Changes in diet and exercise may control blood glucose levels in type 2 diabetes.
d. Type 2 diabetes is usually diagnosed when a patient is admitted in hyperglycemic
coma. - ANSWER--ANS: C
The nurse is assessing a 22-yr-old patient experiencing the onset of symptoms of type 1
diabetes. To which question would the nurse anticipate a positive response?
a. "Are you anorexic?"
b. "Is your urine dark colored?"
c. "Have you lost weight lately?"
d. "Do you crave sugary drinks?" - ANSWER--ANS: C
Weight loss occurs because the body is no longer able to absorb glucose and starts to break
down protein and fat for energy. The patient is thirsty but does not necessarily crave
sugar-containing fluids. Increased appetite is a classic symptom of type 1 diabetes. With the
classic symptom of polyuria, urine will be very dilute.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity



The nurse is assessing a 55-yr-old female patient with type 2 diabetes who has a body mass
index (BMI) of 31 kg/m2.Which goal in the plan of care is most important for this patient?
a. The patient will reach a glycosylated hemoglobin level of less than 7%.
b. The patient will follow a diet and exercise plan that results in weight loss.
c. The patient will choose a diet that distributes calories throughout the day.
d. The patient will state the reasons for eliminating simple sugars in the diet. - ANSWER--ANS: A
The complications of diabetes are related to elevated blood glucose and the most important
patient outcome is the reduction of glucose to near-normal levels. A BMI of 30.9/kg/m2 or
above is considered obese, so the other outcomes are appropriate but are not as high in
priority.
DIF: Cognitive Level: Analyze (analysis)
OBJ: Special Questions: Prioritization TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity

A patient who has type 1 diabetes plans to swim laps for an hour daily at 1:00 PM. What
advice should the clinic nurse plan to give the patient?
a. Increase the morning dose of NPH insulin (Novolin N).
b. Check glucose level before, during, and after swimming.
c. Time the morning insulin injection to peak while swimming.
d. Delay eating the noon meal until after finishing the swimming - ANSWER--ANS: B
The change in exercise will affect blood glucose, and the patient will need to monitor glucose
carefully to determine the need for changes in diet and insulin administration. Because
exercise tends