LPN Diabetes Care: Glucose and Insulin 4

Question 1

A patient with diabetic ketoacidosis (DKA) is admitted. Which laboratory finding is most characteristic of this condition?

Accepted Answer

Blood glucose > 250 mg/dL, pH < 7.3, positive serum ketones

Answer

Blood glucose 180 mg/dL, pH 7.38, negative serum ketones

Answer

Sodium 128 mEq/L, glucose 90 mg/dL, pH 7.30

Answer

Glucose > 600 mg/dL, pH 7.36, no ketones

Question 2

When teaching a patient to perform self-monitoring of blood glucose (SMBG), which technique should the nurse emphasize?

Accepted Answer

Use the side of the fingertip rather than the pad to reduce pain and get an adequate sample

Answer

Squeeze the fingertip firmly before lancing to ensure a large blood drop

Answer

Wipe the first drop of blood away and use the second drop for testing

Answer

Disinfect the site with alcohol and test immediately while still wet

Question 3

A type 2 diabetic patient is prescribed metformin. Which assessment finding would require the LPN to hold the medication and notify the provider?

Accepted Answer

Serum creatinine of 2.4 mg/dL indicating significant renal impairment

Answer

Fasting blood glucose of 130 mg/dL

Answer

HbA1c of 7.8%

Answer

Blood pressure of 138/88 mmHg

Question 4

Which patient statement indicates a correct understanding of the Dawn phenomenon?

Accepted Answer

'My blood sugar rises in the early morning because of hormones released during sleep, not because I ate anything.'

Answer

'My blood sugar goes low at night and then bounces up—that is why my morning reading is high.'

Answer

'Dawn phenomenon means my insulin stops working after midnight.'

Answer

'High morning glucose means I ate too many carbohydrates at dinner.'

Question 5

An LPN is caring for a patient receiving a continuous insulin infusion. The patient becomes pale, diaphoretic, and confused. Blood glucose reads 48 mg/dL. What is the immediate priority action?

Accepted Answer

Stop the insulin infusion and notify the RN immediately

Answer

Decrease the infusion rate by half and recheck glucose in 30 minutes

Answer

Document the finding and continue monitoring every 15 minutes

Answer

Administer the next scheduled meal bolus to raise glucose

Question 6

A patient with type 1 diabetes develops nausea, vomiting, and inability to eat. Which sick-day rule should the nurse reinforce?

Accepted Answer

Continue taking basal insulin and check blood glucose every 2–4 hours

Answer

Omit all insulin since the patient is not eating

Answer

Double the insulin dose because illness raises blood glucose

Answer

Only take insulin if blood glucose exceeds 300 mg/dL

Question 7

Which site preparation technique is correct before subcutaneous insulin injection?

Accepted Answer

Cleanse the site with an alcohol swab and allow it to dry completely before injecting

Answer

Rub the site vigorously with alcohol immediately before inserting the needle

Answer

Apply a warm compress for 5 minutes to increase absorption speed

Answer

Pinch the skin and inject at a 90-degree angle only in obese patients