1. A patient with asthma has a personal best peak expiratory flow rate (PEFR) of 400 L/min. When

explaining the asthma action plan, the nurse will teach the patient that a change in therapy is needed

when the PEFR is less than L/minute

ANS: 320

A PEFR less than 80% of the personal best indicates that the patient is in the yellow zone where

changes in therapy are needed to prevent progression of the airway narrowing.

Which statement by a nurse to a

patient newly diagnosed with type 2 diabetes is correct?

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 levelsin type 2 diabetes.

d) Type 2 diabetes is usually diagnosed when the patient is admitted with a

hyperglycemic coma.

ANS: C

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.

2. A patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL

(6.7 mmol/L). The nurse will plan to teach the patient about

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.

ANS: C

The patient’s impaired fasting glucose indicates prediabetes, and the patient should be

counseled about lifestyle changesto 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.

3. 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.