Sugar
A clinician is working with a patient with type 2 diabetes mellitus, and the clinician wants to evaluate the patient’s insulin production. What test can be used?
A1c
C-peptide test
Islet antibody test
Oral glucose tolerance test
C- Peptide test
Rationale: A C-peptide test measures insulin production.
A mother is wondering how her child, who was recently diagnosed with type 1 diabetes mellitus, developed the disease. The nurse explains that which of the following is the number one cause of type 1 diabetes mellitus?
Genetic defect
autoimmune disorder
obesity and sendentary lifestyle
95% of cases are unknown
autoimmune disorder
rationale: the majority of type 1DM are due to autoimmune attack of the b cells
A mother comes the clinic wanting her child to be evaluated for diabetes mellitus, as she feels the child has some of the signs and symptoms. Which of the following would be signs and symptoms the child may display with diabetes mellitus?
Hyperactivity and a lack of focus on activities
Thirsty all the time, weight loss, and getting up in the night to urinate
Lack of interest in activities, lethargy, and weight gain
Nauseated, stomach bloating, and constipation
Thirsty all the time, weight loss, and getting up in the night to urinate
Rationale: Polyuria and polydipsia are common signs of diabetes mellitus.
Individuals with diabetes mellitus (DM) are at an increased risk for chronic infections with which of the following infectious agents?
Clostridium difficile
Escherichia coli
Candia albicans
Neisseria meningitidis
Candia albicans
Rationale: Those with DM are at an increased risk for Candida albicans infections.
A nurse is explaining to a patient that, although he feels “fine,” glycemic control is important as chronic hyperglycemia has been associated with increased risk for which of the following?
osteoporosis
amputation
thyroid gland suppression
liver failure
Amputation
A patient insists that his blood glucose has been excellent. Which of the following lab results would support his conclusion?
A1c of 4.9%
C-peptides results are normal
No glucose in urine
pt self reported postprandial blood glucose
A1c of 4.9%
Insulin helps move glucose into cells. Which other hormones are also involved in glucose regulation? Select all that apply.
Glucagon
Antidiuretic hormone (ADH)
Thyroxine
Somatostatin
Glucagon-like peptide-1
Glucagon, Somatostatin, Glucagonlike peptide-1
Rationale: Glucagon is released from the alpha cells of the pancreas and raises blood glucose.
Rationale: Somatostatin diminished insulin release, decreasing glucose uptake.
Rationale: Glucagon-like peptide-1 causes an anticipatory rise in insulin after a meal.
A pregnant woman wants to know why she needs to be concerned about gestational diabetes. What of the following are possible developments the nurse could share with the patient?
Gestational diabetes can lead to newborns presenting with signs and symptoms similar to fetal alcohol syndrome.
If you have gestational diabetes, you will be at a decreased risk for developing diabetes while not pregnant.
Infants of mothers with gestational diabetes may develop macrosomia.
Infants of mothers with gestational diabetes are more likely to develop vision problems.
Infants of mothers with gestational diabetes may develop macrosomia.
Rationale: An infant born to a mother with gestational diabetes may have a larger-than-normal body size.
On a fundoscopic examination of a patient with diabetes mellitus (DM), proliferative retinopathy is noted. Which of the following is the correct interpretation?
Positive sign of retinal recovery
Loss of retinal blood vessels
Occurrence of retinal detachment
Damage to microvasculature of the retina
Damage to microvasculature of the retina
Rationale: Proliferative retinopathy often develops in DM. Although new vessels are formed, the vessels are fragile.
A nurse is working with a patient who has had type 2 diabetes mellitus (DM) for several years. The nurse will need to keep in mind which of the following psychological aspects?
Patients should be encouraged to refrain from getting emotional about having DM.
So that patients with DM do not become discouraged, long-term complications of the disease should not be discussed.
Schizophrenia may develop in those with DM for 10 or more years.
Rationale: DM does not increase the risk for schizophrenia.
People with DM are twice as likely to suffer depression.
People with DM are twice as likely to suffer depression.
Rationale: Individuals suffering from DM are twice as likely to suffer from depression.
Which of the following would indicate to a nurse that a patient has type 1 diabetes mellitus (DM) rather than type 2 DM?
Glucose in urine
ketones in uriine
blood in urine
albumin in urine
Ketones in urine
ketones in the urine are more common in type 1DM
A nurse sees in the patient records that the patient has diabetes. Blood laboratory values reveal hyperinsulinemia. Which of the following is true?
The patient has type 1,but not type 2 diabetes mellitus.
The patient has diabetes insipidus, not diabetes mellitus.
The patient will likely test positive for islet cells antibodies.
C-peptide test may reveal high levels.
C-peptide test may reveal high levels.
Rationale: When insulin is produced, C-peptide is also released. With hyperinsulinemia, C-peptide levels are also likely elevated.
A patient states to a nurse that he is experiencing changes in the skin and tissue in the location he uses for his insulin injection. What is an appropriate response by the nurse?
Ask the patient if he is rotating injection sites.
Suggest that the patient is having an allergic reaction.
Suggest that the patient switch insulin types.
Ask the patient to refrain from insulin injections until the site heals.
Ask the patient if he is rotating injection sites.
Rationale: Insulin injection sites should be rotated.
A patient has recently been diagnosed with type 2 diabetes mellitus. He wants to know whether his disease can lead to any long-term problems. Which of the following may the nurse share as a long-term complication of diabetes mellitus?
Hypoglycemia
Blindness
Diabetic ketoacidosis
Dawn syndrome
Blindness
Rationale: DM damages the retinal vessels and can cause blindness
Because diabetes mellitus can damage the autonomic nervous system, the nurse wants to explain some signs and symptoms that the patient may experience. Which should she include on her list for a patient with disrupted autonomic nervous system functioning?
Erectile dysfunction
Skin appearance changes
Sense of sustained muscle contraction
Loss of sensation from the extremities
Erectile dysfunction
Rationale: Erectile dysfunction can develop when the autonomic nervous system is compromised.
A patient’s blood glucose levels are 90 mg/dL after an eight-hour fast. Which of the following is the correct assessment of these results?
The blood glucose levels are normal.
The blood glucose levels indicate prediabetes.
The blood glucose levels indicate diabetes.
The blood glucose levels indicate hypoglycemia.
The blood glucose levels are normal.
Rationale: The patient’s blood glucose levels are normal.
Which of the following results is more indicative of type 1 rather than type 2 diabetes mellitus?
Hyperglycemia
Polyuria
Ketones in urine
Glucose in urine
Ketones in urine
Rationale: Ketone formation more commonly occurs in type 1 diabetes mellitus due to lack of insulin.
A patient with type 2 diabetes mellitus (DM) receives urinalysis results that are positive for albumin. What does the nurse suspect?
The patient is dehydrated.
The patient has entered renal failure.
The patient may be developing diabetic nephropathy.
The patient has a kidney stone.
The patient may be developing diabetic nephropathy.
Rationale: Albumin in the urine may indicate glomerular damage, which occurs with diabetic nephropathy.
A patient with DM has noted that she is suffering a greater incidence of yeast infections. What is an appropriate explanation by the nurse?
“Yeast organisms require sugar for growth. With the elevated glucose levels in diabetes mellitus, it provides a good environment for yeast growth.”
“The yeast infections are a result of an overreactive immune system, which is common in diabetes mellitus.”
“With diabetes, you are less likely to suffer bacterial infections. This increases your risk for yeast infections.”
“All medications for diabetes mellitus are immunosuppressants, that is why you have more infections.”
“Yeast organisms require sugar for growth. With the elevated glucose levels in diabetes mellitus, it provides a good environment for yeast growth.”
Rationale: Hyperglycemia can encourage the growth of yeast organisms.
Patients with diabetes should eat regular meals with approximately ______________ percent of the calories provided by carbohydrates.
20
10
50
30
50
A patient with type 1 diabetes mellitus has glycated hemoglobin levels of 7.8%. The patient states his blood glucose levels have been perfect over the past several weeks. Which of the following is an appropriate response by the nurse?
I don't think you are telling the truth about your blood glucose levels.
All of your blood glucose values appear to be excellent.
Although you may feel your blood glucose levels have been perfect, these additional test results reveal glycemic control needs to be improved.
Your insulin regimen is apparently not working.
Although you may feel your blood glucose levels have been perfect, these additional test results reveal glycemic control needs to be improved.
Rationale: The patient’s A1c level is elevated, indicating poor glycemic control over the past three months.
A patient is working towards better glycemic control. She has become frustrated though, saying how variable her measurements are. The nurse decides to review all the factors that influence her blood glucose levels. Which of the following should be included? Select all that apply.
Timing and type of nutrient intake
Rationale: Timing and type of nutrient intake can affect blood glucose levels.
Physical activity
Rationale: Physical activity affects blood glucose levels.
Lipoprotein levels
Rationale: Lipoprotein levels do not directly affect blood glucose levels.
Status of insulin resistance
Rationale: Insulin resistance affects blood glucose levels.
Illness and stressors
Rationale: Illness and stressors can alter blood glucose levels.
Timing and type of nutrient intake, Physical activity, Status of insulin resistance, Illness and stressors
Rationale: Timing and type of nutrient intake can affect blood glucose levels.
Rationale: Physical activity affects blood glucose levels.
Rationale: Insulin resistance affects blood glucose levels.
Rationale: Illness and stressors can alter blood glucose levels.
A nurse is working with a patient who is performing “insulin purging.” What is the correct association for the nurse to make?
The patient is taking all her insulin in one shot per day.
The patient is restricting insulin usage to promote weight loss.
The patient is taking extra insulin to stimulate her metabolic rate.
The patient is using only one site for her insulin injections.
The patient is restricting insulin usage to promote weight loss.
Rationale: Insulin purging is the restriction of insulin in order to promote weight loss.
A nurse is concerned about the poor glycemic control of a patient and the complaints of blurred vision by the patient. Which of the following is recommended?
Fundoscopic examination
Change in corrective eye wear
LASIK surgery
Cataract surgery
Fundoscopic examination
Rationale: A fundoscopic examination will enable an examination of any retinal changes.
Which of the following tests may be used to diagnose type 2 diabetes? Select all that apply.
Fasting blood glucose
Hemoglobin and hematocrit
A1c
Dexamethasone suppression test
Oral glucose tolerance test
Fasting blood glucose
Oral glucose tolerance test OGTT
A1c