diabetes mellitus
Which of the following best describes the underlying pathophysiology of type 1 diabetes mellitus?
A. Decreased sensitivity of insulin receptors on target cells
B. Gradual destruction of pancreatic beta cells by the immune system
C. Excessive hepatic glucose production due to insulin resistance
D. Increased insulin production in response to high blood glucose levels
Correct Answer: B
Rationale: Type 1 diabetes is characterized by autoimmune destruction of the insulin-producing beta cells in the pancreas, resulting in absolute insulin deficiency.
Which physiological change primarily contributes to the development of dehydration in a client with diabetic ketoacidosis (DKA)?
A. Increased insulin secretion
B. Polyuria caused by osmotic diuresis
C. Vasodilation from acidosis
D. Increased aldosterone production
Correct Answer: B
Rationale: In DKA, hyperglycemia causes osmotic diuresis, leading to excessive urination (polyuria), which in turn results in dehydration and electrolyte depletion.
A nurse is educating a client at risk for type 2 diabetes about prevention strategies. Which recommendation is most effective in reducing the client’s risk?
A. Taking insulin daily
B. Losing weight through diet and exercise
C. Increasing red meat intake for energy
D. Avoiding all carbohydrates
Correct Answer: B
Rationale: Weight loss through healthy eating and physical activity is the most effective strategy to prevent or delay type 2 diabetes, especially in high-risk individuals.
A nurse is counseling a client with pre-hypertension. Which dietary change is most appropriate to recommend?
A. Increase sodium intake to maintain fluid balance
B. Follow a diet rich in fruits, vegetables, and low-fat dairy
C. Eliminate all carbohydrates from the diet
D. Increase red meat consumption for protein
Correct Answer: B
Rationale: The DASH (Dietary Approaches to Stop Hypertension) diet, which includes fruits, vegetables, and low-fat dairy, is proven to help lower blood pressure.
Which statement best describes the pathophysiology of atherosclerosis?
A. A sudden narrowing of arteries due to calcium buildup
B. A progressive buildup of plaque within the arterial walls
C. A genetic condition that causes immediate heart failure
D. A reversible condition caused by a single high-fat meal
Correct Answer: B
Rationale: Atherosclerosis is a slow, progressive process where plaque builds up in the inner lining of arteries, leading to narrowed and hardened vessels.
Which of the following is considered a risk factor for the development of type 1 diabetes mellitus? (Select all that apply.)
A. Family history of autoimmune disease
B. Obesity and sedentary lifestyle
C. Exposure to certain viral infections
D. Genetic predisposition
E. High intake of refined sugar
Correct Answers: A, C, D
Rationale: Type 1 diabetes has autoimmune, genetic, and environmental risk factors, including viral infections. Unlike type 2 diabetes, obesity and high sugar intake are not primary risk factors.
Which assessment finding in a patient with DKA indicates the body is attempting to compensate for metabolic acidosis?
A. Bradycardia
B. Kussmaul respirations
C. Decreased respiratory rate
D. Hypertension
Correct Answer: B
Rationale: Kussmaul respirations are deep, rapid breaths that help expel carbon dioxide, compensating for the metabolic acidosis seen in DKA.
Which dietary recommendation supports diabetes prevention based on current research?
A. Choose foods high in saturated fats to maintain energy
B. Increase intake of whole grains and dietary fiber
C. Limit carbohydrates to less than 10% of total calories
D. Replace fiber with simple sugars for quick digestion
Correct Answer: B
Rationale: Diets rich in whole grains and fiber have been shown to improve insulin sensitivity and reduce the risk of developing type 2 diabetes.
A nurse explains to a client that making dietary changes while blood pressure is still in the pre-hypertensive range is important because:
A. Medications are ineffective unless started early
B. It helps prevent the need for insulin therapy
C. It may prevent the progression to full hypertension
D. It reduces the need for daily weight checks
Correct Answer: C
Rationale: Early dietary intervention can help reduce blood pressure in pre-hypertensive individuals and prevent progression to clinical hypertension.
A nurse understands that the complications of atherosclerosis depend primarily on which of the following factors?
A. The patient’s age and weight
B. The type of cholesterol consumed
C. The size, stability, and location of the plaque
D. The total daily fat intake
Correct Answer: C
Rationale: The risk of complications such as heart attack or stroke depends on how large or unstable the plaque is and where it is located in the vascular system.
A 10-year-old child is brought to the clinic with polyuria, polydipsia, weight loss, and fatigue. The nurse suspects type 1 diabetes. Which laboratory test result would confirm this diagnosis?
A. Hemoglobin A1c of 5.4%
B. Random blood glucose of 90 mg/dL
C. Fasting blood glucose of 132 mg/dL
D. Fasting blood glucose of 210 mg/dL
Correct Answer: D
Rationale: A fasting blood glucose ≥126 mg/dL on two separate occasions indicates diabetes. A value of 210 mg/dL is diagnostic when correlated with classic symptoms.
A nurse is assessing a client with suspected DKA. Which symptom should be addressed first?
A. Fruity breath odor
B. Nausea and vomiting
C. Confusion
D. Fatigue
Correct Answer: C
Rationale: Altered mental status, such as confusion, may indicate worsening acidosis or impending diabetic coma and should be prioritized as a potentially life-threatening complication.
Which statement by a client indicates understanding of the Diabetes Prevention Program (DPP)?
A. “The DPP helps me control my blood sugar with medication.”
B. “The DPP emphasizes surgery for weight loss.”
C. “The DPP focuses on lifestyle changes like eating healthy and exercising regularly.”
D. “The DPP only works if I completely eliminate all sugar from my diet.”
Correct Answer: C
Rationale: The DPP promotes lifestyle changes—specifically weight loss through healthy eating and physical activity—as a key strategy to prevent or delay type 2 diabetes.
Which nutrient, when consumed in excess, is most associated with increased blood pressure?
A. Calcium
B. Sodium
C. Fiber
D. Vitamin D
Correct Answer: B
Rationale: High sodium intake is directly linked to increased blood pressure and a higher risk for hypertension.
Which dietary pattern is most effective in slowing the progression of atherosclerosis?
A. High-protein, low-carbohydrate diet
B. Diet high in saturated fats and sodium
C. Mediterranean-style diet rich in vegetables, whole grains, and healthy fats
D. Diet high in refined sugars and trans fats
Correct Answer: C
Rationale: Diets rich in plant-based foods and healthy fats (like those found in the Mediterranean diet) are associated with reduced progression of atherosclerosis and lower CVD risk.
Which nursing intervention is the priority for a newly diagnosed pediatric patient with type 1 diabetes?
A. Encourage high-calorie meals
B. Monitor for signs of hyperinsulinemia
C. Teach the family how to administer insulin
D. Recommend oral hypoglycemic agents
Correct Answer: C
Rationale: Type 1 diabetes requires lifelong insulin therapy, and teaching families how to safely administer insulin is a key nursing priority.
A nurse knows that without prompt treatment, DKA may progress to which of the following?
A. Cerebral edema and renal failure
B. Respiratory alkalosis and hypertension
C. Diabetic coma and death
D. Metabolic alkalosis and bradycardia
Correct Answer: C
Rationale: DKA can lead to severe acidosis, dehydration, and electrolyte imbalances that result in diabetic coma and, if untreated, death.
A nurse is counseling a client with a family history of diabetes. Which dietary change is most appropriate to recommend for diabetes prevention?
A. Increase sugary drinks to prevent hypoglycemia
B. Use high-protein diets with limited vegetable intake
C. Replace white bread with whole grain options
D. Limit fruit due to natural sugars
Correct Answer: C
Rationale: Whole grains help regulate blood glucose and improve insulin sensitivity, making them an important component of diabetes prevention.
A nurse is designing a health promotion plan for a normotensive patient at risk for hypertension. Which intervention is most appropriate?
A. Recommend daily intake of processed snacks for energy
B. Suggest reducing potassium intake
C. Encourage a diet high in saturated fats
D. Promote regular physical activity and a heart-healthy diet
Correct Answer: D
Rationale: Physical activity and a balanced, heart-healthy diet help maintain normal blood pressure and reduce hypertension risk.
Which patient statement indicates understanding of dietary strategies to reduce the risk of atherosclerosis?
A. "I should limit my intake of leafy green vegetables."
B. "Eating more fiber can help lower my cholesterol levels."
C. "I will increase my intake of fried foods to get enough calories."
D. "Salt and sugar have no effect on heart health."
Correct Answer: B
Rationale: Dietary fiber, especially soluble fiber, helps reduce LDL cholesterol and is protective against plaque formation in the arteries.
A nurse is teaching a patient with newly diagnosed type 1 diabetes about insulin therapy. Which statement by the patient indicates a need for further teaching?
A. "I will rotate injection sites to prevent skin problems."
B. "I can take my insulin orally if I don’t want to use needles."
C. "I should check my blood glucose before meals and at bedtime."
D. "I will carry a source of fast-acting glucose in case of low blood sugar."
Rationale: Insulin cannot be taken orally because it is broken down in the digestive system. This statement indicates a misunderstanding that needs to be corrected.
Which electrolyte imbalance should the nurse anticipate in a client with DKA?
A. Hypercalcemia
B. Hypokalemia
C. Hyponatremia
D. Hypernatremia
Correct Answer: C
Rationale: Polyuria in DKA leads to loss of sodium and water, often resulting in hyponatremia. Potassium levels may vary depending on insulin therapy and hydration status.
Why is reducing saturated fat intake recommended in diabetes prevention?
A. It lowers insulin production
B. It reduces the body’s need for carbohydrates
C. It improves insulin resistance and aids in weight loss
D. It increases blood pressure to improve circulation
Correct Answer: C
Rationale: Lower saturated fat intake can reduce insulin resistance and promote weight loss, both of which are protective against type 2 diabetes.
Which statement made by a client indicates understanding of the role of diet in blood pressure regulation?
A. "Since I have normal blood pressure, I don’t need to worry about what I eat."
B. "If I eat healthy now, I can help prevent future blood pressure problems."
C. "Only medication can control blood pressure."
D. "Drinking more caffeine helps reduce my risk of high blood pressure."
Correct Answer: B
Rationale: Even normotensive individuals benefit from dietary improvements, which can prevent the development of hypertension and related complications.
A nurse is planning a cardiovascular health education session. Which group of individuals would benefit most from dietary counseling about atherosclerosis prevention?
A. Young adults with no family history of CVD
B. Individuals with prehypertension and borderline high cholesterol
C. Children under the age of five
D. Patients already taking cholesterol-lowering medication
Correct Answer: B
Rationale: Individuals with risk factors like prehypertension or borderline cholesterol benefit greatly from dietary changes to prevent progression to atherosclerosis and cardiovascular disease.