Disease Process
A nurse is educating a patient with Type 1 diabetes. Which statement indicates the patient understands the disease?
a) "I have insulin resistance, so I need to lose weight."
b) "My pancreas does not produce insulin, so I need lifelong insulin therapy."
c) "I can manage my diabetes with diet and exercise alone."
d) "I only need insulin when my blood sugar is high."
Answer: b) "My pancreas does not produce insulin, so I need lifelong insulin therapy."
Rationale: Type 1 diabetes results from autoimmune destruction of pancreatic beta cells, leading to absolute insulin deficiency. Commonly genetic
What is the primary goal of diabetes management?
a) Keep blood glucose levels as high as possible
b) Normalize insulin activity and glucose levels to reduce complications
c) Prevent weight loss
d) Avoid all carbohydrates
Answer: b) Normalize insulin activity and glucose levels to reduce complications
Rationale: The main goal is to maintain blood glucose control to prevent complications such as retinopathy, nephropathy, and neuropathy.
Which laboratory value is diagnostic for diabetes?
a) Fasting blood glucose of 118 mg/dL
b) HbA1c of 5.5%
c) Random glucose of 205 mg/dL
d) Fasting blood glucose of 110 mg/dL
Answer: c) Random glucose of 205 mg/dL
Rationale: A random glucose ≥ 200 mg/dL with symptoms is diagnostic for diabetes.
Which insulin can be given IV?
a) Rapid-acting insulin
b) Short-acting insulin
c) Intermediate-acting insulin
d) Long-acting insulin
Answer: b) Short-acting insulin
Rationale: Short-acting/Regular insulin is the only insulin that can be given intravenously (IV).
Which nursing interventions help manage diabetes effectively? (Select all that apply.)
a) Encourage lifestyle changes
b) Monitor blood glucose regularly
c) Recommend skipping meals to lower glucose
d) Teach insulin administration
Answers: a, b, d
A patient is diagnosed with prediabetes. Which statement by the nurse is correct?
a) "Your blood glucose levels are always high."
b) "You should start insulin immediately."
c) "Your glucose levels are sometimes high, but usually remain normal."
d) "This diagnosis does not increase your risk of diabetes."
Answer: c) "Your glucose levels are sometimes high, but usually remain normal."
Rationale: Prediabetes is a condition in which blood glucose levels fluctuate between normal and hyperglycemia.
A nurse is educating a patient on the glycemic index. Which statement is correct?
a) "Combining carbohydrates with protein or fat can slow glucose absorption."
b) "Eating only refined carbohydrates prevents blood sugar spikes."
c) "Sugar-free foods do not impact blood sugar levels."
d) "Fruit juices have a lower glycemic index than whole fruits."
Answer: a) "Combining carbohydrates with protein or fat can slow glucose absorption."
Rationale: Eating carbohydrates with protein or fat helps slow digestion and reduces blood glucose spikes.
A diabetic patient presents with headache, confusion, and disorientation. What is the nurse’s priority intervention?
a) Administer IV fluids
b) Give the patient 4 oz of diet soda
c) Check the patient’s blood glucose
d) Give an insulin injection
Answer: c) Check the patient’s blood glucose
Rationale: Hypoglycemia symptoms include confusion and headache.
Which insulin regimen provides tight glucose control but increases the risk of hypoglycemia?
a) Conventional regimen
b) Intensive regimen
c) Once-daily insulin
d) Oral antidiabetics
Answer: b) Intensive regimen
Rationale: Intensive insulin therapy (3-4 injections/day) achieves tight control but increases hypoglycemia risk.
A diabetic patient is at risk for long-term complications. Which conditions are associated with diabetes? (Select all that apply.)
a) Nephropathy
b) Retinopathy
c) Osteoporosis
d) Neuropathy
Answers: a, b, d
Rationale: Diabetes affects the kidneys, eyes, and nerves. Osteoporosis is not directly related.
Diabetes can be associated with other conditions. Which of the following is a known cause?
a) Long-term steroid use
b) Excess protein intake
c) Low sodium levels
d) Frequent hydration
Answer: a) Long-term steroid use
Rationale: Prolonged steroid use can lead to steroid-induced diabetes due to insulin resistance and increased blood sugar levels.
A patient with Type 1 diabetes wants to exercise. What advice should the nurse give?
a) "Avoid exercise because it raises blood sugar."
b) "Eat a 15g carbohydrate snack before moderate exercise."
c) "Inject extra insulin before working out."
d) "You do not need to check your blood sugar before exercising."
Answer: b) "Eat a 15g carbohydrate snack before moderate exercise."
Rationale: Insulin normally decreases with exercise. A carbohydrate snack helps prevent hypoglycemia.
Which category of insulin has no peak and provides a steady release?
a) Rapid-acting insulin
b) Short-acting insulin
c) Intermediate-acting insulin
d) Long-acting insulin
Answer: d) Long-acting insulin
Rationale: Long-acting insulins (e.g., Lantus) have no peak and provide steady insulin release
What is a potential issue with insulin pump therapy?
a) It requires no patient effort
b) The tubing can kink or become occluded
c) It eliminates the risk of hypoglycemia
d) It is only used in hospitals
Answer: b) The tubing can kink or become occluded
Rationale: Insulin pumps can malfunction due to kinked tubing, battery failure, or occlusion.
Which clinical manifestations are commonly seen in hyperglycemia? (Select all that apply.)
a) Polyuria
b) Polydipsia
c) Sudden weight gain
d) Weakness and fatigue
Answers: a, b, d
Rationale: Hyperglycemia presents with polyuria, polydipsia, and fatigue. Sudden weight loss (not gain) is also common.
Which risk factors are associated with Type 1 diabetes? (Select all that apply.)
a) Genetic predisposition
b) Autoimmune destruction of beta cells
c) Obesity
d) Young age at onset
Answers: a, b, d
Rationale: Type 1 diabetes is primarily caused by genetics, autoimmune beta-cell destruction, and younger age onset. Obesity is more associated with Type 2 diabetes.
A diabetic patient is experiencing hypoglycemia and is unconscious. What should the nurse do?
a) Give the patient 4 oz of juice
b) Administer glucagon IM or 50% dextrose IV
c) Wait for the patient to wake up before intervening
d) Give the patient a piece of candy
Answer: b) Administer glucagon IM or 50% dextrose IV
Rationale: If a patient is unconscious, do NOT give oral glucose. Instead, administer IM glucagon or IV dextrose.
Which complications can occur due to insulin therapy? (Select all that apply.)
a) Local allergic reactions
b) Lipodystrophy
c) Hypoglycemia
d) Dehydration
Answers: a, b, c
Rationale: Allergic reactions, lipodystrophy (fat loss at injection sites), and hypoglycemia are complications of insulin therapy. Dehydration is not a direct insulin complication.
A patient using intensive insulin therapy asks about the risks. What is the nurse’s best response?
a) "Intensive insulin therapy eliminates hypoglycemia risk."
b) "This therapy requires more frequent blood sugar monitoring to avoid hypoglycemia."
c) "It only requires one daily injection."
d) "It is not effective for Type 1 diabetes."
Answer: b) "This therapy requires more frequent blood sugar monitoring to avoid hypoglycemia."
Rationale: Intensive insulin therapy (3-4 injections/day) provides tight glucose control but increases the risk of hypoglycemia.
What should be included in diabetes self-management? (Select all that apply.)
a) Keep a log of insulin use, meals, and blood sugar readings
b) Monitor blood glucose levels frequently
c) Only check blood sugar when feeling symptoms
d) Follow a structured insulin regimen
Answers: a, b, d
Rationale: Self-monitoring blood glucose levels, keeping a log, and following an insulin regimen are crucial for diabetes management.
Which factors increase the risk of developing diabetes? (Select all that apply.)
a) Obesity
b) Sedentary lifestyle
c) Race/ethnicity
d) Family history
Answers: a, b, c, d
Rationale: Obesity, inactivity, genetics, and race (higher in African American, Hispanic, and Native American populations)
Which type of insulin regimen is best for a frail, older adult with limited activity?
a) Intensive insulin therapy
b) Conventional insulin therapy
c) Insulin pump therapy
d) Oral antidiabetics
Answer: b) Conventional insulin therapy
Rationale: Conventional therapy (1-2 injections/day) is ideal for frail older adults because it requires less frequent adjustments and is easier to manage.
Which statements about conventional insulin therapy are correct? (Select all that apply.)
a) It requires only 1-2 injections per day
b) It is ideal for patients with frail health or limited activity
c) It provides tight glucose control
d) It is not suitable for Type 1 diabetes
Answers: a, b
Rationale: Conventional therapy involves 1-2 injections/day, making it easier for frail or older patients. However, it does not provide tight glucose control.
A diabetic patient says, "I only buy sugar-free foods, so they must be healthy." What is the best response by the nurse?
a) "Sugar-free foods always have fewer calories."
b) "Sugar-free does not mean calorie-free. Some still raise blood sugar."
c) "You don’t need to monitor sugar intake if you eat sugar-free products."
d) "Sugar-free products eliminate the need for insulin."
Answer: b) "Sugar-free does not mean calorie-free. Some still raise blood sugar."
Rationale: Sugar-free products can still contain carbohydrates and calories, which may impact blood glucose levels.
What are the long-term complications of diabetes? (Select all that apply.)
a) Neuropathy
b) Cerebrovascular disease
c) Osteoporosis
d) Neuropathic ulcers
Answers: a, b, d
Rationale: Diabetes leads to complications such as neuropathy, cerebrovascular disease, and neuropathic ulcers, but osteoporosis is not a common complication.