Chapter 33 Patho - Endocrine

A hospital patient has been complaining of increasing fatigue for several hours and his nurse has entered his room to find him unarousable. The nurse immediately checked the patients blood glucose level, which is 22 mg/dL (1.2 mmol/L). The nurse should prepare to administer which of the following? A snack that combines simple sugars, protein, and complex carbohydrates A 50% glucose solution intravenously Infusion of rapid-acting insulin Oral solution containing glucagon and simple sugars

A 50% glucose solution intravenously

Which of the following pregnant women likely faces the greatest risk of developing gestational diabetes? A patient who was diagnosed with placenta previa early in her pregnancy. A patient who is gravida five (in her fifth pregnancy) A patient who has hypertension and elevated triglycerides A patient who is morbidly obese

A patient who is morbidly obese

The results of a 44-year-old obese mans recent diagnostic workup have culminated in a new diagnosis of type 2 diabetes. Which of the following pathophysiologic processes underlies the patients new diagnosis? Beta-cell exhaustion due to long-standing insulin resistance Destruction of beta cells that is not attributable to autoimmunity T-lymphocytemediated hypersensitivity reactions Actions of insulin autoantibodies (IAAs) and islet cell autoantibodies (ICAs)

Beta-cell exhaustion due to long-standing insulin resistance

Which of the following comorbidities represents the greatest risk for the development of foot ulcers in a diabetic patient? Distal symmetric neuropathy Previous incidents of diabetic ketoacidosis Diabetic nephropathy Autonomic neuropathy

Distal symmetric neuropathy

Which test provides a way to monitor fluctuations of blood glucose levels over the previous 6 to 12 weeks? Glucose tolerance test Fasting blood glucose Capillary blood glucose Glycosylated hemoglobin

Glycosylated hemoglobin

Type 1 diabetes mellitus results from destruction of the pancreatic beta cells by two mechanisms. The mechanism for type 1A diabetes is _______ destruction. genetic resistant idiopathic autoimmune

autoimmune

Which of the following insulin-administration regimens is most likely to result in stable blood glucose levels for a patient with a diagnosis of type 1 diabetes? One large dose of long-acting insulin each day before breakfast Intermediate-acting insulin at 8:00 AM and 8:00 PM with rapid-acting insulin before each meal Six to eight small doses of rapid-acting insulin each day, with capillary monitoring before each Long-acting insulin twice daily (breakfast and bedtime), with intermediate-acting insulin in the afternoon

Intermediate-acting insulin at 8:00 AM and 8:00 PM with rapid-acting insulin before each meal

A diabetic patients most recent blood work indicated a decreased glomerular filtration rate and urine testing revealed microalbuminuria. Which of the following self-care measures should the patients care team suggest to the patient? Use of over-the-counter diuretics Increased fluid intake Decreased oral sugar intake Measures to lower blood pressure

Measures to lower blood pressure

A hospital patient with a diagnosis of type 1 diabetes has been administered a scheduled dose of regular insulin. Which of the following effects will result from the action of insulin? Promotion of fat breakdown Promotion of glucose uptake by target cells Promotion of gluconeogenesis and protein synthesis Initiation of glycogenolysis

Promotion of glucose uptake by target cells

A patients primary care provider has ordered an oral glucose tolerance test (OGTT) as a screening measure for diabetes. Which of the following instructions should the patient be given? The lab tech will give you a sugar solution and then measure your blood sugar levels at specified intervals. Youll have to refrain from eating after midnight and then go to the lab to have your blood taken first thing in the morning. Theyll take a blood sample and see how much sugar is attached to your red blood cells. You can go to the lab at any time; just tell the technician when you last ate before they draw a blood sample.

The lab tech will give you a sugar solution and then measure your blood sugar levels at specified intervals.

Which of the following assessment findings of a male patient constitutes a criterion for a diagnosis of metabolic syndrome? The patient states that he does less than 30 minutes of strenuous physical activity each week. The patients resting heart rate is typically 85 to 95 beats per minute. The patients blood pressure is consistently in the range of 140/90 mm Hg. The patient has a family history of type 2 diabetes.

The patients blood pressure is consistently in the range of 140/90 mm Hg.

A patient with longstanding type 2 diabetes is surprised at his high blood sugar readings while recovering from an emergency surgery. Which of the following factors may have contributed to the patients inordinately elevated blood glucose levels? The tissue trauma of surgery resulted in gluconeogenesis. Illness inhibited the release and uptake of glucagon. The stress of the event caused the release of cortisol. Sleep disruption in the hospital precipitated the dawn effect.

The stress of the event caused the release of cortisol.

Impaired and delayed healing in a person with diabetes is caused by chronic complications that include: ketoacidosis. Somogyi effect. fluid imbalances. chronic neuropathies.

chronic neuropathies.

A change in the circadian rhythm for glucose tolerance and an inappropriate increase in counterregulatory hormones can lead to _______ in diabetics. hypoglycemia Somogyi effect hyperinsulinemia dawn phenomenon

dawn phenomenon

Diabetic ketoacidosis (DKA) more commonly occurs in patients with type 1 diabetes, when the lack of insulin leads to the mobilization of _____ that causes excess ketone production by the liver. cortisol fatty acids potassium bicarbonate

fatty acids

Factors that contribute to the severe hyperglycemia that precipitates hyperglycemic hyperosmolar state (HHS) include: fluid retention and edema. thromboembolism formation. insulin overdose. glycosuria and water loss.

glycosuria and water loss.

Diabetic retinopathy, the leading cause of acquired blindness in the United States, is characterized by retinal: glaucoma hemorrhages. dehydration. infections.

hemorrhages.

the metabolic abnormalities that lead to type 2 diabetes include: chronic overeating. insulin resistance. acute pancreatitis. recurrent hypoglycemia.

insulin resistance.

One of the first renal manifestations of diabetic nephropathy is: microalbuminuria. oliguria. hypertension. hyperlipidemia.

microalbuminuria.

In people with type 1 diabetes, the beneficial effects of exercise also carry an increased risk of: rapid weight loss. respiratory disorders. rebound hyperglycemia. profound hypoglycemia.

profound hypoglycemia.