Chapter 48: Diabetes Mellitus

Which question would the nurse ask a patient with polyuria, polydipsia, and polyphagia to rule out a false-negative glucose result? "Have you had any illnesses recently?" "Have you recently taken acetaminophen?" "Have you been severely restricting your carbohydrate intake?" "Have you been lying around and resting a lot for the past few days?"

"Have you recently taken acetaminophen?" Acetaminophen can cause a false-negative result on glucose tests. Illness, severe restriction of carbohydrates, and bed rest cause higher glucose levels.

Which components may result in metabolic syndrome? Select all that apply. Low body weight Low glucose levels Low levels of triglycerides Elevated BP Decreased levels of high-density lipoproteins (HDL)

Elevated BP Decreased levels of high-density lipoproteins (HDL)

Which findings are associated with type 1 diabetes mellitus? Select all that apply. Fatigue Excessive thirst Frequent urination Recurrent infections Unexplained weight loss

Excessive Thirst frequent urination unexplained weight loss Excessive thirst, frequent urination, and unexplained weight loss are clinical symptoms of both type 1 and type 2 diabetes mellitus. Fatigue and recurrent infections are clinical manifestations of type 2 diabetes.

Which tissue has specific receptors for insulin and is considered an insulin-dependent tissue? Hepatic tissue Adipose tissue Nervous tissue Vascular tissue

Adipose tissue is insulin dependent because it requires insulin to "unlock" its receptor sites, which allows the transport of glucose into the cells for consumption. Hepatic tissue, nervous tissue, and vascular tissue do not directly depend on insulin for the transport of glucose. They need a supply of glucose only for their normal functioning.

Which mechanism is altered in individuals with type 1 diabetes? Defective insulin receptors in muscle Excess glucose production by the liver Increased glucagon secretion by the pancreas Autoimmune destruction of the β-cells of the pancreas

Autoimmune destruction of the β-cells of the pancreas

Which laboratory parameter assesses the function of pancreatic β-cells? C-peptide level Hemoglobin level Urine-specific gravity Serum creatinine level

Proinsulin is the precursor of insulin. Enzymatic activity helps to split proinsulin into insulin and C-peptide. Therefore the function of pancreatic beta cells can be assessed by measuring C-peptide levels. Hemoglobin levels indicate the oxygen-carrying capacity of the blood. Urine-specific gravity indicates fluid and electrolyte balance. Serum creatinine levels indicate renal function.

Which is an insulin-dependent tissue? Brain Kidney Skeletal muscle Red blood cells

skeletal muscle have specific receptors that are activated by insulin that permit the transportation of glucose into the cells. The brain, kidney, and red blood cells do not have receptors; instead, they require only a specific amount of glucose for normal functioning.

A patient, admitted with type 1 diabetes, asks the nurse what "type 1" means. Which response by the nurse is accurate? "There is decreased insulin secretion, cellular resistance to insulin that is produced, or both." "An increased amount of adipose tissue has led to an insufficient amount of insulin being produced." "The body produces autoantibodies that destroy beta cells in the pancreas." "The insulin being made is not used by the tissues properly, leading to high blood sugar."

"The body produces autoantibodies that destroy beta cells in the pancreas."

A patient admitted with type 2 diabetes asks the nurse what "type 2" means. Which response by the nurse is accurate? "With type 2 diabetes, the body of the pancreas becomes inflamed." "With type 2 diabetes, insulin secretion is decreased and insulin resistance is increased." "With type 2 diabetes, the patient is totally dependent on an outside source of insulin." "With type 2 diabetes, the body produces autoantibodies that destroy β-cells in the pancreas."

"With type 2 diabetes, insulin secretion is decreased and insulin resistance is increased." In type 2 diabetes mellitus, the secretion of insulin by the pancreas is reduced or the cells of the body become resistant to insulin. The pancreas becomes inflamed with pancreatitis.

Which blood glucose level indicates hyperglycemia? 60 to 70 mg/dL 80 to 110 mg/dL 100 to 125 mg/dL 200 to 250 mg/dL

200 to 250 mg/dL Hyperglycemia is a condition in which the blood glucose level is greater than 200 mg/dL. If the blood glucose level ranges from 60 to 70 mg/dL, then it indicates hypoglycemia. The blood glucose level is considered normal if it ranges from 80 to 110 mg/dL. The blood glucose level ranges from 100 to 125 mg/dL in prediabetes.

Which components are associated with metabolic syndrome? Select all that apply. Abdominal obesity Elevated glucose levels Elevated BP Low levels of triglycerides Increased levels of high-density lipoproteins (HDL)

Abdominal obesity Elevated glucose levels Elevated BP

Which factor is the primary defect associated with type 1 diabetes mellitus? Absent or minimal insulin production Alteration in production of adipokines Decreased insulin production over time and insulin resistance Abnormal increase in insulin production by the pancreas over time

Absent or minimal insulin production Type 1 diabetes mellitus is a result of the absence or minimal production of insulin by the pancreas. Alteration in production of adipokines, decreased insulin production over time, and insulin resistance are the defect factors associated with type 2 diabetes mellitus.

Which hormone regulates the normal blood glucose level in the body? Insulin Glucagon Epinephrine Growth hormone

Insulin is a hormone secreted by β-cells in the Islet of Langerhans of the pancreas. It helps in regulating the blood glucose level. Glucagon is a hormone secreted by the α-cells of the Islet of Langerhans. It increases the blood glucose level by counteracting the mechanism of insulin.

Which medication is categorized as a starch blocker? Miglitol Alogliptin Nateglinide Glimepiride

Miglitol is categorized as an alpha-glucosidase inhibitor, also known as a starch blocker. Alogliptin is a dipeptidyl peptidase-4 inhibitor. Nateglinide is a meglitinide, and glimepiride is a sulfonylureas.

Which assessment finding supports the nurse's suspicion that a diabetic patient has necrobiosis lipoidica diabeticorum? Reddish, flat, and oval patches on the shins Red-yellow lesions, with shiny atrophic skin Reddish-brown, scaly, and round patches on the thighs Velvety, light-brown to black skin thickening on the neck

Necrobiosis lipoidica diabeticorum-anuncommon skin condition seen in patients with diabetes, characterized by red-yellow lesions, with atrophic skin that becomes shiny and transparent, revealing tiny blood vessels under the surface. Diabetic dermopathy is the most common diabetic skin lesion; it is characterized by reddish-brown, round, or oval patches. They are scaly initially, and then they flatten and become indented. The lesions appear most frequently on the shins but can also be found on the front of the thighs, forearms, sides of the feet, scalp, and trunk. Acanthosis nigricans -skin pigmentation characterized by velvety, light-brown to black skin thickening, predominantly seen on flexures, axillae, and the neck.

Which factor is associated with type 1 diabetes mellitus? Obesity Viral infection Sedentary lifestyle High-carbohydrate diet

Viral infection Type 1 diabetes mellitus is caused due to a complete pancreatic shutdown. One of the many causes is a viral infection that may trigger production of antibodies against the pancreas. Obesity, sedentary lifestyle, and intake of a high-carbohydrate diet may increase the risk for type 2 diabetes mellitus.