Diabetes

Which of the following clients would be considered to be exhibiting manifestations of "prediabetes"? a. A middle-aged overweight adult with a fasting plasma glucose level of 122 with follow-up OGTT of 189 mg/dL. b. A school-aged child who had a blood glucose level of 115 following lunch. c. An elderly client who got "light-headed" when he skipped his lunch. Blood glucose level was 60 mg/dL at this time. d. A retired female registered nurse with a fasting plasma glucose level of 92 mg/dL.

A middle-aged overweight adult with a fasting plasma glucose level of 122 with follow-up OGTT of 189 mg/dL. Persons with IFG (impaired fasting plasma glucose [IFG] defined by an elevated FPG of 100 to 125 mg/dL) and/or IGT (impaired glucose tolerance [IGT] plasma glucose levels of 140 to 199 mg/dL with an OGTT) are often referred to as having prediabetes, meaning they are at relatively high risk for the future development of diabetes as well as cardiovascular disease.

A hospital client 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? a. Promotion of glucose uptake by target cells b. Initiation of glycogenolysis c. Promotion of fat breakdown synthesis. Glucagon, not insulin, promotes glycogenolysis. d. Promotion of gluconeogenesis

A: Promotion of glucose uptake by target cells (The actions of insulin are threefold: (1) it promotes glucose uptake by target cells and provides for glucose storage as glycogen; (2) it prevents fat and glycogen breakdown; and (3) it inhibits gluconeogenesis and increases protein )

A diabetic client presents to the clinic. He is concerned his lower legs are "feeling funny." Which of the following assessment findings lead the health care provider to suspect the client may have developed somatic neuropathy? Select all that apply. a. Both legs appear to be the same as far as numbness is involved. b. Right foot has a diminished perception of vibration; left foot is normal. c. With eyes closed, the client cannot identify where the HCP is touching his feet. d. Bilateral cool ankles and feet. e. One leg has a reddened area in the calf and has a positive Homan sign.

Both legs appear to be the same as far as numbness is involved., Bilateral cool ankles and feet., With eyes closed, the client cannot identify where the HCP is touching his feet.

A client with type 1 diabetes has started a new exercise routine. Knowing there may be some increase risks associated with exercise, the health care provider should encourage the client to: a. Monitor for respiratory disorders b. Be careful that you're not experiencing a rebound hyperglycemia c. Carry a snack with carbs to prevent profound hypoglycemia d. Watch for too rapid weight los

C: Carry a snack with carbs to prevent profound hypoglycemia

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

D

While trying to explain the physiology behind type 2 diabetes to a group of nursing students, the instructor will mention which of the following accurate information? Select one: a. In skeletal muscle, insulin resistance prompts decreased uptake of glucose. Following meals (postprandial), glucose levels are higher due to diminished efficiency of glucose clearance. b. They have increased predisposition to other autoimmune disorders such as Graves disease, rheumatoid arthritis, and Addison disease. c. Because of the loss of insulin response, all people with type 2 diabetes require exogenous insulin replacement to control blood glucose levels. d. The destruction of beta cells and absolute lack of insulin in people with type 2 diabetes means that they are particularly prone to the development of diabetic complication.

In skeletal muscle, insulin resistance prompts decreased uptake of glucose. Following meals (postprandial), glucose levels are higher due to diminished efficiency of glucose clearance.

A diabetic client presents to a clinic for routine visit. Blood work reveals a HbA1C of 11.0% (high)? Which response by the patient may account for this abnormal lab result? Select one: a. "I've had more periods of hypoglycemia than usual over the past few months." b. "To tell you the truth, my blood glucose levels have been pretty normal for me." c. "I've been doing great. I haven't needed much insulin coverage before meals." d. "My meter broke so I have not been checking my blood glucose levels for a while."

My meter broke so I have not been checking my blood glucose levels for a while.

A client with long-standing 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 client's inordinately elevated blood glucose levels? Select one: a. Illness inhibited the release and uptake of glucagon. b. The stress of the event caused the release of cortisol. c. The tissue trauma of surgery resulted in gluconeogenesis. d. Sleep disruption in the hospital precipitated the dawn effect

The stress of the event caused the release of cortisol.

A young child develops type 1A diabetes. The parents ask, "They tell us this is genetic. Does that mean our other children will get diabetes?" The best response by the health care provider would be: Select one: a. "This autoimmune disorder causes destruction of the beta cells, placing your children at high risk of developing diabetes." b. "We don't know what causes diabetes, so we will just have to wait and see." c. "Probably not since genetically your other children have a different cellular makeup, they just might not become diabetic." d. "If you put all your children on a low-carbohydrate diet, maybe they won't get diabetes."

This autoimmune disorder causes destruction of the beta cells, placing your children at high risk of developing diabetes."

A client with type 2 diabetes has routine lab work, which reveals elevated free fatty acids (FFA). The client asks, "Why is this significant?" The most accurate response would be: . a. Excess fatty acids may interfere with the way your body responds to an infection. b. Excess fat in the liver causes a decrease in hepatic glucose production leading to severe hypoglycemia. c. This may increase the amount of triglyceride (a form of fat) stored in your liver or around your heart. d. Your pancreas is affected by increased fat (lipotoxicity), which causes beta cell dysfunction, leading to the need for insulin. e. Nonalcoholic fatty liver disease may lead to needing a liver transplant.

This may increase the amount of triglyceride (a form of fat) stored in your liver or around your heart., Your pancreas is affected by increased fat (lipotoxicity), which causes beta cell dysfunction, leading to the need for insulin.

The results of a 44-year-old obese man's recent diagnostic workup have culminated in a new diagnosis of type 2 diabetes. Which of the following pathophysiologic processes underlies the client's new diagnosis? Select one: a. T-lymphocyte-mediated hypersensitivity reactions b. Actions of insulin autoantibodies (IAAs) and islet cell autoantibodies (ICAs) c. Destruction of beta cells that is not attributable to autoimmunity d. Beta cell exhaustion due to long-standing insulin resistance

d. Beta cell exhaustion due to long-standing insulin resistance Exhaustion of the beta cells arising from insulin resistance is characteristic of type 2 diabetes. Beta cell destruction in the absence of an autoimmune reaction is associated with type 1b diabetes, while autoimmune processes contribute to type 1a diabetes.