Diabetes practice questions
Glucose is an important molecule in a cell because this molecule is primarily used for: A. Extraction of energy B. Synthesis of protein C. Building of genetic material D. Formation of cell membranes
A
Which of the following is NOT a rapid-acting insulin? A. Lispro B. Aspart C. Glargine D. Glulisine
C
Jansen is receiving metformin (Glucophage). What will be the best plan of the nurse with regard to patient education with this drug? Select all that apply. A. It stimulates the pancreas to produce more insulin. B. It must be taken with meals. C. It decreases sugar production in the liver. D. It inhibits the absorption of carbohydrates. E. It reduces insulin resistance.
B,c,e
Ben injects his insulin as prescribed, but then gets busy and forgets to eat. What will the best assessment of the nurse reveal? A. The client will be very thirsty. B. The client will complain of nausea. C. The client will need to urinate. D. The client will have moist clammy skin.
D
A nurse is caring for a client admitted to the ER with DKA. In the acute phase the priority nursing action is to prepare to: A. Administer regular insulin intravenously B. Administer 5% dextrose intravenously C. Correct the acidosis D. Apply an electrocardiograph monitor
a
23. A nurse is reviewing dietary choices with a diabetic client. Which food choice indicates the client understands proper nutrition? A. Grilled chicken salad with low-fat dressing B. Large fruit smoothie with whipped cream C. Fried fish and potato chips D. White bread with honey
A
A client is in diabetic ketoacidosis (DKA) secondary to infection. As the condition progresses, which of the following symptoms might the nurse see? A. Kussmaul's respirations and a fruity odor on the breath B. Shallow respirations and severe abdominal pain C. Decreased respiration and increased urine output D. Cheyne-stokes respirations and foul-smelling urine
A
Glycosylated hemoglobin (HbA1C) test measures the average blood glucose control of an individual over the previous three months. Which of the following values is considered a diagnosis of pre-diabetes? A. 6.5-7% B. 5.7-6.4% C. 5-5.6% D. >5.6%
B
The nurse is admitting a client with hypoglycemia. Identify the signs and symptoms the nurse should expect. Select all that apply. A. Thirst B. Palpitations C. Diaphoresis D. Slurred speech E. Hyperventilation
B, C, D
A client diagnosed with type 1 diabetes receives insulin. He asks the nurse why he can't just take pills instead. What is the best response by the nurse? A. "Insulin must be injected because it needs to work quickly." B. "Insulin can't be in a pill because it is destroyed in stomach acid." C. "Have you talked to your doctor about taking pills instead?" D. "I know it is tough, but you will get used to the shots soon.
B
A client is taking NPH insulin daily every morning. The nurse instructs the client that the most likely time for a hypoglycemic reaction to occur is: A. 2-4 hours after administration B. 6-14 hours after administration C. 16-18 hours after administration D. 18-24 hours after administration
B
A client with diabetes is prescribed metformin. Which organ should the nurse closely monitor for potential side effects? A. Liver B. Kidneys C. Heart D. Lungs
B
A clinical feature that distinguishes a hypoglycemic reaction from a ketoacidosis reaction IS: A. Blurred vision B. Diaphoresis C. Nausea D. Weakness
B
A nurse went to a patient's room to do routine vital signs monitoring and found out that the patient's bedtime snack was not eaten. This should alert the nurse to check and assess for: A. Elevated serum bicarbonate and decreased blood pH B. Signs of hypoglycemia earlier than expected C. Symptoms of hyperglycemia during the peak time of NPH insulin D. Sugar in the urine
B
A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the ER. Which finding would a nurse expect to note as confirming this diagnosis? A. Elevated blood glucose level and a low plasma bicarbonate B. Decreased urine output C. Increased respiration and an increase in pH D. Comatose state
A
A client with diabetes mellitus visits a health care clinic. The client's diabetes previously had been well controlled with glyburide (Diabeta), 5 mg PO daily, but recently, the fasting blood glucose has been running 180-200 mg/dl. Which medication, if added to the clients regimen, may have contributed to the hyperglycemia? A. prednisone (Deltasone) B. atenolol (Tenormin) C. phenelzine (Nardil) D. allopurinol (Zyloprim)
A
A client with type 1 diabetes mellitus calls the nurse to report recurrent episodes of hypoglycemia with exercise. Which statement by the client indicated an inadequate understanding of the peak action of NPH insulin and exercise? A. "The best time for me to exercise is every afternoon." B. "The best time for me to exercise is right after I eat." C. "The best time for me to exercise is after breakfast." D. "The best time for me to exercise is after my morning snack."
A
A diabetic client is scheduled for a CT scan with contrast. What should the nurse do? A. Hold the client's metformin 48 hours before and after the procedure. B. Give the client an extra dose of insulin. C. Ensure the client fasts for 12 hours. D. Check for ketones in the urine.
A
A nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The priority nursing diagnosis would be: A. High risk for deficient fluid volume B. Deficient knowledge: disease process and treatment C. Imbalanced nutrition: less than body requirements D. Disabled family coping: compromised
A
A patient was recently diagnosed with type 1 diabetes mellitus and received insulin. Which laboratory test will the nurse assess A. Potassium B. AST (aspartate aminotransferase) C. Serum amylase D. Sodium
A
A patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage? A. Lispro (Humalog) b. Glargine (Lantus) Detemir (Levemir) d. NPH (Humulin N)
A
An external insulin pump is prescribed for a client with DM. The client asks the nurse about the functioning of the pump. The nurse bases the response on the information that the pump: A. Gives a small continuous dose of regular insulin subcutaneously, and the client can self-administer a bolus with an additional dosage from the pump before each meal. B. It is timed to release programmed doses of regular or NPH insulin into the bloodstream at specific intervals. C. It is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases the nsulin into the bloodstream. D. It continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels.
A
A 44-year-old woman with type 1 diabetes comes to the emergency department due to abdominal pain accompanied by nausea and vomiting. The patient had a history of chronic back pain due to a motor accident 20 years ago. Her situation renders her unable to work and pay for the increasing price of insulin, which has doubled during the last five years. The patient doesn't have medical coverage or insurance; therefore, she rations her insulin intake, making her unable to follow her prescribed therapeutic regimen for her diabetes. Because of her situation, the client is at high risk of developing diabetic ketoacidosis. As her nurse, which of the following symptoms would you anticipate the client to exhibit? Select all that apply. A. Fruity odor breath B. Deep and labored respirations C. Blurred vision D. Increased urination E. Increased thirst F. Fatigue G. Blood glucose level of 60 mg/dL H. Dehydration I. Respiratory rate
A,b,c,d,e,f,h
patient receives aspart (NovoLog) insulin at 8:00 AM. At which time would the nurse anticipate the highest risk for hypoglycemia? A. 10:00 AM c. 2:00 PM b. 12:00 AM d. 4:0 PM
A.
Albert, a 35-year-old insulin-dependent diabetic, is admitted to the hospital with a diagnosis of pneumonia. He has been febrile since admission. His daily insulin requirement is 24 units of NPH. Every morning Albert is given NPH insulin at 0730. Meals are served at 0830, 1230, and 1830. The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of: A. 1130 and 1330 B. 1330 and 1930 C. 1530 and 2130 D. 1730 and 2330
B
Dawn phenomenon in diabetes refers to: A. A mid-afternoon blood sugar drop. B. An early morning rise in blood sugar. C. Fluctuations in blood sugar during menstruation. D. A post-meal spike in blood sugar.
B
Diabetic ketoacidosis (DKA) is characterized by: A. Hypoglycemia, dehydration, and acid-base imbalance. B. Hyperglycemia, ketonuria, and acid-base imbalance. C. Hyperglycemia, hyponatremia, and fluid overload. D. Hypoglycemia, ketonuria, and metabolic alkalosis.
B
Rotating injection sites when administering insulin prevents which of the following complications? A. Insulin edema B. Insulin lipodystrophy C. Insulin resistance D. Systemic allergic reactions
B
The nurse is assessing a 22-yr-old patient experiencing the onset of symptoms of type I diabetes. To which question would the nurse anticipate a positive response? A. Are you anorexic?" B. "Have you lost weight lately?" C. "Is your urine dark colored?" D. "Do you crave sugary drinks?"
B
The nurse is teaching a client regarding the administration of insulin as part of the discharge plan. Which of the following insulin has the most rapid onset of action? A. insulin regular (Humulin R) B. lispro (Admelog) C. glargine (Toujeo) D. insulin NPH (Humulin N)
B
The nurse recognizes that additional teaching is necessary when the client who is learning alternative site testing (AST) for glucose monitoring says: A. "I need to rub my forearm vigorously until warm before testing at this site." B. "The fingertip is preferred for glucose monitoring if hyperglycemia is suspected." C. "I have to make sure that my current glucose monitor can be used at an alternate site." D. "Alternate site testing is unsafe if I am experiencing a rapid change in glucose levels.
B
When a client is experiencing diabetic ketoacidosis, the insulin that would be administered is: A. Human NPH insulin B. Human regular insulin C. Insulin lispro injection D. Insulin glargine injection
B
When mixing regular insulin with NPH insulin, the nurse should: A. Draw up NPH first, then regular. B. Draw up regular first, then NPH. C. Mix equal parts of each insulin. D. Avoid mixing the two insulins.
B
When teaching a client about the Somogy effect, the nurse should explain: A. It is a rapid drop in glucose levels after a meal. B. It is a morning hyperglycemia in response to overnight hypoglycemia. C. It is an expected elevation in glucose levels before breakfast. D. It is caused by insufficient evening insulin.
B
Which of the following chronic complications is associated with diabetes? A. Dizziness, dyspnea on exertion, and coronary artery disease B. Retinopathy, neuropathy, and coronary artery disease C. Leg ulcers, cerebral ischemic events, and pulmonary infarcts D. Fatigue, nausea, vomiting, muscle weakness, and cardiac arrhythmias
B
Which patient action indicates good understanding of the nurse's teaching about administration of aspart (NovoLog) insulin? A. The patient avoids iniecting the insulin into the unner abdominal arca. B. The patient cleans the skin with soap and water before insulin administration. C. The patient stores the insulin in the freezer after administering the prescribed dose D. The patient pushes the plunger down while removing the syringe from the inlection site
B
client with diabetes mellitus type 1 reports feeling shaky, sweaty, and tachvcardic. The nurse should first: A. Administer insulin. B. Check the client's blood sugar. C. Give the client a glass of water. D. Encourage the client to rest. Answer: B Rationale: The client's symptoms
B
Dr. Shrunk orders intravenous (IV) insulin for Rita, a client with a blood sugar of 563. Nurse AJ administers insulin lispro (Humalog) intravenously (IV). What does the best evaluation of the nurse reveal? Select all that apply. A. The nurse could have given the insulin subcutaneously. B. The nurse should have contacted the physician. C. The nurse should have used regular insulin (Humulin R). D. The nurse used the correct insulin. E. The nurse could have given the nsulin intramuscularlv.
B,c
Which of the following diabetes drugs acts by decreasing the amount of glucose produced by the liver? Sulfonylureas Meglitinides Biguanides Alpha-glucosidase inhibitors
Biguanides
A client taking pioglitazone (Actos) should be monitored for which adverse effect? A. Weight loss B. Osteoporosis C. Pulmonary edema D. Thyroid dysfunction
C
A client with type 1 diabetes mellitus has a fingerstick glucose level of 258mg/di at bedtime. An order for sliding scale insulin exists. The nurse should: A. Call the physician B. Encourage the intake of fluids C. Administer the insulin as ordered D. Give the client 1/2 c. of orange juice
C
A client's blood glucose reads 320 mg/dL. The nurse should first: A. Give the client food. B. Administer short-acting insulin. C. Check for ketones in urine. D. Encourage the client to exercise.
C
A male nurse is providing a bedtime snack for his patient. This is based on the knowledge that intermediate-acting insulins are effective for an approximate duration of: A. 6-8 hours B. 10-14 hours C. 14-18 hours D. 24-28 hours
C
A nurse notes that a diabetic client's urine test is positive for microalbuminuria. This finding is an early sign of: A. Diabetic retinopathy. B. Diabetic ketoacidosis. C. Diabetic nephropathy. D. Diabetic neuropathy.
C
A patient asks why they need to rotate insulin injection sites. What is the nurse's best response? A. "It reduces the risk of insulin resistance." B. "It ensures faster absorption of insulin." C. "It prevents lipodystrophy at the injection site." D. "It minimizes the pain of injection."
C
Clients with type 1 diabetes may require which of the following changes to their daily routine during periods of infection? • A. No changes • B. Less insulin • C. More insulin • D. Oral antidiabetic agents
C
Rotation sites for insulin iniection should be separated from one another by 2.5 cm (1 inch) and should be used only every: A. Third day B. Every other day C. 1-2 weeks D. 2-4 weeks
C
The nurse expects that a type 1 diabetic may receive how much of his or her morning dose of insulin preoperatively? A. 10-20% B. 25-40% C. 50-60% D. 85-90%
C
The nurse knows that glucagon may be given in the treatment of hypoglycemia because it: A. Inhibits gluconeogenesis B. Stimulates the release of insulin C. Increases blood glucose levels D. Provides more storage of glucose.
C
What is a potential side effect of sulfonylureas like glipizide? A. Hyperglycemia B. Weight loss C. Hypoglycemia D. Ketonuria
C
When a client is first admitted with hyperglycemic hyperosmolar nonketotic syndrome (HHNS), the nurse's priority is to provide: 1 points) A. Oxygen B. Carbohydrates C. Fluid replacement D. Dietary instruction
C
Which exercise recommendation is most appropriate for a client with peripheral neuropathy due to diabetes? A. High-impact aerobics B. Long-distance running C. Swimming or water aerobics D. Barefoot yoga
C
Which of the following nursing interventions should be taken for a client who complains of nausea and vomits one hour after taking his glyburide (DiaBeta)? A. Give glyburide again B. Give subcutaneous insulin and monitor blood glucose C. Monitor blood glucose closely, and look for signs of hypoglycemia D. Monitor blood glucose, and assess for signs of hyperglycemia
C
Which symptom is a client with hypoglycemia likely to exhibit? A. Deep, rapid breathing B. Dry, flushed skin C. Tremors D. Fruity breath odor
C
Marlisa has been diagnosed with diabetes mellitus type 1. She asks Nurse Errol what this means. What is the best response by the nurse? Select all that apply. A. "Your alpha cells should be able to secrete insulin, but cannot." B. "The exocrine function of your pancreas is to secrete insulin." C. "Without insulin, you will develop ketoacidosis (DKA)." D. "The endocrine function of your pancreas is to secrete insulin." E. "It means your pancreas cannot secrete insulin."
C,d,e
28-yr-old male patient with type I diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching? a. The patient always carries hard candies when engaging in exercise. B. The patient goes for a vigorous walk when his glucose is 200 mg/dL. C. The patient has a peanut butter sandwich before going for a bicycle ride. D. The patient incrcases daily cxercise when kctoncs are present in the urinc.
D
A 28-yr-old male patient with type I diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching? A. The patient always carries hard candies when engaging in exercise. B. The patient goes for a vigorous walk when his glucose is 200 mg/dL. c. The patient has a peanut butter sandwich before going for a bicycle ride. d. The patient increases daily exercise when ketones are present in the urine.
D
A client's blood gases reflect diabetic acidosis. The nurse should expect: A. Increased pH B. Decreased P02 C. Increased PCO2 D. Decreased HCO3
D
Clinical nursing assessment for a patient with microangiopathy who has manifested impaired peripheral arterial circulation includes all of the following, except: A. Integumentary inspection for the presence of brown spots on the lower extremities B. Observation for paleness of the lower extremities C. Observation for blanching of the feet after the legs are elevated for 60 seconds D. Palpation for increased pulse volume in the arteries of the lower extremities
D
Insulin forces which of the following electrolytes out of the plasma and into the cells? A. Calcium B. Magnesium C. Phosphorus D. Potassium
D
Knowing that gluconeogenesis helps to maintain blood glucose levels, a nurse should: A. Document weight changes because of fatty acid mobilization. B. Evaluate the patient's sensitivity to low room temperatures because of decreased adipose tissue insulation. C. Protect the patient from sources of infection because of decreased cellular protein deposits. D. Do all of the above.
D
Which is the primary goal when treating a client with DKA? A. Administering oral hypoglycemic agents. B. Restoring electrolyte balance. C. Administering high doses of insulin. D. Hydration and normalizing blood glucose levels.
D
Which of the following causes of Hyperglycaemic Hyperosmolar Non-Ketotic Syndrome (HHNS) is most common? A. Insulin overdose B. Removal of the adrenal gland C. Undiagnosed, untreated hyperpituitarism D. Undiagnosed, untreated diabetes mellitus
D
Which of the following methods of insulin administration would be used in the initial treatment of hyperglycemia in a client with diabetic ketoacidosis? 1 point (S A. Subcutaneous B. Intramuscular C. IV bolus only D. IV bolus, followed by continuous infusion
D
Which statement about hemoglobin A 1C is correct? A. It measures immediate blood glucose levels. B. It reflects average blood glucose over 1 month. C. It should be checked weekly in diabetic clients. D. It reflects average blood glucose levels over 2-3 months.
D
Excessive thirst and volume of very dilute urine may be symptoms of: Urinary tract infection Diabetes insipidus Viral gastroenteritis Hypoglycemia
Diabetes insipidus
The risk factors for type 1 diabetes include all of the following except: Diet Genetic Autoimmune Environmental
Diet
Among female children and adolescents, the first sign of type 1 diabetes may be: Rapid weight gain Constipation Genital candidiasis Insomnia
Genital candidiasis
Proliferative retinopathy is often treated using: Tonometry Fluorescein angiogram Antibiotics Laser surgery
Laser surgery
Diabetics are at increased risk of heart disease if they also: Smoke Have high HDL cholesterol levels Take aspirin Consume a high-fiber diet
Smoke
The benefits of using an insulin pump include all of the following except: By continuously providing insulin they eliminate the need for injections of insulin They simplify management of blood sugar and often improve A1C They enable exercise without compensatory carbohydrate consumption They help with weight loss
They help with weight loss
Which of the following regimens offers the best blood glucose control for persons with type 1 diabetes? A single anti-diabetes drugs Once daily insulin injections A combination of oral anti-diabetic medications Three or four injections per day of different types of insulin.
Three or four injections per day of different types of insulin.
Untreated diabetes may result in all of the following except: Blindness Cardiovascular disease Kidney disease Tinnitus
Tinnitus
Hyperinsulinemia may be caused by all of the following except: An insulinoma Nesidioblastosis Insulin resistance Type 1 diabetes
Type 1 diabetes
Untreated hyperglycemia may lead to all of the following complications except: Hyperosmolar syndrome Vitiligo Diabetic ketoacidosis Coma
Vitiligo
Which patient action indicates a good understanding of the nurse's teaching about the use of A. The patient programs the pump for an insulin bolus after eating B. The patient changes the location of the insertion site every weck. C. The patient takes the pump off at bedtime and starts it again each morning D. The patient plans a diet with more calories than usual when using the pump
a
