Diabetes Mellitus Practice Questions

1. The nurse is reviewing laboratory results for the clinic patients to be seen today. Which patient meets
the diagnostic criteria for diabetes mellitus?

a. A 48-year-old woman with a hemoglobin A1C of 8.4%

b. A 58-year-old man with a fasting blood glucose of 111 mg/dL
c. A 68-year-old woman with a random plasma glucose of 190 mg/dL
d. A 78-year-old man with a 2-hour glucose tolerance plasma glucose of 184 mg/dL

a. A 48-year-old woman with a hemoglobin A1C of 8.4%

Criteria for a diagnosis of diabetes mellitus include a hemoglobin A1C ≥ 6.5%, fasting plasma glucose
level =126 mg/dL, 2-hour plasma glucose level =200 mg/dL during an oral glucose tolerance test, or
classic symptoms of hyperglycemia or hyperglycemic crisis with a random plasma glucose =200 mg/dL.

2. The nurse teaches a 38-year-old man who was recently diagnosed with type 1 diabetes mellitus about
insulin administration. Which statement by the patient requires an intervention by the nurse?

a. "I will discard any insulin bottle that is cloudy in appearance."

b. "The best injection site for insulin administration is in my abdomen."
c. "I can wash the site with soap and water before insulin administration."
d. "I may keep my insulin at room temperature (75o F) for up to a month."

a. "I will discard any insulin bottle that is cloudy in appearance."

3. The nurse instructs a 22-year-old female patient with diabetes mellitus about a healthy eating plan. Which
statement made by the patient indicates that teaching was successful?

a. "I plan to lose 25 pounds this year by following a high-protein diet."

b. "I may have a hypoglycemic reaction if I drink alcohol on an empty stomach."
c. "I should include more fiber in my diet than a person who does not have diabetes."
d. "If I use an insulin pump, I will not need to limit the amount of saturated fat in my diet."

b. "I may have a hypoglycemic reaction if I drink alcohol on an empty stomach."

4. The nurse is teaching a 60-year-old woman with type 2 diabetes mellitus how to prevent diabetic
nephropathy. Which statement made by the patient indicates that teaching has been successful?

a. "Smokeless tobacco products decrease the risk of kidney damage."

b. "I can help control my blood pressure by avoiding foods high in salt."
c. "I should have yearly dilated eye examinations by an ophthalmologist."
d. "I will avoid hypoglycemia by keeping my blood sugar above 180 mg/dL."

b. "I can help control my blood pressure by avoiding foods high in salt."

5. A 54-year-old patient admitted with type 2 diabetes asks the nurse what "type 2" means. What is the
most appropriate response by the nurse?
 Diabetes Mellitus Practice Questions

a. "With type 2 diabetes, the body of the pancreas becomes inflamed."

b. "With type 2 diabetes, insulin secretion is decreased, and insulin resistance is increased."
c. "With type 2 diabetes, the patient is totally dependent on an outside source of insulin."
d. "With type 2 diabetes, the body produces autoantibodies that destroy β-cells in the pancreas."

b. "With type 2 diabetes, insulin secretion is decreased, and insulin resistance is increased."

6. The nurse caring for a patient hospitalized with diabetes mellitus would look for which laboratory test
result to obtain information on the patient's past glucose control?

a. Prealbumin level
b. Urine ketone level
c. Fasting glucose level
d. Glycosylated hemoglobin level

d. Glycosylated hemoglobin level

7. The nurse is evaluating a 45-year-old patient diagnosed with type 2 diabetes mellitus. Which symptom
reported by the patient is considered one of the classic clinical manifestations of diabetes?

a. Excessive thirst
b. Gradual weight gain
c. Overwhelming fatigue
d. Recurrent blurred vision

a. Excessive thirst

8. A patient, who is admitted with diabetes mellitus, has a glucose level of 380 mg/dL and a moderate
level of ketones in the urine. As the nurse assesses for signs of ketoacidosis, which respiratory pattern
would the nurse expect to find?

a. Central apnea
b. Hypoventilation
c. Kussmaul respirations
d. Cheyne-Stokes respirations

c. Kussmaul respirations
 Diabetes Mellitus Practice Questions

9. The nurse is assisting a patient with newly diagnosed type 2 diabetes to learn dietary planning as part of
the initial management of diabetes. The nurse would encourage the patient to limit intake of which foods
to help reduce the percent of fat in the diet?

a. Cheese
b. Broccoli
c. Chicken
d. Oranges

a. Cheese

10. Laboratory results have been obtained for a 50-year-old patient with a 15-year history of type 2
diabetes. Which result reflects the expected pattern accompanying macrovascular disease as a
complication of diabetes?

a. Increased triglyceride levels

b. Increased high-density lipoproteins (HDL)
c. Decreased low-density lipoproteins (LDL)
d. Decreased very-low-density lipoproteins (VLDL)

a. Increased triglyceride levels

11. A patient is admitted with diabetes mellitus, malnutrition, and cellulitis. The patient's potassium level
is 5.6 mEq/L. The nurse understands that what could be contributing factors for this laboratory result (select
all that apply)?

a. The level may be increased because of dehydration that accompanies hyperglycemia.

b. The patient may be excreting extra sodium and retaining potassium because of malnutrition.
c. The level is consistent with renal insufficiency that can develop with renal nephropathy.
d. The level may be raised because of metabolic ketoacidosis caused by hyperglycemia.
e. This level demonstrates adequate treatment of the cellulitis and effective serum glucose control.

a. The level may be increased because of dehydration that accompanies hyperglycemia.

c. The level is consistent with renal insufficiency that can develop with renal nephropathy.
d. The level may be raised because of metabolic ketoacidosis caused by hyperglycemia.
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12. The patient received regular insulin 10 units subcutaneously at 8:30 PM for a blood glucose level of
253 mg/dL. The nurse plans to monitor this patient for signs of hypoglycemia at which time related to the
insulin's peak action?

a. 8:40 PM to 9:00 PM
b. 11:30 PM
c. 10:30 PM to 1:30 AM
d. 12:30 AM to 8:30 AM

c. 10:30 PM to 1:30 AM

Regular insulin exerts peak action in 2 to 5 hours, making the patient most at risk for hypoglycemia
between 10:30 PM and 1:30 AM. Rapid-acting insulin's onset is between 10-30 minutes with peak action
and hypoglycemia most likely to occur between 9:00 PM and 11:30 PM. With intermediate acting insulin,
hypoglycemia may occur from 12:30 AM to 8:30 AM.

13. A college student is newly diagnosed with type 1 diabetes. She now has a headache, changes in her
vision, and is anxious, but does not have her portable blood glucose monitor with her. Which action
should the campus nurse advise her to take?

a. Eat a piece of pizza.

b. Drink some diet pop.
c. Eat 15 g of simple carbohydrates.
d. Take an extra dose of rapid-acting insulin.

c. Eat 15 g of simple carbohydrates.

14. The newly diagnosed patient with type 2 diabetes has been prescribed metformin (Glucophage). What
should the nurse tell the patient to best explain how this medication works?

a. Increases insulin production from the pancreas.

b. Slows the absorption of carbohydrate in the small intestine.
c. Reduces glucose production by the liver and enhances insulin sensitivity.
d. Increases insulin release from the pancreas, inhibits glucagon secretion, and decreases gastric
emptying.
 Diabetes Mellitus Practice Questions

c. Reduces glucose production by the liver and enhances insulin sensitivity.

15. Polydipsia and polyuria related to diabetes mellitus are primarily due to:

a. the release of ketones from cells during fat metabolism

b. fluid shifts resulting from the osmotic effect of hyperglycemia
c. damage to the kidneys from exposure to high levels of glucose.
d. changes in RBCs resulting from attachment of excessive glucose to hemoglobin.

b. fluid shifts resulting from the osmotic effect of hyperglycemia

16. You are caring for a patient with newly diagnosed type 1 diabetes. What information is essential to
include in your patient teaching before discharge from the hospital? (select all that apply)

a. insulin administration
b. elimination of sugar from diet
c. need to reduce physical activity
d. use of portable blood glucose monitor
e. hypoglycemia prevention, symptoms, and treatment

a. insulin administration
d. use of portable blood glucose monitor
e. hypoglycemia prevention, symptoms, and treatment

17. A diabetic patient has a serum glucose level of 824 mg/dL and is unresponsive. Following assessment
of the patient, the nurse suspects diabetic ketoacidosis rather than hyperosmolar hyperglycemic syndrome
based on the finding of?

a. polyuria
b. severe dehydration
c. rapid, deep respirations
d. decreased serum potassium
 Diabetes Mellitus Practice Questions

c. rapid, deep respirations