ATI Medical-Surgical: Endocrine Disorders – Diabetes Focus 2026
|Questions |Answers |Rationales
1. A nurse is reviewing the laboratory results of a client. Which Glycosylated
hemoglobin (HbA1c) level is diagnostic for diabetes mellitus?
A. 5.7%
B. 6.5%
C. 6.1%
D. 5.0%
Answer: B
Rationale: An HbA1c level of 6.5% or higher on two separate tests indicates diabetes
mellitus. Values between 5.7% and 6.4% indicate prediabetes.
2. Which type of insulin should the nurse expect to reach its peak effect within
30 to 90 minutes after administration?
A. Insulin glargine
B. NPH insulin
C. Regular insulin
D. Insulin lispro
Answer: D
Rationale: Insulin lispro is a rapid-acting insulin with a peak of 30 to 90 minutes. Regular
is short-acting (2-4 hours), NPH is intermediate (4-12 hours), and Glargine is long-acting
(no peak).
,3. A client is prescribed Metformin for Type 2 Diabetes. Which laboratory value
should the nurse monitor closely to prevent lactic acidosis?
A. Serum amylase
B. Serum creatinine
C. Platelet count
D. Serum potassium
Answer: B
Rationale: Metformin is excreted by the kidneys; impaired renal function (monitored via
creatinine) increases the risk of life-threatening lactic acidosis.
4. A nurse is teaching a client about the ‘Rule of 15’ for hypoglycemia. What is
the first step when blood glucose is 60 mg/dL?
A. Administer 1 mg of glucagon IM
B. Drink 8 oz of whole milk
C. Inject 10 units of regular insulin
D. Consume 15g of simple carbohydrates
Answer: D
Rationale: The Rule of 15 involves consuming 15g of rapidly absorbed carbohydrates (like
4oz juice) and rechecking glucose in 15 minutes.
5. When mixing Regular and NPH insulin in one syringe, which step is performed
first after injecting air into both vials?
A. Draw up the Regular insulin
B. Draw up the NPH insulin
C. Wait 5 minutes for stabilization
D. Mix the two insulins in the vial
Answer: A
Rationale: When mixing insulin, you draw the clear (Regular) before the cloudy (NPH) to
prevent contaminating the Regular vial with NPH.
, 6. Which clinical manifestation is uniquely associated with Diabetic Ketoacidosis
(DKA) rather than Hyperglycemic Hyperosmolar State (HHS)?
A. Kussmaul respirations
B. Blood glucose > 600 mg/dL
C. Dehydration
D. Altered mental status
Answer: A
Rationale: Kussmaul respirations (deep, rapid breathing) are a compensatory mechanism
for metabolic acidosis found in DKA, but not typically in HHS.
7. A client with Type 1 Diabetes reports feeling shaky and sweaty. After
confirming hypoglycemia, the nurse should provide which of the following?
A. A diet soda
B. A piece of sugar-free gum
C. 4 oz of orange juice
D. A high-protein candy bar
Answer: C
Rationale: Simple sugars like fruit juice are required to quickly raise blood glucose. Diet or
sugar-free items do not contain the necessary glucose.
8. What is the primary action of Sulfonylureas, such as Glipizide, in the
treatment of Type 2 Diabetes?
A. Decreasing glucose production in the liver
B. Increasing insulin sensitivity in the muscle
C. Stimulating insulin secretion from the pancreas
D. Delaying carbohydrate absorption in the gut
Answer: C
Rationale: Sulfonylureas work by stimulating the beta cells of the pancreas to release more
insulin.
|Questions |Answers |Rationales
1. A nurse is reviewing the laboratory results of a client. Which Glycosylated
hemoglobin (HbA1c) level is diagnostic for diabetes mellitus?
A. 5.7%
B. 6.5%
C. 6.1%
D. 5.0%
Answer: B
Rationale: An HbA1c level of 6.5% or higher on two separate tests indicates diabetes
mellitus. Values between 5.7% and 6.4% indicate prediabetes.
2. Which type of insulin should the nurse expect to reach its peak effect within
30 to 90 minutes after administration?
A. Insulin glargine
B. NPH insulin
C. Regular insulin
D. Insulin lispro
Answer: D
Rationale: Insulin lispro is a rapid-acting insulin with a peak of 30 to 90 minutes. Regular
is short-acting (2-4 hours), NPH is intermediate (4-12 hours), and Glargine is long-acting
(no peak).
,3. A client is prescribed Metformin for Type 2 Diabetes. Which laboratory value
should the nurse monitor closely to prevent lactic acidosis?
A. Serum amylase
B. Serum creatinine
C. Platelet count
D. Serum potassium
Answer: B
Rationale: Metformin is excreted by the kidneys; impaired renal function (monitored via
creatinine) increases the risk of life-threatening lactic acidosis.
4. A nurse is teaching a client about the ‘Rule of 15’ for hypoglycemia. What is
the first step when blood glucose is 60 mg/dL?
A. Administer 1 mg of glucagon IM
B. Drink 8 oz of whole milk
C. Inject 10 units of regular insulin
D. Consume 15g of simple carbohydrates
Answer: D
Rationale: The Rule of 15 involves consuming 15g of rapidly absorbed carbohydrates (like
4oz juice) and rechecking glucose in 15 minutes.
5. When mixing Regular and NPH insulin in one syringe, which step is performed
first after injecting air into both vials?
A. Draw up the Regular insulin
B. Draw up the NPH insulin
C. Wait 5 minutes for stabilization
D. Mix the two insulins in the vial
Answer: A
Rationale: When mixing insulin, you draw the clear (Regular) before the cloudy (NPH) to
prevent contaminating the Regular vial with NPH.
, 6. Which clinical manifestation is uniquely associated with Diabetic Ketoacidosis
(DKA) rather than Hyperglycemic Hyperosmolar State (HHS)?
A. Kussmaul respirations
B. Blood glucose > 600 mg/dL
C. Dehydration
D. Altered mental status
Answer: A
Rationale: Kussmaul respirations (deep, rapid breathing) are a compensatory mechanism
for metabolic acidosis found in DKA, but not typically in HHS.
7. A client with Type 1 Diabetes reports feeling shaky and sweaty. After
confirming hypoglycemia, the nurse should provide which of the following?
A. A diet soda
B. A piece of sugar-free gum
C. 4 oz of orange juice
D. A high-protein candy bar
Answer: C
Rationale: Simple sugars like fruit juice are required to quickly raise blood glucose. Diet or
sugar-free items do not contain the necessary glucose.
8. What is the primary action of Sulfonylureas, such as Glipizide, in the
treatment of Type 2 Diabetes?
A. Decreasing glucose production in the liver
B. Increasing insulin sensitivity in the muscle
C. Stimulating insulin secretion from the pancreas
D. Delaying carbohydrate absorption in the gut
Answer: C
Rationale: Sulfonylureas work by stimulating the beta cells of the pancreas to release more
insulin.
