MED SURG 170 Final Exam Practice: Diabetes & Related Conditions
MED-SURG EXAM 3
50 NCLEX-Style Multiple Choice Questions
UNIT 5: DIABETES
1. A 19-year-old client presents to the emergency department with polyuria, polydipsia, weight
loss, and fatigue. The client reports having a viral illness two weeks ago. Blood glucose is 420
mg/dL. The nurse understands that the underlying pathophysiology of this condition is most
likely related to which process?
A. Peripheral insulin resistance due to obesity
B. Autoimmune destruction of pancreatic beta cells
C. Excess glucagon production from alpha cells
D. Impaired glucose absorption in the intestine
2. A client with type 2 diabetes reports fasting blood glucose levels consistently between 180–
220 mg/dL. The nurse recognizes this is primarily caused by:
A. Complete lack of insulin production
B. Increased insulin sensitivity
C. Insulin resistance with beta-cell fatigue
D. Excess carbohydrate intake only
3. A hospitalized diabetic client becomes diaphoretic, shaky, and confused. The client is
conscious and able to swallow. Blood glucose is 54 mg/dL. What is the nurse’s priority action?
A. Administer IV dextrose
B. Give 15 g of rapid-acting carbohydrate
C. Administer 30 g carbohydrate immediately
D. Notify the provider
4. A nurse is teaching a newly diagnosed diabetic client about sick-day management. Which
statement by the client indicates correct understanding?
MED SURG 170 Final Exam Practice: Diabetes & Related Conditions
, MED SURG 170 Final Exam Practice: Diabetes & Related Conditions
A. “I will stop insulin if I am not eating.”
B. “I should check my blood sugar every 2–4 hours.”
C. “I will drink fruit juice hourly.”
D. “If my sugar is 250 mg/dL, I will skip insulin.”
5. A client’s early morning blood sugars are consistently elevated. Overnight glucose logs show
no hypoglycemia. The nurse suspects which condition?
A. Somogyi effect
B. Dawn phenomenon
C. Insulin stacking
D. Reactive hypoglycemia
6. A diabetic client experiences nocturnal hypoglycemia at 0200 followed by a fasting blood
glucose of 240 mg/dL. The nurse identifies this pattern as:
A. Dawn phenomenon
B. Somogyi effect
C. Insulin resistance
D. Stress hyperglycemia
7. Which insulin can be administered intravenously during diabetic ketoacidosis?
A. Glargine
B. NPH
C. Lispro
D. Regular
8. The nurse is preparing to mix NPH and regular insulin. Which action is correct?
A. Draw up cloudy before clear
B. Inject air into clear, then cloudy
C. Draw clear insulin before cloudy
D. Shake the NPH vial vigorously
9. A client taking metformin is scheduled for a CT scan with contrast dye. What is the nurse’s
priority?
MED SURG 170 Final Exam Practice: Diabetes & Related Conditions
MED-SURG EXAM 3
50 NCLEX-Style Multiple Choice Questions
UNIT 5: DIABETES
1. A 19-year-old client presents to the emergency department with polyuria, polydipsia, weight
loss, and fatigue. The client reports having a viral illness two weeks ago. Blood glucose is 420
mg/dL. The nurse understands that the underlying pathophysiology of this condition is most
likely related to which process?
A. Peripheral insulin resistance due to obesity
B. Autoimmune destruction of pancreatic beta cells
C. Excess glucagon production from alpha cells
D. Impaired glucose absorption in the intestine
2. A client with type 2 diabetes reports fasting blood glucose levels consistently between 180–
220 mg/dL. The nurse recognizes this is primarily caused by:
A. Complete lack of insulin production
B. Increased insulin sensitivity
C. Insulin resistance with beta-cell fatigue
D. Excess carbohydrate intake only
3. A hospitalized diabetic client becomes diaphoretic, shaky, and confused. The client is
conscious and able to swallow. Blood glucose is 54 mg/dL. What is the nurse’s priority action?
A. Administer IV dextrose
B. Give 15 g of rapid-acting carbohydrate
C. Administer 30 g carbohydrate immediately
D. Notify the provider
4. A nurse is teaching a newly diagnosed diabetic client about sick-day management. Which
statement by the client indicates correct understanding?
MED SURG 170 Final Exam Practice: Diabetes & Related Conditions
, MED SURG 170 Final Exam Practice: Diabetes & Related Conditions
A. “I will stop insulin if I am not eating.”
B. “I should check my blood sugar every 2–4 hours.”
C. “I will drink fruit juice hourly.”
D. “If my sugar is 250 mg/dL, I will skip insulin.”
5. A client’s early morning blood sugars are consistently elevated. Overnight glucose logs show
no hypoglycemia. The nurse suspects which condition?
A. Somogyi effect
B. Dawn phenomenon
C. Insulin stacking
D. Reactive hypoglycemia
6. A diabetic client experiences nocturnal hypoglycemia at 0200 followed by a fasting blood
glucose of 240 mg/dL. The nurse identifies this pattern as:
A. Dawn phenomenon
B. Somogyi effect
C. Insulin resistance
D. Stress hyperglycemia
7. Which insulin can be administered intravenously during diabetic ketoacidosis?
A. Glargine
B. NPH
C. Lispro
D. Regular
8. The nurse is preparing to mix NPH and regular insulin. Which action is correct?
A. Draw up cloudy before clear
B. Inject air into clear, then cloudy
C. Draw clear insulin before cloudy
D. Shake the NPH vial vigorously
9. A client taking metformin is scheduled for a CT scan with contrast dye. What is the nurse’s
priority?
MED SURG 170 Final Exam Practice: Diabetes & Related Conditions
