N4010 Adult Health Exam 1 Questions with
Verified Correct Answers
Relate the clinical manifestations of diabetes to the associated pathophysiologic
changes: (ie: the three p's, fatigue, weight loss, vision changes, numbness)
Polyuria (excessive urination):
-Caused by osmotic diuresis from excess glucose in the urine pulling water out.
Polydipsia (excessive thirst):
-Fluid loss from polyuria stimulates the thirst center.
Polyphagia (excessive hunger):
-Despite high blood glucose, cells are starved of energy because glucose cannot enter without
insulin → stimulates hunger.
Fatigue/weakness:
-Cells cannot use glucose efficiently for energy.
Weight loss (more common in type 1):
-Breakdown of fat and muscle for energy due to insulin deficiency. Blurred vision:
-Osmotic changes in the lens from high blood glucose.
Slow wound healing/recurrent infections:
-High glucose impairs immune function and tissue repair. Numbness/tingling in extremities
(neuropathy):
-Due to chronic hyperglycemia damaging nerves and circulation.
What is an HbA1c and what is its significance of its glucose test results?
,-Reflects average blood glucose over ~3 months (lifespan of RBCs). Normal: < 5.7%
Prediabetes: 5.7–6.4%
Diabetes: ≥ 6.5% (diagnostic if confirmed).
Significance: Higher levels = poor long-term glucose control; used to monitor therapy
What is a Fasting glucose test and what is its significance of its glucose test results?
Fasting Plasma Glucose (FPG):
-Blood glucose after ≥8 hours fasting.
Normal: < 100 mg/dL
Prediabetes: 100–125 mg/dL Diabetes: ≥ 126 mg/dL (confirmed on repeat testing).
What is a Random Glucose test and what is its significance of its glucose test results?
Random Plasma Glucose:
-Measured any time of day, regardless of meals.
-Diabetes diagnosis: ≥ 200 mg/dL with symptoms (polyuria, polydipsia, unexplained weight
loss).
What is a“high” glucose test and what is the significance of its glucose test results?
Treatments?
Hyperglycemia (high): >180 mg/dL after meals or persistently elevated.
-Risks: DKA (type 1), HHS (type 2), long-term organ damage.
-Treatment: Adjust insulin or oral meds, hydration, diet changes.
What is a“low” glucose test and what is the significance of its glucose test results?
,Treatments?
Hypoglycemia (low): <70 mg/dL.
-Symptoms: Shakiness, sweating, irritability, confusion, seizures, coma.
-Treatment: “Rule of 15” — give 15 g rapid-acting carbs (juice, glucose tablets), recheck in
15 min, repeat if still <70. If unconscious → IV dextrose or glucagon injection.
Explain the dietary modifications recommended for management of people with
diabetes.
-Balanced, individualized meal plan based on age, activity, culture, and comorbidities.
-Carbohydrate consistency and quality are key: Complex carbs, whole grains, fruits,
vegetables preferred. Limit refined sugars and sweetened drinks.
-Moderate fat intake (emphasize unsaturated fats; limit saturated and trans fats to reduce CV
risk).
-Adequate protein (lean meats, plant proteins).
-Sodium restriction (especially if hypertensive).
-Alcohol in moderation, always with food (to prevent hypoglycemia in those on
insulin/secretagogues).
-Carbohydrate counting or exchange system often used for insulin users.
Describe the relationships among diet, exercise, and medication for people with diabetes
, Diet:
-Controls carbohydrate intake → helps regulate blood glucose.
Exercise:
-Increases insulin sensitivity and glucose uptake into muscle.
-Helps with weight control and cardiovascular health.
-Risk: May cause hypoglycemia if meds/insulin not adjusted → patients may need to eat a
snack before or after.
Medication:
-Oral agents or insulin are used when diet and exercise aren’t enough.
-Dose/timing must be balanced with meal patterns and activity level.
Integration:
-Best glucose control happens when all three are consistently balanced.
-Example: If a patient exercises more, they may need less insulin or an extra snack.
Develop a plan for teaching insulin self-management
-Storage: Keep unopened insulin in refrigerator; opened vials/pens at room temp (28 days
usually).
-Administration: Rotate injection sites (abdomen, thigh, arm, buttock) to prevent
lipodystrophy; abdomen absorbs fastest.
-Timing: Match insulin type with meals and activity.
-Monitoring: Check blood glucose regularly; adjust based on results, meals, stress, illness,
and activity.
Verified Correct Answers
Relate the clinical manifestations of diabetes to the associated pathophysiologic
changes: (ie: the three p's, fatigue, weight loss, vision changes, numbness)
Polyuria (excessive urination):
-Caused by osmotic diuresis from excess glucose in the urine pulling water out.
Polydipsia (excessive thirst):
-Fluid loss from polyuria stimulates the thirst center.
Polyphagia (excessive hunger):
-Despite high blood glucose, cells are starved of energy because glucose cannot enter without
insulin → stimulates hunger.
Fatigue/weakness:
-Cells cannot use glucose efficiently for energy.
Weight loss (more common in type 1):
-Breakdown of fat and muscle for energy due to insulin deficiency. Blurred vision:
-Osmotic changes in the lens from high blood glucose.
Slow wound healing/recurrent infections:
-High glucose impairs immune function and tissue repair. Numbness/tingling in extremities
(neuropathy):
-Due to chronic hyperglycemia damaging nerves and circulation.
What is an HbA1c and what is its significance of its glucose test results?
,-Reflects average blood glucose over ~3 months (lifespan of RBCs). Normal: < 5.7%
Prediabetes: 5.7–6.4%
Diabetes: ≥ 6.5% (diagnostic if confirmed).
Significance: Higher levels = poor long-term glucose control; used to monitor therapy
What is a Fasting glucose test and what is its significance of its glucose test results?
Fasting Plasma Glucose (FPG):
-Blood glucose after ≥8 hours fasting.
Normal: < 100 mg/dL
Prediabetes: 100–125 mg/dL Diabetes: ≥ 126 mg/dL (confirmed on repeat testing).
What is a Random Glucose test and what is its significance of its glucose test results?
Random Plasma Glucose:
-Measured any time of day, regardless of meals.
-Diabetes diagnosis: ≥ 200 mg/dL with symptoms (polyuria, polydipsia, unexplained weight
loss).
What is a“high” glucose test and what is the significance of its glucose test results?
Treatments?
Hyperglycemia (high): >180 mg/dL after meals or persistently elevated.
-Risks: DKA (type 1), HHS (type 2), long-term organ damage.
-Treatment: Adjust insulin or oral meds, hydration, diet changes.
What is a“low” glucose test and what is the significance of its glucose test results?
,Treatments?
Hypoglycemia (low): <70 mg/dL.
-Symptoms: Shakiness, sweating, irritability, confusion, seizures, coma.
-Treatment: “Rule of 15” — give 15 g rapid-acting carbs (juice, glucose tablets), recheck in
15 min, repeat if still <70. If unconscious → IV dextrose or glucagon injection.
Explain the dietary modifications recommended for management of people with
diabetes.
-Balanced, individualized meal plan based on age, activity, culture, and comorbidities.
-Carbohydrate consistency and quality are key: Complex carbs, whole grains, fruits,
vegetables preferred. Limit refined sugars and sweetened drinks.
-Moderate fat intake (emphasize unsaturated fats; limit saturated and trans fats to reduce CV
risk).
-Adequate protein (lean meats, plant proteins).
-Sodium restriction (especially if hypertensive).
-Alcohol in moderation, always with food (to prevent hypoglycemia in those on
insulin/secretagogues).
-Carbohydrate counting or exchange system often used for insulin users.
Describe the relationships among diet, exercise, and medication for people with diabetes
, Diet:
-Controls carbohydrate intake → helps regulate blood glucose.
Exercise:
-Increases insulin sensitivity and glucose uptake into muscle.
-Helps with weight control and cardiovascular health.
-Risk: May cause hypoglycemia if meds/insulin not adjusted → patients may need to eat a
snack before or after.
Medication:
-Oral agents or insulin are used when diet and exercise aren’t enough.
-Dose/timing must be balanced with meal patterns and activity level.
Integration:
-Best glucose control happens when all three are consistently balanced.
-Example: If a patient exercises more, they may need less insulin or an extra snack.
Develop a plan for teaching insulin self-management
-Storage: Keep unopened insulin in refrigerator; opened vials/pens at room temp (28 days
usually).
-Administration: Rotate injection sites (abdomen, thigh, arm, buttock) to prevent
lipodystrophy; abdomen absorbs fastest.
-Timing: Match insulin type with meals and activity.
-Monitoring: Check blood glucose regularly; adjust based on results, meals, stress, illness,
and activity.
