Exam Bank for Diabetes- Questions Answered Correctly (Graded A+)
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. - Answers Correct answer: D. Do all of the above
All measures ensure gluconeogenesis in maintaining glucose homeostasis.
The nurse is admitting a patient diagnosed with type 2 diabetes mellitus. The nurse should expect the
following symptoms during an assessment, except:
A. Hypoglycemia
B. Frequent bruising
C. Ketonuria
D. Dry mouth - Answers Correct answer: A. Hypoglycemia
Option A: Hypoglycemia does not occur in type 2 diabetes unless the patient is on insulin therapy or
taking other diabetes medication.
Option B: Type 2 diabetes can affect blood circulation which makes it easier for the skin to bruise.
Option C: The presence of ketones in the urine happens due to a lack of available insulin.
Option D: Losing a lot of fluids caused by frequent urination can lead to dehydration hence patients can
develop dry mouth.
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% - Answers Correct answer: B. 5.7-6.4%
Option B: Glycosylated hemoglobin levels between 5.7%-6.4% is considered as pre-diabetes.
,Option A: Glycosylated hemoglobin levels over 6.5 % are considered diagnostic of diabetes.
Options C and D: Glycosylated hemoglobin levels less than 5.6 % are normal.
Rotation sites for insulin injection 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 - Answers Correct answer: C. 1-2 weeks
Rotation of sites for insulin injection should be done every week or two. Frequently using the same spot
over time can cause fat cells to break down or build up (lipodystrophy) causing lumps under the skin and
may interfere with insulin absorption.
A clinical feature that distinguishes a hypoglycemic reaction from a ketoacidosis reaction is:
A. Blurred vision
B. Diaphoresis
C. Nausea
D. Weakness - Answers Correct answer: B. Diaphoresis
A hypoglycemic reaction activates a fight-or-flight response in the body which then triggers the release
of epinephrine and norepinephrine resulting in diaphoresis.
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% - Answers Correct answer: C. 50-60%
Surgical procedures may result in a number of metabolic perturbations that can alter normal glucose
homeostasis. Patients with type 1 diabetes mellitus who are using long-acting insulins, such as glargine,
should continue these as normal when fasting. If the patient is prone to morning hypoglycemia, the dose
can be reduced by 20%. Thus, the diabetic patient may receive 80% of his or her morning dose of insulin
preoperatively. Patients taking premixed insulins or fixed-combination insulins are more of a challenge.
,It may not be feasible or economical to change the patient's premixed insulin just before surgery. In
these situations, the patient can take ½ - ¾ of the morning dose, followed by administration of a
dextrose-containing intravenous fluid and frequent blood glucose checks.
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 - Answers Correct answer: B. 1330 and 1930
The peak time of insulin is the time it is working the hardest to lower the blood glucose. NPH insulin is
an intermediate-acting insulin that has an onset of 1 to 3 hours after injection, peaks 4 to 12 hours later,
and is effective for about 12 to 16 hours.
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 - Answers Correct answer: C. 14-18 hours
Option C: Intermediate-acting insulins include Humulin N and Novolin N. They have an onset of two to
four hours, peak of 4 to 12 hours, and a duration of 14 to 18 hours.
Option A: Regular or short-acting insulins include Humulin R and Novolin R. They have an onset of half
an hour, a peak of two to three hours, and a duration of six to eight hours.
Option D: Long-acting insulins include Levemir and Lantus. They have an onset of several hours, minimal
or no peak, and a duration of 24 hours or more.
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 - Answers Correct answer: B. Signs of hypoglycemia earlier than expected.
Eating a bedtime snack can prevent blood glucose levels from dropping very low during the night and
lessen the Somogyi effect where glucose levels drop significantly between 2:00 a.m. and 3:00 a.m.
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 - Answers Correct answer: B. 6-14 hours after administration
The peak time of insulin is the time it is working the hardest to lower the blood glucose. NPH insulin is
an intermediate-acting insulin that has an onset of 1 to 3 hours after injection, peaks 4 to 12 hours later,
and is effective for about 12 to 16 hours.
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 insulin into the bloodstream.
D. It continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring
blood glucose levels. - Answers Correct answer: 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.
An insulin pump provides a small continuous dose of regular insulin subcutaneously throughout the day
and night, and the client can self-administer a bolus with additional dosage from the pump before each
meal as needed. Regular insulin is used in an insulin pump. An external pump is not attached surgically
to the pancreas.
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?
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. - Answers Correct answer: D. Do all of the above
All measures ensure gluconeogenesis in maintaining glucose homeostasis.
The nurse is admitting a patient diagnosed with type 2 diabetes mellitus. The nurse should expect the
following symptoms during an assessment, except:
A. Hypoglycemia
B. Frequent bruising
C. Ketonuria
D. Dry mouth - Answers Correct answer: A. Hypoglycemia
Option A: Hypoglycemia does not occur in type 2 diabetes unless the patient is on insulin therapy or
taking other diabetes medication.
Option B: Type 2 diabetes can affect blood circulation which makes it easier for the skin to bruise.
Option C: The presence of ketones in the urine happens due to a lack of available insulin.
Option D: Losing a lot of fluids caused by frequent urination can lead to dehydration hence patients can
develop dry mouth.
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% - Answers Correct answer: B. 5.7-6.4%
Option B: Glycosylated hemoglobin levels between 5.7%-6.4% is considered as pre-diabetes.
,Option A: Glycosylated hemoglobin levels over 6.5 % are considered diagnostic of diabetes.
Options C and D: Glycosylated hemoglobin levels less than 5.6 % are normal.
Rotation sites for insulin injection 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 - Answers Correct answer: C. 1-2 weeks
Rotation of sites for insulin injection should be done every week or two. Frequently using the same spot
over time can cause fat cells to break down or build up (lipodystrophy) causing lumps under the skin and
may interfere with insulin absorption.
A clinical feature that distinguishes a hypoglycemic reaction from a ketoacidosis reaction is:
A. Blurred vision
B. Diaphoresis
C. Nausea
D. Weakness - Answers Correct answer: B. Diaphoresis
A hypoglycemic reaction activates a fight-or-flight response in the body which then triggers the release
of epinephrine and norepinephrine resulting in diaphoresis.
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% - Answers Correct answer: C. 50-60%
Surgical procedures may result in a number of metabolic perturbations that can alter normal glucose
homeostasis. Patients with type 1 diabetes mellitus who are using long-acting insulins, such as glargine,
should continue these as normal when fasting. If the patient is prone to morning hypoglycemia, the dose
can be reduced by 20%. Thus, the diabetic patient may receive 80% of his or her morning dose of insulin
preoperatively. Patients taking premixed insulins or fixed-combination insulins are more of a challenge.
,It may not be feasible or economical to change the patient's premixed insulin just before surgery. In
these situations, the patient can take ½ - ¾ of the morning dose, followed by administration of a
dextrose-containing intravenous fluid and frequent blood glucose checks.
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 - Answers Correct answer: B. 1330 and 1930
The peak time of insulin is the time it is working the hardest to lower the blood glucose. NPH insulin is
an intermediate-acting insulin that has an onset of 1 to 3 hours after injection, peaks 4 to 12 hours later,
and is effective for about 12 to 16 hours.
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 - Answers Correct answer: C. 14-18 hours
Option C: Intermediate-acting insulins include Humulin N and Novolin N. They have an onset of two to
four hours, peak of 4 to 12 hours, and a duration of 14 to 18 hours.
Option A: Regular or short-acting insulins include Humulin R and Novolin R. They have an onset of half
an hour, a peak of two to three hours, and a duration of six to eight hours.
Option D: Long-acting insulins include Levemir and Lantus. They have an onset of several hours, minimal
or no peak, and a duration of 24 hours or more.
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 - Answers Correct answer: B. Signs of hypoglycemia earlier than expected.
Eating a bedtime snack can prevent blood glucose levels from dropping very low during the night and
lessen the Somogyi effect where glucose levels drop significantly between 2:00 a.m. and 3:00 a.m.
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 - Answers Correct answer: B. 6-14 hours after administration
The peak time of insulin is the time it is working the hardest to lower the blood glucose. NPH insulin is
an intermediate-acting insulin that has an onset of 1 to 3 hours after injection, peaks 4 to 12 hours later,
and is effective for about 12 to 16 hours.
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 insulin into the bloodstream.
D. It continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring
blood glucose levels. - Answers Correct answer: 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.
An insulin pump provides a small continuous dose of regular insulin subcutaneously throughout the day
and night, and the client can self-administer a bolus with additional dosage from the pump before each
meal as needed. Regular insulin is used in an insulin pump. An external pump is not attached surgically
to the pancreas.
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?
