NR 566 WEEKS 1 TO 3 PRACTICE QUESTIONS
WITH DETAILED SOLUTIONS 2026
◉ Type 2 DM: pathophysiology. Answer: Risk factors including: BMI
>26, inactivity, low HDL and high triglyceride, metabolic syndrome,
high risk ethnicity, large baby, CV disease contribute to DM 2.
Pathophysiology: Insulin is present in the body, but the cells resist
insulin and over time the pancreas cannot keep up with the
increasing amount of insulin needed
◉ Type 2 DM: clinical manifestations. Answer: Clinical
manifestations: fatigue, poor wound healing, cardiovascular disease,
visual changes, renal insufficiency, recurring infection
◉ Type 2 DM: nursing management and collaborative care. Answer:
Nursing management: education, monitor signs of complications,
S/S of hyper or hypoglycemia, administer oral hypoglycemic agents
and educate about lifestyle changes, self-management education via
monitoring BS (continuous monitoring, self monitor, monitor A1C),
educate importance of vaccines and proper foot care (wear shoes, go
to podiatrist for nails to be cut)
Collaborative care: work with a dietitian to learn about carbohydrate
counting and diet modification for flexibility, see a podiatrist for foot
,care, medication management and education about "stress/sick" day
plan
◉ DM Type 2 Complications: Hyperosmolar Hypergylcemic State
(HHS). Answer: -serious metabolic condition
-hyperglycemia, hyperosmolality, dehydration w/o ketoacidosis
-less common than DKA and less severe
-common in older patients and often triggered by disease
state/stress with reduced fluid intake associated (infection = most
common)
S/S: BS >600 mg/dL, severe dehydration, pH>7.4
treatment: IV fluid, manage changes in LOC such as airway
management, possible need for IV insulin
◉ Distinguish between Type I and Type II diabetes. Answer: Type 1
diabetes: autoimmune, destruction of beta cells and complete lack of
insulin results, generally early diagnosis (childhood or teen), more
genetic based, insulin is only treatment option and oral
hypoglycemic agents are ineffective
Type 2 diabetes: progressive disease, issue is insulin resistance, may
use insulin if progresses to severe state but generally managed with
,oral hypoglycemic meds and lifestyle changes, generally diagnosed
later in life
◉ Understand the S&S of hypoglycemia and hyperglycemia. Answer:
Hypoglycemia:
-can be life-threatening emergency!
-BS <65mg/dL
-anxiety
-circumoral paresthesia (numb around lips)
-sweaty, shaky
-palpitations
-hunger
-irritable
If severe hypoglycemia:
-sleepiness and fatigue, difficulty thinking, dizziness
-progresses to seizure, coma
Hyperglycemia:
-3 P's (polydipsia, polyphagia, polyuria)
-fatigue
-extreme thirst
, ◉ Treatment of Hypoglycemia. Answer: FSBS <65mg/dL
-oral glucose preferred for conscious pt (juice, crackers, honey,
bread)
-if unable to swallow or absorb oral carbs, use IV dextrose
-if unable to swallow and no IV access, IM glucagon injection
◉ Understand the long-term complications of diabetes mellitus.
Answer: -many systemic complications with prolonged
hyperglycemia
-depressed immune response can lead to frequent infection and
slow wound healing
Macrovascular complications:
-CV disease
-myocardial infarction
-stroke
Microvascular complications:
-diabetic retinopathy
-periodontal bacteria and dental disease
-renal failure
WITH DETAILED SOLUTIONS 2026
◉ Type 2 DM: pathophysiology. Answer: Risk factors including: BMI
>26, inactivity, low HDL and high triglyceride, metabolic syndrome,
high risk ethnicity, large baby, CV disease contribute to DM 2.
Pathophysiology: Insulin is present in the body, but the cells resist
insulin and over time the pancreas cannot keep up with the
increasing amount of insulin needed
◉ Type 2 DM: clinical manifestations. Answer: Clinical
manifestations: fatigue, poor wound healing, cardiovascular disease,
visual changes, renal insufficiency, recurring infection
◉ Type 2 DM: nursing management and collaborative care. Answer:
Nursing management: education, monitor signs of complications,
S/S of hyper or hypoglycemia, administer oral hypoglycemic agents
and educate about lifestyle changes, self-management education via
monitoring BS (continuous monitoring, self monitor, monitor A1C),
educate importance of vaccines and proper foot care (wear shoes, go
to podiatrist for nails to be cut)
Collaborative care: work with a dietitian to learn about carbohydrate
counting and diet modification for flexibility, see a podiatrist for foot
,care, medication management and education about "stress/sick" day
plan
◉ DM Type 2 Complications: Hyperosmolar Hypergylcemic State
(HHS). Answer: -serious metabolic condition
-hyperglycemia, hyperosmolality, dehydration w/o ketoacidosis
-less common than DKA and less severe
-common in older patients and often triggered by disease
state/stress with reduced fluid intake associated (infection = most
common)
S/S: BS >600 mg/dL, severe dehydration, pH>7.4
treatment: IV fluid, manage changes in LOC such as airway
management, possible need for IV insulin
◉ Distinguish between Type I and Type II diabetes. Answer: Type 1
diabetes: autoimmune, destruction of beta cells and complete lack of
insulin results, generally early diagnosis (childhood or teen), more
genetic based, insulin is only treatment option and oral
hypoglycemic agents are ineffective
Type 2 diabetes: progressive disease, issue is insulin resistance, may
use insulin if progresses to severe state but generally managed with
,oral hypoglycemic meds and lifestyle changes, generally diagnosed
later in life
◉ Understand the S&S of hypoglycemia and hyperglycemia. Answer:
Hypoglycemia:
-can be life-threatening emergency!
-BS <65mg/dL
-anxiety
-circumoral paresthesia (numb around lips)
-sweaty, shaky
-palpitations
-hunger
-irritable
If severe hypoglycemia:
-sleepiness and fatigue, difficulty thinking, dizziness
-progresses to seizure, coma
Hyperglycemia:
-3 P's (polydipsia, polyphagia, polyuria)
-fatigue
-extreme thirst
, ◉ Treatment of Hypoglycemia. Answer: FSBS <65mg/dL
-oral glucose preferred for conscious pt (juice, crackers, honey,
bread)
-if unable to swallow or absorb oral carbs, use IV dextrose
-if unable to swallow and no IV access, IM glucagon injection
◉ Understand the long-term complications of diabetes mellitus.
Answer: -many systemic complications with prolonged
hyperglycemia
-depressed immune response can lead to frequent infection and
slow wound healing
Macrovascular complications:
-CV disease
-myocardial infarction
-stroke
Microvascular complications:
-diabetic retinopathy
-periodontal bacteria and dental disease
-renal failure
