NURSES' GUIDE TO TEACHING
DIABETES SELF-MANAGEMENT,
SECOND EDITION
2ND EDITION
• AUTHOR(S)RITA GIROUARD
MERTIG
TEST BANK
1) Insulin timing and meal coordination
Reference: Ch. 1 — How Insulin Works — Patient Teaching
Strategies
Stem:
A 17-year-old with type 1 diabetes receives a prescription for
rapid-acting insulin before lunch. When the nurse arrives, the
,patient says, “My tray is delayed, but I can take the shot now
and eat later.” The premeal glucose is 168 mg/dL. Which
instruction is best?
Options:
A. Take the insulin now because the blood glucose is elevated
B. Hold the insulin until the meal tray is present and the patient
is ready to eat
C. Take the insulin after finishing the meal to prevent nausea
D. Mix the rapid-acting insulin with regular insulin in the same
syringe
Correct Answer: B
Rationales:
Correct Answer: Rapid-acting insulin works quickly and
should be matched to food intake. Giving it before a delayed
meal increases the risk of hypoglycemia. Teaching should
emphasize coordination between insulin administration and
meal availability.
A: The glucose is elevated, but insulin without food
coverage can still cause a dangerous drop in blood sugar.
C: Giving rapid-acting insulin after meals reduces its
effectiveness for postprandial control.
D: Mixing insulins is not the issue here, and rapid-acting
insulin is not mixed in this scenario-based teaching point.
,Teaching Point:
Match rapid-acting insulin with an available meal to prevent
hypoglycemia.
Citation:
Mertig, R. G. Nurses' Guide to Teaching Diabetes Self-
Management (2nd ed.), Ch. 1.
2) How exercise helps glucose control
Reference: Ch. 1 — How Insulin Works — Patient Teaching
Strategies
Stem:
A 52-year-old newly diagnosed with type 2 diabetes asks why
the provider keeps stressing walking after meals. The patient is
overweight and has a family history of diabetes. Which
explanation is best?
Options:
A. Exercise forces the pancreas to stop making insulin
B. Exercise helps the body use insulin more effectively and
lowers blood glucose
C. Exercise replaces the need for all diabetes medication
immediately
D. Exercise cures type 2 diabetes in most adults
Correct Answer: B
, Rationales:
Correct Answer: Physical activity improves insulin sensitivity
and helps muscle cells take up glucose, lowering blood sugar.
This is a core teaching principle in diabetes self-management.
A: Exercise does not stop pancreatic insulin production; it
improves glucose handling.
C: Exercise is beneficial, but medication changes require
provider guidance.
D: Exercise can improve control and reduce risk, but it does
not guarantee a cure.
Teaching Point:
Exercise improves insulin sensitivity and lowers blood glucose.
Citation:
Mertig, R. G. Nurses' Guide to Teaching Diabetes Self-
Management (2nd ed.), Ch. 1.
3) Confirming diabetes in an asymptomatic adult
Reference: Ch. 1 — Diagnostic Criteria — Clinical Judgment
Stem:
A 45-year-old without classic symptoms has an A1c of 6.7%
during a health screening. The client asks whether diabetes is
confirmed. Which teaching by the nurse is best?
Options:
A. “One abnormal A1c always confirms diabetes.”
DIABETES SELF-MANAGEMENT,
SECOND EDITION
2ND EDITION
• AUTHOR(S)RITA GIROUARD
MERTIG
TEST BANK
1) Insulin timing and meal coordination
Reference: Ch. 1 — How Insulin Works — Patient Teaching
Strategies
Stem:
A 17-year-old with type 1 diabetes receives a prescription for
rapid-acting insulin before lunch. When the nurse arrives, the
,patient says, “My tray is delayed, but I can take the shot now
and eat later.” The premeal glucose is 168 mg/dL. Which
instruction is best?
Options:
A. Take the insulin now because the blood glucose is elevated
B. Hold the insulin until the meal tray is present and the patient
is ready to eat
C. Take the insulin after finishing the meal to prevent nausea
D. Mix the rapid-acting insulin with regular insulin in the same
syringe
Correct Answer: B
Rationales:
Correct Answer: Rapid-acting insulin works quickly and
should be matched to food intake. Giving it before a delayed
meal increases the risk of hypoglycemia. Teaching should
emphasize coordination between insulin administration and
meal availability.
A: The glucose is elevated, but insulin without food
coverage can still cause a dangerous drop in blood sugar.
C: Giving rapid-acting insulin after meals reduces its
effectiveness for postprandial control.
D: Mixing insulins is not the issue here, and rapid-acting
insulin is not mixed in this scenario-based teaching point.
,Teaching Point:
Match rapid-acting insulin with an available meal to prevent
hypoglycemia.
Citation:
Mertig, R. G. Nurses' Guide to Teaching Diabetes Self-
Management (2nd ed.), Ch. 1.
2) How exercise helps glucose control
Reference: Ch. 1 — How Insulin Works — Patient Teaching
Strategies
Stem:
A 52-year-old newly diagnosed with type 2 diabetes asks why
the provider keeps stressing walking after meals. The patient is
overweight and has a family history of diabetes. Which
explanation is best?
Options:
A. Exercise forces the pancreas to stop making insulin
B. Exercise helps the body use insulin more effectively and
lowers blood glucose
C. Exercise replaces the need for all diabetes medication
immediately
D. Exercise cures type 2 diabetes in most adults
Correct Answer: B
, Rationales:
Correct Answer: Physical activity improves insulin sensitivity
and helps muscle cells take up glucose, lowering blood sugar.
This is a core teaching principle in diabetes self-management.
A: Exercise does not stop pancreatic insulin production; it
improves glucose handling.
C: Exercise is beneficial, but medication changes require
provider guidance.
D: Exercise can improve control and reduce risk, but it does
not guarantee a cure.
Teaching Point:
Exercise improves insulin sensitivity and lowers blood glucose.
Citation:
Mertig, R. G. Nurses' Guide to Teaching Diabetes Self-
Management (2nd ed.), Ch. 1.
3) Confirming diabetes in an asymptomatic adult
Reference: Ch. 1 — Diagnostic Criteria — Clinical Judgment
Stem:
A 45-year-old without classic symptoms has an A1c of 6.7%
during a health screening. The client asks whether diabetes is
confirmed. Which teaching by the nurse is best?
Options:
A. “One abnormal A1c always confirms diabetes.”
