NURSES' GUIDE TO TEACHING
DIABETES SELF-MANAGEMENT,
SECOND EDITION
2ND EDITION
• AUTHOR(S)RITA GIROUARD
MERTIG
TEST BANK
1) How insulin works — glucose uptake
Reference: Ch. 1 — How Insulin Works — Glucose Uptake
Question:
A nurse is teaching a newly diagnosed client with type 1
diabetes how insulin helps lower blood glucose. The client asks,
“What does insulin actually do after I eat?” Which explanation
is best?
,A. “It prevents the liver from making any glucose.”
B. “It helps glucose move from the blood into the body’s cells.”
C. “It replaces all the glucose your body loses in urine.”
D. “It makes the pancreas stop producing digestive enzymes.”
Correct Answer: B
Rationale — Correct Answer:
Insulin helps glucose enter cells so it can be used for energy,
which lowers blood glucose. This is the core physiologic action
patients need to understand for self-management and
medication adherence.
Rationale — Incorrect Options:
A. The liver does reduce glucose release in response to insulin,
but insulin’s main teaching point is cellular glucose uptake.
C. Insulin does not replace glucose lost in urine; glucose in urine
suggests hyperglycemia.
D. Insulin does not stop digestive enzymes; that is unrelated to
glucose regulation.
Teaching Point:
Insulin moves glucose from the bloodstream into cells for
energy.
Citation:
Mertig, R. G. (n.d.). Nurses' Guide to Teaching Diabetes Self-
Management (2nd ed.). Ch. 1.
2) How insulin works — blood glucose balance
,Reference: Ch. 1 — How Insulin Works — Blood Glucose
Regulation
Question:
A client with type 2 diabetes says, “My blood sugar rises after
meals because I eat too much sugar.” Which nurse response
best explains why blood glucose rises?
A. “Blood glucose rises when insulin is not available or not
working effectively.”
B. “Blood glucose rises only when the kidneys stop filtering
glucose.”
C. “Blood glucose rises because the stomach releases sugar into
the blood.”
D. “Blood glucose rises when the muscles produce too much
insulin.”
Correct Answer: A
Rationale — Correct Answer:
Diabetes causes hyperglycemia when insulin is absent,
insufficient, or ineffective. This explanation supports patient
understanding of why medication, meal planning, and
monitoring matter.
Rationale — Incorrect Options:
B. Kidney filtering is not the primary cause of hyperglycemia.
C. The stomach does not release sugar into the blood.
D. Muscles do not produce insulin.
, Teaching Point:
Hyperglycemia happens when insulin is missing, inadequate, or
ineffective.
Citation:
Mertig, R. G. (n.d.). Nurses' Guide to Teaching Diabetes Self-
Management (2nd ed.). Ch. 1.
3) How insulin works — fat and protein metabolism
Reference: Ch. 1 — How Insulin Works — Energy Use in
Diabetes
Question:
A client with untreated type 1 diabetes has lost weight and says,
“I eat more, but I still feel weak.” Which teaching best explains
this finding?
A. “Without enough insulin, the body cannot use glucose well
and begins breaking down fat and protein.”
B. “The pancreas is making too much insulin, which causes the
body to burn fat.”
C. “The kidneys are storing glucose instead of using it.”
D. “The liver is turning all protein into insulin.”
Correct Answer: A
Rationale — Correct Answer:
When insulin is absent, cells cannot use glucose effectively, so
the body breaks down fat and protein for energy. This can cause
DIABETES SELF-MANAGEMENT,
SECOND EDITION
2ND EDITION
• AUTHOR(S)RITA GIROUARD
MERTIG
TEST BANK
1) How insulin works — glucose uptake
Reference: Ch. 1 — How Insulin Works — Glucose Uptake
Question:
A nurse is teaching a newly diagnosed client with type 1
diabetes how insulin helps lower blood glucose. The client asks,
“What does insulin actually do after I eat?” Which explanation
is best?
,A. “It prevents the liver from making any glucose.”
B. “It helps glucose move from the blood into the body’s cells.”
C. “It replaces all the glucose your body loses in urine.”
D. “It makes the pancreas stop producing digestive enzymes.”
Correct Answer: B
Rationale — Correct Answer:
Insulin helps glucose enter cells so it can be used for energy,
which lowers blood glucose. This is the core physiologic action
patients need to understand for self-management and
medication adherence.
Rationale — Incorrect Options:
A. The liver does reduce glucose release in response to insulin,
but insulin’s main teaching point is cellular glucose uptake.
C. Insulin does not replace glucose lost in urine; glucose in urine
suggests hyperglycemia.
D. Insulin does not stop digestive enzymes; that is unrelated to
glucose regulation.
Teaching Point:
Insulin moves glucose from the bloodstream into cells for
energy.
Citation:
Mertig, R. G. (n.d.). Nurses' Guide to Teaching Diabetes Self-
Management (2nd ed.). Ch. 1.
2) How insulin works — blood glucose balance
,Reference: Ch. 1 — How Insulin Works — Blood Glucose
Regulation
Question:
A client with type 2 diabetes says, “My blood sugar rises after
meals because I eat too much sugar.” Which nurse response
best explains why blood glucose rises?
A. “Blood glucose rises when insulin is not available or not
working effectively.”
B. “Blood glucose rises only when the kidneys stop filtering
glucose.”
C. “Blood glucose rises because the stomach releases sugar into
the blood.”
D. “Blood glucose rises when the muscles produce too much
insulin.”
Correct Answer: A
Rationale — Correct Answer:
Diabetes causes hyperglycemia when insulin is absent,
insufficient, or ineffective. This explanation supports patient
understanding of why medication, meal planning, and
monitoring matter.
Rationale — Incorrect Options:
B. Kidney filtering is not the primary cause of hyperglycemia.
C. The stomach does not release sugar into the blood.
D. Muscles do not produce insulin.
, Teaching Point:
Hyperglycemia happens when insulin is missing, inadequate, or
ineffective.
Citation:
Mertig, R. G. (n.d.). Nurses' Guide to Teaching Diabetes Self-
Management (2nd ed.). Ch. 1.
3) How insulin works — fat and protein metabolism
Reference: Ch. 1 — How Insulin Works — Energy Use in
Diabetes
Question:
A client with untreated type 1 diabetes has lost weight and says,
“I eat more, but I still feel weak.” Which teaching best explains
this finding?
A. “Without enough insulin, the body cannot use glucose well
and begins breaking down fat and protein.”
B. “The pancreas is making too much insulin, which causes the
body to burn fat.”
C. “The kidneys are storing glucose instead of using it.”
D. “The liver is turning all protein into insulin.”
Correct Answer: A
Rationale — Correct Answer:
When insulin is absent, cells cannot use glucose effectively, so
the body breaks down fat and protein for energy. This can cause
