NURSES' GUIDE TO TEACHING
DIABETES SELF-MANAGEMENT,
SECOND EDITION
2ND EDITION
• AUTHOR(S)RITA GIROUARD
MERTIG
TEST BANK
1) How Insulin Works — Basic Physiology
Reference: Ch. 1 — Diabetes: The Basics — How Insulin Works
Question:
A 52-year-old client with new-onset type 2 diabetes asks why
diabetes can cause high blood glucose even when the body is
“making insulin.” The nurse explains that in diabetes, the most
,accurate concern is that insulin may not work effectively at the
cell level. Which statement best describes insulin’s normal role?
A. It breaks down glucose so it can be stored in the liver
B. It helps glucose move from the bloodstream into body cells
C. It prevents the kidneys from filtering glucose into urine
D. It converts glucose into ketones for energy
Correct Answer: B
Rationale:
Correct: Insulin facilitates transport of glucose from the
bloodstream into cells, where it can be used for energy or
stored. This is the central teaching concept for understanding
hyperglycemia in diabetes.
A: Insulin does not break down glucose; it promotes uptake and
storage.
C: The kidneys filter glucose independently of insulin.
D: Insulin does not convert glucose into ketones; ketone
production increases when insulin is absent or insufficient.
Teaching Point: Insulin moves glucose into cells for energy use
and storage.
Citation: Mertig, R. G. (2019). Nurses' Guide to Teaching
Diabetes Self-Management (2nd ed.). Ch. 1.
2) How Insulin Works — Lipid and Protein Effects
Reference: Ch. 1 — Diabetes: The Basics — How Insulin Works
,Question:
A client newly diagnosed with diabetes asks why the provider
says insulin “does more than lower glucose.” The nurse teaches
that insulin also affects fat and protein metabolism. Which
response best shows understanding?
A. “Insulin helps the body store glucose, fat, and protein.”
B. “Insulin only affects carbohydrate digestion after meals.”
C. “Insulin mainly raises blood glucose when it falls too low.”
D. “Insulin works only in the pancreas and not in other tissues.”
Correct Answer: A
Rationale:
Correct: Insulin is an anabolic hormone that supports storage of
glucose and influences fat and protein metabolism. This broad
effect helps explain weight changes, catabolism, and
ketoacidosis risk when insulin is absent.
B: Insulin is not limited to carbohydrate digestion.
C: Insulin lowers blood glucose; it does not raise it.
D: Insulin acts on multiple tissues, including liver, muscle, and
adipose tissue.
Teaching Point: Insulin is an anabolic hormone that stores
glucose, fat, and protein.
Citation: Mertig, R. G. (2019). Nurses' Guide to Teaching
Diabetes Self-Management (2nd ed.). Ch. 1.
3) How Insulin Works — Insulin Deficiency
, Reference: Ch. 1 — Diabetes: The Basics — How Insulin Works
Question:
A client with type 1 diabetes reports nausea, abdominal pain,
and blood glucose of 378 mg/dL. The nurse recognizes that the
client may be experiencing a consequence of insulin deficiency.
Which explanation is most accurate?
A. The body cannot use glucose effectively and begins breaking
down fat
B. The body stores too much glucose in the muscles and
becomes toxic
C. The pancreas makes excess insulin that damages the liver
D. The kidneys release insulin into the bloodstream too slowly
Correct Answer: A
Rationale:
Correct: Without enough insulin, glucose cannot enter cells
effectively, so the body breaks down fat for energy, which can
lead to ketone production and diabetic ketoacidosis.
B: Toxicity is not caused by muscle storage of excess glucose.
C: Type 1 diabetes is characterized by insulin deficiency, not
excess insulin.
D: The kidneys do not release insulin.
Teaching Point: Severe insulin deficiency shifts the body to fat
breakdown and ketone production.
Citation: Mertig, R. G. (2019). Nurses' Guide to Teaching
Diabetes Self-Management (2nd ed.). Ch. 1.
DIABETES SELF-MANAGEMENT,
SECOND EDITION
2ND EDITION
• AUTHOR(S)RITA GIROUARD
MERTIG
TEST BANK
1) How Insulin Works — Basic Physiology
Reference: Ch. 1 — Diabetes: The Basics — How Insulin Works
Question:
A 52-year-old client with new-onset type 2 diabetes asks why
diabetes can cause high blood glucose even when the body is
“making insulin.” The nurse explains that in diabetes, the most
,accurate concern is that insulin may not work effectively at the
cell level. Which statement best describes insulin’s normal role?
A. It breaks down glucose so it can be stored in the liver
B. It helps glucose move from the bloodstream into body cells
C. It prevents the kidneys from filtering glucose into urine
D. It converts glucose into ketones for energy
Correct Answer: B
Rationale:
Correct: Insulin facilitates transport of glucose from the
bloodstream into cells, where it can be used for energy or
stored. This is the central teaching concept for understanding
hyperglycemia in diabetes.
A: Insulin does not break down glucose; it promotes uptake and
storage.
C: The kidneys filter glucose independently of insulin.
D: Insulin does not convert glucose into ketones; ketone
production increases when insulin is absent or insufficient.
Teaching Point: Insulin moves glucose into cells for energy use
and storage.
Citation: Mertig, R. G. (2019). Nurses' Guide to Teaching
Diabetes Self-Management (2nd ed.). Ch. 1.
2) How Insulin Works — Lipid and Protein Effects
Reference: Ch. 1 — Diabetes: The Basics — How Insulin Works
,Question:
A client newly diagnosed with diabetes asks why the provider
says insulin “does more than lower glucose.” The nurse teaches
that insulin also affects fat and protein metabolism. Which
response best shows understanding?
A. “Insulin helps the body store glucose, fat, and protein.”
B. “Insulin only affects carbohydrate digestion after meals.”
C. “Insulin mainly raises blood glucose when it falls too low.”
D. “Insulin works only in the pancreas and not in other tissues.”
Correct Answer: A
Rationale:
Correct: Insulin is an anabolic hormone that supports storage of
glucose and influences fat and protein metabolism. This broad
effect helps explain weight changes, catabolism, and
ketoacidosis risk when insulin is absent.
B: Insulin is not limited to carbohydrate digestion.
C: Insulin lowers blood glucose; it does not raise it.
D: Insulin acts on multiple tissues, including liver, muscle, and
adipose tissue.
Teaching Point: Insulin is an anabolic hormone that stores
glucose, fat, and protein.
Citation: Mertig, R. G. (2019). Nurses' Guide to Teaching
Diabetes Self-Management (2nd ed.). Ch. 1.
3) How Insulin Works — Insulin Deficiency
, Reference: Ch. 1 — Diabetes: The Basics — How Insulin Works
Question:
A client with type 1 diabetes reports nausea, abdominal pain,
and blood glucose of 378 mg/dL. The nurse recognizes that the
client may be experiencing a consequence of insulin deficiency.
Which explanation is most accurate?
A. The body cannot use glucose effectively and begins breaking
down fat
B. The body stores too much glucose in the muscles and
becomes toxic
C. The pancreas makes excess insulin that damages the liver
D. The kidneys release insulin into the bloodstream too slowly
Correct Answer: A
Rationale:
Correct: Without enough insulin, glucose cannot enter cells
effectively, so the body breaks down fat for energy, which can
lead to ketone production and diabetic ketoacidosis.
B: Toxicity is not caused by muscle storage of excess glucose.
C: Type 1 diabetes is characterized by insulin deficiency, not
excess insulin.
D: The kidneys do not release insulin.
Teaching Point: Severe insulin deficiency shifts the body to fat
breakdown and ketone production.
Citation: Mertig, R. G. (2019). Nurses' Guide to Teaching
Diabetes Self-Management (2nd ed.). Ch. 1.
