Rasmussen University NUR 2571 Exam 3 (pdf) | 2026/2027 | PN2
Q&A | Nursing
1. Which of the following best describes the underlying pathophysiology of
Type 1 diabetes mellitus?
A) Insulin resistance with inadequate compensatory insulin secretion
B) Autoimmune destruction of pancreatic beta cells causing absolute insulin
deficiency
C) Genetic mutation affecting insulin receptor function on target cells
D) Progressive loss of pancreatic alpha cells leading to glucagon excess
Correct Answer: Autoimmune destruction of pancreatic beta cells causing
absolute insulin deficiency
Rationale: Type 1 diabetes is an autoimmune disorder in which the body's
immune system destroys the beta cells of the pancreas, leading to an
absolute lack of insulin production. Patients are dependent on exogenous
insulin to prevent ketoacidosis and maintain life. Onset is frequently in
childhood, typically between ages 10 and 15.
2. A client newly diagnosed with Type 2 diabetes asks the nurse how this
condition differs from Type 1. Which response by the nurse is most accurate?
A) "Type 2 diabetes is an autoimmune destruction of insulin-producing cells."
B) "Type 2 diabetes always requires insulin therapy from the time of
diagnosis."
C) "Type 2 diabetes involves insulin resistance with inadequate insulin
secretion to compensate."
D) "Type 2 diabetes only occurs in children and young adults."
Correct Answer: "Type 2 diabetes involves insulin resistance with inadequate
insulin secretion to compensate."
,Rationale: Type 2 diabetes is characterized by a combination of insulin
resistance and inadequate insulin secretion. It is often linked to obesity,
sedentary lifestyle, and heredity, with onset predominately in adulthood after
age 35. It is usually controlled initially with diet, exercise, and oral
hypoglycemics.
3. A nurse is assessing a client with newly diagnosed diabetes. Which classic
triad of symptoms should the nurse expect the client to report?
A) Polyuria, polydipsia, and polyphagia
B) Polyuria, polydipsia, and weight gain
C) Polyphagia, polydipsia, and bradycardia
D) Polyuria, polyphagia, and hypotension
Correct Answer: Polyuria, polydipsia, and polyphagia
Rationale: The classic "three Ps" of diabetes mellitus are polyuria (excessive
urination), polydipsia (excessive thirst), and polyphagia (excessive hunger).
These symptoms result from hyperglycemia causing osmotic diuresis,
dehydration, and cellular starvation. Weight loss is more common in Type 1,
while weight gain may occur in Type 2.
4. A client with Type 1 diabetes is admitted with diabetic ketoacidosis (DKA).
Which assessment finding is most consistent with this diagnosis?
A) Blood glucose of 180 mg/dL with clear sensorium
B) Fruity, acetone breath and Kussmaul's respirations
C) Slow onset of symptoms over several weeks
D) Absence of ketones in the urine
Correct Answer: Fruity, acetone breath and Kussmaul's respirations
,Rationale: DKA is characterized by fruity, acetone breath and Kussmaul's
respirations (deep, rapid breathing) as the body attempts to blow off CO2 to
compensate for metabolic acidosis. Blood glucose is typically greater than
300 mg/dL, and ketones are present in the urine. DKA often has a rapid onset
and may be the first sign of Type 1 diabetes.
5. Which laboratory finding is most consistent with a diagnosis of diabetes
mellitus?
A) Fasting blood glucose of 110 mg/dL
B) Hemoglobin A1C of 5.5%
C) Fasting blood glucose of 130 mg/dL on two separate occasions
D) Random blood glucose of 180 mg/dL
Correct Answer: Fasting blood glucose of 130 mg/dL on two separate
occasions
Rationale: The diagnostic criteria for diabetes include a fasting blood glucose
level above 126 mg/dL on two separate occasions. An A1C greater than 6.5%
is also diagnostic. A random glucose greater than 200 mg/dL with symptoms
is also diagnostic.
6. A nurse is preparing to administer insulin to a client with diabetes. Which
insulin can be given intravenously?
A) Insulin glargine (Lantus)
B) Insulin detemir (Levemir)
C) Regular insulin
D) NPH insulin
Correct Answer: Regular insulin
, Rationale: Regular insulin is the only insulin that can be administered
intravenously. It is a short-acting insulin given approximately 30-60 minutes
before meals. NPH insulin is an intermediate-acting insulin given
subcutaneously only.
7. A client is prescribed NPH insulin and regular insulin to be mixed in the
same syringe. Which action by the nurse is correct?
A) Draw up the regular insulin first, then the NPH insulin
B) Draw up the NPH insulin first, then the regular insulin
C) Mix the insulins in a separate vial before drawing up
D) Administer the insulins in two separate injections
Correct Answer: Draw up the regular insulin first, then the NPH insulin
Rationale: When mixing regular insulin (clear) with NPH insulin (cloudy), the
clear insulin should be drawn up first to prevent contamination of the regular
insulin vial with NPH. The mnemonic "clear to cloudy" helps remember this 顺
序. NPH insulin contains protamine, which delays absorption and extends
duration.
8. A client with diabetes reports feeling shaky, sweaty, and dizzy. The client's
blood glucose is 55 mg/dL. Which action should the nurse take first?
A) Administer 15-20 grams of fast-acting carbohydrate
B) Administer glucagon intramuscularly
C) Give the client a candy bar
D) Wait 15 minutes and recheck the blood glucose
Correct Answer: Administer 15-20 grams of fast-acting carbohydrate
Q&A | Nursing
1. Which of the following best describes the underlying pathophysiology of
Type 1 diabetes mellitus?
A) Insulin resistance with inadequate compensatory insulin secretion
B) Autoimmune destruction of pancreatic beta cells causing absolute insulin
deficiency
C) Genetic mutation affecting insulin receptor function on target cells
D) Progressive loss of pancreatic alpha cells leading to glucagon excess
Correct Answer: Autoimmune destruction of pancreatic beta cells causing
absolute insulin deficiency
Rationale: Type 1 diabetes is an autoimmune disorder in which the body's
immune system destroys the beta cells of the pancreas, leading to an
absolute lack of insulin production. Patients are dependent on exogenous
insulin to prevent ketoacidosis and maintain life. Onset is frequently in
childhood, typically between ages 10 and 15.
2. A client newly diagnosed with Type 2 diabetes asks the nurse how this
condition differs from Type 1. Which response by the nurse is most accurate?
A) "Type 2 diabetes is an autoimmune destruction of insulin-producing cells."
B) "Type 2 diabetes always requires insulin therapy from the time of
diagnosis."
C) "Type 2 diabetes involves insulin resistance with inadequate insulin
secretion to compensate."
D) "Type 2 diabetes only occurs in children and young adults."
Correct Answer: "Type 2 diabetes involves insulin resistance with inadequate
insulin secretion to compensate."
,Rationale: Type 2 diabetes is characterized by a combination of insulin
resistance and inadequate insulin secretion. It is often linked to obesity,
sedentary lifestyle, and heredity, with onset predominately in adulthood after
age 35. It is usually controlled initially with diet, exercise, and oral
hypoglycemics.
3. A nurse is assessing a client with newly diagnosed diabetes. Which classic
triad of symptoms should the nurse expect the client to report?
A) Polyuria, polydipsia, and polyphagia
B) Polyuria, polydipsia, and weight gain
C) Polyphagia, polydipsia, and bradycardia
D) Polyuria, polyphagia, and hypotension
Correct Answer: Polyuria, polydipsia, and polyphagia
Rationale: The classic "three Ps" of diabetes mellitus are polyuria (excessive
urination), polydipsia (excessive thirst), and polyphagia (excessive hunger).
These symptoms result from hyperglycemia causing osmotic diuresis,
dehydration, and cellular starvation. Weight loss is more common in Type 1,
while weight gain may occur in Type 2.
4. A client with Type 1 diabetes is admitted with diabetic ketoacidosis (DKA).
Which assessment finding is most consistent with this diagnosis?
A) Blood glucose of 180 mg/dL with clear sensorium
B) Fruity, acetone breath and Kussmaul's respirations
C) Slow onset of symptoms over several weeks
D) Absence of ketones in the urine
Correct Answer: Fruity, acetone breath and Kussmaul's respirations
,Rationale: DKA is characterized by fruity, acetone breath and Kussmaul's
respirations (deep, rapid breathing) as the body attempts to blow off CO2 to
compensate for metabolic acidosis. Blood glucose is typically greater than
300 mg/dL, and ketones are present in the urine. DKA often has a rapid onset
and may be the first sign of Type 1 diabetes.
5. Which laboratory finding is most consistent with a diagnosis of diabetes
mellitus?
A) Fasting blood glucose of 110 mg/dL
B) Hemoglobin A1C of 5.5%
C) Fasting blood glucose of 130 mg/dL on two separate occasions
D) Random blood glucose of 180 mg/dL
Correct Answer: Fasting blood glucose of 130 mg/dL on two separate
occasions
Rationale: The diagnostic criteria for diabetes include a fasting blood glucose
level above 126 mg/dL on two separate occasions. An A1C greater than 6.5%
is also diagnostic. A random glucose greater than 200 mg/dL with symptoms
is also diagnostic.
6. A nurse is preparing to administer insulin to a client with diabetes. Which
insulin can be given intravenously?
A) Insulin glargine (Lantus)
B) Insulin detemir (Levemir)
C) Regular insulin
D) NPH insulin
Correct Answer: Regular insulin
, Rationale: Regular insulin is the only insulin that can be administered
intravenously. It is a short-acting insulin given approximately 30-60 minutes
before meals. NPH insulin is an intermediate-acting insulin given
subcutaneously only.
7. A client is prescribed NPH insulin and regular insulin to be mixed in the
same syringe. Which action by the nurse is correct?
A) Draw up the regular insulin first, then the NPH insulin
B) Draw up the NPH insulin first, then the regular insulin
C) Mix the insulins in a separate vial before drawing up
D) Administer the insulins in two separate injections
Correct Answer: Draw up the regular insulin first, then the NPH insulin
Rationale: When mixing regular insulin (clear) with NPH insulin (cloudy), the
clear insulin should be drawn up first to prevent contamination of the regular
insulin vial with NPH. The mnemonic "clear to cloudy" helps remember this 顺
序. NPH insulin contains protamine, which delays absorption and extends
duration.
8. A client with diabetes reports feeling shaky, sweaty, and dizzy. The client's
blood glucose is 55 mg/dL. Which action should the nurse take first?
A) Administer 15-20 grams of fast-acting carbohydrate
B) Administer glucagon intramuscularly
C) Give the client a candy bar
D) Wait 15 minutes and recheck the blood glucose
Correct Answer: Administer 15-20 grams of fast-acting carbohydrate
