GALEN COLLEGE OF NURSING
Bachelor of Science in Nursing (BSN)
NUR257 — Concepts of Aging & Chronic Illness
Academic Year: 2026/2027
Comprehensive Question Bank — Exam 3
Question 1
A client is diagnosed with type 1 diabetes mellitus. Which pathophysiological mechanism
underlies this condition?
A. Progressive insulin resistance with insufficient insulin production
B. Autoimmune destruction of pancreatic beta cells leading to absolute insulin deficiency
C. Impaired glucose uptake due to defective insulin receptors
D. Excessive glucagon secretion from alpha cells
Correct answer: B. Autoimmune destruction of pancreatic beta cells leading to absolute insulin
deficiency
Rationale:
Type 1 diabetes is an autoimmune disorder in which the body's immune system destroys pancreatic beta
cells, resulting in an absolute lack of insulin. This requires exogenous insulin for survival. Options A and C
describe type 2 diabetes; option D is not the primary mechanism.
Question 2
The nurse is caring for a young adult recently diagnosed with type 1 diabetes. Which classic
symptom triad is most commonly associated with this diagnosis?
A. Thirst, fatigue, and blurred vision
B. Polyuria, polydipsia, and polyphagia
C. Weight gain, bradycardia, and cold intolerance
D. Headache, dizziness, and palpitations
Correct answer: B. Polyuria, polydipsia, and polyphagia
Rationale:
The classic triad of type 1 diabetes includes polyuria (excessive urination), polydipsia (excessive thirst), and
polyphagia (excessive hunger) due to hyperglycemia and osmotic diuresis. Option A describes symptoms
more typical of type 2 diabetes; C and D are not characteristic.
, Question 3
A client with type 2 diabetes asks the nurse to explain the underlying cause of this condition.
Which response is most accurate?
A. The pancreas produces no insulin at all.
B. The body produces excess glucagon, which destroys insulin.
C. The body does not make enough insulin or the cells stop responding to insulin.
D. The immune system attacks the insulin-producing cells.
Correct answer: C. The body does not make enough insulin or the cells stop responding to insulin.
Rationale:
Type 2 diabetes is a progressive disorder characterized by insulin resistance and relative insulin deficiency.
Unlike type 1, the pancreas still produces some insulin, but it is insufficient for the body's needs. Option D
describes type 1; A is incorrect; B is not the primary mechanism.
Question 4
The nurse is assessing a client with undiagnosed type 2 diabetes. Which set of symptoms
should the nurse recognize as potential indicators of this condition?
A. Polyuria, polydipsia, and weight loss
B. Thirst, fatigue, blurred vision, and vascular complications
C. Kussmaul respirations, fruity breath, and coma
D. Tremors, diaphoresis, and confusion
Correct answer: B. Thirst, fatigue, blurred vision, and vascular complications
Rationale:
Type 2 diabetes often presents with thirst, fatigue, blurred vision, and signs of vascular complications such
as retinopathy, neuropathy, and cardiovascular disease. Option A is more classic for type 1; C suggests
DKA; D indicates hypoglycemia.
, Question 5
According to current diagnostic criteria, which combination of tests on two different days
confirms a diagnosis of diabetes mellitus?
A. Fasting plasma glucose and oral glucose tolerance test
B. Fasting plasma glucose, hemoglobin A1c, or random blood glucose
C. Hemoglobin A1c and serum insulin level
D. Urine ketones and fasting plasma glucose
Correct answer: B. Fasting plasma glucose, hemoglobin A1c, or random blood glucose
Rationale:
Diabetes is diagnosed by any two of the following tests on two separate occasions: FPG ≥126 mg/dL, A1c
≥6.5%, or random glucose ≥200 mg/dL with symptoms. Options A, C, and D do not represent the
complete diagnostic criteria.
Question 6
A client's fasting plasma glucose (FPG) is 118 mg/dL. How should the nurse interpret this result?
A. Normal
B. Prediabetes
C. Diabetes
D. Inconclusive
Correct answer: B. Prediabetes
Rationale:
Fasting plasma glucose of 100–125 mg/dL indicates prediabetes. Normal FPG is <100 mg/dL; diabetes is
diagnosed at ≥126 mg/dL on two occasions. This client falls in the prediabetes range and is at increased
risk for developing diabetes.
, Question 7
A client has a hemoglobin A1c level of 6.1%. Which classification is most accurate?
A. Normal
B. Prediabetes
C. Diabetes
D. Impaired glucose tolerance
Correct answer: B. Prediabetes
Rationale:
A hemoglobin A1c of 5.8–6.4% indicates prediabetes. Normal A1c is <5.7%; diabetes is diagnosed at
≥6.5% on two occasions. The client's result of 6.1% places them in the prediabetes category.
Question 8
The nurse is reviewing laboratory results. Which fasting plasma glucose value is diagnostic for
diabetes mellitus?
A. 100 mg/dL
B. 120 mg/dL
C. 126 mg/dL
D. 140 mg/dL
Correct answer: C. 126 mg/dL
Rationale:
A fasting plasma glucose of ≥126 mg/dL on two separate occasions is diagnostic for diabetes. Values
between 100–125 mg/dL indicate prediabetes; normal is <100 mg/dL. Option D (140 mg/dL) also meets
criteria, but 126 mg/dL is the threshold.
Bachelor of Science in Nursing (BSN)
NUR257 — Concepts of Aging & Chronic Illness
Academic Year: 2026/2027
Comprehensive Question Bank — Exam 3
Question 1
A client is diagnosed with type 1 diabetes mellitus. Which pathophysiological mechanism
underlies this condition?
A. Progressive insulin resistance with insufficient insulin production
B. Autoimmune destruction of pancreatic beta cells leading to absolute insulin deficiency
C. Impaired glucose uptake due to defective insulin receptors
D. Excessive glucagon secretion from alpha cells
Correct answer: B. Autoimmune destruction of pancreatic beta cells leading to absolute insulin
deficiency
Rationale:
Type 1 diabetes is an autoimmune disorder in which the body's immune system destroys pancreatic beta
cells, resulting in an absolute lack of insulin. This requires exogenous insulin for survival. Options A and C
describe type 2 diabetes; option D is not the primary mechanism.
Question 2
The nurse is caring for a young adult recently diagnosed with type 1 diabetes. Which classic
symptom triad is most commonly associated with this diagnosis?
A. Thirst, fatigue, and blurred vision
B. Polyuria, polydipsia, and polyphagia
C. Weight gain, bradycardia, and cold intolerance
D. Headache, dizziness, and palpitations
Correct answer: B. Polyuria, polydipsia, and polyphagia
Rationale:
The classic triad of type 1 diabetes includes polyuria (excessive urination), polydipsia (excessive thirst), and
polyphagia (excessive hunger) due to hyperglycemia and osmotic diuresis. Option A describes symptoms
more typical of type 2 diabetes; C and D are not characteristic.
, Question 3
A client with type 2 diabetes asks the nurse to explain the underlying cause of this condition.
Which response is most accurate?
A. The pancreas produces no insulin at all.
B. The body produces excess glucagon, which destroys insulin.
C. The body does not make enough insulin or the cells stop responding to insulin.
D. The immune system attacks the insulin-producing cells.
Correct answer: C. The body does not make enough insulin or the cells stop responding to insulin.
Rationale:
Type 2 diabetes is a progressive disorder characterized by insulin resistance and relative insulin deficiency.
Unlike type 1, the pancreas still produces some insulin, but it is insufficient for the body's needs. Option D
describes type 1; A is incorrect; B is not the primary mechanism.
Question 4
The nurse is assessing a client with undiagnosed type 2 diabetes. Which set of symptoms
should the nurse recognize as potential indicators of this condition?
A. Polyuria, polydipsia, and weight loss
B. Thirst, fatigue, blurred vision, and vascular complications
C. Kussmaul respirations, fruity breath, and coma
D. Tremors, diaphoresis, and confusion
Correct answer: B. Thirst, fatigue, blurred vision, and vascular complications
Rationale:
Type 2 diabetes often presents with thirst, fatigue, blurred vision, and signs of vascular complications such
as retinopathy, neuropathy, and cardiovascular disease. Option A is more classic for type 1; C suggests
DKA; D indicates hypoglycemia.
, Question 5
According to current diagnostic criteria, which combination of tests on two different days
confirms a diagnosis of diabetes mellitus?
A. Fasting plasma glucose and oral glucose tolerance test
B. Fasting plasma glucose, hemoglobin A1c, or random blood glucose
C. Hemoglobin A1c and serum insulin level
D. Urine ketones and fasting plasma glucose
Correct answer: B. Fasting plasma glucose, hemoglobin A1c, or random blood glucose
Rationale:
Diabetes is diagnosed by any two of the following tests on two separate occasions: FPG ≥126 mg/dL, A1c
≥6.5%, or random glucose ≥200 mg/dL with symptoms. Options A, C, and D do not represent the
complete diagnostic criteria.
Question 6
A client's fasting plasma glucose (FPG) is 118 mg/dL. How should the nurse interpret this result?
A. Normal
B. Prediabetes
C. Diabetes
D. Inconclusive
Correct answer: B. Prediabetes
Rationale:
Fasting plasma glucose of 100–125 mg/dL indicates prediabetes. Normal FPG is <100 mg/dL; diabetes is
diagnosed at ≥126 mg/dL on two occasions. This client falls in the prediabetes range and is at increased
risk for developing diabetes.
, Question 7
A client has a hemoglobin A1c level of 6.1%. Which classification is most accurate?
A. Normal
B. Prediabetes
C. Diabetes
D. Impaired glucose tolerance
Correct answer: B. Prediabetes
Rationale:
A hemoglobin A1c of 5.8–6.4% indicates prediabetes. Normal A1c is <5.7%; diabetes is diagnosed at
≥6.5% on two occasions. The client's result of 6.1% places them in the prediabetes category.
Question 8
The nurse is reviewing laboratory results. Which fasting plasma glucose value is diagnostic for
diabetes mellitus?
A. 100 mg/dL
B. 120 mg/dL
C. 126 mg/dL
D. 140 mg/dL
Correct answer: C. 126 mg/dL
Rationale:
A fasting plasma glucose of ≥126 mg/dL on two separate occasions is diagnostic for diabetes. Values
between 100–125 mg/dL indicate prediabetes; normal is <100 mg/dL. Option D (140 mg/dL) also meets
criteria, but 126 mg/dL is the threshold.
