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NUR 231 – ADULT NURSING II – EXAM 3 2026/2027
COMPLETE CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
NURSING
Prepare for NUR 231 Exam 3 with this focused Adult Nursing II study resource from
Illinois State University. It is designed to reinforce essential adult nursing concepts,
clinical judgment, patient care strategies, and medical-surgical topics. Use it to review
important material, strengthen your understanding, and identify areas that may
require additional study. This resource provides a structured supplement to your
coursework and can help you approach the exam with greater confidence.
MULTIPLE CHOICE.
Diabetes – Medical Management & Meal Planning (Q1–Q20)
1. A patient with type 1 diabetes asks how to calculate mealtime insulin.
The nurse explains that the insulin-to-carbohydrate ratio is typically:
A. 1 unit per 5 g carbohydrate
B. 1 unit per 10 g carbohydrate
C. 1 unit per 15 g carbohydrate
D. 1 unit per 20 g carbohydrate
Answer: C
Rationale: The standard insulin-to-carb ratio is commonly 1 unit per 15 g
of carbohydrate, though it is individualized.
2. Which food classification system is most commonly used for diabetes
meal planning?
A. Ketogenic pyramid
B. Exchange list system
C. DASH diet only
D. Glycemic load index
Answer: B
Rationale: The exchange list system classifies foods into groups with
similar macronutrient and calorie content to simplify meal planning.
, Page 2 of 32
3. A patient with diabetes wants to drink alcohol. Which instruction
should the nurse include?
A. Drink on an empty stomach to avoid hyperglycemia
B. Avoid alcohol entirely if taking insulin
C. Always consume alcohol with food to prevent hypoglycemia
D. Alcohol has no effect on blood glucose
Answer: C
Rationale: Alcohol inhibits gluconeogenesis and can cause delayed
hypoglycemia, especially when consumed without food.
4. The FIT acronym for exercise in diabetes management stands for:
A. Frequency, Intensity, Time
B. Flexibility, Intensity, Training
C. Frequency, Insulin, Testing
D. Food, Insulin, Time
Answer: A
Rationale: FIT stands for Frequency, Intensity, and Time—key parameters
for prescribing safe exercise in diabetes.
5. A patient taking metformin should be taught to:
A. Take it with meals to reduce GI upset
B. Expect hypoglycemia as a common side effect
C. Stop the medication before any imaging with contrast
D. Increase the dose when skipping meals
Answer: A
Rationale: Metformin is best taken with meals to minimize
gastrointestinal side effects; it does not typically cause hypoglycemia
when used alone.
6. Which statement by a patient with diabetes indicates correct
understanding of sick-day rules?
A. “I will stop taking my insulin if I can’t eat.”
B. “I will check my blood glucose every 4 hours.”
C. “I will drink less fluid to avoid frequent urination.”
D. “I will only call my provider if my glucose is over 300.”
, Page 3 of 32
Answer: B
Rationale: During illness, blood glucose should be monitored every 3–4
hours; insulin is often still needed even if oral intake is reduced.
7. A patient with type 1 diabetes is NPO for surgery. The nurse should
anticipate:
A. Holding all insulin
B. Administering half the usual long-acting insulin
C. Starting an IV insulin infusion with dextrose
D. Giving oral hypoglycemics instead
Answer: B
Rationale: Patients with type 1 diabetes need basal insulin even when
NPO to prevent DKA; half the usual long-acting dose is commonly given.
8. Which laboratory value best reflects long-term glycemic control?
A. Fasting blood glucose
B. Postprandial glucose
C. Hemoglobin A1c
D. Random glucose
Answer: C
Rationale: HbA1c reflects average blood glucose over the previous 2–3
months.
9. A patient with diabetes reports numbness and tingling in the feet. The
nurse recognizes this as:
A. Peripheral arterial disease
B. Diabetic peripheral neuropathy
C. Venous insufficiency
D. Claudication
Answer: B
Rationale: Diabetic peripheral neuropathy commonly presents as
bilateral numbness, tingling, or burning in the distal extremities.
10. When teaching a patient about hypoglycemia, the nurse should
include that an initial sign is:
A. Polyuria
, Page 4 of 32
B. Polydipsia
C. Shakiness
D. Kussmaul respirations
Answer: C
Rationale: Shakiness, diaphoresis, and palpitations are early adrenergic
signs of hypoglycemia.
11. A conscious patient with a blood glucose of 52 mg/dL should first
receive:
A. 15 g of a fast-acting carbohydrate
B. 1 mg glucagon IM
C. 50 mL of D50W IV
D. A peanut butter sandwich
Answer: A
Rationale: The rule of 15: give 15 g of fast-acting carbohydrate, recheck in
15 minutes.
12. An unconscious patient with suspected hypoglycemia should receive:
A. Oral glucose gel
B. Glucagon IM or IV dextrose
C. Orange juice with sugar
D. Nothing until blood glucose is confirmed
Answer: B
Rationale: Unconscious patients cannot safely swallow; glucagon or IV
dextrose is required.
13. Which finding is most characteristic of DKA?
A. Blood glucose 180 mg/dL, pH 7.45
B. Blood glucose 480 mg/dL, pH 7.25, ketonuria
C. Blood glucose 600 mg/dL, pH 7.40, no ketones
D. Blood glucose 90 mg/dL, pH 7.30
Answer: B
Rationale: DKA presents with hyperglycemia (>250), acidosis (pH <7.30),
and ketones.
NUR 231 – ADULT NURSING II – EXAM 3 2026/2027
COMPLETE CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
NURSING
Prepare for NUR 231 Exam 3 with this focused Adult Nursing II study resource from
Illinois State University. It is designed to reinforce essential adult nursing concepts,
clinical judgment, patient care strategies, and medical-surgical topics. Use it to review
important material, strengthen your understanding, and identify areas that may
require additional study. This resource provides a structured supplement to your
coursework and can help you approach the exam with greater confidence.
MULTIPLE CHOICE.
Diabetes – Medical Management & Meal Planning (Q1–Q20)
1. A patient with type 1 diabetes asks how to calculate mealtime insulin.
The nurse explains that the insulin-to-carbohydrate ratio is typically:
A. 1 unit per 5 g carbohydrate
B. 1 unit per 10 g carbohydrate
C. 1 unit per 15 g carbohydrate
D. 1 unit per 20 g carbohydrate
Answer: C
Rationale: The standard insulin-to-carb ratio is commonly 1 unit per 15 g
of carbohydrate, though it is individualized.
2. Which food classification system is most commonly used for diabetes
meal planning?
A. Ketogenic pyramid
B. Exchange list system
C. DASH diet only
D. Glycemic load index
Answer: B
Rationale: The exchange list system classifies foods into groups with
similar macronutrient and calorie content to simplify meal planning.
, Page 2 of 32
3. A patient with diabetes wants to drink alcohol. Which instruction
should the nurse include?
A. Drink on an empty stomach to avoid hyperglycemia
B. Avoid alcohol entirely if taking insulin
C. Always consume alcohol with food to prevent hypoglycemia
D. Alcohol has no effect on blood glucose
Answer: C
Rationale: Alcohol inhibits gluconeogenesis and can cause delayed
hypoglycemia, especially when consumed without food.
4. The FIT acronym for exercise in diabetes management stands for:
A. Frequency, Intensity, Time
B. Flexibility, Intensity, Training
C. Frequency, Insulin, Testing
D. Food, Insulin, Time
Answer: A
Rationale: FIT stands for Frequency, Intensity, and Time—key parameters
for prescribing safe exercise in diabetes.
5. A patient taking metformin should be taught to:
A. Take it with meals to reduce GI upset
B. Expect hypoglycemia as a common side effect
C. Stop the medication before any imaging with contrast
D. Increase the dose when skipping meals
Answer: A
Rationale: Metformin is best taken with meals to minimize
gastrointestinal side effects; it does not typically cause hypoglycemia
when used alone.
6. Which statement by a patient with diabetes indicates correct
understanding of sick-day rules?
A. “I will stop taking my insulin if I can’t eat.”
B. “I will check my blood glucose every 4 hours.”
C. “I will drink less fluid to avoid frequent urination.”
D. “I will only call my provider if my glucose is over 300.”
, Page 3 of 32
Answer: B
Rationale: During illness, blood glucose should be monitored every 3–4
hours; insulin is often still needed even if oral intake is reduced.
7. A patient with type 1 diabetes is NPO for surgery. The nurse should
anticipate:
A. Holding all insulin
B. Administering half the usual long-acting insulin
C. Starting an IV insulin infusion with dextrose
D. Giving oral hypoglycemics instead
Answer: B
Rationale: Patients with type 1 diabetes need basal insulin even when
NPO to prevent DKA; half the usual long-acting dose is commonly given.
8. Which laboratory value best reflects long-term glycemic control?
A. Fasting blood glucose
B. Postprandial glucose
C. Hemoglobin A1c
D. Random glucose
Answer: C
Rationale: HbA1c reflects average blood glucose over the previous 2–3
months.
9. A patient with diabetes reports numbness and tingling in the feet. The
nurse recognizes this as:
A. Peripheral arterial disease
B. Diabetic peripheral neuropathy
C. Venous insufficiency
D. Claudication
Answer: B
Rationale: Diabetic peripheral neuropathy commonly presents as
bilateral numbness, tingling, or burning in the distal extremities.
10. When teaching a patient about hypoglycemia, the nurse should
include that an initial sign is:
A. Polyuria
, Page 4 of 32
B. Polydipsia
C. Shakiness
D. Kussmaul respirations
Answer: C
Rationale: Shakiness, diaphoresis, and palpitations are early adrenergic
signs of hypoglycemia.
11. A conscious patient with a blood glucose of 52 mg/dL should first
receive:
A. 15 g of a fast-acting carbohydrate
B. 1 mg glucagon IM
C. 50 mL of D50W IV
D. A peanut butter sandwich
Answer: A
Rationale: The rule of 15: give 15 g of fast-acting carbohydrate, recheck in
15 minutes.
12. An unconscious patient with suspected hypoglycemia should receive:
A. Oral glucose gel
B. Glucagon IM or IV dextrose
C. Orange juice with sugar
D. Nothing until blood glucose is confirmed
Answer: B
Rationale: Unconscious patients cannot safely swallow; glucagon or IV
dextrose is required.
13. Which finding is most characteristic of DKA?
A. Blood glucose 180 mg/dL, pH 7.45
B. Blood glucose 480 mg/dL, pH 7.25, ketonuria
C. Blood glucose 600 mg/dL, pH 7.40, no ketones
D. Blood glucose 90 mg/dL, pH 7.30
Answer: B
Rationale: DKA presents with hyperglycemia (>250), acidosis (pH <7.30),
and ketones.
