2026 NURSING PRACTICE
QUESTIONS AND ANSWERS WITH
RATIONALE FROM MEDICAL BOOKS.
1. The nurse prepares discharge instructions for a patient with chronic syndrome of
inappropriate antidiuretic hormone (SIADH). Which statement indicates that the patient
understands these instructions?
a. “I’ll check all food labels to make sure that I restrict my sodium intake.”
b. “I’ll keep a log of my daily weight and call the doctor if I gain 2 lb (0.90 kg) or more in a
day without changing my eating habits.”
c. “I’ll check my pulse every morning and will contact my doctor if it’s irregular or rapid”
d. “I’II measure my urine and check the specific gravity with a refractometer. If it begins
to gradually rise, I’ll tell my doctor”
Rationale: B
Daily weight measurement is the most accurate means of monitoring hydration status at home.
The patient should be encouraged to increase dietary intake of both sodium and potassium,
particularly if diuretics are prescribed. Pulse checks and urine specific gravity measurements
are unnecessary in a patient with chronic SIADH.
Reference: Bare, B.G. and Smeltzer, S.C. (2004). Brunner & Suddarth’s Textbook of Medical-
Surgical Nursing. 10th Edition, Vol. 2. Page 1212
SITUATION: Gabby is a 48-year-old overweight man who was seen for a routine check-up. His
fasting blood glucose is 135 mg/dl, so he’s scheduled for a repeat test.
2. Gabby asks the nurse, why he has to return for another test. The nurse’s best response
would be:
A.“Your fasting blood glucose level was normal, but we need a confirmation of that result.”
B.“Fasting blood glucose level tests are always repeated.”
C.“You have type 2 diabetes mellitus, so the test must be repeated.”
,D.“Your fasting blood glucose was abnormal and needed to be tested again.”
Rationale: D
Type 2 diabetes is diagnosed with two fasting blood glucose levels> 126 mg/dl or a casual
plasma glucose level > 200 mg/dl and symptoms. Because his first fasting blood glucose level
was > 126 mg/dl, it must be repeated to make the diagnosis of type 2 diabetes.
Reference: Bare, B.G. and Smeltzer, S.C. (2004). Brunner & Suddarth’s Textbook of Medical-
Surgical Nursing. 10th Edition, Vol. 2. Page 1154
3. The second fasting blood glucose level was 131 mg/dl, and Miguel asks what caused his
diabetes, the nurse should reply that type 2 diabetes is:
A.An autoimmune disease
B.Caused by decreased insulin levels
C.Caused by insulin resistance
D.Caused by eating too many sweets
Rationale: C
June 2009 NLE Question (Etiology of Type I and Type II diabetes)
The pathophysiology of type 2 diabetes involves insulin resistance, impaired insulin secretion,
and inappropriate hepatic glucose production. Type 2 diabetes isn’t an autoimmune disease.
Although type 2 diabetes is characterized by elevated insulin levels, because of insulin
resistance, that insulin isn’t effective. Eating sweets doesn’t cause diabetes. However, it may
contribute to the development of diabetes if eating sweets causes obesity.
Reference: Bare, B.G. and Smeltzer, S.C. (2004). Brunner & Suddarth’s Textbook of Medical-
Surgical Nursing. 10th Edition, Vol. 2. Page 1153
4. Which of the following statements about insulin is incorrect?
A.It is secreted by the alpha cells of the Islet of Langerhans in the pancreas
B.It inhibits the breakdown of stored glucose, insulin and fat
C.It transports and metabolizes glucose for energy
D.It enhances the storage of dietary fat in the tissue
Rationale: A
, Option b, c and d are correct about insulin. Option A should be – the beta cells of the Islets of
Langerhans in the pancreas, Insulin is an anabolic or storage hormone. It is glucagon that is
produced by the alpha cells.
Reference: Bare, B.G. and Smeltzer, S.C. (2004). Brunner & Suddarth’s Textbook of Medical-
Surgical Nursing. 10th Edition, Vol. 2. Page 1151
5. The initial treatment for Miguel is meal plan change, with a goal of modest weight loss and
exercise. Modest weight loss and exercise are used to treat type 2 diabetes because each
will:
A.Enhance insulin sensitivity
B.Enhance insulin secretion
C.Make patients feel better
D.Prevent the progression of diabetes
Rationale: A
Modest weight loss (5% to 10% of body weight) and exercise both decrease insulin resistance,
which improves insulin sensitivity. These management modalities don’t enhance insulin
secretion, but the insulin that’s secreted is more effective. Although modest weight loss and
exercise generally help patients feel better, this isn’t the major reason these modalities are
prescribed. The natural history of type 2 diabetes is a gradual inability of the pancreas to
maintain the required insulin secretion. Therefore, it’s unlikely that modest weight loss and
exercise will prevent the progression of diabetes for the rest of the patient’s life, although they
will delay the progression as long as the patient maintains euglycemia.
Reference: Bare, B.G. and Smeltzer, S.C. (2004). Brunner & Suddarth’s Textbook of Medical-
Surgical Nursing. 10th Edition, Vol. 2. Page 1156
6. Blood glucose monitoring is a cornerstone of diabetes management. The nurse is teaching
the client on self-monitoring of blood glucose. She should recommend that it should be
done how many times daily?
A.Once a day c. Anytime the client wants to
B.Two to four times d. Before and after meals and at bedtime
QUESTIONS AND ANSWERS WITH
RATIONALE FROM MEDICAL BOOKS.
1. The nurse prepares discharge instructions for a patient with chronic syndrome of
inappropriate antidiuretic hormone (SIADH). Which statement indicates that the patient
understands these instructions?
a. “I’ll check all food labels to make sure that I restrict my sodium intake.”
b. “I’ll keep a log of my daily weight and call the doctor if I gain 2 lb (0.90 kg) or more in a
day without changing my eating habits.”
c. “I’ll check my pulse every morning and will contact my doctor if it’s irregular or rapid”
d. “I’II measure my urine and check the specific gravity with a refractometer. If it begins
to gradually rise, I’ll tell my doctor”
Rationale: B
Daily weight measurement is the most accurate means of monitoring hydration status at home.
The patient should be encouraged to increase dietary intake of both sodium and potassium,
particularly if diuretics are prescribed. Pulse checks and urine specific gravity measurements
are unnecessary in a patient with chronic SIADH.
Reference: Bare, B.G. and Smeltzer, S.C. (2004). Brunner & Suddarth’s Textbook of Medical-
Surgical Nursing. 10th Edition, Vol. 2. Page 1212
SITUATION: Gabby is a 48-year-old overweight man who was seen for a routine check-up. His
fasting blood glucose is 135 mg/dl, so he’s scheduled for a repeat test.
2. Gabby asks the nurse, why he has to return for another test. The nurse’s best response
would be:
A.“Your fasting blood glucose level was normal, but we need a confirmation of that result.”
B.“Fasting blood glucose level tests are always repeated.”
C.“You have type 2 diabetes mellitus, so the test must be repeated.”
,D.“Your fasting blood glucose was abnormal and needed to be tested again.”
Rationale: D
Type 2 diabetes is diagnosed with two fasting blood glucose levels> 126 mg/dl or a casual
plasma glucose level > 200 mg/dl and symptoms. Because his first fasting blood glucose level
was > 126 mg/dl, it must be repeated to make the diagnosis of type 2 diabetes.
Reference: Bare, B.G. and Smeltzer, S.C. (2004). Brunner & Suddarth’s Textbook of Medical-
Surgical Nursing. 10th Edition, Vol. 2. Page 1154
3. The second fasting blood glucose level was 131 mg/dl, and Miguel asks what caused his
diabetes, the nurse should reply that type 2 diabetes is:
A.An autoimmune disease
B.Caused by decreased insulin levels
C.Caused by insulin resistance
D.Caused by eating too many sweets
Rationale: C
June 2009 NLE Question (Etiology of Type I and Type II diabetes)
The pathophysiology of type 2 diabetes involves insulin resistance, impaired insulin secretion,
and inappropriate hepatic glucose production. Type 2 diabetes isn’t an autoimmune disease.
Although type 2 diabetes is characterized by elevated insulin levels, because of insulin
resistance, that insulin isn’t effective. Eating sweets doesn’t cause diabetes. However, it may
contribute to the development of diabetes if eating sweets causes obesity.
Reference: Bare, B.G. and Smeltzer, S.C. (2004). Brunner & Suddarth’s Textbook of Medical-
Surgical Nursing. 10th Edition, Vol. 2. Page 1153
4. Which of the following statements about insulin is incorrect?
A.It is secreted by the alpha cells of the Islet of Langerhans in the pancreas
B.It inhibits the breakdown of stored glucose, insulin and fat
C.It transports and metabolizes glucose for energy
D.It enhances the storage of dietary fat in the tissue
Rationale: A
, Option b, c and d are correct about insulin. Option A should be – the beta cells of the Islets of
Langerhans in the pancreas, Insulin is an anabolic or storage hormone. It is glucagon that is
produced by the alpha cells.
Reference: Bare, B.G. and Smeltzer, S.C. (2004). Brunner & Suddarth’s Textbook of Medical-
Surgical Nursing. 10th Edition, Vol. 2. Page 1151
5. The initial treatment for Miguel is meal plan change, with a goal of modest weight loss and
exercise. Modest weight loss and exercise are used to treat type 2 diabetes because each
will:
A.Enhance insulin sensitivity
B.Enhance insulin secretion
C.Make patients feel better
D.Prevent the progression of diabetes
Rationale: A
Modest weight loss (5% to 10% of body weight) and exercise both decrease insulin resistance,
which improves insulin sensitivity. These management modalities don’t enhance insulin
secretion, but the insulin that’s secreted is more effective. Although modest weight loss and
exercise generally help patients feel better, this isn’t the major reason these modalities are
prescribed. The natural history of type 2 diabetes is a gradual inability of the pancreas to
maintain the required insulin secretion. Therefore, it’s unlikely that modest weight loss and
exercise will prevent the progression of diabetes for the rest of the patient’s life, although they
will delay the progression as long as the patient maintains euglycemia.
Reference: Bare, B.G. and Smeltzer, S.C. (2004). Brunner & Suddarth’s Textbook of Medical-
Surgical Nursing. 10th Edition, Vol. 2. Page 1156
6. Blood glucose monitoring is a cornerstone of diabetes management. The nurse is teaching
the client on self-monitoring of blood glucose. She should recommend that it should be
done how many times daily?
A.Once a day c. Anytime the client wants to
B.Two to four times d. Before and after meals and at bedtime
