Chapter 44: Diabetes Mellitus
f9 f9 f9
Thef9nursef9isf9caringf9forf9af9patientf9whof9justf9finishedf9breakfast.f9Thef9nurs
ef9understandsf9isf9releasedf9fromf9thef9cellsf9off9thef9pancreasf9tof9maintainf9th
ef9bloodf9sugarf9withinf9normalf9range.
A.f9glucagon,f9alpha
B.f9insulin,f9alpha
C.f9glucagon,f9beta
D.f9insulin,f9betaf9-f9correctf9answer✔ ✔ D
Thef9nursef9understandsf9isf9releasedf9fromf9thef9cellsf9off9thef9pancreasf9when
f9thef9patientf9isf9hypoglycemic.
A.f9glucagon,f9alpha
B.f9insulin,f9alpha
C.f9glucagon,f9beta
D.f9insulin,f9betaf9-f9correctf9answer✔ ✔ A
Thef9nursef9recognizesf9thef9actionf9off9insulinf9isf9to:f9
A.f9Transportf9glucosef9tof9thef9cell
B.f9Metabolizef9glucosef9withinf9thef9cell
C.f9Transportf9glucosef9tof9thef9liverf9forf9storagef9
,D.f9Transportf9glucosef9acrossf9thef9cellf9membranef9-f9correctf9answer✔
✔ D
Thef9nursef9understandsf9thatf9typef91f9DMf9isf9causedf9byf9whichf9off9thef9foll
owingf9conditions?f9(Selectf9allf9thatf9apply.)
A.f9Gestationalf9diabetes
B.f9Af9historyf9off9mumpsf9orf9rubella
C.f9Familyf9historyf9off9autoimmunef9disorders
D.f9Autoimmunef9destructionf9off9thef9betaf9cellsf9off9thef9pancreas
E.f9Obesityf9-f9correctf9answer✔ ✔ Answer:f9Bf9andf9D
Rationale:f9Typef9If9DMf9isf9causedf9byf9anf9autoimmunef9processf9inf9whichf9
thef9insulin-
producingf9betaf9cellsf9off9thef9pancreasf9aref9destroyed.f9Triggersf9aref9notf9fu
llyf9understood,f9butf9af9historyf9off9mumpsf9orf9rubellaf9aref9sometimesf9impl
icated.
Thef9nursef9monitorsf9forf9whichf9clinicalf9manifestationsf9inf9thef9patientf9ne
wlyf9diagnosedf9withf9typef91f9DM?f9(Selectf9allf9thatf9apply.)
A.f9Polyuriaf9
B.f9Fatigue
C.f9Weightf9lossf9
D.f9Polyphagia
, E.f9Decreasedf9appetitef9-f9correctf9answer✔ ✔
Answer:f9A,f9B,f9C,f9andf9D
Rationale:f9Fatigue,f9polyuria,f9weightf9loss,f9andf9polyphagiaf9aref9allf9clinic
alf9manifestations.f9Glucosef9isf9typicallyf9totallyf9reabsorbedf9inf9thef9renalf9t
ubules.f9Hyperglycemiaf9resultsf9inf9glucosef9excretionf9inf9thef9urine,f9which
f9createsf9anf9osmoticf9effectf9thatf9effectivelyf9reducesf9waterf9reabsorptionf9i
ntof9thef9renalf9tubules,f9leadingf9tof9excessivef9volumef9lossf9throughf9thef9ki
dneys.f9Hyperglycemiaf9alsof9causesf9hyperosmolarityf9inf9thef9blood,f9whic
hf9causesf9af9shiftf9off9fluidf9fromf9thef9intracellularf9spacef9tof9thef9vascularf9sp
ace.f9Thef9lossf9off9intracellularf9waterf9combinedf9withf9thef9volumef9lossf9thr
oughf9thef9kidneysf9createsf9excessivef9thirstf9inf9thef9patient,f9orf9polydipsia.f9
Thef9lackf9off9insulinf9necessaryf9tof9movef9glucosef9intof9thef9cellsf9leadsf9tof9t
hef9breakdownf9off9proteinsf9andf9fatf9asf9af9sourcef9off9energy.f9Thisf9starvatio
nf9off9thef9cellsf9leadsf9tof9polyphagia,f9increasedf9appetite.f9Despitef9anf9incre
asedf9appetitef9leadingf9tof9consumptionf9off9largef9amountsf9off9food,f9thef9co
ntinualf9breakdownf9off9fatsf9andf9proteinsf9leadsf9tof9weightf9lossf9andf9fatigu
e.
Thef9nursef9correlatesf9whichf9laboratoryf9valuef9withf9thef9diagnosisf9off9DM
?
A.f9Fastingf9bloodf9glucosef9greaterf9thanf9140f9mg/dLf9
B.f9Hemoglobinf9A1c,f95.8%
C.f9Randomf9bloodf9glucose,f9150f9mg/dLf9
D.f9OGTT,f9155f9mg/dLf9-f9correctf9answer✔ ✔ Answer:f9A
Rationale:f9Af9fastingf9bloodf9glucosef9greaterf9thanf9140f9mg/dLf9indicatesf9
DM.f9Thef9otherf9valuesf9aref9indicativef9off9prediabetes.
f9 f9 f9
Thef9nursef9isf9caringf9forf9af9patientf9whof9justf9finishedf9breakfast.f9Thef9nurs
ef9understandsf9isf9releasedf9fromf9thef9cellsf9off9thef9pancreasf9tof9maintainf9th
ef9bloodf9sugarf9withinf9normalf9range.
A.f9glucagon,f9alpha
B.f9insulin,f9alpha
C.f9glucagon,f9beta
D.f9insulin,f9betaf9-f9correctf9answer✔ ✔ D
Thef9nursef9understandsf9isf9releasedf9fromf9thef9cellsf9off9thef9pancreasf9when
f9thef9patientf9isf9hypoglycemic.
A.f9glucagon,f9alpha
B.f9insulin,f9alpha
C.f9glucagon,f9beta
D.f9insulin,f9betaf9-f9correctf9answer✔ ✔ A
Thef9nursef9recognizesf9thef9actionf9off9insulinf9isf9to:f9
A.f9Transportf9glucosef9tof9thef9cell
B.f9Metabolizef9glucosef9withinf9thef9cell
C.f9Transportf9glucosef9tof9thef9liverf9forf9storagef9
,D.f9Transportf9glucosef9acrossf9thef9cellf9membranef9-f9correctf9answer✔
✔ D
Thef9nursef9understandsf9thatf9typef91f9DMf9isf9causedf9byf9whichf9off9thef9foll
owingf9conditions?f9(Selectf9allf9thatf9apply.)
A.f9Gestationalf9diabetes
B.f9Af9historyf9off9mumpsf9orf9rubella
C.f9Familyf9historyf9off9autoimmunef9disorders
D.f9Autoimmunef9destructionf9off9thef9betaf9cellsf9off9thef9pancreas
E.f9Obesityf9-f9correctf9answer✔ ✔ Answer:f9Bf9andf9D
Rationale:f9Typef9If9DMf9isf9causedf9byf9anf9autoimmunef9processf9inf9whichf9
thef9insulin-
producingf9betaf9cellsf9off9thef9pancreasf9aref9destroyed.f9Triggersf9aref9notf9fu
llyf9understood,f9butf9af9historyf9off9mumpsf9orf9rubellaf9aref9sometimesf9impl
icated.
Thef9nursef9monitorsf9forf9whichf9clinicalf9manifestationsf9inf9thef9patientf9ne
wlyf9diagnosedf9withf9typef91f9DM?f9(Selectf9allf9thatf9apply.)
A.f9Polyuriaf9
B.f9Fatigue
C.f9Weightf9lossf9
D.f9Polyphagia
, E.f9Decreasedf9appetitef9-f9correctf9answer✔ ✔
Answer:f9A,f9B,f9C,f9andf9D
Rationale:f9Fatigue,f9polyuria,f9weightf9loss,f9andf9polyphagiaf9aref9allf9clinic
alf9manifestations.f9Glucosef9isf9typicallyf9totallyf9reabsorbedf9inf9thef9renalf9t
ubules.f9Hyperglycemiaf9resultsf9inf9glucosef9excretionf9inf9thef9urine,f9which
f9createsf9anf9osmoticf9effectf9thatf9effectivelyf9reducesf9waterf9reabsorptionf9i
ntof9thef9renalf9tubules,f9leadingf9tof9excessivef9volumef9lossf9throughf9thef9ki
dneys.f9Hyperglycemiaf9alsof9causesf9hyperosmolarityf9inf9thef9blood,f9whic
hf9causesf9af9shiftf9off9fluidf9fromf9thef9intracellularf9spacef9tof9thef9vascularf9sp
ace.f9Thef9lossf9off9intracellularf9waterf9combinedf9withf9thef9volumef9lossf9thr
oughf9thef9kidneysf9createsf9excessivef9thirstf9inf9thef9patient,f9orf9polydipsia.f9
Thef9lackf9off9insulinf9necessaryf9tof9movef9glucosef9intof9thef9cellsf9leadsf9tof9t
hef9breakdownf9off9proteinsf9andf9fatf9asf9af9sourcef9off9energy.f9Thisf9starvatio
nf9off9thef9cellsf9leadsf9tof9polyphagia,f9increasedf9appetite.f9Despitef9anf9incre
asedf9appetitef9leadingf9tof9consumptionf9off9largef9amountsf9off9food,f9thef9co
ntinualf9breakdownf9off9fatsf9andf9proteinsf9leadsf9tof9weightf9lossf9andf9fatigu
e.
Thef9nursef9correlatesf9whichf9laboratoryf9valuef9withf9thef9diagnosisf9off9DM
?
A.f9Fastingf9bloodf9glucosef9greaterf9thanf9140f9mg/dLf9
B.f9Hemoglobinf9A1c,f95.8%
C.f9Randomf9bloodf9glucose,f9150f9mg/dLf9
D.f9OGTT,f9155f9mg/dLf9-f9correctf9answer✔ ✔ Answer:f9A
Rationale:f9Af9fastingf9bloodf9glucosef9greaterf9thanf9140f9mg/dLf9indicatesf9
DM.f9Thef9otherf9valuesf9aref9indicativef9off9prediabetes.
