NURSES' GUIDE TO TEACHING
DIABETES SELF-MANAGEMENT,
SECOND EDITION
2ND EDITION
• AUTHOR(S)RITA GIROUARD
MERTIG
TEST BANK
1) How insulin works
Reference: Ch. 1 — How Insulin Works
Question: A client newly diagnosed with type 1 diabetes says, “I
do not understand why my blood sugar stays high even when I
have not eaten much.” The nurse explains that insulin normally
helps glucose move from the bloodstream into body cells for
energy. Which response by the nurse is the best teaching
statement?
,Options:
A. “Insulin prevents the liver from making any glucose.”
B. “Insulin allows glucose to enter cells and be used for energy.”
C. “Insulin makes the kidneys remove all excess glucose.”
D. “Insulin changes glucose directly into protein.”
Correct Answer: B
Rationale — Correct Answer B: Insulin is the hormone that
allows glucose to enter many body cells, especially muscle and
fat cells, where it can be used for energy or stored. In type 1
diabetes, there is little or no insulin, so glucose remains in the
bloodstream. This teaching supports basic self-management
understanding.
Why A is incorrect: The liver still makes glucose, especially
between meals and overnight. Insulin helps regulate that
process, but it does not stop liver glucose production
completely.
Why C is incorrect: The kidneys excrete some glucose when
blood levels are high, but they do not remove all excess glucose.
That is not insulin’s primary action.
Why D is incorrect: Insulin does not convert glucose into
protein. It helps the body use or store glucose.
Teaching Point: Insulin lets glucose enter cells; without it, blood
glucose rises.
Citation: Mertig, R. G. (n.d.). Nurses' Guide to Teaching Diabetes
Self-Management (2nd ed.). Ch. 1.
,2) Insulin resistance in type 2 diabetes
Reference: Ch. 1 — How Insulin Works
Question: A client with obesity and newly diagnosed type 2
diabetes asks why exercise was recommended even though the
client is already taking metformin. The nurse explains that
physical activity improves the body’s response to its own
insulin. Which statement best reflects this teaching?
Options:
A. “Exercise replaces the need for beta cells to function.”
B. “Exercise prevents the intestines from absorbing all
carbohydrates.”
C. “Exercise increases insulin sensitivity so cells use glucose
more effectively.”
D. “Exercise causes the pancreas to stop making glucagon.”
Correct Answer: C
Rationale — Correct Answer C: Exercise improves insulin
sensitivity, meaning body cells respond better to available
insulin and take up glucose more effectively. This is one reason
activity is a key part of diabetes self-management. It also
supports weight control and cardiovascular health.
Why A is incorrect: Exercise cannot replace beta-cell function. It
may improve glucose control, but it does not regenerate insulin-
producing cells.
, Why B is incorrect: Exercise does not block intestinal
carbohydrate absorption. That is not how physical activity
lowers glucose.
Why D is incorrect: Exercise does not stop glucagon production.
Glucagon continues to help maintain blood glucose during
fasting or exertion.
Teaching Point: Activity improves insulin sensitivity and lowers
glucose usefully.
Citation: Mertig, R. G. (n.d.). Nurses' Guide to Teaching Diabetes
Self-Management (2nd ed.). Ch. 1.
3) Classification of diabetes: type 1
Reference: Ch. 1 — Classification of Diabetes
Question: A 9-year-old arrives at the clinic with weight loss,
excessive thirst, frequent urination, and ketones in the urine.
The parent says the child “was healthy until a few weeks ago.”
Which classification is most likely?
Options:
A. Type 1 diabetes
B. Type 2 diabetes
C. Prediabetes
D. Gestational diabetes
Correct Answer: A
Rationale — Correct Answer A: This pattern is most consistent
with type 1 diabetes, which often develops rapidly and is
DIABETES SELF-MANAGEMENT,
SECOND EDITION
2ND EDITION
• AUTHOR(S)RITA GIROUARD
MERTIG
TEST BANK
1) How insulin works
Reference: Ch. 1 — How Insulin Works
Question: A client newly diagnosed with type 1 diabetes says, “I
do not understand why my blood sugar stays high even when I
have not eaten much.” The nurse explains that insulin normally
helps glucose move from the bloodstream into body cells for
energy. Which response by the nurse is the best teaching
statement?
,Options:
A. “Insulin prevents the liver from making any glucose.”
B. “Insulin allows glucose to enter cells and be used for energy.”
C. “Insulin makes the kidneys remove all excess glucose.”
D. “Insulin changes glucose directly into protein.”
Correct Answer: B
Rationale — Correct Answer B: Insulin is the hormone that
allows glucose to enter many body cells, especially muscle and
fat cells, where it can be used for energy or stored. In type 1
diabetes, there is little or no insulin, so glucose remains in the
bloodstream. This teaching supports basic self-management
understanding.
Why A is incorrect: The liver still makes glucose, especially
between meals and overnight. Insulin helps regulate that
process, but it does not stop liver glucose production
completely.
Why C is incorrect: The kidneys excrete some glucose when
blood levels are high, but they do not remove all excess glucose.
That is not insulin’s primary action.
Why D is incorrect: Insulin does not convert glucose into
protein. It helps the body use or store glucose.
Teaching Point: Insulin lets glucose enter cells; without it, blood
glucose rises.
Citation: Mertig, R. G. (n.d.). Nurses' Guide to Teaching Diabetes
Self-Management (2nd ed.). Ch. 1.
,2) Insulin resistance in type 2 diabetes
Reference: Ch. 1 — How Insulin Works
Question: A client with obesity and newly diagnosed type 2
diabetes asks why exercise was recommended even though the
client is already taking metformin. The nurse explains that
physical activity improves the body’s response to its own
insulin. Which statement best reflects this teaching?
Options:
A. “Exercise replaces the need for beta cells to function.”
B. “Exercise prevents the intestines from absorbing all
carbohydrates.”
C. “Exercise increases insulin sensitivity so cells use glucose
more effectively.”
D. “Exercise causes the pancreas to stop making glucagon.”
Correct Answer: C
Rationale — Correct Answer C: Exercise improves insulin
sensitivity, meaning body cells respond better to available
insulin and take up glucose more effectively. This is one reason
activity is a key part of diabetes self-management. It also
supports weight control and cardiovascular health.
Why A is incorrect: Exercise cannot replace beta-cell function. It
may improve glucose control, but it does not regenerate insulin-
producing cells.
, Why B is incorrect: Exercise does not block intestinal
carbohydrate absorption. That is not how physical activity
lowers glucose.
Why D is incorrect: Exercise does not stop glucagon production.
Glucagon continues to help maintain blood glucose during
fasting or exertion.
Teaching Point: Activity improves insulin sensitivity and lowers
glucose usefully.
Citation: Mertig, R. G. (n.d.). Nurses' Guide to Teaching Diabetes
Self-Management (2nd ed.). Ch. 1.
3) Classification of diabetes: type 1
Reference: Ch. 1 — Classification of Diabetes
Question: A 9-year-old arrives at the clinic with weight loss,
excessive thirst, frequent urination, and ketones in the urine.
The parent says the child “was healthy until a few weeks ago.”
Which classification is most likely?
Options:
A. Type 1 diabetes
B. Type 2 diabetes
C. Prediabetes
D. Gestational diabetes
Correct Answer: A
Rationale — Correct Answer A: This pattern is most consistent
with type 1 diabetes, which often develops rapidly and is
