NUR 257 CHRONIC EXAM 3 2026/2027
COMPLETE TEST BANK | REAL EXAM CURRENTLY
TESTING QUESTIONS WITH VERIFIED ANSWERS AND
RATIONALES| NUR 257 CHRONIC EXAM PREP EXPERT
VERIFIED FOR GUARANTEED PASS 2026
DIABETES MELLITUS MANAGEMENT (Questions 1–40)
Question 1
Antipsychotic drugs can cause the following in a diabetic patient. Select all that
apply.
A. Decreased appetite
B. Insulin resistance
C. Weight gain
D. Hyperglycemia emergencies
E. B-cell damage to the pancreas
Correct Answer: B, C, D, E
Rationale: Antipsychotic medications, especially atypical antipsychotics (e.g.,
olanzapine, clozapine), can cause insulin resistance, weight gain, hyperglycemia
emergencies (e.g., diabetic ketoacidosis, hyperosmolar hyperglycemic state), and
direct damage to pancreatic B-cells. They do not typically cause decreased
appetite; in fact, they often increase appetite and cause significant weight gain.
The metabolic syndrome associated with antipsychotics includes central obesity,
dyslipidemia, and insulin resistance.
Question 2
Type 1 diabetes is common in the aging adult.
Correct Answer: False
Rationale: Type 1 diabetes is most commonly diagnosed in children, adolescents,
and young adults. It is an autoimmune condition where the pancreas produces
little to no insulin. While it can occur at any age, it is much less common in older
1|Page
,adults, who are more likely to develop Type 2 diabetes due to insulin resistance
and age-related pancreatic changes.
Question 3
Patient is an older adult with pre-diabetes, you need to teach them which of the
following? Select all that apply.
A. Smoking cessation
B. Keeping the low-density lipoprotein (LDL) level below 100mg/dL
C. Keeping the triglyceride level above 150 mg/dl
D. Keeping the fasting blood sugar (FBS) below 126 mg/dl
E. Maintaining her blood pressure (BP) at 130/80 mm Hg or less
F. Maintaining a cholesterol level above 200mg/dL
Correct Answer: A, B, D, E
Rationale: The patient with prediabetes should be taught lifestyle modifications
and cardiovascular risk reduction. Smoking cessation is critical (A) as smoking
increases cardiovascular risk. LDL should be kept below 100 mg/dL (B) to reduce
cardiovascular risk. Fasting blood sugar should be kept below 126 mg/dL (D); a
fasting glucose of 100-125 mg/dL indicates prediabetes. Blood pressure should be
maintained at 130/80 mmHg or less (E) in patients with diabetes or prediabetes.
Triglycerides should be kept below 150 mg/dL, not above (C). Cholesterol should
be kept below 200 mg/dL, not above (F).
Question 4
A patient with Type 2 diabetes is prescribed metformin. Which statement by the
patient indicates the need for further teaching?
A. "I will take this medication with meals to prevent stomach upset."
B. "I need to monitor my blood sugar regularly."
C. "This medication can cause me to gain weight."
D. "I should report any unusual muscle pain to my provider."
Correct Answer: C
Rationale: Metformin is a biguanide that typically causes weight loss or weight
neutrality, not weight gain. It is taken with meals to reduce gastrointestinal side
effects. Blood sugar monitoring is essential. Muscle pain should be reported as it
2|Page
,may indicate lactic acidosis, a rare but serious side effect. The statement about
weight gain is incorrect and requires further teaching.
Question 5
A patient with Type 1 diabetes is experiencing symptoms of hypoglycemia. Which
of the following is the priority nursing intervention?
A. Administer glucagon
B. Check blood glucose level
C. Administer oral glucose
D. Give 50% dextrose IV push
Correct Answer: B
Rationale: The priority intervention is to check the blood glucose level to confirm
hypoglycemia before treatment. If the patient is conscious and able to swallow,
oral glucose is appropriate. If unconscious, glucagon or IV dextrose may be
needed. However, confirmation of hypoglycemia is the first and most important
step to prevent over-treatment and hyperglycemia.
Question 6
A patient with diabetes is prescribed insulin glargine (Lantus). The nurse should
teach the patient that this insulin:
A. Has a peak effect in 2-4 hours
B. Should be given once daily at bedtime
C. Can be mixed with regular insulin
D. Is used for acute hyperglycemia
Correct Answer: B
Rationale: Insulin glargine is a long-acting basal insulin with a duration of 24
hours. It has no pronounced peak and should be given once daily, typically at
bedtime. It should not be mixed with other insulins. It is not used for acute
hyperglycemia; rapid-acting insulins are used for that purpose.
Question 7
A patient with diabetes is experiencing diabetic ketoacidosis (DKA). Which
laboratory finding is most characteristic?
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, A. Serum glucose 350 mg/dL
B. Serum bicarbonate 10 mEq/L
C. Serum pH 7.20
D. All of the above
Correct Answer: D
Rationale: DKA is characterized by hyperglycemia (glucose > 250 mg/dL),
metabolic acidosis (pH < 7.30, bicarbonate < 15 mEq/L), and ketonuria. The
patient may also have elevated serum ketones, elevated potassium (initially), and
elevated BUN/creatinine (due to dehydration). All of the above findings are
consistent with DKA.
Question 8
A patient with diabetes is at risk for foot ulcers. Which instruction should the
nurse provide?
A. Soak feet in hot water daily
B. Walk barefoot to improve circulation
C. Inspect feet daily for any cuts or blisters
D. Apply heating pads to the feet
Correct Answer: C
Rationale: Daily foot inspection is essential for diabetic patients to detect any
cuts, blisters, or ulcers early. Hot water can cause burns, barefoot walking
increases injury risk, and heating pads can cause burns due to decreased
sensation. Proper foot care includes wearing well-fitting shoes and keeping feet
clean and dry.
Question 9
A patient with Type 2 diabetes is prescribed a GLP-1 receptor agonist. Which side
effect should the nurse monitor for?
A. Hypoglycemia
B. Weight gain
C. Gastrointestinal upset (nausea, vomiting)
D. Hyperkalemia
Correct Answer: C
4|Page
COMPLETE TEST BANK | REAL EXAM CURRENTLY
TESTING QUESTIONS WITH VERIFIED ANSWERS AND
RATIONALES| NUR 257 CHRONIC EXAM PREP EXPERT
VERIFIED FOR GUARANTEED PASS 2026
DIABETES MELLITUS MANAGEMENT (Questions 1–40)
Question 1
Antipsychotic drugs can cause the following in a diabetic patient. Select all that
apply.
A. Decreased appetite
B. Insulin resistance
C. Weight gain
D. Hyperglycemia emergencies
E. B-cell damage to the pancreas
Correct Answer: B, C, D, E
Rationale: Antipsychotic medications, especially atypical antipsychotics (e.g.,
olanzapine, clozapine), can cause insulin resistance, weight gain, hyperglycemia
emergencies (e.g., diabetic ketoacidosis, hyperosmolar hyperglycemic state), and
direct damage to pancreatic B-cells. They do not typically cause decreased
appetite; in fact, they often increase appetite and cause significant weight gain.
The metabolic syndrome associated with antipsychotics includes central obesity,
dyslipidemia, and insulin resistance.
Question 2
Type 1 diabetes is common in the aging adult.
Correct Answer: False
Rationale: Type 1 diabetes is most commonly diagnosed in children, adolescents,
and young adults. It is an autoimmune condition where the pancreas produces
little to no insulin. While it can occur at any age, it is much less common in older
1|Page
,adults, who are more likely to develop Type 2 diabetes due to insulin resistance
and age-related pancreatic changes.
Question 3
Patient is an older adult with pre-diabetes, you need to teach them which of the
following? Select all that apply.
A. Smoking cessation
B. Keeping the low-density lipoprotein (LDL) level below 100mg/dL
C. Keeping the triglyceride level above 150 mg/dl
D. Keeping the fasting blood sugar (FBS) below 126 mg/dl
E. Maintaining her blood pressure (BP) at 130/80 mm Hg or less
F. Maintaining a cholesterol level above 200mg/dL
Correct Answer: A, B, D, E
Rationale: The patient with prediabetes should be taught lifestyle modifications
and cardiovascular risk reduction. Smoking cessation is critical (A) as smoking
increases cardiovascular risk. LDL should be kept below 100 mg/dL (B) to reduce
cardiovascular risk. Fasting blood sugar should be kept below 126 mg/dL (D); a
fasting glucose of 100-125 mg/dL indicates prediabetes. Blood pressure should be
maintained at 130/80 mmHg or less (E) in patients with diabetes or prediabetes.
Triglycerides should be kept below 150 mg/dL, not above (C). Cholesterol should
be kept below 200 mg/dL, not above (F).
Question 4
A patient with Type 2 diabetes is prescribed metformin. Which statement by the
patient indicates the need for further teaching?
A. "I will take this medication with meals to prevent stomach upset."
B. "I need to monitor my blood sugar regularly."
C. "This medication can cause me to gain weight."
D. "I should report any unusual muscle pain to my provider."
Correct Answer: C
Rationale: Metformin is a biguanide that typically causes weight loss or weight
neutrality, not weight gain. It is taken with meals to reduce gastrointestinal side
effects. Blood sugar monitoring is essential. Muscle pain should be reported as it
2|Page
,may indicate lactic acidosis, a rare but serious side effect. The statement about
weight gain is incorrect and requires further teaching.
Question 5
A patient with Type 1 diabetes is experiencing symptoms of hypoglycemia. Which
of the following is the priority nursing intervention?
A. Administer glucagon
B. Check blood glucose level
C. Administer oral glucose
D. Give 50% dextrose IV push
Correct Answer: B
Rationale: The priority intervention is to check the blood glucose level to confirm
hypoglycemia before treatment. If the patient is conscious and able to swallow,
oral glucose is appropriate. If unconscious, glucagon or IV dextrose may be
needed. However, confirmation of hypoglycemia is the first and most important
step to prevent over-treatment and hyperglycemia.
Question 6
A patient with diabetes is prescribed insulin glargine (Lantus). The nurse should
teach the patient that this insulin:
A. Has a peak effect in 2-4 hours
B. Should be given once daily at bedtime
C. Can be mixed with regular insulin
D. Is used for acute hyperglycemia
Correct Answer: B
Rationale: Insulin glargine is a long-acting basal insulin with a duration of 24
hours. It has no pronounced peak and should be given once daily, typically at
bedtime. It should not be mixed with other insulins. It is not used for acute
hyperglycemia; rapid-acting insulins are used for that purpose.
Question 7
A patient with diabetes is experiencing diabetic ketoacidosis (DKA). Which
laboratory finding is most characteristic?
3|Page
, A. Serum glucose 350 mg/dL
B. Serum bicarbonate 10 mEq/L
C. Serum pH 7.20
D. All of the above
Correct Answer: D
Rationale: DKA is characterized by hyperglycemia (glucose > 250 mg/dL),
metabolic acidosis (pH < 7.30, bicarbonate < 15 mEq/L), and ketonuria. The
patient may also have elevated serum ketones, elevated potassium (initially), and
elevated BUN/creatinine (due to dehydration). All of the above findings are
consistent with DKA.
Question 8
A patient with diabetes is at risk for foot ulcers. Which instruction should the
nurse provide?
A. Soak feet in hot water daily
B. Walk barefoot to improve circulation
C. Inspect feet daily for any cuts or blisters
D. Apply heating pads to the feet
Correct Answer: C
Rationale: Daily foot inspection is essential for diabetic patients to detect any
cuts, blisters, or ulcers early. Hot water can cause burns, barefoot walking
increases injury risk, and heating pads can cause burns due to decreased
sensation. Proper foot care includes wearing well-fitting shoes and keeping feet
clean and dry.
Question 9
A patient with Type 2 diabetes is prescribed a GLP-1 receptor agonist. Which side
effect should the nurse monitor for?
A. Hypoglycemia
B. Weight gain
C. Gastrointestinal upset (nausea, vomiting)
D. Hyperkalemia
Correct Answer: C
4|Page
