Endocrine part 1
- 1.
A 46 year old male with a h/o hypertension has fasting blood glucose of 118 and hemoglobin A1C was 6.3%, glucose tolerance of 2 hours is 199 during annual follow up visit. What education should the nurse provide?
- A.
How to monitor glucose and self test. How to administer insulin and what s/s of hypoglycemia are.
- B.
Instruct the patient that they will start on oral hypoglycemic medication and caution the s/s of hypoglycemia
- C.
Encourage patient to keep diet as is and no modification is necessary since he is not exceeding the defined limit to be diagnosed as a diabetic.
- D.
Caution the patient that they are considered “pre-diabetic” and that they will have to make some lifestyle changes to healthier diet and exercise because it takes about 10 years for Type II DM to develop.
Correct Answer
D. Caution the patient that they are considered “pre-diabetic” and that they will have to make some lifestyle changes to healthier diet and exercise because it takes about 10 years for Type II DM to develop.Explanation
Diagnosis of Diabetes
́Fasting blood glucose (FBG) > or = to 126mg/dL
́Two hour Oral Glucose Tolerance Test (OGTT) > or = to 200 mg/dL
́Random Blood Sugar (RBS) 200mg/dL with classic symptoms of diabetes
́HbA1C 6.5% or higher
The patient is prediabetic, and at an increased risk for developing Type 2 DM.
With prediabetes it takes about 10 years for Type II DM to develop.Prediabetes is defined as impaired glucose tolerance and impaired fasting glucose or both. Fasting blood glucose results between 100 mg/dL (5.56 mmol/L) and 125 mg/dL (6.9 mmol/L) indicate prediabetes. A diagnosis of impaired glucose tolerance is made if the 2-hour oral glucose tolerance test (OGTT) results are between 140 mg/dL (7.8 mmol/L) and 199 mg/dL (11.0 mmol/L).Rate this question:
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- 2.
Select all the leading complications of diabetes, SATA
- A.
Cause of new cases of blindness
- B.
End stage renal disease
- C.
Lower leg amputation
- D.
Pancreatic cancer
Correct Answer(s)
A. Cause of new cases of blindness
B. End stage renal diseaseExplanation
́#1 cause of new cases of blindness, end-stage renal disease and non traumatic lower limb amputationRate this question:
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- 3.
A woman who had gestational diabetes should not be concerned with developing diabetes because delivering the baby resolves the issue
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
While it’s true that delivering the baby will resolve the gestational diabetes but she should still be concerned with developing type 2 later in life.
An important teaching point is gestational diabetes applies to women that develop glucose intolerance during pregnancy – 63% chance of developing DM within 16 yearsRate this question:
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- 4.
What is the primary action of insulin in the body?
- A.
Aids in the process of gluconeogenesis.
- B.
Enhances the transport of glucose across cell walls.
- C.
Decreases the intestinal absorption of glucose.
- D.
Stimulates the pancreatic beta cells.
Correct Answer
B. Enhances the transport of glucose across cell walls.Explanation
Insulin, a hormone produced by the beta cells of the Islets of Langerhans in the pancreas. Insulin is secreted by these cells in response to the presence of food, and in particular, carbohydrates, which are broken down into glucose.
Promotes the transport of glucose from the bloodstream into the cells.
In particular, skeletal and adipose cells require insulin to unlock receptor sites, to allow the transportation of glucose into their cells to be used for energy.Rate this question:
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- 5.
What is true about pre-diabetes? SATA
- A.
From impaired glucose tolerance
- B.
The beta cells do not produce insulin
- C.
They are at higher risks for diabetic ketoacidosis
- D.
From impaired fasting glucose
Correct Answer(s)
A. From impaired glucose tolerance
D. From impaired fasting glucoseExplanation
Pre diabetes is a asymptomatic, condition where individuals are at an increased risk for developing Type 2 DM, type 1 is more at risk for DKA.
Caused by impaired glucose tolerance (IGT), impaired fasting glucose (IFG), or both.Rate this question:
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- 6.
Identify the critical point of insulin?
- A.
Stimulates protein uptake in skeletal muscles
- B.
Stimulates liver to convert glucose to glycogen
- C.
Stimulates uptake of fat in adipose tissue
- D.
Without insulin, protein and body fat are broken down
Correct Answer
D. Without insulin, protein and body fat are broken downExplanation
Every option is correct BUT the critical point is that without insulin the body needs energy (glucose) and will get energy from protein and body fat.
Necessary to supply glucose to the body’s tissue
Without insulin, body fat and protein are broken down
If inadequate amount of insulin produced to meet body’s needs, then exogenous source neededRate this question:
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- 7.
A patient who’s HbA1C level was at 7.3% said to the nurse, “I don’t understand why it’s so high, I stopped eating sugary food and pop for a whole month?” What’s the best response from the nurse?
- A.
“We will retest your HbA1C level as soon as possible”
- B.
Assess if the patient ate breakfast the morning before the test
- C.
“HbA1C test detects how well controlled your blood sugar has been over 2-3 months”
- D.
Explain that the level is just slightly elevated
Correct Answer
C. “HbA1C test detects how well controlled your blood sugar has been over 2-3 months”Explanation
the hemoglobin A1C test provides a measurement of glycemic control over the previous 2 to 3 months, with increases in the A1C reflecting elevated blood glucose levels. The hemoglobin A1C test has several advantages over the FPG test, including greater convenience because fasting is not required.Rate this question:
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- 8.
What best describes the cause of type 1 DM?
- A.
Too much glucose in blood causes desensitization of cells to take in glucose and become insulin resistant
- B.
The immune system destroys the cells that make insulin
- C.
Being obese
- D.
The liver does not release enough glycogen
Correct Answer
B. The immune system destroys the cells that make insulinExplanation
Type 1 DM is an immune-mediated disease – active autoimmunity directed at the beta cells of the pancreas; these antibodies progressively decrease the effective circulating insulin level till no insulin is produced; occurs when there is 80-90% of the pancreatic beta cells destroyed.
Keep in mind that there are no preventative measures for type 1, can only prevent complications by exercise and dietRate this question:
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- 9.
Select all that apply for type 1 diabetes signs and symptoms
- A.
Gradual onset
- B.
Rapid onset
- C.
Increase thirst
- D.
Increased eating
- E.
Weight gain
- F.
Increased frequency of infections
Correct Answer(s)
B. Rapid onset
C. Increase thirst
D. Increased eating
F. Increased frequency of infectionsExplanation
Clinical manifestations – rapid onset with acute manifestations
• 3Ps
Polyphagia (increased hunger)
Polydipsia (increased thirst)
Polyuria (increased urination)
Fatigue
Weight loss
More frequent infections
Family history
Peak incidence from 10-15 years oldRate this question:
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- 10.
What best describes the cause of type 2 DM?
- A.
Too much glucose in blood causes desensitization of cells to take in glucose and become insulin resistant & impaired insulin secretion
- B.
The immune system destroys the cells that make insulin
- C.
Being obese
- D.
The liver does not release enough glycogen
Correct Answer
A. Too much glucose in blood causes desensitization of cells to take in glucose and become insulin resistant & impaired insulin secretionExplanation
Beta cell response to repeated hyperglycemia desensitizes their response to further high glucose levels; also liver and peripheral tissues may become insulin resistance; results in insulin resistance and impaired insulin secretion.Insulin resistance is when cells in your muscles, fat, and liver don't respond well to insulin and can't easily take up glucose from your blood. Experts believe obesity, especially too much fat in the abdomen and around the organs, called visceral fat, is a main cause of insulin resistance. A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance.Rate this question:
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- 11.
Select all the signs and symptoms of type 2 diabetes.
- A.
Gradual onset
- B.
Rapid onset
- C.
Increased thirst
- D.
Increased hunger
- E.
Tingling feet
- F.
Blurred vision
Correct Answer(s)
A. Gradual onset
C. Increased thirst
D. Increased hunger
E. Tingling feet
F. Blurred visionExplanation
Clinical manifestations - gradual onset
• 3Ps
• Polyphagia (increased hunger)
• Polydipsia (increased thirst)
• Polyuria (increased urination)
Lack of energy
Blurred vision
Dry/itchy skin
Tingling of the feet
Sore heals slowly
Weight loss or gain
Rate this question:
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- 12.
What statement made by a patient with diabetes indicate that they need further education about health maintenance visits?
- A.
“I will make a doctor appointment every 3 months to check my heart, skin, meds, and lab”
- B.
“I see my ophthalmologist every 2 years with dilated eye exam”
- C.
“I never miss my yearly podiatrist appointments”
- D.
“I need to schedule an appointment with a dietitian since my blood sugar has been out of control”
Correct Answer
B. “I see my opHthalmologist every 2 years with dilated eye exam”Explanation
•Health Maintenance Visits:
•Participate in a diabetic education program initially and as needed •Ophthalmology visit yearly with dilated eye exam
•Dental exam/cleaning every 6 months
•PCP every 3 months for eval of CV status, skin integrity, meds, and labs •Yearly podiatry visitRate this question:
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- 13.
A patient is scheduled for a routine glycosylated hemoglobin (HbA1C) test. What is important for the nurse to tell the patient before this test?
- A.
Drink only water after midnight and come to the clinic early in the morning.
- B.
Eat a normal breakfast and be at the clinic 2 hours later.
- C.
Expect to be at the clinic for several hours because of the multiple blood draws.
- D.
Come to the clinic for your morning appointment to have your blood drawn.
Correct Answer
D. Come to the clinic for your morning appointment to have your blood drawn.Explanation
No prep time is required for HbA1C, just keep the appointmentRate this question:
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- 14.
Select ALL the major complications from diabetes
- A.
Wounds in foot that will not heal and leads to amputation
- B.
Blindness from damaged vessels in the retina
- C.
Heart disease
- D.
Stroke
- E.
Kidney failure
Correct Answer(s)
A. Wounds in foot that will not heal and leads to amputation
B. Blindness from damaged vessels in the retina
C. Heart disease
D. Stroke
E. Kidney failureExplanation
All options are correctRate this question:
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Dec 20, 2023Quiz Edited by
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Dec 20, 2023Quiz Created by
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