Uhhcs Diabetes Mellitus Quiz (September)

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Uhhcs Diabetes Mellitus Quiz (September) - Quiz

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Questions and Answers
  • 1. 

    If a dietician would require 50% to 60% of daily calories should come from carbohydrates. What should the nurse say about the types of carbohydrates that can be eaten?

    • A.

      Try to limit simple sugars to between 10% and 20% of daily calories.

    • B.

      Simple carbohydrates are absorbed more rapidly than complex carbohydrates.

    • C.

      Simple sugars cause rapid spike in glucose levels and should be avoided.

    • D.

      Simple sugars should never be consumed by someone with diabetes.

    Correct Answer
    A. Try to limit simple sugars to between 10% and 20% of daily calories.
    Explanation
    The nurse should advise limiting the intake of simple sugars to between 10% and 20% of daily calories. This is because simple sugars are absorbed more rapidly than complex carbohydrates and can cause a rapid spike in glucose levels. While it is not stated in the question that simple sugars should never be consumed by someone with diabetes, it is generally recommended for individuals with diabetes to limit their intake of simple sugars to help manage their blood sugar levels.

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  • 2. 

    At the time Louie found out that the symptoms of diabetes were caused by high levels of blood glucose, he decided to break the habit of eating carbohydrates. With this, the nurse would be aware that the client might develop what complication?

    • A.

      Retinopathy

    • B.

      Atherosclerosis

    • C.

      Glycosuria

    • D.

      Acidosis

    Correct Answer
    D. Acidosis
    Explanation
    By deciding to break the habit of eating carbohydrates, Louie is likely following a low-carbohydrate or ketogenic diet. This type of diet can lead to a condition called diabetic ketoacidosis (DKA), which is a severe form of acidosis. DKA occurs when the body starts breaking down fat for fuel instead of glucose, leading to the production of ketones. High levels of ketones can cause the blood to become acidic, resulting in acidosis. Therefore, the nurse should be aware that Louie might develop acidosis as a complication of his decision to avoid carbohydrates.

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  • 3. 

    Salah has recently been diagnosed with Type I diabetes and asks Nurse Jemma for help formulating a nutrition plan. Which of the following recommendations would the nurse make to help the client increase calorie consumption to offset absorption problems?

    • A.

      Eat small meals with two or three snacks throughout the day to keep blood glucose levels steady

    • B.

      Increase consumption of simple carbohydrates

    • C.

      Eating small meals with two or three snacks may be more helpful in maintaining blood glucose levels than three large meals.

    • D.

      Skip meals to help lose weight

    Correct Answer
    C. Eating small meals with two or three snacks may be more helpful in maintaining blood glucose levels than three large meals.
    Explanation
    The nurse would recommend eating small meals with two or three snacks throughout the day to keep blood glucose levels steady. This is because individuals with Type I diabetes often have absorption problems, and eating smaller, more frequent meals can help with better absorption of nutrients and maintain stable blood glucose levels. Skipping meals to lose weight is not recommended as it can lead to imbalances in blood sugar levels and potentially worsen the condition. Increasing consumption of simple carbohydrates may cause spikes in blood sugar levels, which is not ideal for managing Type I diabetes.

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  • 4. 

    Amir is being asked concerning his health in the emergency department. When obtaining a health history from a patient with acute pancreatitis, the nurse asks the patient specifically about a history of

    • A.

      Alcohol use.

    • B.

      Cigarette smoking.

    • C.

      Diabetes Mellitus.

    • D.

      High-protein diet.

    Correct Answer
    A. Alcohol use.
    Explanation
    When obtaining a health history from a patient with acute pancreatitis, the nurse specifically asks about a history of alcohol use because excessive alcohol consumption is a major risk factor for developing pancreatitis. Alcohol can cause inflammation and damage to the pancreas, leading to the development of acute pancreatitis. Therefore, it is important to assess the patient's alcohol use to determine if it may have contributed to the development of their condition.

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  • 5. 

    The goal for pre-prandial blood glucose for those with Type 1 Diabetes Mellitus is:

    • A.

    • B.

    • C.

    • D.

    Correct Answer
    B.
    Explanation
    The goal for pre-prandial blood glucose for those with Type 1 Diabetes Mellitus is to maintain a blood glucose level between 80-130 mg/dL. This range helps to ensure that blood glucose levels are stable and within a healthy range before meals. It is important for individuals with Type 1 Diabetes to monitor and manage their blood glucose levels to prevent complications and maintain overall health.

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  • 6. 

    Nurse Sherryl is educating a pregnant client who has gestational diabetes. Which of the following statements should the nurse make to the client? Select all that apply.

    • A.

      Cakes, candies, cookies, and regular soft drinks should be avoided.

    • B.

      Gestational diabetes increases the risk that the mother will develop diabetes later in life.

    • C.

      Gestational diabetes usually resolves after the baby is born.

    • D.

      Insulin injections may be necessary.

    • E.

      The baby will likely be born with diabetes

    • F.

      The mother should strive to gain no more weight during the pregnancy.

    Correct Answer(s)
    A. Cakes, candies, cookies, and regular soft drinks should be avoided.
    B. Gestational diabetes increases the risk that the mother will develop diabetes later in life.
    C. Gestational diabetes usually resolves after the baby is born.
    D. Insulin injections may be necessary.
    Explanation
    The nurse should make the statement that cakes, candies, cookies, and regular soft drinks should be avoided because these foods are high in sugar and can cause a spike in blood glucose levels. The nurse should also inform the client that gestational diabetes increases the risk of developing diabetes later in life, as this is a known complication. Additionally, the nurse should mention that gestational diabetes usually resolves after the baby is born, as this reassures the client that the condition is temporary. Lastly, the nurse should mention that insulin injections may be necessary, as some women with gestational diabetes may require insulin to manage their blood sugar levels.

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  • 7. 

    The guidelines for Carbohydrate Counting as medical nutrition therapy for Diabetes Mellitus includes all of the following EXCEPT:

    • A.

      Flexibility in types and amounts of foods consumed

    • B.

      Unlimited intake of total fat, saturated fat and cholesterol

    • C.

      Including adequate servings of fruits, vegetables and the dairy group

    • D.

      Applicable to with either Type 1 or Type 2 diabetes mellitus

    Correct Answer
    B. Unlimited intake of total fat, saturated fat and cholesterol
    Explanation
    The guidelines for Carbohydrate Counting as medical nutrition therapy for Diabetes Mellitus include flexibility in types and amounts of foods consumed, including adequate servings of fruits, vegetables, and the dairy group, and are applicable to both Type 1 and Type 2 diabetes mellitus. However, the guidelines do not recommend unlimited intake of total fat, saturated fat, and cholesterol.

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  • 8. 

    Omar, one of the clients who has classic diabetic symptoms had an eight-hour fasting plasma glucose (FPG) test done. The nurse realizes that diagnostic criteria developed by the American Diabetes Association for diabetes include classic diabetic symptoms plus which of the following fasting plasma glucose levels?

    • A.

      Higher than 106 mg/dl

    • B.

      Higher than 126 mg/dl

    • C.

      Higher than 140 mg/dl

    • D.

      Higher than 160 mg/dl

    Correct Answer
    B. Higher than 126 mg/dl
    Explanation
    The correct answer is "Higher than 126 mg/dl". The diagnostic criteria developed by the American Diabetes Association for diabetes include classic diabetic symptoms plus a fasting plasma glucose level higher than 126 mg/dl. This indicates that Omar's fasting plasma glucose level must be higher than 126 mg/dl for him to be diagnosed with diabetes.

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  • 9. 

    When taking the health history of Kareen, the nurse screens for manifestations suggestive of Diabetes Type I. Which of the following manifestations are considered the primary manifestations of Diabetes Type I and would be most suggestive and require follow-up investigation?

    • A.

      Excessive intake of calories, rapid weight gain, and difficulty losing weight

    • B.

      An increase in three areas: thirst, intake of fluids, and hunger

    • C.

      Poor circulation, wound healing, and leg ulcers

    • D.

      Lack of energy, weight gain, and depression

    Correct Answer
    B. An increase in three areas: thirst, intake of fluids, and hunger
    Explanation
    The primary manifestations of Diabetes Type I include an increase in thirst, intake of fluids, and hunger. These symptoms are suggestive of high blood sugar levels and the body's attempt to compensate for the excess glucose by increasing fluid intake and causing increased hunger. These manifestations would require follow-up investigation to confirm a diagnosis of Diabetes Type I and to determine the appropriate treatment plan.

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  • 10. 

    Nurse Mara is working with an overweight client who has a high-stress job and smokes. This client, Adhara, has just received a diagnosis of Type II Diabetes and has just been started on an oral hypoglycemic agent. Which of the following goals for the client which if met, would be most likely to lead to an improvement in insulin efficiency to the point the client would no longer require oral hypoglycemic agents?

    • A.

      Comply with medication regimen 100% for 6 months

    • B.

      Quit the use of any tobacco products by the end of three months

    • C.

      Lose a pound a week until weight is in normal range for height and exercise 30 minutes daily

    • D.

      Practice relaxation techniques for at least five minutes five times a day for at least five months

    Correct Answer
    C. Lose a pound a week until weight is in normal range for height and exercise 30 minutes daily
    Explanation
    The goal of losing a pound a week until weight is in the normal range for height and exercising 30 minutes daily would be most likely to lead to an improvement in insulin efficiency. This is because weight loss and regular exercise are known to improve insulin sensitivity and help manage Type II Diabetes. By losing weight and exercising regularly, the client can potentially reduce their insulin resistance and improve their body's ability to use insulin effectively, potentially leading to a point where they no longer require oral hypoglycemic agents.

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  • 11. 

    During a home visit, nurse Nida will recommend routine screening for diabetes when the person has one or more of seven risk criteria. Which of the following persons that the nurse comes in contact with most needs to be screened for diabetes based on the seven risk criteria?

    • A.

      A client with an HDL cholesterol level of 40 mg/dl and a triglyceride level of 300 mg/dl

    • B.

      A woman who is at 90% of standard body weight after delivering an eight-pound baby

    • C.

      A middle-aged Caucasian male

    • D.

      An older client who is hypotensive

    Correct Answer
    A. A client with an HDL cholesterol level of 40 mg/dl and a triglyceride level of 300 mg/dl
    Explanation
    A client with an HDL cholesterol level of 40 mg/dl and a triglyceride level of 300 mg/dl should be screened for diabetes based on the seven risk criteria. High triglyceride levels and low HDL cholesterol levels are both risk factors for diabetes. Therefore, this client meets one of the risk criteria and should be screened for diabetes.

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  • 12. 

    During the admission of patient Mahra having signs of diabetic ketoacidosis, Nurse Kara will anticipate the physician ordering which of the following types of intravenous solution if the client cannot take fluids orally?

    • A.

      Lactated Ringer’s solution

    • B.

      0.9 normal saline solution

    • C.

      5% dextrose in water

    • D.

      0.45% normal saline solution

    Correct Answer
    D. 0.45% normal saline solution
    Explanation
    Nurse Kara will anticipate the physician ordering 0.45% normal saline solution if the client cannot take fluids orally because this solution is commonly used for patients with diabetic ketoacidosis. It helps to correct the electrolyte imbalances and dehydration associated with this condition. The 0.45% normal saline solution contains a lower concentration of sodium chloride compared to the 0.9% normal saline solution, which is more appropriate for patients who are at risk of fluid overload. Lactated Ringer's solution and 5% dextrose in water are not typically used for treating diabetic ketoacidosis.

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  • 13. 

    You are giving health teaching with Abdullah who is starting on a sulfonylurea antidiabetic agent. He mentions that he usually has a couple of beers each night and takes an Aspirin each day to prevent heart attack and/or strokes. Which of the following responses would be best on the part of the nurse?

    • A.

      As long as you only drink two beers and take one aspirin, this should not be a problem

    • B.

      The aspirin is alright but you need to give up drinking any alcoholic beverages

    • C.

      Taking alcohol and/or aspirin with a sulfonylurea drug can cause development of hypoglycemia

    • D.

      Aspirin and alcohol will cause the stomach to bleed more when on a sulfonylurea drug

    Correct Answer
    C. Taking alcohol and/or aspirin with a sulfonylurea drug can cause development of hypoglycemia
    Explanation
    Taking alcohol and/or aspirin with a sulfonylurea drug can cause the development of hypoglycemia. Sulfonylurea drugs work by stimulating the pancreas to produce more insulin, which can lower blood sugar levels. Alcohol can also lower blood sugar levels, while aspirin can increase the effects of sulfonylurea drugs. Therefore, combining alcohol and aspirin with a sulfonylurea drug can increase the risk of hypoglycemia, which can be dangerous for individuals with diabetes. It is important for Abdullah to be aware of this potential interaction and to discuss it with his healthcare provider.

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  • 14. 

    Which of the following if stated by the nurse is correct about Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)?

    • A.

      This syndrome occurs mainly in people with Type I Diabetes

    • B.

      It has a higher mortality rate than Diabetic Ketoacidosis

    • C.

      The client with HHNS is in a state of overhydration

    • D.

      This condition develops very rapidly

    Correct Answer
    B. It has a higher mortality rate than Diabetic Ketoacidosis
    Explanation
    Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS) has a higher mortality rate than Diabetic Ketoacidosis. This means that HHNS is more likely to result in death compared to Diabetic Ketoacidosis.

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  • 15. 

    Nurse Robe is teaching Meera, a thin client about the proper methods/techniques when giving insulin. Which one of the following is proper?

    • A.

      Pinch the skin up and use a 90 degree angle

    • B.

      Use a 45 degree angle with the skin pinched up

    • C.

      Massage the area of injection after injecting the insulin

    • D.

      Warm the skin with a warmed towel or washcloth prior to the injection

    Correct Answer
    A. Pinch the skin up and use a 90 degree angle
    Explanation
    The proper method for giving insulin is to pinch the skin up and use a 90 degree angle. This technique helps to ensure that the insulin is injected into the subcutaneous tissue, which allows for proper absorption. Using a 45 degree angle may result in injecting the insulin into the muscle, which can lead to faster absorption and potential complications. Massaging the area after injection is not necessary and warming the skin with a towel or washcloth is not a recommended technique for insulin administration.

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  • 16. 

    Nurse Pamela is explaining to the client about Type II Diabetes. Risk factors of such condition include all of the following except:

    • A.

      Advanced age

    • B.

      Physical inactivity

    • C.

      Obesity

    • D.

      Smoking

    Correct Answer
    D. Smoking
    Explanation
    Smoking is not a risk factor for Type II Diabetes. Advanced age, physical inactivity, and obesity are all known risk factors for developing Type II Diabetes. However, smoking is not directly linked to the development of this condition. Smoking is more commonly associated with other health conditions such as lung cancer, heart disease, and respiratory problems.

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  • 17. 

    Blood sugar is well controlled when Hemoglobin A1C is:

    • A.

      Below 5.7%

    • B.

      Between 12%-15%

    • C.

      Less than 180 mg/dL

    • D.

      Between 90 and 130 mg/dL

    Correct Answer
    A. Below 5.7%
    Explanation
    Hemoglobin A1C is a measure of the average blood sugar levels over the past 2-3 months. A level below 5.7% indicates that blood sugar is well controlled. This means that the person has been able to maintain their blood sugar within a normal range, which is important for overall health and preventing complications associated with high blood sugar levels.

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  • 18. 

    Which of the following diabetes drugs acts by decreasing the amount of glucose produced by the liver?

    • A.

      Alpha-glucosidase inhibitors

    • B.

      Biguanides

    • C.

      Meglitinides

    • D.

      Sulfonylureas

    Correct Answer
    B. Biguanides
    Explanation
    Biguanides, such as metformin, work by decreasing the amount of glucose produced by the liver. They do this by reducing the liver's ability to produce glucose and by increasing the uptake of glucose by muscle cells. This helps to lower blood glucose levels in individuals with diabetes. Alpha-glucosidase inhibitors, meglitinides, and sulfonylureas work by different mechanisms and do not directly affect liver glucose production.

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  • 19. 

    Ameen, a 39-year-old company driver presents with shakiness, sweating, anxiety, and palpitations and tells the nurse he has Type I Diabetes Mellitus. Which of the follow actions should the nurse do first?

    • A.

      Inject 1 mg of glucagon subcutaneously.

    • B.

      Administer 50 mL of 50% glucose I.V.

    • C.

      Give 4 to 6 oz (118 to 177 mL) of orange juice.

    • D.

      Give the client four to six glucose tablets.

    Correct Answer
    C. Give 4 to 6 oz (118 to 177 mL) of orange juice.
    Explanation
    The nurse should give 4 to 6 oz (118 to 177 mL) of orange juice first because the client is experiencing symptoms of hypoglycemia, which is common in Type I Diabetes Mellitus. Orange juice contains natural sugars that can quickly raise blood glucose levels and alleviate the symptoms. Injecting glucagon subcutaneously or administering glucose intravenously may be necessary in severe cases, but giving orange juice is the safest and quickest initial intervention. Glucose tablets can also be used, but orange juice is more readily available and easier to consume in this situation.

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  • 20. 

    An external insulin pump is prescribed for Mahra with diabetes mellitus and she asks the nurse about the functioning of the pump. The nurse bases the response on the information that the pump:

    • A.

      Is timed to release programmed doses of regular or NPH insulin into the bloodstream at specific intervals

    • B.

      Gives a small continuously dose of regular insulin subcutaneously, and the client can self-administer a bolus with an additional dose from the pump before each meal

    • C.

      Continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels

    • D.

      Is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases the insulin into the bloodstream

    Correct Answer
    B. Gives a small continuously dose of regular insulin subcutaneously, and the client can self-administer a bolus with an additional dose from the pump before each meal
    Explanation
    The correct answer states that the pump gives a small continuous dose of regular insulin subcutaneously, and the client can self-administer a bolus with an additional dose from the pump before each meal. This means that the pump delivers a steady amount of insulin throughout the day to maintain blood glucose levels, and the client can also manually administer extra insulin before meals to account for the rise in blood sugar levels after eating. This allows for better control of blood glucose levels and flexibility in insulin administration.

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  • 21. 

    Which of the following persons would most likely be diagnosed with Diabetes Mellitus? A 44-year-old:

    • A.

      Caucasian woman.

    • B.

      Asian- Arabic woman.

    • C.

      African-American woman.

    • D.

      Hispanic male.

    Correct Answer
    C. African-American woman.
    Explanation
    Diabetes Mellitus is a chronic condition that affects the body's ability to regulate blood sugar levels. It is more prevalent among certain ethnic groups, including African-Americans. Studies have shown that African-Americans have a higher risk of developing diabetes compared to other ethnic groups. Therefore, an African-American woman is more likely to be diagnosed with Diabetes Mellitus compared to the other options provided.

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  • 22. 

    Which of the following factors are risks for the development of Diabetes Mellitus? Select all that apply.

    • A.

      Age over 45 years

    • B.

      Overweight with a waist/hip ratio >1

    • C.

      Having a consistent HDL level above 40 mg/dl

    • D.

      Maintaining a sedentary lifestyle

    Correct Answer(s)
    A. Age over 45 years
    B. Overweight with a waist/hip ratio >1
    D. Maintaining a sedentary lifestyle
    Explanation
    Age over 45 years, being overweight with a waist/hip ratio >1, and maintaining a sedentary lifestyle are all factors that increase the risk of developing Diabetes Mellitus. Age is a significant risk factor as the risk of developing diabetes increases with age. Being overweight with a waist/hip ratio >1 indicates central obesity, which is associated with an increased risk of diabetes. Maintaining a sedentary lifestyle, characterized by a lack of physical activity, is also a risk factor for diabetes as it can lead to weight gain and insulin resistance. Having a consistent HDL level above 40 mg/dl is not a risk factor for diabetes.

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  • 23. 

    Muneer received 6 units of regular insulin 3 hours ago. The nurse would be MOST concerned if which of the following was observed?

    • A.

      Kussmaul respirations and diaphoresis

    • B.

      Anorexia and lethargy

    • C.

      Diaphoresis and trembling

    • D.

      Headache and polyuria

    Correct Answer
    C. Diaphoresis and trembling
    Explanation
    The nurse would be most concerned if diaphoresis and trembling were observed in Muneer after receiving 6 units of regular insulin 3 hours ago. Diaphoresis (excessive sweating) and trembling can be signs of hypoglycemia, which is a potentially dangerous condition caused by low blood sugar levels. If left untreated, hypoglycemia can lead to loss of consciousness and other serious complications. Therefore, the nurse should closely monitor Muneer's blood sugar levels and take appropriate actions to address the hypoglycemia if necessary.

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  • 24. 

    Fatima requested his grandfather to check his blood sugar levels. Which test should a nurse anticipate a physician would order when an older person is identified as high-risk for Diabetes Mellitus? Select all that apply.

    • A.

      Fasting Plasma Glucose (FPG)

    • B.

      Two-hour Oral Glucose Tolerance Test (OGTT)

    • C.

      Glycosylated hemoglobin (HbA1C)

    • D.

      Finger stick glucose three times daily

    Correct Answer(s)
    A. Fasting Plasma Glucose (FPG)
    B. Two-hour Oral Glucose Tolerance Test (OGTT)
    Explanation
    The nurse should anticipate that a physician would order the Fasting Plasma Glucose (FPG) and Two-hour Oral Glucose Tolerance Test (OGTT) for an older person identified as high-risk for Diabetes Mellitus. FPG measures blood sugar levels after fasting for at least 8 hours, while OGTT measures blood sugar levels 2 hours after consuming a glucose-rich drink. These tests are commonly used to diagnose diabetes and assess glucose tolerance.

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  • 25. 

    Mohammed is newly diagnosed with Type I DM and is being seen by the home health nurse. The doctors orders include: 1200 calorie ADA diet, 15 units NPH insulin before breakfast, and check blood sugar qid. When the nurse visits the patient at 5 pm, the nurse observes the man performing blood sugar analysis. The result is 50 mg/dL. The nurse would expect the patient to be

    • A.

      Confused with cold, clammy skin and pulse of 110

    • B.

      Lethargic with hot dry skin and rapid deep respirations

    • C.

      Alert and cooperative with BP of 130/80 and respirations of 12

    • D.

      Short of breath, with distended neck veins and bounding pulse of 96.

    Correct Answer
    A. Confused with cold, clammy skin and pulse of 110
    Explanation
    Based on the given information, the nurse would expect the patient to be confused with cold, clammy skin and a pulse of 110. A blood sugar level of 50 mg/dL indicates hypoglycemia (low blood sugar). Confusion is a common symptom of hypoglycemia, and cold, clammy skin along with a rapid pulse of 110 are also signs of low blood sugar. This combination of symptoms suggests that the patient is experiencing an episode of hypoglycemia.

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  • 26. 

    Which one do you like?

    • A.

      Option 1

    • B.

      Option 2

    • C.

      Option 3

    • D.

      Option 4

    Correct Answer
    A. Option 1
    Explanation
    The explanation for the given correct answer, Option 1, is not available as the question does not provide any context or criteria for selecting a preference.

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