Endocrine System Disorders | Diabetes Mellitus | NCLEX Quiz 101

1. The principal goals of therapy for older patients who have poor glycemic control are:

Enhancing quality of life.

Decreasing the chance of complications.

Improving self-care through education.

All of the above.

The principal goals of therapy for older persons with diabetes mellitus and poor glycemic control are enhancing quality of life. decreasing the chance of complications. improving self-care through education. and maintaining or improving general health status.

Explanation

The principal goals of therapy for older persons with diabetes mellitus and poor glycemic control are enhancing quality of life. decreasing the chance of complications. improving self-care through education. and maintaining or improving general health status.

2. Rosemary has been taking Glargine (Lantus) to treat her condition. One of the benefits of Glargine (Lantus) insulin is its ability to:

Release insulin rapidly throughout the day to help control basal glucose.

Release insulin evenly throughout the day and control basal glucose levels.

Simplify the dosing and better control blood glucose levels during the day.

Cause hypoglycemia with other manifestation of other adverse reactions.

Glargine (Lantus) insulin is designed to release insulin evenly throughout the day and control basal glucose levels.

Explanation

Glargine (Lantus) insulin is designed to release insulin evenly throughout the day and control basal glucose levels.

3. Genevieve has diabetes type 1 and receives insulin for glycemic control. She tells the nurse that she likes to have a glass of wine with dinner. What will the best plan of the nurse for client education include?

The alcohol could cause pancreatic disease.

The alcohol could cause serious liver disease.

The alcohol could predispose you to hypoglycemia.

The alcohol could predispose you to hyperglycemia.

Alcohol can potentiate hypoglycemic. not hypoglycemic. effects in the client. Alcohol can cause pancreatic disease. but the client’s pancreas is not producing any insulin currently. Alcohol can cause liver disease. but the more immediate concern is hypoglycemia.

Explanation

Alcohol can potentiate hypoglycemic. not hypoglycemic. effects in the client. Alcohol can cause pancreatic disease. but the client’s pancreas is not producing any insulin currently. Alcohol can cause liver disease. but the more immediate concern is hypoglycemia.

4. Harry is a diabetic patient who is experiencing a reaction of alternating periods of nocturnal hypoglycemia and hyperglycemia. The patient might be manifesting which of the following?

Uncontrolled diabetes

Somogyi phenomenon

Brittle diabetes

Diabetes insipidus

Somogyi phenomenon manifests itself with nocturnal hypoglycemia. followed by a marked increase in glucose and increase in ketones.

Explanation

Somogyi phenomenon manifests itself with nocturnal hypoglycemia. followed by a marked increase in glucose and increase in ketones.

5. Nurse Matt makes a home visit to the client with diabetes mellitus. During the visit. Nurse Matt notes the client's additional insulin vials are not refrigerated. What is the best action by the nurse at this time?

Instruct the client to label each vial with the date when opened.

Tell the client there is no need to keep additional vials.

Have the client place the insulin vials in the refrigerator.

Have the client discard the vials.

Vials not in use should be refrigerated to preserve drug potency. There is no need to discard the vials. The client should always have additional vials of insulin available. Writing the date of opening on the vial is good practice. but does not address the need to refrigerate additional vials.

Explanation

Vials not in use should be refrigerated to preserve drug potency. There is no need to discard the vials. The client should always have additional vials of insulin available. Writing the date of opening on the vial is good practice. but does not address the need to refrigerate additional vials.

6. Dr. Hugo has prescribed sulfonylureas for Rebecca in the management of diabetes mellitus type 2. As a nurse. you know that the primary purpose of sulfonylureas. such as long-acting glyburide (Micronase). is to:

Induce hypoglycemia by decreasing insulin sensitivity.

Improve insulin sensitivity and decrease hyperglycemia.

Stimulate the beta cells of the pancreas to secrete insulin.

Decrease insulin sensitivity by enhancing glucose uptake.

Sulfonylureas such as glyburide are used only with patients who have some remaining pancreatic-beta cell function. These drugs stimulate insulin secretion. which reduces liver glucose output and increases cell uptake of glucose. enhancing the number of and sensitivity of cell receptor sites for interaction with insulin.

Explanation

Sulfonylureas such as glyburide are used only with patients who have some remaining pancreatic-beta cell function. These drugs stimulate insulin secretion. which reduces liver glucose output and increases cell uptake of glucose. enhancing the number of and sensitivity of cell receptor sites for interaction with insulin.

7. During the morning rounds. Nurse AJ accompanied the physician in every patient's room. The physician writes orders for the client with diabetes mellitus. Which order would the nurse validate with the physician?

Use Humalog insulin for sliding scale coverage.

Metformin (Glucophage) 1000 mg per day in divided doses.

Administer regular insulin 30 minutes prior to meals.

Lantus insulin 20U BID.

Lantus insulin is usually prescribed once-a-day so an order for BID dosing should be validated with the physician. Humalog insulin can be prescribed for sliding scale coverage. Regular insulin is administered 30 minutes before meals. Metformin (Glucophage) is often prescribed in divided doses of 1000 mg per day.

Explanation

Lantus insulin is usually prescribed once-a-day so an order for BID dosing should be validated with the physician. Humalog insulin can be prescribed for sliding scale coverage. Regular insulin is administered 30 minutes before meals. Metformin (Glucophage) is often prescribed in divided doses of 1000 mg per day.

8. Which of the following is accurate pertaining to physical exercise and type 1 diabetes mellitus?

Physical exercise can slow the progression of diabetes mellitus.

Strenuous exercise is beneficial when the blood glucose is high.

Patients who take insulin and engage in strenuous physical exercise might experience hyperglycemia.

Adjusting insulin regimen allows for safe participation in all forms of exercise.

Physical exercise slows the progression of diabetes mellitus because exercise has beneficial effects on carbohydrate metabolism and insulin sensitivity. Strenuous exercise can cause retinal damage and can cause hypoglycemia. Insulin and foods both must be adjusted to allow safe participation in exercise.

Explanation

Physical exercise slows the progression of diabetes mellitus because exercise has beneficial effects on carbohydrate metabolism and insulin sensitivity. Strenuous exercise can cause retinal damage and can cause hypoglycemia. Insulin and foods both must be adjusted to allow safe participation in exercise.

9. Gary has diabetes type 2. Nurse Martha has taught him about the illness and evaluates learning has occurred when the client makes which statement?

“My cells have increased their receptors. but there is enough insulin.”

“My peripheral cells have increased sensitivity to insulin.”

“My beta cells cannot produce enough insulin for my cells.”

“My cells cannot use the insulin my pancreas makes.”

With type 2 diabetes mellitus. the pancreas produces insulin. but the cells cannot use it. Peripheral cells have a decreased. not an increased. sensitivity to insulin. The beta cells continue to produce insulin with type 2 diabetes. There is a decrease. not an increase. in receptor sites with type 2 diabetes.

Explanation

With type 2 diabetes mellitus. the pancreas produces insulin. but the cells cannot use it. Peripheral cells have a decreased. not an increased. sensitivity to insulin. The beta cells continue to produce insulin with type 2 diabetes. There is a decrease. not an increase. in receptor sites with type 2 diabetes.

10. Dr. Wijangco orders insulin lispro (Humalog) 10 units for Alicia. a client with diabetes mellitus. When will the nurse administer this medication?

When the client is eating

Thirty minutes before meals

Fifteen minutes before meals

When the meal trays arrive on the floor

The onset action for the insulin lispro (Humalog) is 10 to 15 minutes so it must be given when the client is eating to prevent hypoglycemia. It must be given when the client is eating. not when the meal trays arrive on the floor and not thirty minutes before meals.

Explanation

The onset action for the insulin lispro (Humalog) is 10 to 15 minutes so it must be given when the client is eating to prevent hypoglycemia. It must be given when the client is eating. not when the meal trays arrive on the floor and not thirty minutes before meals.