Deck 26: Diabetes Mellitus

Question 1

Type 1 diabetes accounts for _____ of diabetes cases in the United States.

A)5-10%
B)10-25%
C)50-75%
D)90-95%

Answer 1

A

Question 2

Prediabetes is used to classify blood glucose levels between normal and those of diabetes; that is, if a fasting plasma glucose is between:

A)60 and 74 mg/dL.
B)74 and 106 mg/dL.
C)100 and 125 mg/dL.
D)126 and 140 mg/dL.

Answer 2

C

Question 3

Diabetic ketoacidosis can develop when blood glucose is greater than

A)250 mg/dL.
B)450 mg/dL.
C)650 mg/dL.
D)700 mg/dL.

Answer 3

A

Question 4

Diabetes ranks _____ among the leading causes of death in the United States.

A)1st
B)3rd
C)4th
D)7th

Question 5

All of the following are associated with diabetic ketosis except

A)dehydration.
B)blood glucose level less than 65 mg/dL.
C)electrolyte depletion.
D)deep breathing.

Question 6

Which of the following is an acute complication associated with diabetes?

A)Ketoacidosis
B)Hypoglycemia
C)Hyperosmolar hyperglycemic state
D)All of the above

Question 7

A hormone that opposes insulin's actions is

A)glucagon.
B)testosterone.
C)estrogen.
D)glycogen.

Question 8

The primary defect for type 2 diabetes is

A)insulin deficiency.
B)insulin resistance.
C)absence of receptor sites for insulin.
D)beta-cell exhaustion.

Question 9

Which of the following ethnic populations has the lowest relative risk for developing type 2 diabetes?

A)Pacific Islanders
B)Mexican American
C)European Americans
D)Native Americans

Question 10

Glycosuria usually occurs when blood glucose exceeds

A)140 mg/dL.
B)160 mg/dL.
C)180 mg/dL.
D)200 mg/dL.

Question 11

People with type 1 diabetes need insulin because they

A)have become insulin resistant.
B)have developed hyperinsulinemia.
C)no longer synthesize sufficient insulin.
D)digest insulin with GI enzymes.

Question 12

Fatigue, increased urination, and dry mouth are symptoms of

A)hyperglycemia.
B)hypoglycemia.
C)macroangiopathies.
D)microangiopathies.

Question 13

Type 2 diabetes generally develops in children and teens who

A)are of Native American descent.
B)have a family history of diabetes.
C)are overweight or obese.
D)all of the above

Question 14

Which of the following is not a major risk factor for type 2 diabetes?

A)Obesity
B)Older age
C)Native American ancestry
D)Physical activity

Question 15

Diabetes is now estimated to affect _____ of people aged 20 or more in the United States.

A)4.2%
B)6.5%
C)8.5%
D)10.2%

Question 16

Which of the following best describes clients with type 2 diabetes?

A)Usually lean
B)Rapid onset of symptoms
C)Weight loss needed
D)Ketosis prone

Question 17

Mason has type 1 diabetes.He is amazed at how many people are not aware of the differences between type 1 and type 2 diabetes.Which of the following is true about his illness?

A)It occurs mostly in those over 40
B)Obesity is the major cause
C)There is no link with genetic inheritance
D)It is caused by autoimmune destruction

Question 18

All of the following are factors that interfere with glucose, insulin sensitivity, or pancreatic function except:

A)pancreatitis.
B)cystic fibrosis.
C)drug or chemical toxicity.
D)certain infections.
E)inflammatory bowel disease.

Question 19

Normal fasting plasma glucose levels are approximately:

A)60 to 74 mg/dL.
B)75 to 100 mg/dL.
C)110 to 125 mg/dL.
D)126 to 140 mg/dL.

Question 20

Acetone breath is a symptom of diabetes due to

A)insulin resistance.
B)ketosis.
C)hyperglycemia.
D)gangrene.

Question 21

Perry is a patient with gastroparesis.Which form of nutrition therapy is the most appropriate?

A)A clear liquid diet
B)A 100 gram carbohydrate diet
C)Jejunostomy feeding
D)PEG tube feeding

Question 22

To re-evaluate a diabetic treatment plan, all of the following information is used except

A)body weight.
B)blood pressure.
C)midarm muscle circumference.
D)blood glucose levels.

Question 23

While you are making rounds at the beginning of the evening shift at 4 p.m., Mrs.Davis complains of feeling dizzy.When taking her pulse, you note that her hand trembles slightly and feels cool and moist.It is most likely that Mrs.Davis is experiencing

A)a relapse into ketoacidosis.
B)hypoglycemia.
C)respiratory alkalosis from hyperventilation.
D)hyperglycemia.

Question 24

Which statement is false?

A)Hyperglycemia and hypertension are both characteristic of diabetic ketoacidosis.
B)Ketoacidosis may occur in type 2 diabetes, but only rarely because even relatively low insulin concentrations can prevent excessive production of ketone bodies.
C)Diabetic ketoacidosis may be brought on by alcohol abuse, infection, or inadequate insulin administration.
D)Insulin therapy, fluid and electrolyte replacement, and bicarbonate therapy are appropriate medical treatments for a type 1 diabetic experiencing ketoacidosis.

Question 25

Diet plans for patients with diabetes should provide _____ carbohydrate sources.

A)low-
B)high-
C)consistent
D)fluctuating

Question 26

The goal of diabetes treatment is an HbA_1c value under _____ percent.

A)5
B)7
C)9
D)10

Question 27

Sweating, shakiness, and disorientation are all symptoms of

A)hyperglycemia.
B)hypoglycemia.
C)macroangiopathies.
D)microangiopathies.

Question 28

Which of the following factors influences glycemic response to foods?

A)Sodium content of the food
B)Fiber content of the food
C)Individual preferences
D)All of the above

Question 29

For a diabetic, overdoses of insulin, strenuous physical activity, skipped meals, and inadequate intake of food can all result in

A)hyperglycemia.
B)hypoglycemia.
C)dawn phenomenon.
D)rebound hyperglycemia.

Question 30

Glycosylated hemoglobin (A_Ic) can best be described as a(n)

A)by-product of fat metabolism.
B)reflection of mean blood glucose concentration over two to three months.
C)end-product of protein metabolism formed in the liver.
D)summary of hemoglobin rates for type 1 diabetes.

Question 31

Blood glucose is monitored at least _____ times a day ideally for people with type 1 diabetes.

A)1
B)2
C)3
D)4

Question 32

_____ is/are the loss of small quantities of urinary protein during the early stages of diabetic nephropathy.

A)Polyuria
B)Glycosuria
C)Microalbuminuria
D)Advanced glycation end-products

Question 33

Mr.Mervin is a 45-year-old man with type 2 diabetes.He is 5'9" and weighs 210 lbs.His diabetes is currently controlled with diet alone.Which of the following will help to improve his glycemic control?

A)Weight reduction
B)Hard candy for hypoglycemia
C)Antioxidants
D)Three meals plus a morning, afternoon, and bedtime snack

Question 34

Which of the following has the greatest effect on blood glucose?

A)Carbohydrate
B)Protein
C)Fat
D)All have equal effect

Question 35

Type 2 diabetes is not typically associated with _____.

A)ketoacidosis
B)insulin resistance
C)hyperinsulinemia
D)hyperosmolar hyperglycemia

Question 36

Mr.Jacobs has high blood lipids.The physician would instruct him to limit dietary intake of which of the following from sweeteners but not from whole foods (i.e., fruits and vegetables)?

A)Fructose
B)Sucrose
C)Glucose
D)Sucralose

Question 37

Signs and symptoms of diabetic neuropathy include which of the following?

A)Pain or burning
B)Blurred vision
C)Reduced urine output
D)All of the above

Question 38

The red blood cell component most commonly used for screening and monitoring diabetes is

A)hemoglobin A_1c.
B)heme iron.
C)heme protein.
D)none of the above

Question 39

Mr.Howe is admitted to the hospital for a foot ulcer.Which of the following is a probable cause?

A)Diabetes
B)Peripheral vascular disease
C)Kidney disease
D)a and b
E)All of the above

Question 40

Symptoms of hypoglycemia include

A)confusion and slurred speech.
B)increased thirst and polyuria.
C)acetone breath.
D)warm, flushed skin.

Question 41

Which of the following represents an appropriate snack at the beginning of an episode of hypoglycemia?

A)4 glucose tablets
B)8 oz.orange juice with 1 teaspoon sugar
C)10 saltine crackers
D)a and b

Question 42

When nighttime hypoglycemia leads to fasting hyperglycemia, this condition is known as:

A)rebound hypoglycemia.
B)rebound hyperglycemia.
C)dawn phenomenon.
D)nocturnal hypoglycemia.

Question 43

If using multiple daily injections to manage type 1 diabetes, ideally _____ insulin is injected to meet basal needs and ____ insulin is used before meals.

A)rapid-acting, long-acting
B)rapid-acting or short-acting, intermediate-acting or long-acting
C)intermediate-acting or long-acting, rapid-acting or short-acting
D)long-acting, intermediate-acting

Question 44

Physiological stress, such as colds and surgery, causes _____ in blood glucose.

A)a decrease
B)an increase
C)no change

Question 45

Mrs.Barclay's physician has prescribed regular insulin and NPH for control of her diabetes.Mrs.Barclay is 5'3", weighs 112 lbs., and is an active woman who plays handball three times per week.While preparing her for discharge, the nurse should tell Mrs.Barclay that

A)she does not need to eat extra food for exercise as her diet is designed to cover strenuous activity.
B)she should eat three meals only to cover the action of her insulin.
C)she could miss one injection if she gets too busy.
D)if she drinks alcoholic beverages, she is at risk of hypoglycemia.

Question 46

Mr.Lilly, a 42-year-old male, tells you that he used to take "pills" for his diabetes but is now taking insulin.What is the most likely reason that he no longer takes oral antidiabetic agents?

A)They are only effective in type 1 diabetes.
B)His body now stimulates enough insulin to meet his needs.
C)They suppress insulin release.
D)They were not controlling his blood glucose.

Question 47

Short-acting insulin begins to act _____ after it is injected.

A)15 minutes
B)30 minutes
C)1 to 3 hours
D)2 to 4 hours

Question 48

Alcoholic beverages should be consumed with food when people with diabetes are taking which of the following types of medications?

A)Insulin
B)Medications that stimulate insulin secretion
C)Aspirin
D)a and b
E)a, b and c

Question 49

Drug therapy for type 2 diabetes includes

A)drugs to reduce glucose production by the liver.
B)drugs to stimulate insulin secretion.
C)drugs to improve use of glucose by the tissues.
D)all of the above
E)a and b only

Question 50

When symptoms of hypoglycemia begin, _____ grams of carbohydrates should be consumed.

A)5 to 10
B)10 to 15
C)15 to 20
D)20 to 25

Question 51

Stewart has type 1 diabetes.He is getting ready to go for a 2-mile run.His blood glucose is 200 mg/dL.Stewart should:

A)eat a snack.
B)go for his run.
C)skip the exercise.
D)call his doctor.

Question 52

Malia has diabetes and is also ill with a cold.She is having difficulty controlling her blood sugar.Which of the following may be increasing her blood glucose levels?

A)Decongestants
B)Sugar-free cough medicine
C)Insulin
D)Vitamin C

Question 53

Each of the following food sources provides approximately how much carbohydrate? 1 Tbsp honey
15 small jelly beans
4 oz.canned orange juice

A)5 grams
B)10 grams
C)15 grams
D)20 grams

Question 54

Approximately _____ of women who do not have diabetes prior to pregnancy develop gestational diabetes.

A)3%
B)7%
C)10%
D)13%

Question 55

Abstention from alcohol is recommended for which of the following?

A)All people with diabetes
B)People with abnormally high triglyceride levels
C)People with absence of neuropathy
D)People with abnormally low triglyceride levels
E)All of the above

Question 56

During an acute illness, clients with type 1 diabetes should

A)decrease their medications if their appetite is poor.
B)decrease their fluid intake to prevent nausea.
C)drink fluids with sugar if their blood glucose is greater than 240 mg/dL.
D)monitor their urine for ketones.

Question 57

Patients with type 1 diabetes should consume carbohydrate before exercising if their blood glucose levels are less than

A)250 mg/dL.
B)100 mg/dL.
C)150 mg/dL.
D)175 mg/dL.

Question 58

Which of the following statements is true regarding carbohydrate counting?

A)You do not need to worry about portion size
B)Breakfast meats are counted as a carbohydrate
C)Works well with those patients using intensive insulin therapy
D)You can eat as much as you want and not gain weight

Question 59

The actions of oral antidiabetic agents include all of the following except:

A)decreased insulin resistance.
B)decreased insulin secretion.
C)improved use of glucose by the liver.
D)delayed carbohydrate absorption.

Question 60

The exchange list system sorts foods according to their proportions of

A)carbohydrate.
B)fat.
C)protein.
D)a and c
E)all of the above

Question 61

Metabolic syndrome is currently estimated to affect _____ percent of the adult population in the United States.

A)6
B)12
C)29
D)34%

Question 62

Complications of poor glycemic control during pregnancy include which of the following in newborns?

A)Respiratory distress syndrome
B)Jaundice
C)Hypoglycemia
D)All of the above
E)b and c only

Question 63

The registered dietitian visits with Michael to instruct him on his diabetic diet.She informs him that alcohol _____ his blood glucose.

A)may increase
B)may decrease
C)has no effect on
D)a and b
E)none of the above

Question 64

Which of the following treatments is not recommended for pregnant women with diabetes?

A)Insulin therapy
B)High-calorie/high-protein diet
C)Physical activity
D)Low-carbohydrate breakfast

Question 65

Martha has a triglycerides level of 350 mg/dL, a waist circumference of 45 inches, a fasting plasma glucose of 100 mg/dL, and an HDL cholesterol level of 35 mg/dL.What is her diagnosis likely to be? (Choose the best answer.)

A)Hypertriglyceridemia
B)Heart disease
C)Metabolic syndrome
D)Borderline diabetes

Question 66

Although the precise cause of metabolic syndrome is not known, the close relationship between _____ and _____ suggests that obesity is at least partly responsible.

A)type 2 diabetes, heart disease
B)abdominal obesity, insulin resistance
C)type 2 diabetes, insulin resistance
D)abdominal obesity, stroke

Question 67

Women with diabetes who are attempting to become pregnant should be aware that uncontrolled blood glucose can contribute to all of the following except

A)diabetes in the infant.
B)high birthweight of the infant.
C)risk of spontaneous abortion.
D)birth defects.

Question 68

Ruth Ann's doctor can best evaluate long-term diabetic compliance by checking her:

A)fasting blood glucose.
B)urine for ketones.
C)blood pressure.
D)glycated hemoglobin.

Question 69

The prenatal care for women who develop gestational diabetes can include

A)insulin therapy.
B)a high protein intake.
C)a reduced carbohydrate intake.
D)a and b
E)a and c

Question 70

Ruth Ann meets with a registered dietitian and is provided sample menus.A month later she returns for a follow-up: she has gained weight and her blood sugar is still high.Ruth Ann states that she is being compliant.What is the possible cause for the weight gain?

A)Misuse of diabetic medications
B)Incorrect portion size
C)Poor cooking techniques
D)Carbohydrate counting

Question 71

Which one of the following characteristics is not associated with metabolic syndrome?

A)Insulin resistance
B)Hypertension
C)Elevated HDL
D)Elevated triglycerides

Question 72

Fifteen years pass and Ruth Ann is experiencing some visual impairments.Her eye doctor explains that it could be:

A)diabetic nephropathy.
B)diabetic hypoglycemia.
C)diabetic retinopathy.
D)diabetic gastroparesis.

Question 73

Pregnant women who are not from high-risk groups should be screened for diabetes between _____ weeks of gestation.

A)10 and 14
B)19 and 23
C)24 and 28
D)30 and 34

Question 74

Which statement is false?

A)Even a small weight loss (10 to 20 pounds) can improve symptoms of metabolic syndrome.
B)Dietary recommendations for metabolic syndrome include restricting added sugars and refined carbohydrates while emphasizing high-fiber foods such as fruits and vegetables.
C)Increased fatty acid concentrations in the blood are thought to result from obesity and to cause the accumulation of triglycerides in the muscle, liver, and abdomen.
D)Obesity alters hormone levels by increasing secretion of adiponectin and decreasing secretion of resistin.

Question 75

Which of the following statements is true?

A)Pregnancy increases insulin resistance.
B)Uncontrolled diabetes in the early stages of pregnancy increases the risk of miscarriage.
C)Women with gestational diabetes are at high risk of hypotension.
D)a and b
E)a, b, and c