Deck 26: Diabetes Mellitus

Question 1

Diabetic ketoacidosis is characterized by severe ketosis, acidosis, and ____.

A) renal failure
B) hallucinations
C) hyperglycemia
D) myocardial ischemia

Answer 1

C

Question 2

What best describes polydipsia?

A) excessive thirst
B) excessive urination
C) increased glucose in the urine
D) excessive hunger

Answer 2

A

Question 3

Normal fasting plasma glucose levels are approximately ____ mg/dL.

A) 60 to 74
B) 75 to 100
C) 110 to 125
D) 126 to 140

Answer 3

B

Question 4

Which of the following is NOT a feature of type 2 diabetes?

A) insulin resistance
B) autoimmune disease
C) obesity is a causative factor
D) some cases require insulin therapy

Question 5

Which condition is a microvascular complication of diabetes?

A) peripheral vascular disease
B) diabetic retinopathy
C) intermittent claudication
D) hypertriglyceridemia

Question 6

People with type 1 diabetes need exogenous insulin because they ____.

A) have become insulin-resistant
B) have developed hyperinsulinemia
C) no longer synthesize insulin
D) digest insulin with gastrointestinal enzymes

Question 7

The renal threshold is described as ____.

A) a decrease in erythropoietin production because of insulin imbalance
B) nutrient depletion in the renal tubules caused from deficient insulin
C) hemoglobin's exposure to glucose within the kidneys
D) the concentration at which the kidneys begin to pass glucose into the urine

Question 8

The oral glucose tolerance test uses a glucose load of ____ grams.

A) 25
B) 50
C) 75
D) 100

Question 9

Glycosuria usually occurs when plasma glucose concentration exceeds ____ mg/dL.

A) 140
B) 160
C) 180
D) 200

Question 10

A fasting blood glucose level above ____ mg/dL is classified as diabetes.

A) 90
B) 100
C) 116
D) 126

Question 11

Which ethnic population has the lowest relative risk for developing type 2 diabetes?

A) Pacific Islanders
B) Asian Indians
C) European Americans
D) Native Americans

Question 12

Diabetic ketoacidosis can develop when blood glucose is greater than ____ mg/dL.

A) 250
B) 450
C) 650
D) 700

Question 13

About ____ percent of persons with diabetes are unaware that they have it.

A) 7
B) 17
C) 24
D) 37

Question 14

The pancreatic hormone that promotes gluconeogenesis in the liver is ____.

A) glycogen
B) estrogen
C) glucagon
D) leptin

Question 15

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

A) 5 to 10
B) 15 to 25
C) 50 to 75
D) 90 to 95

Question 16

Using the "intensive therapy" approach, blood glucose is monitored at least ____ time(s) a day for people with type 1 diabetes.

A) one
B) two
C) three
D) four

Question 17

What is the standard treatment for hyperosmolar hyperglycemic syndrome?

A) intravenous fluid and electrolyte replacement and insulin therapy
B) intravenous administration of ketones
C) surgical resection of the pancreas
D) a low-carbohydrate, low-fat diet

Question 18

Which is NOT a sign or symptom of diabetic neuropathy?

A) Numbness or tingling in extremities
B) gastroparesis
C) bladder dysfunction
D) diarrhea

Question 19

A blood glucose level between 100 and 125 mg/dL after an 8-hour fast would be classified as ____.

A) impaired fasting glucose
B) hypoglycemia
C) impaired glucose tolerance
D) normal fasting glucose

Question 20

Symptoms of hypoglycemia include ____.

A) sweating and heart palpitations
B) increased thirst and polyuria
C) acetone breath
D) warm, flushed skin

Question 21

Mrs. Barclay has type 2 diabetes and you are preparing her for discharge. She tells you that she loves red beans and rice and knows that she must eliminate them from her diet because they will elevate her blood glucose level. You should explain to her that ____.

A) on a carbohydrate-counting meal plan, these foods in recommended portion sizes can fit within her carbohydrate allowance at meals
B) red beans are eliminated because they are high in complex carbohydrates
C) red beans are high in water-soluble fiber and should be avoided
D) peas are a better choice than red beans

Question 22

As per the carbohydrate-counting meal plan, how many grams of carbohydrates is in a snack that consists of 2 cups of ice cream and a small apple?

A) 60 grams
B) 75 grams
C) 45 grams
D) 15 grams

Question 23

The newborn of a mother with diabetes is at greater risk of which metabolic condition?

A) hypocalcemia
B) sepsis
C) transient tachypnea
D) congenital heart disease

Question 24

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

A) 15 to 20 minutes
B) 30 to 60 minutes
C) 1 to 3 hours
D) 2 to 4 hours

Question 25

Approximately ____ percent of nondiabetic women in the United States develop gestational diabetes.

A) 4 to 14
B) 14 to 24
C) 24 to 34
D) 34 to 44

Question 26

Hemoglobin A _1c can best be described as a(n) ____.

A) by-product of fat metabolism
B) reflection of glycemic control over the preceding 2 to 3 months
C) end-product of protein metabolism formed in the liver
D) summary of hemoglobin rates for type 1 diabetes

Question 27

Women with gestational diabetes are at greater risk of which condition later in life?

A) obesity
B) type 2 diabetes
C) metabolic syndrome
D) chronic kidney disease

Question 28

Insulin is most often administered by ____.

A) subcutaneous injection
B) oral administration
C) intramuscular injection
D) intravenous administration

Question 29

Which antidiabetic drug is classified as a biguanide?

A) acarbose
B) pramlintide
C) metformin
D) nateglinide

Question 30

The goal of diabetes treatment is an HbA _1c value under ____ percent.

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

Question 31

What is an advantage seen with intensive therapy for patients with type 1 diabetes?

A) delayed progression of retinopathy, nephropathy, and neuropathy
B) less weight gain
C) greater stability noted in fructosamine results
D) fewer incidents of severe hypoglycemia

Question 32

Which recommendation is not advised for pregnant women with diabetes?

A) insulin therapy
B) 10% weight loss
C) physical activity
D) low-carbohydrate breakfast

Question 33

What maternal complication has been associated with uncontrolled diabetes during pregnancy?

A) preeclampsia
B) obesity
C) hyperemesis gravidarum
D) miscarriage

Question 34

Hyperglycemia that results from the release of counterregulatory hormones following nighttime hypoglycemia is known as ____.

A) fasting hyperglycemia
B) rebound hyperglycemia
C) dawn phenomenon
D) nocturnal hyperglycemia

Question 35

What test may be used to determine glycemic control over the preceding 2- to 3-week period?

A) fructosamine
B) ketone
C) glucose tolerance
D) insulin antibody

Question 36

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) Oral agents are effective only in type 1 diabetes.
B) His body now stimulates enough insulin to meet his needs.
C) Oral agents suppress insulin release.
D) The oral agents were not effectively controlling his blood glucose levels.

Question 37

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

A) fructose
B) sucrose
C) glucose
D) sucralose

Question 38

Which intervention is most appropriate as part of sick-day management of diabetes?

A) Discontinue all antidiabetic medications and insulin.
B) Measure blood glucose and urine ketones once a day.
C) Discontinue antidiabetic drugs and only use insulin.
D) Consume the usual diet if possible.

Question 39

As per the carbohydrate-counting meal plan, how many grams of carbohydrates is in 2 cups of brown rice and a cup of red beans?

A) 100 grams
B) 120 grams
C) 150 grams
D) 175 grams

Question 40

What is a metabolic effect that may occur with taking thiazolidinediones for glycemic control?

A) fluid retention
B) weight loss
C) allergic skin reactions
D) vitamin B ₁₂ deficiency

Question 41

Which patient would have the most risk factors for gestational diabetes?

A) Rita, who has a prepregnancy body mass index (BMI) of 24
B) Zhu, who just moved to the United States from China
C) Amy, who once had an 8-pound baby
D) Sarah, whose father has diabetes

Question 42

An estimated ____ percent of adults in the United States meet the criteria for metabolic syndrome.

A) 6
B) 12
C) 23
D) 34

Question 43

Which antidiabetic drug is sometimes prescribed for type 2 diabetic women during pregnancy?

A) glimepiride
B) nateglinide
C) repaglinide
D) glyburide

Question 44

56-60. Short Case-Study Questions  
Michael Fern is a 21-year-old college student majoring in electrical engineering. His medical history is unremarkable. He comes to his family doctor for the second time this month because of symptoms of lethargy, fatigue, weight loss, and frequent thirst and urination.
After 6 months, Michael's endocrinologist orders an insulin pump. Which best describes the use of an insulin pump with type 1 diabetes?

A) Hyperglycemia is not a concern with the insulin pump.
B) Hypoglycemia can occur with insulin treatment.
C) Michael does not need to follow a modified diet.
D) Michael no longer needs to worry about exercising.

Question 45

Diagnostic criteria for metabolic syndrome include a fasting plasma glucose of ____ mg/dL or higher.

A) 80
B) 90
C) 100
D) 110

Question 46

Diagnostic criteria for metabolic syndrome include blood pressure of ____ mm Hg or higher.

A) 110/80
B) 130/85
C) 150/90
D) 170/95

Question 47

56-60. Short Case-Study Questions  
Michael Fern is a 21-year-old college student majoring in electrical engineering. His medical history is unremarkable. He comes to his family doctor for the second time this month because of symptoms of lethargy, fatigue, weight loss, and frequent thirst and urination.
The registered dietitian visits with Michael to instruct him on his diabetic diet. What is important for Michael to know about consuming alcohol?

A) He should not consume any alcohol.
B) He should consume food when he ingests alcoholic beverages to avoid hypoglycemia.
C) He should limit his food intake prior to consuming alcohol in order to avoid hyperglycemia.
D) Excessive alcohol intake will likely cause severe hypoglycemia.

Question 48

56-60. Short Case-Study Questions  
Michael Fern is a 21-year-old college student majoring in electrical engineering. His medical history is unremarkable. He comes to his family doctor for the second time this month because of symptoms of lethargy, fatigue, weight loss, and frequent thirst and urination.
Michael is rushed to the hospital after a simple blood test determines a blood glucose of 600 mg/dL. He is most likely suffering from ____.

A) hypoglycemia
B) hyperglycemia
C) dehydration
D) infection

Question 49

Diagnostic criteria for metabolic syndrome include waist circumference of greater than ____ inches in women.

A) 33
B) 35
C) 38
D) 40

Question 50

Inflammation of endothelial tissue, obesity, and insulin resistance can all contribute to blood clots by promoting the increased production of procoagulant proteins such as ____.

A) hirudin
B) fibrinogen
C) dicoumarol
D) andexanet alfa

Question 51

Macrosomia develops as a result of ____.

A) insulin's stimulatory effect on fat synthesis
B) excessive insulin production by the fetal pancreas
C) poor maternal kidney function due to excess glucose
D) the enzymatic glycation of serum proteins

Question 52

56-60. Short Case-Study Questions  
Michael Fern is a 21-year-old college student majoring in electrical engineering. His medical history is unremarkable. He comes to his family doctor for the second time this month because of symptoms of lethargy, fatigue, weight loss, and frequent thirst and urination.
Michael's ketoacidosis leads to a diagnosis of type 1 diabetes. Which medication will Michael need to take to treat his diabetes?

A) sulfonylureas
B) metformin
C) insulin injections
D) alpha-glucosidase inhibitors

Question 53

56-60. Short Case-Study Questions  
Michael Fern is a 21-year-old college student majoring in electrical engineering. His medical history is unremarkable. He comes to his family doctor for the second time this month because of symptoms of lethargy, fatigue, weight loss, and frequent thirst and urination.
Michael has been diagnosed with diabetic ketoacidosis. In addition to severely elevated blood glucose levels, what other symptom is associated with this condition?

A) fruity odor on the breath
B) fluid retention
C) high blood pressure
D) vision loss

Question 54

Regina is at her first prenatal visit after recently discovering that she is pregnant. She is a low-risk patient with no history of diabetes. At what point will her physician test Regina for gestational diabetes?

A) 12 to 15 weeks
B) 16 to 20 weeks
C) 24 to 28 weeks
D) 29 to 32 weeks

Question 55

Diagnostic criteria for metabolic syndrome include high-density lipoprotein (HDL) levels of less than ____ mg/dL in men.

A) 30
B) 35
C) 40
D) 50

Question 56

Diagnostic criteria for metabolic syndrome include very-low-density lipoprotein (VLDL) levels of ____ mg/dL or higher.

A) 100
B) 125
C) 150
D) 175

Question 57

Emily has gestational diabetes and a BMI of 33. What nutrition recommendation should be made for Emily for weight control during her pregnancy?

A) Strive to lose 11 to 14 lb by the end of her pregnancy.
B) Increase carbohydrate intake to 55 to 60% of total energy.
C) Reduce kcalorie intake by 30% to slow further weight gain.
D) Continue with a normal diet and strive to lose weight after pregnancy.

Question 58

How does obesity lead to the development of hypertriglyceridemia?

A) Insulin causes adipose cells to store more triglycerides.
B) HDL competes with VLDL for cholesterol binding sites.
C) The liver produces more VLDL in response to fatty acids released by insulin-resistant adipose cells.
D) Fatty acids in the bloodstream resist excretion by HDL.

Question 59

The hyperinsulinemia that typically accompanies obesity promotes sodium reabsorption in the kidneys, resulting in fluid retention and ____.

A) increased abdominal obesity
B) hypertension
C) atherosclerosis
D) hypertriglyceridemia

Question 60

What dietary recommendation is advised for individuals with hypertriglyceridemia?

A) Reduce intake of added sugars and refined grain products.
B) Decrease sodium intake and improve intake of dairy products.
C) E liminate polyunsaturated fatty acids in the diet.
D) Reduce kcalorie intake by 45% daily.

Question 61

61-65. Short Case Study Questions  
Ruth Ann Glebowski is a 40-year-old woman. She has a medical history of gestational diabetes, high cholesterol, hypothyroidism, and depression. She is 5 ft 4 in. tall and weighs 190 lb. Recently she has made an appointment with her physician since she has been having excessive hunger and frequent urination.
Ruth Ann's doctor can best evaluate long-term diabetic compliance by checking her ____.

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

Question 63

Illustrate the acute complications of uncontrolled diabetes.

Question 64

Discuss how the intakes of protein, carbohydrate, fat, sodium, and alcohol are modified for a patient with diabetes.

Question 65

Discuss sick-day management for people with diabetes.

Question 66

Compare and contrast conventional and intensive therapies for type 1 diabetic patients, including the advantages and disadvantages of each.

Question 67

Discuss how diabetes develops as a consequence of pregnancy and the potential consequences for both mother and fetus.

Question 68

Describe the criteria that are currently used to diagnose diabetes.

Question 69

Describe the variations in insulin preparations available for the treatment of diabetes.

Question 70

Explain the relationship of body weight and type 2 diabetes.

Question 71

61-65. Short Case Study Questions  
Ruth Ann Glebowski is a 40-year-old woman. She has a medical history of gestational diabetes, high cholesterol, hypothyroidism, and depression. She is 5 ft 4 in. tall and weighs 190 lb. Recently she has made an appointment with her physician since she has been having excessive hunger and frequent urination.
In addition to anti-diabetic medications, what can Ruth Ann do to help control her blood glucose?

A) lose weight
B) try a high-fat diet
C) take calcium supplements
D) start glucagon injections

Question 72

61-65. Short Case Study Questions  
Ruth Ann Glebowski is a 40-year-old woman. She has a medical history of gestational diabetes, high cholesterol, hypothyroidism, and depression. She is 5 ft 4 in. tall and weighs 190 lb. Recently she has made an appointment with her physician since she has been having excessive hunger and frequent urination.
Ruth Ann meets with a registered dietitian and is educated on carbohydrate counting for meal planning. Which of the following snacks would be appropriate if she is allowed 30 grams of carbohydrates?

A) A small apple and 4 sandwich cream-cookies
B) A small granola bar and a medium peach
C) 1 English muffin with a tablespoon of butter and 3 chocolate kisses
D) 2 slices of bread and 2 tablespoons of grape jelly

Question 73

Describe the different methods of insulin delivery available to people with diabetes.

Question 74

Describe the different types of neuropathy that may develop in patients with diabetes.

Question 75

61-65. Short Case Study Questions  
Ruth Ann Glebowski is a 40-year-old woman. She has a medical history of gestational diabetes, high cholesterol, hypothyroidism, and depression. She is 5 ft 4 in. tall and weighs 190 lb. Recently she has made an appointment with her physician since she has been having excessive hunger and frequent urination.
Fifteen years pass and Ruth Ann is experiencing some visual impairments. Her eye doctor explains that it could be diabetic ______________

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

Question 76

61-65. Short Case Study Questions  
Ruth Ann Glebowski is a 40-year-old woman. She has a medical history of gestational diabetes, high cholesterol, hypothyroidism, and depression. She is 5 ft 4 in. tall and weighs 190 lb. Recently she has made an appointment with her physician since she has been having excessive hunger and frequent urination.
Ruth Ann is diagnosed with type 2 diabetes. Which factors puts her at increased risk for diabetes?

A) Weight and gestational diabetes
B) Depression and middle age
C) high cholesterol and hypothyroidism
D) Hypothyroidism