Deck 26: Diabetes Mellitus

Question 1

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

Answer 1

D

Question 2

Which intervention would most likely contribute to prevention of type 2 diabetes?

A)sustained weight loss of 1 to 4 percent of body weight
B)routine monitoring for diabetes at least once per year
C)at least 90 minutes of moderate-intensity exercise per week
D)increased intake of whole grains, red wine, and unsaturated fats

Answer 2

B

Question 3

What is a sign or symptom of diabetic neuropathy?

A)pain or burning in the feet
B)blurred vision
C)reduced urine output
D)diarrhea

Answer 3

A

Question 4

Glycosuria usually occurs when blood glucose exceeds ____ mg/dL.

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

Question 5

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

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

Question 6

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 7

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 8

Symptoms of hypoglycemia include ____.

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

Question 9

What is the standard treatment for hyperosmolar hyperglycemic syndrome?

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

Question 10

What best describes polydipsia?

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

Question 11

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

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

Question 12

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

A)7
B)17
C)28
D)37

Question 13

The pancreatic hormone that promotes glucose production in the liver is ____.

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

Question 14

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

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

Question 15

Which condition is a microvascular complication of diabetes?

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

Question 16

Ketoacidosis is characterized by severe acidosis and ____.

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

Question 17

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

Question 18

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

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

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

Question 20

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

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

Question 21

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

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

Question 22

Insulin is most often administered by ____.

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

Question 23

Hemoglobin A_1c 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 24

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 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 25

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

A)fluid retention
B)weight loss
C)allergic skin reactions
D)vitamin B₁₂ deficiency

Question 26

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 only effective 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 controlling his blood glucose.

Question 27

What 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 28

Which antidiabetic drug is classified as a biguanide?

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

Question 29

Which recommendation is not advised for pregnant women with diabetes?

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

Question 30

Hector Martinez is a 70-year-old Hispanic man recently diagnosed with type 2 diabetes. He is having difficulty understanding the exchange system and has limited financial resources. Which strategy is most likely to help him control his diabetes?

A)Emphasize how important it is to follow only the exchange list.
B)Try an alternate diet approach that might be more successful.
C)Give him a printed exchange list of traditional Hispanic foods.
D)Encourage him to join a spa and exercise.

Question 31

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

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

Question 32

What is an advantage seen with intensive glucose monitoring therapy?

A)delayed progression of retinopathy and neuropathy
B)improved weight control
C)greater stability noted in fructosamine results
D)decreased cost when compared to conventional therapy

Question 33

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 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 maternal complication has been associated with diabetes in pregnancy? ​

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

Question 36

Approximately ____ percent of people diagnosed with type 2 diabetes benefit from insulin therapy.

A)20
B)30
C)50
D)75

Question 37

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

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

Question 38

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 39

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

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

Question 40

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

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

Question 41

Which antidiabetic drug has been shown to be safe to use during pregnancy? ​

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

Question 42

Michael Fern is a 21-year-old college student majoring in electrical engineering. His past medical history is unremarkable. He comes back to his family doctor for the second time this month due to 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 it 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 43

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)12-16 weeks
B)16-20 weeks
C)24-28 weeks
D)28-32 weeks

Question 44

Michael Fern is a 21-year-old college student majoring in electrical engineering. His past medical history is unremarkable. He comes back to his family doctor for the second time this month due to 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 45

Michael Fern is a 21-year-old college student majoring in electrical engineering. His past medical history is unremarkable. He comes back to his family doctor for the second time this month due to 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 46

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)fibronectin
C)dicoumarol
D)andexanet alfa

Question 47

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

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

Question 48

What describes the relationship of obesity and hypertriglyceridemia?

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

Question 49

Michael Fern is a 21-year-old college student majoring in electrical engineering. His past medical history is unremarkable. He comes back to his family doctor for the second time this month due to 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 50

What dietary recommendation is advised for individuals with hypertriglyceridemia? ​

A)​R educe intake of added sugars and refined grain products.
B)​D ecrease sodium intake and improve intake of dairy products.
C)​E liminate polyunsaturated fatty acids in the diet.
D)​R educe kcalorie intake by 45 percent daily.

Question 51

Diagnostic criteria for metabolic syndrome include HDL levels of less than ____ mg/dL in men.

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

Question 52

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

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

Question 53

Diagnostic criteria for metabolic syndrome include VLDL levels of ____ mg/dL or higher.

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

Question 54

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

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

Question 55

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

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

Question 56

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 57

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 58

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

A)​S trive to lose 11 to 14 pounds by the end of her pregnancy.
B)​I ncrease carbohydrate intake to 55 to 60 percent of total energy.
C)​R educe kcalorie intake by 30 percent to slow further weight gain.
D)​C ontinue with a normal diet and strive to lose weight after pregnancy.

Question 59

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

A)Rita, who has a prepregnancy 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 type 1 diabetes

Question 60

Michael Fern is a 21-year-old college student majoring in electrical engineering. His past medical history is unremarkable. He comes back to his family doctor for the second time this month due to 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)sulfonyureas
B)metformin
C)insulin injections
D)alpha-glucosidase inhibitors

Question 62

Ruth Ann Glebowski is an active 68 year old. She has a past medical history of gestational diabetes, high cholesterol, hypothyroidism, and depression. She is 5 feet 4 inches tall and weighs 170 pounds. She has an appointment with her physician for her annual check-up. What can Ruth Ann do to help control her blood glucose?

A)lose weight
B)try a low-carbohydrate diet
C)take chromium supplements
D)start glucagon injections

Question 68

Ruth Ann Glebowski is an active 68 year old. She has a past medical history of gestational diabetes, high cholesterol, hypothyroidism, and depression. She is 5 feet 4 inches tall and weighs 170 pounds. She has an appointment with her physician for her annual check-up. 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 70

Ruth Ann Glebowski is an active 68 year old. She has a past medical history of gestational diabetes, high cholesterol, hypothyroidism, and depression. She is 5 feet 4 inches tall and weighs 170 pounds. She has an appointment with her physician for her annual check-up. 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 76

Ruth Ann Glebowski is an active 68 year old. She has a past medical history of gestational diabetes, high cholesterol, hypothyroidism, and depression. She is 5 feet 4 inches tall and weighs 170 pounds. She has an appointment with her physician for her annual check-up. 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 77

Ruth Ann Glebowski is an active 68 year old. She has a past medical history of gestational diabetes, high cholesterol, hypothyroidism, and depression. She is 5 feet 4 inches tall and weighs 170 pounds. She has an appointment with her physician for her annual check-up. Ruth Ann is diagnosed with type 2 diabetes. Which risk factor puts her at risk?

A)weight
B)depression
C)high cholesterol
D)hypothyroidism