Deck 20: Nutrition and Diabetes Mellitus

Question 1

Routine checks for microalbuminuria help to determine whether diabetes is affecting the eyes.​

Answer 1

False

Question 2

Close monitoring of glucose levels is especially important for the pregnant woman with diabetes.​

Answer 2

True

Question 3

Prediabetes is diagnosed when a person has a fasting blood glucose level that falls between 100 and 125 mg/dL.​

Answer 3

True

Question 4

When the plasma glucose concentration rises above about _____ mg/dL, it exceeds the renal threshold, the concentration at which the kidneys begin to pass glucose into the urine.​

A) ​60
B) ​120
C) ​140
D) ​175
E) ​200

Question 5

Clinical trials have demonstrated that intensive treatment can keep blood glucose levels tightly controlled and reduce the incidence and severity of the chronic complications of diabetes.​

Question 6

Claudication is a symptom of diabetes that often develops because of polyuria.​

Question 7

Diabetes mellitus describes a group of metabolic disorders characterized by _____.​

A) ​elevated blood glucose
B) ​low hemoglobin
C) ​accelerated intestinal transit
D) ​lactose intolerance
E) ​poor iron absorption

Question 8

In severe cases of diabetic ketoacidosis, blood glucose levels can exceed 1000 mg/dL.​

Question 9

Development of type 2 diabetes is closely associated with overweight and obesity.​

Question 10

The hyperosmolar hyperglycemic syndrome is usually a complication of type 2 diabetes.​

Question 11

Which is a symptom of diabetes mellitus?​

A) ​High blood pressure
B) ​Blurred vision
C) ​Edema
D) ​Mouth sores
E) ​Hair loss

Question 12

Obesity alone can cause some degree of insulin resistance.​

Question 13

Physical activity has not been shown to aid blood glucose control in people with type 1 diabetes.​

Question 14

Excessive urine production is known as _____.​

A) ​polydipsia
B) ​polyuria
C) ​ketonuria
D) ​glycosuria
E) ​polyphagia

Question 15

Acetone breath is a characteristic symptom of hypoglycemia.​

Question 16

Chronic complications of diabetes typically affect the blood vessels and the bones.​

Question 17

Both the blood and the urine can be checked for the presence of ketones.​

Question 18

The primary cause of type 2 diabetes is autoimmune destruction of the beta cells in the pancreas.​

Question 19

If a person does not produce sufficient insulin, he is more likely to develop _____.​

A) ​hyperglycemia
B) ​poor appetite
C) ​low albumin levels
D) ​hypoglycemia
E) ​ketoacidosis

Question 20

It is appropriate for clients diagnosed with type 2 diabetes to take oral antidiabetic agents and forego recommended dietary changes.​

Question 21

The recommended carbohydrate intake for adults with diabetes is _____ percent of total kcalories.​

A) ​10 to 20
B) ​15 to 30
C) ​35 to 40
D) ​45 to 65
E) ​75 to 80

Question 22

A patient with diabetes is allowed 60 grams of carbohydrate for lunch. This equals _____ portions of carbohydrate foods.​

A) ​2
B) ​3
C) ​4
D) ​5
E) ​6

Question 23

An appropriate goal for HbA1C in adult diabetic patients is _____.​

A) ​<5%
B) ​>6%
C) ​<7%
D) ​<8%
E) ​<9%

Question 24

Type 2 diabetes often goes undiagnosed in overweight children and teens because _____.​

A) ​their glucose levels vary with their stage of growth
B) ​there are frequently no symptoms
C) ​blood glucose tests are not accurate in children and teens
D) ​their lifestyles are not conducive to screening for the disease
E) ​they have other nutrient deficiencies that mask their symptoms

Question 25

By the time symptoms of type 1 diabetes develop, damage to the beta cells has often occurred and the first sign of the disease is _____.​

A) ​ketoacidosis
B) ​hypoglycemia
C) ​high blood lipids
D) ​microalbuminuria
E) ​elevated hemoglobin A1C

Question 26

Hyperosmolar hyperglycemic syndrome leads to profoundly high levels of blood glucose, mainly due to _____.​

A) ​insulin resistance
B) ​inappropriate glucagon production
C) ​increased urine output
D) ​dehydration
E) ​vitamin K deficiency

Question 27

In diabetic nephropathy, damage to the kidneys' specialized capillaries prevents adequate blood filtration, resulting in _____.​

A) ​ketonuria
B) ​elevated blood glucose levels
C) ​polyuria
D) ​an increase in nitrogenous waste excretion
E) ​albuminuria

Question 28

Which insulin has the longest duration of action?​

A) ​Glulisine
B) ​Regular
C) ​NPH
D) ​Aspart
E) ​Detemir

Question 29

What describes the basic principles of carbohydrate counting to plan a diabetic diet?​

A) ​The patient follows a set schedule of when to eat.
B) ​The patient can have most carbohydrates but must avoid artificial sweeteners.
C) ​The patient can eat when he wants but must only eat certain foods.
D) ​The patient has freedom to choose foods based on preference.
E) ​The patient must count carbohydrates but typically has few limits on fat and protein intake.

Question 30

Good glycemic control requires _____.​

A) ​eating small amounts of food
B) ​restricting carbohydrate in the diet
C) ​self-monitoring of blood glucose
D) ​frequent visits to the doctor
E) ​reduced physical activity and exercise

Question 31

The diet for diabetes should provide less than _____ milligrams of cholesterol per day.​

A) ​100
B) ​200
C) ​300
D) ​400
E) ​500

Question 32

What food represents one 15 g portion of a carbohydrate for a diabetic patient?​

A) ​3 oz of yogurt
B) ​2 slices of bread
C) ​1 cup cooked pasta
D) ​1 large baked potato
E) ​½ cup of ice cream

Question 33

What type of insulin has the most rapid onset of action?​

A) ​Lispro
B) ​Regular
C) ​Lente
D) ​NPH
E) ​Glargine

Question 34

The fructosamine test is used to determine _____.​

A) ​average blood glucose over the preceding 120 days
B) ​the average amount of urinary protein
C) ​the level of fructose in the blood
D) ​the presence of ketones in the blood
E) ​glycemic control for the preceding two weeks

Question 35

A disadvantage of intensive therapy for type 1 diabetes is _____.​

A) ​a greater risk of severe hypoglycemia
B) ​greater expense due to lack of insurance reimbursement
C) ​fewer incidences of severe hypoglycemia
D) ​more rapid progression of chronic complications
E) ​an increased risk of weight loss and wasting

Question 36

Type 1 diabetes accounts for ____ percent of diabetes cases.​

A) ​1 to 5
B) ​5 to 10
C) ​12 to 15
D) ​18 to 20
E) ​25 to 30

Question 37

Diabetic ketoacidosis is most likely manifested as _____.​

A) ​blood pH over 7.45
B) ​ketonuria
C) ​blood glucose levels less than 80 mg/dL
D) ​heart rate over 110 bpm
E) ​musty breath odor

Question 38

Type 2 diabetes is most closely associated with _____.​

A) ​autoimmune diseases
B) ​environmental toxins
C) ​destruction of pancreatic beta cells
D) ​viral infection
E) ​insulin resistance

Question 39

The leading cause of death in people with diabetes is _____.​

A) ​cardiovascular disease
B) ​infection
C) ​injury
D) ​stroke
E) ​cancer

Question 40

In treated diabetes, hypoglycemia is a possible complication of _____.​

A) ​overeating
B) ​insulin deficiency
C) ​eating too many carbohydrates
D) ​inappropriate disease management
E) ​fluid overload

Question 41

Jared Joiner is a 56-year-old African American insurance agent. He is single, eats most meals at restaurants, and leads a sedentary lifestyle. He is 5'9" tall and weighs 204 pounds. Mr. Joiner has been feeling particularly fatigued lately and decided to make an appointment with his physician for a check-up. The results of his laboratory tests include a fasting blood glucose level of 121 mg/dL.
How many of his risk factors for type 2 diabetes can Mr. Joiner control?​

A) ​0
B) ​1
C) 2​
D) ​3
E) ​4

Question 42

​The nurse recognizes that the diabetic client understands the principles of her diet when she states _____.

A) ​"I need to restrict my carbohydrate intake and avoid concentrated sweets"
B) ​"I need to first lose weight before making changes in my carbohydrate intake"
C) ​"I need to eat about the same amount of carbohydrate at about the same time each day"
D) ​"I need to restrict my carbohydrate and fat intakes, but increase my protein intake"
E) ​"I need to severely limit my fat intake and choose only complex carbohydrates"

Question 43

A 60-year-old client, Mr. Hummel, has had type 2 DM for several years. Because of a change in insurance coverage, Mr. Hummel changes doctors and at his first appointment, a comprehensive medical exam and dietary history are performed. At the next few appointments, the certified diabetes educator, a registered dietitian, takes a full dietary history.
Mr. Hummel works part-time in a seasonal sporting goods store, having retired last year after 35 years working for a manufacturing plant as a supervisor. He is married to a nurse who works full-time. He does most of the cooking and grocery shopping. He and his wife go for walks on weekends, but he does not exercise otherwise, except for doing chores around the house and occasional yard work or gardening. He is 5'9" tall and weighs 200 lbs., though when his diabetes was initially diagnosed, he weighed more.
Mr. Hummel is interested in weight reduction, especially if it will help him manage his blood glucose, and provides the following 24-hour food recall that typifies how he usually eats:
Breakfast (eats after taking morning blood glucose): Pancakes with diet syrup or a bowl of cereal (usually corn flakes, Chex, or instant oatmeal) with Sweet 'N' Low and nonfat milk. Drinks coffee throughout the day starting at breakfast with 2 nondairy coffee creamer packets per cup. May or may not have 4 oz. of 100% fruit juice depending on hunger.
Lunch (eats after taking afternoon blood glucose): Sandwich (rye or wheat bread), deck of cards-size portion of lunch meat (salami, ham, bologna, turkey, or chicken) with thinly spread mayonnaise; coffee with nondairy creamers. May or may not eat a can of soup (cream of tomato, cream of chicken, or Italian wedding soup) instead of a sandwich, with two slices of buttered rye or wheat bread.
Afternoon Snack: Canned fruit or occasionally a cookie, doughnut, a piece of pizza, or a treat, depending on availability, hunger, blood sugar, and situation. Drinks coffee with nondairy coffee creamer. Usually also has a glass of ice water before dinner.
Dinner (eats after taking evening blood glucose): Roast beef, meat loaf, steak, or another red meat; occasionally eats poultry or fish-approximate amount 8 oz.; plain baked potato, au gratin potatoes, or boiled buttered potatoes; a salad with bottled salad dressing or a vegetable, such as canned green beans; and a slice of rye or wheat bread with butter. May use ketchup, steak sauce, salt, and pepper. Drinks water with dinner.
Evening Snack: Varies-may eat a few handfuls of a bagged snack food, such as Doritos; a bag of buttered microwave popcorn; or cookies.
Labs are as follows:
Fasting glucose: 140-150 mg/dL
Glucose one to two hours after mealtime: 200 mg/dL
Average bedtime glucose: 152 mg/dL
Glycosylated hemoglobin (hemoglobin A1C): 7.5%
Mr. Hummel's BMI indicates he is _____, which likely affects his blood glucose control.​

A) ​underweight
B) ​at his healthy weight
C) ​normal, with increased muscle tissue
D) ​overweight
E) ​obese

Question 44

Metabolic syndrome consists of a cluster of disorders that increases the risk of developing _____.​

A) ​diabetes
B) ​cardiovascular disease
C) ​gout
D) ​renal failure
E) ​COPD

Question 45

A 60-year-old client, Mr. Hummel, has had type 2 DM for several years. Because of a change in insurance coverage, Mr. Hummel changes doctors and at his first appointment, a comprehensive medical exam and dietary history are performed. At the next few appointments, the certified diabetes educator, a registered dietitian, takes a full dietary history.
Mr. Hummel works part-time in a seasonal sporting goods store, having retired last year after 35 years working for a manufacturing plant as a supervisor. He is married to a nurse who works full-time. He does most of the cooking and grocery shopping. He and his wife go for walks on weekends, but he does not exercise otherwise, except for doing chores around the house and occasional yard work or gardening. He is 5'9" tall and weighs 200 lbs., though when his diabetes was initially diagnosed, he weighed more.
Mr. Hummel is interested in weight reduction, especially if it will help him manage his blood glucose, and provides the following 24-hour food recall that typifies how he usually eats:
Breakfast (eats after taking morning blood glucose): Pancakes with diet syrup or a bowl of cereal (usually corn flakes, Chex, or instant oatmeal) with Sweet 'N' Low and nonfat milk. Drinks coffee throughout the day starting at breakfast with 2 nondairy coffee creamer packets per cup. May or may not have 4 oz. of 100% fruit juice depending on hunger.
Lunch (eats after taking afternoon blood glucose): Sandwich (rye or wheat bread), deck of cards-size portion of lunch meat (salami, ham, bologna, turkey, or chicken) with thinly spread mayonnaise; coffee with nondairy creamers. May or may not eat a can of soup (cream of tomato, cream of chicken, or Italian wedding soup) instead of a sandwich, with two slices of buttered rye or wheat bread.
Afternoon Snack: Canned fruit or occasionally a cookie, doughnut, a piece of pizza, or a treat, depending on availability, hunger, blood sugar, and situation. Drinks coffee with nondairy coffee creamer. Usually also has a glass of ice water before dinner.
Dinner (eats after taking evening blood glucose): Roast beef, meat loaf, steak, or another red meat; occasionally eats poultry or fish-approximate amount 8 oz.; plain baked potato, au gratin potatoes, or boiled buttered potatoes; a salad with bottled salad dressing or a vegetable, such as canned green beans; and a slice of rye or wheat bread with butter. May use ketchup, steak sauce, salt, and pepper. Drinks water with dinner.
Evening Snack: Varies-may eat a few handfuls of a bagged snack food, such as Doritos; a bag of buttered microwave popcorn; or cookies.
Labs are as follows:
Fasting glucose: 140-150 mg/dL
Glucose one to two hours after mealtime: 200 mg/dL
Average bedtime glucose: 152 mg/dL
Glycosylated hemoglobin (hemoglobin A1C): 7.5%
Mr. Hummel had been taking oral hypoglycemic agents for three months prior to this visit. Based on his _____ measurement, his glycemic control over this period needed improvement.​

A) ​glycemic index
B) ​hemoglobin A1C
C) ​weight
D) ​fasting glucose
E) ​post-prandial glucose

Question 46

Which group of symptoms is characteristic of the metabolic syndrome?​

A) ​insulin resistance, abdominal obesity, reduced HDL cholesterol levels
B) ​hypertension, hypoglycemia, abdominal obesity
C) ​elevated liver enzymes, insulin resistance, microalbuminuria
D) ​polyuria, polydipsia, polyphagia
E) ​urinary retention, excess sweating, edema

Question 47

Jared Joiner is a 56-year-old African American insurance agent. He is single, eats most meals at restaurants, and leads a sedentary lifestyle. He is 5'9" tall and weighs 204 pounds. Mr. Joiner has been feeling particularly fatigued lately and decided to make an appointment with his physician for a check-up. The results of his laboratory tests include a fasting blood glucose level of 121 mg/dL.
The simplest and most flexible approach to teaching Mr. Joiner the principles of the diet for optimal management of his blood glucose level is _____.​

A) ​carbohydrate counting
B) ​the exchange lists
C) ​MyPlate
D) ​a high-protein diet plan
E) ​portion control

Question 48

Jared Joiner is a 56-year-old African American insurance agent. He is single, eats most meals at restaurants, and leads a sedentary lifestyle. He is 5'9" tall and weighs 204 pounds. Mr. Joiner has been feeling particularly fatigued lately and decided to make an appointment with his physician for a check-up. The results of his laboratory tests include a fasting blood glucose level of 121 mg/dL.
What recommendation to help Mr. Joiner reduce his risk of developing diabetes is most likely to be effective?​

A) ​"Lose about 20 percent of your current body weight."
B) ​"Increase your physical activity."
C) ​"Choose low-sodium foods at restaurants."
D) ​"Learn to cook."
E) ​"Try to decrease your waist measurement by 6 inches."

Question 49

Women with gestational diabetes who are overweight or obese should be encouraged to _____.​

A) ​engage in vigorous exercise
B) ​adjust carbohydrate intake to 40-45 percent of daily kcalories
C) ​increase fluid intake to offset additional kcalories
D) ​limit protein intake to 5 percent of daily kcalories
E) ​lose weight through kcalorie reduction

Question 50

Sam is an African-American male who is obese and has a family history of diabetes. The nurse recognizes that Sam has _____ of the major risk factors for type 2 diabetes.​

A) ​0
B) ​1
C) ​2
D) ​3
E) ​4

Question 51

Those taking _____ should avoid excessive alcohol intake because it may interact with these drugs to cause lactic acidosis.​

A) ​alpha-glucosidase inhibitors
B) ​sulfonylureas
C) ​thiazolidinediones
D) ​biguanides
E) ​meglitinides

Question 52

Though the exact cause of metabolic syndrome is unknown, it is believed to be associated with _____.​

A) ​poverty
B) ​chronic kidney disease
C) ​hypoglycemia
D) ​liver disease
E) ​obesity

Question 53

A patient with diabetes asks the nurse for ice cream. The nurse is aware that this will count as a carbohydrate portion and the amount that equals 1 portion is _____.​

A) ​1/4 cup
B) ​1/3 cup
C) ​1/2 cup
D) ​1 cup
E) ​2 cups

Question 54

Uncontrolled diabetes during pregnancy is most likely linked to what complication?​

A) Prematurity​
B) ​Infant macrosomia
C) ​Placental abruption
D) ​Uterine prolapse
E) ​Placenta previa

Question 55

The mode of action of sulfonylureas is to _____.​

A) ​stimulate insulin secretion by the pancreas
B) ​decrease insulin resistance
C) ​improve glucose utilization
D) ​delay carbohydrate digestion and absorption
E) ​delay stomach emptying

Question 56

A 60-year-old client, Mr. Hummel, has had type 2 DM for several years. Because of a change in insurance coverage, Mr. Hummel changes doctors and at his first appointment, a comprehensive medical exam and dietary history are performed. At the next few appointments, the certified diabetes educator, a registered dietitian, takes a full dietary history.
Mr. Hummel works part-time in a seasonal sporting goods store, having retired last year after 35 years working for a manufacturing plant as a supervisor. He is married to a nurse who works full-time. He does most of the cooking and grocery shopping. He and his wife go for walks on weekends, but he does not exercise otherwise, except for doing chores around the house and occasional yard work or gardening. He is 5'9" tall and weighs 200 lbs., though when his diabetes was initially diagnosed, he weighed more.
Mr. Hummel is interested in weight reduction, especially if it will help him manage his blood glucose, and provides the following 24-hour food recall that typifies how he usually eats:
Breakfast (eats after taking morning blood glucose): Pancakes with diet syrup or a bowl of cereal (usually corn flakes, Chex, or instant oatmeal) with Sweet 'N' Low and nonfat milk. Drinks coffee throughout the day starting at breakfast with 2 nondairy coffee creamer packets per cup. May or may not have 4 oz. of 100% fruit juice depending on hunger.
Lunch (eats after taking afternoon blood glucose): Sandwich (rye or wheat bread), deck of cards-size portion of lunch meat (salami, ham, bologna, turkey, or chicken) with thinly spread mayonnaise; coffee with nondairy creamers. May or may not eat a can of soup (cream of tomato, cream of chicken, or Italian wedding soup) instead of a sandwich, with two slices of buttered rye or wheat bread.
Afternoon Snack: Canned fruit or occasionally a cookie, doughnut, a piece of pizza, or a treat, depending on availability, hunger, blood sugar, and situation. Drinks coffee with nondairy coffee creamer. Usually also has a glass of ice water before dinner.
Dinner (eats after taking evening blood glucose): Roast beef, meat loaf, steak, or another red meat; occasionally eats poultry or fish-approximate amount 8 oz.; plain baked potato, au gratin potatoes, or boiled buttered potatoes; a salad with bottled salad dressing or a vegetable, such as canned green beans; and a slice of rye or wheat bread with butter. May use ketchup, steak sauce, salt, and pepper. Drinks water with dinner.
Evening Snack: Varies-may eat a few handfuls of a bagged snack food, such as Doritos; a bag of buttered microwave popcorn; or cookies.
Labs are as follows:
Fasting glucose: 140-150 mg/dL
Glucose one to two hours after mealtime: 200 mg/dL
Average bedtime glucose: 152 mg/dL
Glycosylated hemoglobin (hemoglobin A1C): 7.5%
The CDE teaches Mr. Hummel how to reduce his kcalories by increasing high-fiber foods in place of foods such as bagged snack chips. A higher intake of fiber could also _____.​

A) ​increase his glycemic control
B) ​increase the glycemic index of his diet
C) ​increase his glycosylated hemoglobin
D) ​increase his blood glucose
E) ​increase his bedtime glucose levels

Question 57

Jared Joiner is a 56-year-old African American insurance agent. He is single, eats most meals at restaurants, and leads a sedentary lifestyle. He is 5'9" tall and weighs 204 pounds. Mr. Joiner has been feeling particularly fatigued lately and decided to make an appointment with his physician for a check-up. The results of his laboratory tests include a fasting blood glucose level of 121 mg/dL.
Four months after his initial exam, Mr. Joiner returns to his physician for a follow-up appointment. He has lost 10 pounds, but his fasting blood glucose level is now 131 mg/dL. Mr. Joiner's prediabetes has progressed to _____.​

A) ​type 1 diabetes
B) ​type 2 diabetes
C) ​gestational diabetes
D) ​hyperosmolar hyperglycemic syndrome
E) ​impaired glucose tolerance

Question 58

Jared Joiner is a 56-year-old African American insurance agent. He is single, eats most meals at restaurants, and leads a sedentary lifestyle. He is 5'9" tall and weighs 204 pounds. Mr. Joiner has been feeling particularly fatigued lately and decided to make an appointment with his physician for a check-up. The results of his laboratory tests include a fasting blood glucose level of 121 mg/dL.
Mr. Joiner's blood glucose level meets the criteria for a diagnosis of _____.​

A) ​type 1 diabetes
B) ​type 2 diabetes
C) ​prediabetes
D) ​ketoacidosis
E) ​impaired glycemic control

Question 59

The progression of metabolic syndrome is worsened by _____.​

A) ​a sedentary lifestyle
B) ​a low-carbohydrate diet
C) ​low blood lipids
D) ​drug therapy
E) ​caffeine intake

Question 60

A 60-year-old client, Mr. Hummel, has had type 2 DM for several years. Because of a change in insurance coverage, Mr. Hummel changes doctors and at his first appointment, a comprehensive medical exam and dietary history are performed. At the next few appointments, the certified diabetes educator, a registered dietitian, takes a full dietary history.
Mr. Hummel works part-time in a seasonal sporting goods store, having retired last year after 35 years working for a manufacturing plant as a supervisor. He is married to a nurse who works full-time. He does most of the cooking and grocery shopping. He and his wife go for walks on weekends, but he does not exercise otherwise, except for doing chores around the house and occasional yard work or gardening. He is 5'9" tall and weighs 200 lbs., though when his diabetes was initially diagnosed, he weighed more.
Mr. Hummel is interested in weight reduction, especially if it will help him manage his blood glucose, and provides the following 24-hour food recall that typifies how he usually eats:
Breakfast (eats after taking morning blood glucose): Pancakes with diet syrup or a bowl of cereal (usually corn flakes, Chex, or instant oatmeal) with Sweet 'N' Low and nonfat milk. Drinks coffee throughout the day starting at breakfast with 2 nondairy coffee creamer packets per cup. May or may not have 4 oz. of 100% fruit juice depending on hunger.
Lunch (eats after taking afternoon blood glucose): Sandwich (rye or wheat bread), deck of cards-size portion of lunch meat (salami, ham, bologna, turkey, or chicken) with thinly spread mayonnaise; coffee with nondairy creamers. May or may not eat a can of soup (cream of tomato, cream of chicken, or Italian wedding soup) instead of a sandwich, with two slices of buttered rye or wheat bread.
Afternoon Snack: Canned fruit or occasionally a cookie, doughnut, a piece of pizza, or a treat, depending on availability, hunger, blood sugar, and situation. Drinks coffee with nondairy coffee creamer. Usually also has a glass of ice water before dinner.
Dinner (eats after taking evening blood glucose): Roast beef, meat loaf, steak, or another red meat; occasionally eats poultry or fish-approximate amount 8 oz.; plain baked potato, au gratin potatoes, or boiled buttered potatoes; a salad with bottled salad dressing or a vegetable, such as canned green beans; and a slice of rye or wheat bread with butter. May use ketchup, steak sauce, salt, and pepper. Drinks water with dinner.
Evening Snack: Varies-may eat a few handfuls of a bagged snack food, such as Doritos; a bag of buttered microwave popcorn; or cookies.
Labs are as follows:
Fasting glucose: 140-150 mg/dL
Glucose one to two hours after mealtime: 200 mg/dL
Average bedtime glucose: 152 mg/dL
Glycosylated hemoglobin (hemoglobin A1C): 7.5%
Which macronutrient distribution is appropriate for Mr. Hummel's daily diet?​

A) ​20-35% kcalories from total fat
B) ​45-65% kcalories from protein
C) ​30% kcalories from carbohydrate
D) ​25% kcalories from protein
E) ​45-65% kcalories from fat

Question 61

Matching​
a. ​a hormone produced by adipose cells that improves insulin sensitivity
b. ​damage to the kidneys that results from long-term diabetes
c. ​delayed stomach emptying caused by nerve damage in stomach tissue
d. ​morning hyperglycemia that is caused by the early-morning release of growth hormone, which reduces insulin sensitivity
e. ​the blood concentration of a substance that exceeds the kidneys' capacity for reabsorption, causing the substance to be passed into the urine
f. ​monitoring of tissue glucose levels using a small sensor placed under the skin
g. ​a lowering of blood pH that results from the excessive production of ketone bodies
h. ​reduced sensitivity to insulin in muscle, adipose, and liver cells
i. ​the condition of having an abnormally large body;
j. ​the amount of carbohydrate that can be handled per unit of insulin
k. ​a pancreatic hormone that regulates glucose metabolism
l. ​a distinctive fruity odor on the breath of a person with ketosis
m. ​a measurement of glycated serum proteins that reflects glycemic control over the preceding two to three weeks
n. ​pertaining to blood glucose
o. ​excessive urine production
​acetone breath

Question 62

Matching​
a. ​a hormone produced by adipose cells that improves insulin sensitivity
b. ​damage to the kidneys that results from long-term diabetes
c. ​delayed stomach emptying caused by nerve damage in stomach tissue
d. ​morning hyperglycemia that is caused by the early-morning release of growth hormone, which reduces insulin sensitivity
e. ​the blood concentration of a substance that exceeds the kidneys' capacity for reabsorption, causing the substance to be passed into the urine
f. ​monitoring of tissue glucose levels using a small sensor placed under the skin
g. ​a lowering of blood pH that results from the excessive production of ketone bodies
h. ​reduced sensitivity to insulin in muscle, adipose, and liver cells
i. ​the condition of having an abnormally large body;
j. ​the amount of carbohydrate that can be handled per unit of insulin
k. ​a pancreatic hormone that regulates glucose metabolism
l. ​a distinctive fruity odor on the breath of a person with ketosis
m. ​a measurement of glycated serum proteins that reflects glycemic control over the preceding two to three weeks
n. ​pertaining to blood glucose
o. ​excessive urine production
​insulin resistance

Question 63

Matching​
a. ​a hormone produced by adipose cells that improves insulin sensitivity
b. ​damage to the kidneys that results from long-term diabetes
c. ​delayed stomach emptying caused by nerve damage in stomach tissue
d. ​morning hyperglycemia that is caused by the early-morning release of growth hormone, which reduces insulin sensitivity
e. ​the blood concentration of a substance that exceeds the kidneys' capacity for reabsorption, causing the substance to be passed into the urine
f. ​monitoring of tissue glucose levels using a small sensor placed under the skin
g. ​a lowering of blood pH that results from the excessive production of ketone bodies
h. ​reduced sensitivity to insulin in muscle, adipose, and liver cells
i. ​the condition of having an abnormally large body;
j. ​the amount of carbohydrate that can be handled per unit of insulin
k. ​a pancreatic hormone that regulates glucose metabolism
l. ​a distinctive fruity odor on the breath of a person with ketosis
m. ​a measurement of glycated serum proteins that reflects glycemic control over the preceding two to three weeks
n. ​pertaining to blood glucose
o. ​excessive urine production
​continuous glucose monitoring

Question 64

A 12-year-old girl is diagnosed with type 1 diabetes and is placed on insulin. Her mother expresses concern that her daughter will refuse to give herself injections. The nurse reassures the mother that _____.​

A) ​she will only need a single injection daily, so the mother can do it
B) ​a pump to administer the insulin without syringes is available
C) ​insulin is available in pill form
D) ​she can still regulate her blood glucose levels if she misses insulin doses at times
E) ​type 1 diabetes does not need to be managed with exogenous insulin

Question 65

Matching​
a. ​a hormone produced by adipose cells that improves insulin sensitivity
b. ​damage to the kidneys that results from long-term diabetes
c. ​delayed stomach emptying caused by nerve damage in stomach tissue
d. ​morning hyperglycemia that is caused by the early-morning release of growth hormone, which reduces insulin sensitivity
e. ​the blood concentration of a substance that exceeds the kidneys' capacity for reabsorption, causing the substance to be passed into the urine
f. ​monitoring of tissue glucose levels using a small sensor placed under the skin
g. ​a lowering of blood pH that results from the excessive production of ketone bodies
h. ​reduced sensitivity to insulin in muscle, adipose, and liver cells
i. ​the condition of having an abnormally large body;
j. ​the amount of carbohydrate that can be handled per unit of insulin
k. ​a pancreatic hormone that regulates glucose metabolism
l. ​a distinctive fruity odor on the breath of a person with ketosis
m. ​a measurement of glycated serum proteins that reflects glycemic control over the preceding two to three weeks
n. ​pertaining to blood glucose
o. ​excessive urine production
​gastroparesis

Question 66

What type of insulin dosage would be adjusted to better cover a diabetic patient's needs between meals and overnight?​

A) ​meal-time insulin
B) ​basal insulin
C) ​overnight insulin
D) ​oral insulin
E) ​post-prandial insulin

Question 67

A patient's blood glucose log shows several episodes of hyperglycemia upon rising in the morning. The nurse explains that this is _____.​

A) ​due to taking too much insulin
B) ​caused by eating too much protein
C) ​called the dawn phenomenon
D) ​known as the evening effect
E) ​normal and needs no treatment

Question 68

Which compound(s) formed in the body during an episode of hyperglycemia can alter protein structures and stimulate damaging metabolic pathways?​

A) ​sorbitol
B) ​glycophosphate
C) ​advanced glycation end products
D) ​low-density lipoproteins
E) ​fructosamine

Question 69

Matching​
a. ​a hormone produced by adipose cells that improves insulin sensitivity
b. ​damage to the kidneys that results from long-term diabetes
c. ​delayed stomach emptying caused by nerve damage in stomach tissue
d. ​morning hyperglycemia that is caused by the early-morning release of growth hormone, which reduces insulin sensitivity
e. ​the blood concentration of a substance that exceeds the kidneys' capacity for reabsorption, causing the substance to be passed into the urine
f. ​monitoring of tissue glucose levels using a small sensor placed under the skin
g. ​a lowering of blood pH that results from the excessive production of ketone bodies
h. ​reduced sensitivity to insulin in muscle, adipose, and liver cells
i. ​the condition of having an abnormally large body;
j. ​the amount of carbohydrate that can be handled per unit of insulin
k. ​a pancreatic hormone that regulates glucose metabolism
l. ​a distinctive fruity odor on the breath of a person with ketosis
m. ​a measurement of glycated serum proteins that reflects glycemic control over the preceding two to three weeks
n. ​pertaining to blood glucose
o. ​excessive urine production
​insulin

Question 70

The nurse is counseling a young athlete with type 1 diabetes. The nurse knows that the athlete understands the instructions when he verbalizes _____.​

A) ​"If my blood sugar is below 100 before practice, I should consume some carbohydrate before beginning"
B) ​"I should drink plenty of Gatorade during practice"
C) ​"I don't need to check my blood sugar during practice"
D) ​"I should not eat during practice"
E) ​"I won't eat before, but I should definitely eat after practice"

Question 71

Matching​
a. ​a hormone produced by adipose cells that improves insulin sensitivity
b. ​damage to the kidneys that results from long-term diabetes
c. ​delayed stomach emptying caused by nerve damage in stomach tissue
d. ​morning hyperglycemia that is caused by the early-morning release of growth hormone, which reduces insulin sensitivity
e. ​the blood concentration of a substance that exceeds the kidneys' capacity for reabsorption, causing the substance to be passed into the urine
f. ​monitoring of tissue glucose levels using a small sensor placed under the skin
g. ​a lowering of blood pH that results from the excessive production of ketone bodies
h. ​reduced sensitivity to insulin in muscle, adipose, and liver cells
i. ​the condition of having an abnormally large body;
j. ​the amount of carbohydrate that can be handled per unit of insulin
k. ​a pancreatic hormone that regulates glucose metabolism
l. ​a distinctive fruity odor on the breath of a person with ketosis
m. ​a measurement of glycated serum proteins that reflects glycemic control over the preceding two to three weeks
n. ​pertaining to blood glucose
o. ​excessive urine production
​diabetic nephropathy

Question 72

For which person would intensive insulin therapy be inappropriate?​

A) ​A patient with type 1 diabetes
B) ​A patient with a limited life expectancy
C) ​A patient with co-occurring kidney disease
D) ​A patient who needs short-acting insulin
E) ​A patient who is newly diagnosed with diabetes

Question 73

Matching​
a. ​a hormone produced by adipose cells that improves insulin sensitivity
b. ​damage to the kidneys that results from long-term diabetes
c. ​delayed stomach emptying caused by nerve damage in stomach tissue
d. ​morning hyperglycemia that is caused by the early-morning release of growth hormone, which reduces insulin sensitivity
e. ​the blood concentration of a substance that exceeds the kidneys' capacity for reabsorption, causing the substance to be passed into the urine
f. ​monitoring of tissue glucose levels using a small sensor placed under the skin
g. ​a lowering of blood pH that results from the excessive production of ketone bodies
h. ​reduced sensitivity to insulin in muscle, adipose, and liver cells
i. ​the condition of having an abnormally large body;
j. ​the amount of carbohydrate that can be handled per unit of insulin
k. ​a pancreatic hormone that regulates glucose metabolism
l. ​a distinctive fruity odor on the breath of a person with ketosis
m. ​a measurement of glycated serum proteins that reflects glycemic control over the preceding two to three weeks
n. ​pertaining to blood glucose
o. ​excessive urine production
​polyuria

Question 74

A patient with type 1 diabetes calls her physician's office complaining of nausea, vomiting, and diarrhea. The nurse should advise the patient to _____.​

A) ​cease her insulin injections until she can tolerate food
B) ​continue her insulin injections and eat tolerated foods that provide the prescribed amount of carbohydrate
C) ​avoid consuming carbohydrates, but continue her insulin injections
D) ​cease her insulin injections and eat tolerated foods that provide the prescribed amount of carbohydrate
E) ​increase her carbohydrate intake but decrease her insulin injections

Question 75

An Hispanic pregnant woman is visiting the community clinic for her first prenatal visit. She has a family history of diabetes, she is obese, and her last baby weighed 9 pounds, 8 ounces. The nurse realizes that she is at risk for _____.​

A) ​poor weight gain
B) ​gestational diabetes
C) ​anemia
D) ​malnutrition
E) ​preeclampsia

Question 76

An obese patient with type 2 diabetes wants to begin an exercise program. The nurse recommends that the patient _____.​

A) ​start by walking 30 minutes a day
B) ​join a gym
C) ​hire a personal trainer
D) ​seek a medical evaluation
E) ​set a goal, such as training for a marathon

Question 77

Matching​
a. ​a hormone produced by adipose cells that improves insulin sensitivity
b. ​damage to the kidneys that results from long-term diabetes
c. ​delayed stomach emptying caused by nerve damage in stomach tissue
d. ​morning hyperglycemia that is caused by the early-morning release of growth hormone, which reduces insulin sensitivity
e. ​the blood concentration of a substance that exceeds the kidneys' capacity for reabsorption, causing the substance to be passed into the urine
f. ​monitoring of tissue glucose levels using a small sensor placed under the skin
g. ​a lowering of blood pH that results from the excessive production of ketone bodies
h. ​reduced sensitivity to insulin in muscle, adipose, and liver cells
i. ​the condition of having an abnormally large body;
j. ​the amount of carbohydrate that can be handled per unit of insulin
k. ​a pancreatic hormone that regulates glucose metabolism
l. ​a distinctive fruity odor on the breath of a person with ketosis
m. ​a measurement of glycated serum proteins that reflects glycemic control over the preceding two to three weeks
n. ​pertaining to blood glucose
o. ​excessive urine production
​ketoacidosis

Question 78

Matching​
a. ​a hormone produced by adipose cells that improves insulin sensitivity
b. ​damage to the kidneys that results from long-term diabetes
c. ​delayed stomach emptying caused by nerve damage in stomach tissue
d. ​morning hyperglycemia that is caused by the early-morning release of growth hormone, which reduces insulin sensitivity
e. ​the blood concentration of a substance that exceeds the kidneys' capacity for reabsorption, causing the substance to be passed into the urine
f. ​monitoring of tissue glucose levels using a small sensor placed under the skin
g. ​a lowering of blood pH that results from the excessive production of ketone bodies
h. ​reduced sensitivity to insulin in muscle, adipose, and liver cells
i. ​the condition of having an abnormally large body;
j. ​the amount of carbohydrate that can be handled per unit of insulin
k. ​a pancreatic hormone that regulates glucose metabolism
l. ​a distinctive fruity odor on the breath of a person with ketosis
m. ​a measurement of glycated serum proteins that reflects glycemic control over the preceding two to three weeks
n. ​pertaining to blood glucose
o. ​excessive urine production
glycemic

Question 79

The nurse teaches a newly diagnosed diabetic patient to treat an episode of hypoglycemia by _____.​

A) ​eating 15 jelly beans
B) ​drinking a 12-oz. soda
C) ​eating an apple
D) ​sucking slowly on a hard candy
E) ​drinking an energy drink

Question 80

Matching​
a. ​a hormone produced by adipose cells that improves insulin sensitivity
b. ​damage to the kidneys that results from long-term diabetes
c. ​delayed stomach emptying caused by nerve damage in stomach tissue
d. ​morning hyperglycemia that is caused by the early-morning release of growth hormone, which reduces insulin sensitivity
e. ​the blood concentration of a substance that exceeds the kidneys' capacity for reabsorption, causing the substance to be passed into the urine
f. ​monitoring of tissue glucose levels using a small sensor placed under the skin
g. ​a lowering of blood pH that results from the excessive production of ketone bodies
h. ​reduced sensitivity to insulin in muscle, adipose, and liver cells
i. ​the condition of having an abnormally large body;
j. ​the amount of carbohydrate that can be handled per unit of insulin
k. ​a pancreatic hormone that regulates glucose metabolism
l. ​a distinctive fruity odor on the breath of a person with ketosis
m. ​a measurement of glycated serum proteins that reflects glycemic control over the preceding two to three weeks
n. ​pertaining to blood glucose
o. ​excessive urine production
​renal threshold