MS 1 Final Exam Review - DM

Question 1

Which question would the nurse ask a patient admitted to the hospital with frequent urination and excessive thirst to support the diagnosis of diabetes?

1 “What is your name?”
2 “What is your height?”
3 “What is your weight?”
4 “Do you have a family history of diabetes?”

Answer 1

4 “Do you have a family history of diabetes?”

The patient’s family history is needed to know if there is any family history of diabetes. The patient’s name is necessary to identify the patient but not the clinical condition. Parameters such as height and weight of the patient are required to calculate the body mass index (BMI). However, the nurse does not ask the patient his or her height and weight; rather, height and weight are measured.

Question 2

Which factor is associated with type 1 diabetes mellitus?

1 Obesity
2 Viral infection
3 Sedentary lifestyle
4 High-carbohydrate diet

Answer 2

2 Viral infection

Type 1 diabetes mellitus is caused due to a complete pancreatic shutdown. One of the many causes is a viral infection that may trigger production of antibodies against the pancreas. Obesity, sedentary lifestyle, and intake of a high-carbohydrate diet may increase the risk for type 2 diabetes mellitus.

Question 3

Which medication is the drug of choice for a patient who has insulin resistance?

1 Acarbose
2 Glimepiride
3 Nateglinide
4 Pioglitazone

Answer 3

4 Pioglitazone

Pioglitazone is an insulin sensitizer that is very effective when the receptors on the insulin-dependent tissue do not respond to the insulin, resulting in insulin resistance. Therefore it is given to patients with insulin resistance. Acarbose is an α-glucose inhibitor and is unassociated with insulin resistance. It reduces absorption of carbohydrate in the intestine. Glimepiride is incapable of treating insulin resistance because it helps boost insulin production and causes hypoglycemia. Nateglinide is not effective for insulin resistance because it enhances insulin production without causing hypoglycemia.

Question 4

2 “Have you recently taken acetaminophen?”

Acetaminophen can cause a false-negative result on glucose tests. Illness, severe restriction of carbohydrates, and bed rest cause higher glucose levels.

Question 5

Which components are associated with metabolic syndrome? Select all that apply.

1 Abdominal obesity
2 Elevated glucose levels
3 Elevated BP
4 Low levels of triglycerides
5 Increased levels of high-density lipoproteins (HDL)

Answer 5

1 Abdominal obesity
2 Elevated glucose levels
3 Elevated BP

The components of metabolic syndrome are abdominal obesity, elevated glucose levels, and elevated BP. Low levels of triglycerides and increased levels of HDL are not components of metabolic syndrome.

Question 6

Which condition would the nurse teach a patient about if the patient’s diagnostic report shows a fasting blood glucose level of 122 mg/dL?

1 Diabetes mellitus type 1
2 Diabetes mellitus type 2
3 Impaired fasting glucose
4 Impaired glucose tolerance

Answer 6

3 Impaired fasting glucose

Impaired fasting glucose is a prediabetic condition, and the blood glucose level may range from 100 to 125 mg/dL. The fasting blood glucose level is 122 mg/dL, which indicates that it is a condition between diabetes and glucose homeostasis. In type 1 and type 2 diabetes, the fasting blood glucose level may be very high. Impaired glucose tolerance is a prediabetic condition; however, the blood glucose levels would range from 140 to 199 mg/dL.

Question 7

Which key factors could be linked with diabetes mellitus type 1? Select all that apply.

1 Endogenous insulin is absent in diabetes mellitus.
2 Islet cell antibodies are absent in diabetes mellitus type 1.
3 Diabetes mellitus type 1 is more common with people of young age.
4 Resistance of ketosis is found except in conditions of infection or stress.
5 Diabetes mellitus type 1 is diagnosed in 5% to 10% of the total diabetes cases.
6 Requirement of insulin is mandatory in all the cases of diabetes mellitus type 1.

Answer 7

1 Endogenous insulin is absent in diabetes mellitus.
3 Diabetes mellitus type 1 is more common with people of young age.
5 Diabetes mellitus type 1 is diagnosed in 5% to 10% of the total diabetes cases.
6 Requirement of insulin is mandatory in all the cases of diabetes mellitus type 1.

Endogenous insulin is absent in patients with diabetes mellitus. Diabetes mellitus type 1 is more common in young people but can occur at any age, with 5% to 10% of the total diabetes diagnoses being type 1 diabetes. Insulin is required for all patients with type 1 diabetes. Islet cell antibodies are often present in diabetes mellitus type 1 patients; absence of these islet cells is associated with diabetes mellitus type 2. The development of type 1 ketosis occurs at onset or during insulin deficiency. Ketosis resistance, except during infections or stress, is associated with diabetes mellitus type 2.

Question 8

Which drug dose would be reduced to lower the risk for diabetes in patients with hypertension and prediabetes?

1 Miglitol
2 Glipizide
3 Thiazides
4 Rosiglitazone

Answer 8

3 Thiazides

Thiazides are given to patients with hypertension. If high doses of thiazides are administered for a long period of time, it may lead to diabetes because thiazides are diabetes-inducing drugs. Therefore for a patient with prediabetes, the doses of thiazides should be reduced. Miglitol is prescribed to patients with diabetes to help reduce the blood glucose level after lunch or dinner. Glipizide is given for treatment of diabetes to enhance the production of insulin by the pancreas. Rosiglitazone is given to patients suffering from insulin resistance because they act as insulin sensitizers.