Chapter 20: Diabetes Mellitus Nursing School Test Banks

Chapter 20: Diabetes Mellitus
Test Bank

MULTIPLE CHOICE

1. The primary organ involved in the disease process of type 1 diabetes mellitus is the
a. adrenal gland.
b. pancreas.
c. kidney.
d. liver.
ANS: B
The hormone insulin must be present for glucose to be used by the cells in the body. Insulin is produced by the cells of the pancreas. Thus the pancreas is the organ involved in the disease process of type 1 diabetes mellitus.

DIF: Cognitive Level: Knowledge REF: 400 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

2. The main factors that influence development of type 2 diabetes mellitus are
a. weight and heredity.
b. liver disease.
c. enzyme deficiencies.
d. childhood illnesses.
ANS: A
Weight and heredity seem to play a role in the development of type 2 diabetes mellitus.

DIF: Cognitive Level: Knowledge REF: 401-402 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

3. Type 2 diabetes is most common in
a. infants.
b. children.
c. adolescents.
d. older adults.
ANS: D
Type 2 diabetes is most common in adults 40 years or older, although it may be seen at younger ages.

DIF: Cognitive Level: Knowledge REF: 403 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

4. A food that represents one carbohydrate exchange would be
a. 1 slice whole wheat bread
b. 1 cup vanilla ice cream
c. 5 ounces white tuna
d. 1 tsp margarine
ANS: A
1 slice whole wheat bread would be 1 carbohydrate exchange. Starches consisting of breads, cereals, and grains are part of the carbohydrate list.

DIF: Cognitive Level: Application REF: 417
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

5. In reviewing the plan of care for a patient with type 2 diabetes who is overweight and likes to eat sweets, an initial goal might be to
a. start 10 units of regular insulin 30 minutes before each meal.
b. replace snack of 5 filled chocolate cookies with 3 graham crackers.
c. check blood sugar after eating cookies and initiate sliding scale insulin.
d. remove all carbohydrate foods and encourage only high protein foods.
ANS: B
Replacing chocolate cookies with graham crackers would be an initial step in improving weight loss and implementation of a healthy lifestyle of proper nutrition and exercise.

DIF: Cognitive Level: Application REF: 412-413|415
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

6. A 62-year-old patient with a history of blood sugars slightly above normal and recurrent skin infections may need to be further assessed for
a. type 2 diabetes.
b. gestational diabetes.
c. chronic kidney disease.
d. hepatitis.
ANS: A
With a history of abnormal blood sugars and recurrent skin infections, assessment for type 2 diabetes should be completed.

DIF: Cognitive Level: Application REF: 404-405
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

7. Uncontrolled diabetes is related to the abnormal metabolism of
a. carbohydrates and proteins.
b. proteins and fats.
c. carbohydrates, proteins, and fats.
d. carbohydrates only.
ANS: C
Uncontrolled diabetes causes alterations in glucose metabolism as well as abnormal metabolism of proteins and fats.

DIF: Cognitive Level: Knowledge REF: 405
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

8. A blood sugar of 85 mg/dL would be considered
a. below normal.
b. borderline.
c. normal.
d. above normal.
ANS: C
The normal range of blood glucose is 70 to 110 mg/dL.

DIF: Cognitive Level: Application REF: 405
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

9. The largest portion of islet cells in the pancreas are the cells that synthesize
a. glucagon.
b. insulin.
c. somatostatin.
d. growth hormone.
ANS: B
The largest portion of islet cells are the cells that synthesize insulin, a hormone.

DIF: Cognitive Level: Knowledge REF: 400 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

10. The hormone that is synthesized by the pancreatic islet cells is
a. glycogen.
b. ketone.
c. somatostatin.
d. insulin.
ANS: C
Somatostatin is produced in the cells of the pancreatic islets.

DIF: Cognitive Level: Knowledge REF: 407 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

11. The hormone considered to act in a manner opposite to insulin is
a. glucagon.
b. somatostatin.
c. growth hormone.
d. adrenaline.
ANS: A
Glucagon is a hormone that acts in a manner opposite to insulin to balance the overall blood glucose level. It can rapidly break down stored glycogen and, to a lesser extent, fat.

DIF: Cognitive Level: Knowledge REF: 407 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

12. Which of the following functions is not associated with the hormone insulin?
a. moves glucose into the cell
b. inhibits fat breakdown
c. converts glucose into glycogen
d. mobilizes liver glycogen to yield glucose
ANS: D
Insulin does not mobilize liver glycogen to yield glucose. Insulin circulates glucose into cells by way of specialized insulin receptors, helps change glucose to glycogen and store it in muscles and liver, stimulates the change of glucose to fat for storage as body fat, inhibits the breakdown of tissue fat and protein, promotes uptake of amino acids by skeletal muscle, and influences the burning of glucose for constant energy as needed.

DIF: Cognitive Level: Knowledge REF: 405|407 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

13. The accumulation of glucose in the blood is called
a. glycosuria.
b. polydipsia.
c. hyperglycemia.
d. hypoglycemia.
ANS: C
The accumulation of glucose in the blood is called hyperglycemia and the presence of low glucose in the blood is called hypoglycemia.

DIF: Cognitive Level: Knowledge REF: 402 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

14. Ketones are a by-product of the metabolism of
a. carbohydrates.
b. proteins.
c. fats.
d. alcohol.
ANS: C
Ketones form as a by-product of fat metabolism when the supply of glucose is insufficient.

DIF: Cognitive Level: Knowledge REF: 407 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

15. An individual attends a community sponsored health screening event and a slightly elevated blood sugar is detected. An appropriate intervention would be to
a. inform the individual that he/she has diabetes and should go to the emergency room immediately.
b. recommend the individual begin a high protein, low carbohydrate diet and begin exercising.
c. recommend the individual follow up with his/her health care practitioner for further evaluation.
d. tell the individual not to worry and there is no need for any additional follow-up.
ANS: C
A recommendation to follow up with their health care practitioner would be most appropriate. The community screening helps to identify those who may benefit from additional medical follow-up and screening for risk of diabetes in the community.

DIF: Cognitive Level: Application REF: 409 TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

16. The three common long-term complications of diabetes affect the cells of the
a. pancreas, liver, and spleen.
b. kidney, eye, and nerve tissue.
c. kidney, liver, and spleen.
d. heart, liver, and brain.
ANS: B
Long-term complications of diabetes affect the kidney (nephropathy), eye (retinopathy), and nerve tissue (neuropathy).

DIF: Cognitive Level: Knowledge REF: 408-409 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

17. For a patient receiving a 2000 kcal diet, the recommended range of calories that should come from carbohydrate is
a. 500 750 kcal.
b. 750 900 kcal.
c. 900 1300 kcal.
d. 1350 165 kcal.
ANS: C
The amount of calories provided by carbohydrate on a 2000 kcal diet would range from 900 1300 kcal. 45% 65% of calories should come from carbohydrate. 2000 kcal x 45% = 900 kcal and 2000 kcal x 65% = 1300 kcal.

DIF: Cognitive Level: Application REF: 412 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

18. A good source of fiber rich food is
a. steel cut oats.
b. grilled chicken breast.
c. cinnamon apple sauce.
d. an English muffin.
ANS: A
Steel cut oats is a good source of fiber.

DIF: Cognitive Level: Application REF: 412-413
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

19. For a patient with diabetes, a good nonnutritive choice to sweeten tea would be
a. cane sugar.
b. aspartame.
c. honey.
d. fructose.
ANS: B
Commonly used nonnutritive sweeteners include aspartame, which has no nutritional value. Sorbitol, honey, and fructose are all nutritive sweeteners because they do provide energy.

DIF: Cognitive Level: Application REF: 412-413
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

20. The nonnutritive sweetener that is composed of two amino acids is
a. saccharine.
b. aspartame.
c. cyclamate.
d. acesulfame-K.
ANS: B
Aspartame is made from two amino acids: phenylalanine and aspartic acid.

DIF: Cognitive Level: Knowledge REF: 412 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

21. The amount of dietary energy intake from fat recommended for a person with diabetes receiving an 1800 kcal diet should range
a. 100 150 kcal.
b. 220 575 kcal.
c. 250 630 kcal.
d. 360 630 kcal.
ANS: D
The percentage of energy from fat for a person with diabetes should be between 20% and 35%. On an 1800 kcal diet: 1800 kcal x 20% = 360 kcal and 1800 kcal x 35% = 630 kcal.

DIF: Cognitive Level: Application REF: 412 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

22. A menu selection high in saturated fat is
a. grilled turkey burgers with onion and peppers.
b. baked ziti with sausage and cream sauce.
c. baked salmon and herbed potatoes.
d. baked macaroni and tomato sauce.
ANS: B
Baked ziti with sausage and cream sauce would contain saturated fats from the sausage and the cream based sauce.

DIF: Cognitive Level: Application REF: 413-414 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

23. The form of insulin that has its peak action within 7 to 14 hours is
a. rapid-acting form.
b. intermediate-acting form.
c. long-acting form.
d. oral hypoglycemic agent.
ANS: B
Intermediate-acting (NPH) insulin has a peak action ranging from 7 to 14 hours.

DIF: Cognitive Level: Knowledge REF: 420 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

24. Women with a history of gestational diabetes mellitus are at risk for developing
a. chronic kidney disease.
b. type 2 diabetes.
c. type 1 diabetes.
d. morbid obesity.
ANS: B
The risk for developing type 2 diabetes is significantly higher in women with a history of gestational diabetes.

DIF: Cognitive Level: Knowledge REF: 403-404 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

25. For individuals with type 2 diabetes, exercise
a. decreases insulin efficiency.
b. stimulates the release of insulin.
c. decreases risk of cardiovascular disease.
d. raises blood glucose levels.
ANS: C
Exercise increases the number of insulin receptors on muscle cells. Long-term studies have shown that with type 2 diabetes, exercise helps control blood glucose and reduces the risk of cardiovascular disease, hyperlipidemia, hypertension, and obesity.

DIF: Cognitive Level: Knowledge REF: 414 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

26. Type 2 diabetes usually appears after the age of _____ years.
a. 30
b. 40
c. 50
d. 60
ANS: B
Type 2 diabetes usually appears after the age of 40 years but is now also being diagnosed in children.

DIF: Cognitive Level: Knowledge REF: 402 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

27. Mr. Jones is 20 lb above his desirable weight and has type 2 diabetes. A recommendation to Mr. Jones would be to
a. increase kilocalorie intake.
b. include between-meal snacks.
c. take extra food during exercise.
d. decrease kilocalorie intake.
ANS: D
Decreasing kilocalorie intake will help Mr. Jones lose weight and control his type 2 diabetes.

DIF: Cognitive Level: Application REF: 411 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

28. The number of kcals from protein for an adult with diabetes receiving a 2200 kcal diet should be between
a. 100 330 kcal.
b. 220 770 kcal.
c. 250 800 kcal
d. 350 1200 kcal.
ANS: B
The protein content for an adult with diabetes is 10% to 35% of total energy intake. On a 2200 kcal diet: 2200 x 10% = 220 kcal and 2200 x 35% = 770 kcal.

DIF: Cognitive Level: Application REF: 412
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

29. A food that is not in the meat group of the Choose Your Foods: Exchange Lists for Diabetes is
a. turkey.
b. shrimp.
c. egg.
d. milk.
ANS: D
Turkey, shrimp, and egg are all part of the meat and meat substitute group. Milk is in a separate group.

DIF: Cognitive Level: Knowledge REF: 417 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

30. If the diet prescription for type 1 diabetes allows 2200 kcal, and if the common distribution of kilocalories is followed, then the number of grams of carbohydrates in the diet plan should be _____ g.
a. 50
b. 100
c. 200
d. 275
ANS: D
Approximately 50% of total kilocalories should be supplied from carbohydrates. In this case, 2200 kcal (50%) = 1100 kcal 4 g/kcal = 275 kcal.

DIF: Cognitive Level: Application REF: 412 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

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