Chapter 50: Diabetes and Hypoglycemia Linton:
Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. A nurse explains that type 1 diabetes mellitus is a disease in which the body does
not produce enough insulin. What is the reason that the blood glucose is elevated?
a.
Prolonged elevation of stress hormone (cortisol, epinephrine, glucagon,
growth hormone) levels
b.
Malfunction of the glycogen-storing capabilities of the liver
c.
Destruction of the beta cells in the pancreas
d.
Insulin resistance of the receptor cells in the muscle tissue
ANS: C
Type 1 diabetes mellitus is a disease in which the pancreas does not produce
adequate insulin because of the destruction of beta cells.
DIF: Cognitive Level: Comprehension REF: p. 968 OBJ: 2
TOP: Type 1 Diabetes Mellitus KEY: Nursing Process Step: Implementation MSC:
NCLEX: Physiological Integrity: Physiological Adaptation
2. A patient newly diagnosed with type 2 diabetes mellitus asks the nurse why she has to
take a pill instead of insulin. The nurse explains that in type 2 diabetes mellitus, the body
still makes insulin. What other information is pertinent for the nurse to relay?
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a.
Overweight and underactive people cannot simply use the insulin produced.
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b.
Metabolism is slowed in some people, so they have to take a pill to speed up
their metabolism.
c.
Sometimes the autoimmune system works against the action of the insulin.
d.
The cells become resistant to the action of insulin. Pills are given to increase
the sensitivity.
ANS: D
Type 2 diabetes mellitus is a disease in which the cells become resistant to the action of
insulin and the blood glucose level rises. Oral hyperglycemic agents make the cells more
sensitive.
, 2
DIF: Cognitive Level: Comprehension REF: pp. 981-982 OBJ: 2
TOP: Type 2 Diabetes Mellitus KEY: Nursing Process Step: Implementation MSC:
NCLEX: Physiological Integrity: Physiological Adaptation
3. A patient tells a nurse that she eats “huge” amounts of food but stays hungry most of
the time. What should the nurse explain as the cause of hunger experienced by persons
with type 1 diabetes?
a.
Excess amount of glucose
b.
Need for additional calories to correct the increased metabolism
c.
Fact that the cells cannot use the blood glucose
d.
Need for exercise to stimulate insulin secretion
ANS: C
, 3
The cells cannot use the glucose without insulin, so the patient with diabetes still
feels hungry even though abundant glucose is circulating in the blood.
DIF: Cognitive Level: Comprehension REF: p. 968 OBJ: 1
TOP: Hunger in the Patient with Diabetes
4. What does the lack of insulin in patients with type 1 diabetes cause that increases the
risk for cardiovascular disorders?
a.
High glucose levels that irritate and shrink the vessels
b.
Inadequate metabolism of proteins, which causes ketosis
c.
Increased fatty acid levels
d.
Increased metabolism of ketones, which causes hypertension
ANS: C
The increase in fatty acid levels causes an increase in the level of triglycerides and
an attendant rise in low-density lipoprotein levels.
DIF: Cognitive Level: Knowledge REF: pp. 968-969 OBJ: 1
TOP: Diabetes: Complications KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
5. The self-care goal of a patient with diabetes is to keep the blood sugar within
normal limits. What causes hyperglycemia to occur?
a.
Blood glucoWsWe
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b.
Insulin conversion of glycogen to glucose is inhibited.
c.
The body responds to glucose-starved tissues by changing stored glycogen
into glucose.
d.
Glycogen is unable to be stored in the liver and muscles.
ANS: C
The hypothalamus is receiving a message that the cells need glucose, so it responds
by adding more glucose to the already overburdened blood.
, 4
DIF: Cognitive Level: Comprehension REF: p. 968 OBJ: 1
6. A young patient complains that diabetes is causing her to “have no life at all. It’s
too hard.” What is the most helpful response by the nurse?
a.
“Yes, you must make some sacrifices.”
b.
“It’s hard, but with significant alterations in your lifestyle, you can live a long
life.”
c.
“What’s hard about exercise, diet, and medicine?”
d.
“Let’s talk about what makes it so hard.”
ANS: D
Involving the patient in decisions about how she will cope with her diabetes will make
the goals more realistic and personal, which will give her a greater chance of success in
meeting them.
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