Module 1: Endocrine & Diabetes Flashcards
(79 cards)
1
Q
Identify 8-10 risk factors for the development of diabetes.
A
- Family history of diabetes (especially type 2)
- Obesity or overweight
- Physical inactivity
- Age 40 (increases with age)
- Ethnic background (indigenous, African, Hispanic, South Asian)
- Hx of gestational dislabetes or delivering baby over 9 lbs
- Hypertension
- PCOS
- Dyslipidemia
- Pre-diabetes
2
Q
Which determinant of health puts individuals at increased risk of diabetes?
A
Income and social status
Low income and food insecurity are associated with a higher prevalence of diabetes and depression.
3
Q
A
4
Q
What are potential complications of diabetes?
A
Heart disease, kidney damage (nephropathy), nerve damage (neuropathy), eye problems, poor circulation, infections, skin problems, gum disease, hearing impairments, mental health issues
These complications can significantly affect a patient’s quality of life and require careful management.
5
Q
Fill in the blank: One potential complication of diabetes is _______.
A
heart disease
6
Q
True or False: Neuropathy is a complication of diabetes.
A
True
7
Q
What damage does nephropathy refer to in the context of diabetes?
A
Kidney damage
8
Q
List three complications of diabetes.
A
- Heart disease
- Eye problems
- Skin problems
9
Q
Fill in the blank: Complications of diabetes can lead to _______ impairments.
A
hearing
10
Q
What mental health issues can arise as a complication of diabetes?
A
Mental health issues
Diabetes can lead to anxiety, depression, and other mental health challenges.
11
Q
What does A1C represent in diabetes management?
A
A1C is a snapshot of your average blood sugar over the past 2-3 months
12
Q
How does A1C help doctors?
A
It helps doctors see how well your diabetes is being managed over time
13
Q
What is the benefit of keeping A1C in a healthy range?
A
It reduces the risk of complications
14
Q
What is the pathophysiology of Type 1 Diabetes Mellitus?
A
The body’s immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas
15
Q
What happens to blood sugar levels in Type 1 Diabetes?
A
Blood sugar levels rise due to the inability to make insulin
16
Q
What is the fasting blood glucose level diagnostic criterion for Type 1 Diabetes?
A
7.0 mmol/L or higher
17
Q
What is the random blood glucose level diagnostic criterion for Type 1 Diabetes?
A
11.1 mmol/L or higher
18
Q
What is the HbA1c diagnostic criterion for Type 1 Diabetes?
A
6.5% or higher
19
Q
What antibody presence indicates Type 1 Diabetes?
A
Positive for antibodies that attack insulin-producing cells
20
Q
List clinical manifestations of Type 1 Diabetes Mellitus.
A
- Rapid weight loss
- Excessive thirst and urination
- Fatigue and weakness
- Blurry vision
- Increased hunger
- Ketones in the urine
21
Q
What is the pathophysiology of Type 2 Diabetes Mellitus?
A
The body either becomes resistant to insulin or doesn’t produce enough insulin
22
Q
What can prolonged high blood sugar levels in Type 2 Diabetes lead to?
A
Long-term damage to organs
23
Q
What is the fasting blood glucose level diagnostic criterion for Type 2 Diabetes?
A
7.0 mmol/L or higher
24
Q
What is the random blood glucose level diagnostic criterion for Type 2 Diabetes?
A
11.1 mmol/L or higher
25
What is the HbA1c diagnostic criterion for Type 2 Diabetes?
6.5% or higher
26
What is the oral glucose tolerance test result diagnostic criterion for Type 2 Diabetes?
11.1 mmol/L or higher after 2 hours
27
List clinical manifestations of Type 2 Diabetes Mellitus.
* Increased thirst and frequent urination
* Fatigue
* Blurry vision
* Slow-healing sores or infections
* Tingling or numbness in hands or feet
* Unexplained weight loss (or weight gain, in some cases)
28
When the body breaks down fat for energy instead of sugar due to insulin deficiency, ketones show up in the urine. This is known as:
A. Insulin deficiency
B. Osmotic Diuresis
C. Ketonuria
D. Acidosis
C. Ketonuria
29
What causes the body to go into DKA and start breaking down fat for energy?
a. Ketonuria
b. Osmotic Diuresis
c. Hyperglycemia
d. Insulin Deficiency
d. Insulin Deficiency
30
In a state of hyperglycemia the kidneys try to filter out extra sugar by increasing urination. As the body loses more water, dehydration occurs. Which process is this?
a. Osmotic Diuresis
b. Ketonuria
c. Hypoglycemic Dehydration
d. Acidosis
a. Osmotic Diuresis
31
Normal or high serum potassium levels are expected in DKA, and this does not require intervention. This will resolve with an insulin infusion and hydration.
True or False?
False. Even though potassium levels might seem normal or even high in blood tests, inside the cells, potassium is actually low, which can be dangerous if not treated.
32
When the body is in DKA, ketones changes the pH of the blood. This puts the body in a state of:
a. Acidosis
b. Alkalosis
c. Metabolic Alkalosis
d. Respiratory Alkalosis
a. Acidosis
33
34
What is hypoglycemia also known as?
Insulin reaction
## Footnote
Commonly seen in Type 1 clients, but may also occur in Type 2.
35
Which type of diabetes is hypoglycemia most commonly associated with?
Type 1
## Footnote
It may also be seen in Type 2.
36
List some causes of hypoglycemia.
* Too much Insulin
* Omitting meals, eating less than usual
* Overexertion, over-exercising
* Nausea & vomiting
* Alcohol intake
## Footnote
Alcohol intake can lead to decreased glucose release from the liver.
37
What are the blood glucose levels that characterize hypoglycemia?
BG levels < 2.7-3.3 mmol/L
## Footnote
Indicates low blood sugar levels.
38
Which symptoms indicate that a patient is experiencing hyperglycemia?
a. polydipsia, polyuria, polyphagia
b. weight gain, fatigue, bradycardia
c. irritability, diaphoresis, tachycardia
d. loss of appetite, abdo pain, oliguria
The correct answer is:
👉 a. polydipsia, polyuria, polyphagia
Translation?
That’s crazy thirsty, peeing like a racehorse, and hungry enough to eat a whole pizza by yourself—the holy trinity of hyperglycemia.
Why? Because when there’s too much sugar in the blood, your body’s like, “Whoa, gotta flush this out” (cue the excessive peeing). That makes you super thirsty (so you drink more), and your cells are starving for energy because the sugar can’t get in without insulin—so you're always hungry. Basically, your body is throwing a sugar tantrum.
The others?
b. Weight gain + tired + slooow heart? That’s your thyroid ghosting you.
c. Irritable, sweaty, heart racing? That’s low blood sugar, aka hangry meets emergency.
d. No appetite, tummy hurts, barely peeing? Sounds like a kidney crisis or DKA drama, not plain old high blood sugar.
So remember: if they’re drinking, peeing, and eating like it’s an Olympic event, think hyperglycemia. 🏅🍕
39
Which timeframe would the nurse instruct a patient only to drink water when scheduled for a fasting blood glucose level at 8 am?
a. 6 pm the evening before
b. Midnight before the test
c. 4 am day of the test
d. 7am day of the test
Let’s break down the choices:
a. 6 pm the evening before – That’s overkill. No need to suffer for 14 hours.
✅ b. Midnight before the test – Perfect! That gives you the standard 8-hour fast.
c. 4 am day of the test – Too late, not enough fasting time.
d. 7 am day of the test – Way too late. You can't have a muffin at 6:59 and expect accurate results.
40
Which laboratory blood value would the nurse monitor in a diabetic patient treated with Dexamethasone?
a. Sodium
b. Calcium
c. Potassium
d. Glucose
👉 d. Glucose
Here’s why:
Dexamethasone is a corticosteroid, and steroids are notorious for raising blood glucose levels, even in non-diabetics. In diabetic patients, this effect can lead to hyperglycemia or even steroid-induced diabetes if not closely monitored.
a. Sodium – Steroids can affect fluid balance a bit, but sodium isn’t the main concern here.
b. Calcium – Long-term steroid use can lead to bone issues, but that’s more a chronic concern.
c. Potassium – Corticosteroids may slightly lower potassium, but not to the same degree of concern as glucose.
✅ d. Glucose – Ding ding ding! Steroids spike sugar. Always check those levels!
41
Which time frame would the nurse instruct the patient to take the prescribed Repaglinide?
a. Immediately before meals
b. When the blood sugar levels are greater than 13.9mmol/L
c. Two hours after meals
d. At bedtime
a. Immediately before meals
Repaglinide is a meglitinide, an oral antidiabetic medication that stimulates insulin release from the pancreas—but only when you eat. That means it should be taken right before meals, typically within 15–30 minutes of eating.
42
Which result reflects the expected pattern accompanying macrovascular disease as a complication of diabetes mellitus?
a. Dyslipidemia
b. Increased high-density lipoproteins (HDL)
c. Decreased low-density lipoproteins (LDL)
d. Decreased very-low density lipoproteins (VLDL)
✅ a. Dyslipidemia – Yes! It’s the umbrella term for this unhealthy lipid combo that accelerates macrovascular damage.
🩺 Quick memory tip:
“Diabetic arteries = greasy highways.”
Too much bad fat (LDL, VLDL), not enough good fat (HDL) = traffic jam for blood flow = macrovascular disease. 🚧🫀
43
Which symptom reported by a patient with type 1 diabetes mellitus is considered one of the classic clinical manifestations?
a. excessive thirst
b. gradual weight gain
c. Overwhelming fatigue
d. recurrent blurred vision
Let’s take a look at the other options:
a. excessive thirst – Correct! This is the first of the 3 P's and one of the classic symptoms of diabetes.
b. gradual weight gain – Nope! In type 1 diabetes, weight loss is usually more common due to the body burning fat and muscle for energy when it can't use glucose properly.
c. overwhelming fatigue – Fatigue can happen, but it’s not one of the classic signs of type 1 diabetes. It’s often seen in both type 1 and type 2, though.
d. recurrent blurred vision – This could happen later, but blurred vision usually occurs after prolonged hyperglycemia, not right at the onset.
🩺 Quick mnemonic:
“When your sugar's high, your thirst is too.”
So, if a patient reports thirsty, peeing a lot, and hungry all the time, think type 1 diabetes!
44
Which statement by the patient indicates an understanding of nutritional education in a patient newly diagnosed with diabetes mellitus?
a. "When my blood sugar is less than 3.9mmol/L, I will take 15g of a fast-acting carb such as orange juice and recheck in 15 mins."
b. "When my blood sugar is less than 3.9mmol/L I will drink 8 oz of milk and recheck in 15 mins."
c. "I will eat a few hard candies when my blood sugar is less than 3.9mmol/L and recheck in 15 mins."
d. "When my blood sugar is less than 3.9 mmol/L, I will take 3-4 sugar tabs and recheck in 30 mins."
A.
Hypoglycemia (low blood sugar) is common in diabetes, especially for those on insulin or certain oral medications. The 15-15 rule is a gold standard for treating hypoglycemia:
Take 15g of fast-acting carbohydrate (such as 4 oz of juice, 3-4 glucose tablets, or 1 tablespoon of honey)
Wait 15 minutes
Recheck blood sugar
Orange juice is a common example of a fast-acting carb, as it’s absorbed quickly into the bloodstream.
🩺 Quick tip:
“When you’re low, go for 15g and wait 15.”
It’s that simple! And remember, always recheck after 15 minutes to see if more carbs are needed.
45
Which information would the nurse include in teaching about diabetes and diet?
a. Avoid non-nutritive sweeteners.
b. Consumer a high-protein diet for weight loss
c. Consume food with alcohol.
d. Include 50 to 60g/day of dietary fibre.
c. consumer food with alcohol
Helps reduce risk of alcohol induced hypoglycemia
46
Which is the current recommendation for fibre intake for persons with diabetes mellitus?
a. 10 to 20g/day
b. 30 to 50g/day
c. 50 to 60g/day
d. 40 to 60g/day
a. 10 to 20g/day – This is too low for someone with diabetes. While fiber is still beneficial in smaller amounts, 30–50g/day is the preferred range for optimal blood sugar and heart health.
b. 30 to 50g/day – Correct! This is the current recommendation for fiber intake, focusing on both soluble and insoluble fibers.
c. 50 to 60g/day – While fiber is important, excessively high amounts (more than 50g/day) could cause digestive issues, like bloating or discomfort, unless gradually incorporated.
d. 40 to 60g/day – Again, a bit on the higher side. The general goal is 30 to 50g/day for most people with diabetes.
47
Which self-care activity would the patient with a neurogenic bladder identify to facilitate bladder emptying to help prevent urinary stasis and infection? Select all that apply.
a. sitting to void
b. Emptying the bladder 3 times a day
c. Tightenting the abdo muscles when voiding
d. Maintaining fluid restriction of 1200mL per day
e. Using Crede's menoeuvre while voiding
✅ a. Sitting to void
This helps utilize gravity and relax pelvic muscles, which can assist in more complete bladder emptying, especially in individuals with mobility issues or impaired sensation.
❌ b. Emptying the bladder 3 times a day
This is not frequent enough. Patients with neurogenic bladder are typically advised to void every 3–4 hours (about 6–8 times/day) to prevent urinary retention and infection.
✅ c. Tightening the abdominal muscles when voiding
This increases intra-abdominal pressure and can assist the bladder in emptying, particularly when bladder muscle tone is weak.
❌ d. Maintaining fluid restriction of 1200mL per day
Not recommended. Limiting fluids to this degree can actually increase the risk of infection and urinary stasis. Adequate hydration is necessary to flush the urinary tract.
✅ e. Using Crede’s manoeuvre while voiding
This involves applying manual pressure over the bladder (lower abdomen) to assist with emptying. It's a common technique for those with flaccid neurogenic bladder.
48
Which info would the nurse include in teaching plan about vascular complications associated with diabetes mellitus?
a. Macroangiopathy doesn't occur in type 1 diabetes but rather severe type 2.
b. Microangiopathy is specific to diabetes mellitus and commonly affects capillary membrances of eyes, kidneys, nerves, and skin.
c. Renal damage resulting from changes in large and medium-sized blood vessels can be prevented by careful glucose control.
d. Macoangiopathy causes slowed gastic emptying and the sexual impotency experienced by a majority of patients with diabetes mellitus
✅ b. Microangiopathy is specific to diabetes mellitus...
This is correct. Microangiopathy refers to damage to small blood vessels (capillaries), and it's a classic complication of diabetes mellitus.
It affects:
Retina → diabetic retinopathy
Kidneys → diabetic nephropathy
Nerves → diabetic neuropathy
Skin → poor wound healing and skin changes
49
Which recommendation would the nurse provide on how to delay development of type 2 diabetes? Select all that apply.
a. Maintain a healthy weight
b. Include 50g/day of fiber in diet
c. Consume a high-protein diet for weight loss
d. Monitor for polyuria, polyphagia, and polydipsia
e. Regularly monitor blood glucose and glycosylated hemoglobin levels
✅ a. Maintain a healthy weight – You already know it. Keeping it tight(ish) around the waistline helps your body use insulin better and keeps blood sugar drama down. Even losing a little bit helps a lot.
✅ e. Regularly monitor blood glucose and glycosylated hemoglobin levels – Think of this as keeping tabs on your metabolic vibes. It’s not just for people already diagnosed — it helps you stay ahead of the game and course-correct before things get messy.
50
Which time would the nurse instruct a patient to monitor the blood glucose reading if dawn phenomenon is suspected?
a. 1 a.m.
b. 3 a.m.
c. 5 a.m.
d. Upon rising
What even is the dawn phenomenon?
It’s that early-morning blood sugar spike (usually between 4–8 a.m.) caused by natural body hormones — not because the patient snuck a midnight snack.
Why not the other times?
a. 1 a.m. – Too early, the rise probably hasn’t started yet
c. 5 a.m. – Might catch it, but it’s already rising — 3 a.m. is better for a clear before/after
d. Upon rising – You’ll see the high, but not whether it’s from dawn phenomenon or overnight hypoglycemia rebound (Somogyi effect 👀)
51
Which statement indicates an understanding of how to prevent complications associated with diabetes mellitus?
a. I must limit fats in my diet to help prevent neuropathy
b. I should use a hot water bottle on my feet when they feel cold
c. I should have an eye examination at least once every two years for glaucoma screening
d. It is important that I take my blood pressure medication to help prevent kidney damage.
✅ d. Blood pressure meds & kidneys?
YES queen 👑 — keeping your blood pressure in check is key to protecting those kidneys from diabetic nephropathy. High BP just makes kidney damage worse, so meds = protection mode ON.
52
Which of the following signs or symptoms would most likely indicate hyperthyroidism?
a. Cold intolerance, weight gain, bradycardia
b. Heat intolerance, weight loss, tachycardia
c. Fatigue, constipation, dry skin
d. Puffy face, slow speech, depression
Hyperthyroidism = your thyroid is doing the most. Too many hormones = everything speeds up:
You feel hot all the time (heat intolerance)
You’re dropping pounds without trying (weight loss)
Your heart is racing like it's in the Indy 500 (tachycardia)
53
A patient with hypothyroidism is complaining of fatigue, dry skin, and constipation. Which of the following lab results would most likely be expected in this patient?
a. Increased TSH, decreased T3/T4
b. Decreased TSH, increased T3/T4
c. Normal TSH, normal T3/T4
d. Increased TSH, increased T3/T4
A.
In hypothyroidism, the thyroid gland isn’t producing enough T3 and T4 (the "cookies" that give you energy 🥯🍪) (T3=cookie, T4=cookie dough). So, the body tries to compensate by cranking up TSH (Thyroid Stimulating Hormone) to get the thyroid to produce more. But the thyroid’s not pulling its weight, so the T3 and T4 levels stay low.
a is what happens: High TSH + Low T3/T4 = classic hypothyroid vibes. 😴
54
Which hormone stimulates glycogenolysis and gluconeogenesis in the body?
a. Insulin
b. Oxytocin
c. Glucagon
d. Somatostatin
Glucagon
Stimulates glycogenolysis (breaks down glycogen to release glucose)
Stimulates gluconeogenesis (creates new glucose from non-carb sources like amino acids)
Function: Raises blood sugar when levels are low
Where it's released: Pancreas
This hormone is like your "sugar rescue"—it tells the liver to release glucose when your body needs it most!
55
What are the symptoms of a thyrotoxic crisis (thyroid storm)?
a. Sweating, seizures, fever, tachycardia, confusion, multi-system failure
b. hypotension, hypothermia, hypoxia
c. fever, bradycardia.
d. tachycardia, hypoxia, seizures, hypotension
a.
🔥 Quick Way to Remember:
"Thyroid STORM"
S: Sweating / Seizures
T: Tachycardia / Tremors
O: Overheating (fever)
R: Restlessness / confusion
M: Multi-system failure (cardiac, GI, neuro)
56
Which lab value is suggestive of hypothyroidism?
a. Elevated thyroid-stimulating hormone (TSH) levels
b. Lack of thyroid peroxidase antibodies
c. Decreased triglyceride levels
d. Elevated red blood cell count
Correct answer: a. Elevated thyroid-stimulating hormone (TSH) levels
💡 Think of TSH like a manager yelling at a lazy worker (your thyroid).
If your thyroid is slacking off and not making enough hormones (T3/T4), the pituitary gland (the boss) starts yelling louder — aka it cranks up the TSH.
So in hypothyroidism, your thyroid hormones are low, but your TSH is high because your body’s trying to motivate the thyroid to get back to work.
57
Which type of hyperparathyroidism is caused by a problem within the parathyroid gland itself (like a benign tumor)?
a) Primary
b) Secondary
c) Tertiary
Primary: Parathyroid gland itself is the troublemaker (tumor or hyperplasia) — it’s making too much hormone all on its own.
58
Which type happens because of another condition (like chronic kidney disease) that causes low calcium, making the parathyroid glands work overtime?
a) Primary
b) Secondary
c) Tertiary
Secondary: The glands are working overtime because something else (like kidney disease) is causing low calcium, so they try to fix it by pumping out more hormone.
59
Which type happens when the parathyroid glands don’t stop overproducing PTH even after the original issue (like kidney disease) is fixed?
a) Primary
b) Secondary
c) Tertiary
Tertiary: Even after the original problem is fixed, the glands keep going full throttle and don’t chill out.
60
Hypoparathyroidism is 56% more common than hyperparathyroidism.
True or False?
False.
Hypoparathyroidism is an uncommon condition that most often occurs because of iatrogenic causes such as accidental removal or destruction to the vascular supply of the parathyroid glands (e.g., surgical, autoimmune).
61
Which information would the nurse provide to a patient diagnosed with Graves' disease?
a. Characterized by hormone-secreting tumours.
b. Will not develop a goitre or any thyroid enlargement
c. Can be cured with compliance to treatment.
d. Causes hyperthyroidism but can also lead to hypothyroidism.
d. Causes hyperthyroidism but can also lead to hypothyroidism.
👩⚕️ “Graves’ disease is like your thyroid partying way too hard — it’s jacked up, pumping out hormones like there’s no tomorrow (aka hyperthyroidism). But when doctors come in with treatments to calm things down — like radioactive iodine or surgery — sometimes they calm it a little too well… and boom, your thyroid ends up on permanent vacation (aka hypothyroidism).”
62
Insulin is known as the anabolic or storage hormone.
True or false?
True
Yes, it's true — insulin is an anabolic hormone. That just means it helps your body store stuff — like sugar, fat, and even helps build protein. So basically, insulin is your body’s little storage manager making sure energy gets packed away for later.
63
Type 1 diabetes can be controlled with lifestyle and dietary changes, and does not require insulin.
True or false?
False
Type 1 diabetes means the body doesn’t make insulin at all, so no matter how healthy you eat or how active you are, you still need insulin injections to survive. Lifestyle stuff can help manage blood sugar, but insulin is absolutely non-negotiable.
No insulin = no sugar getting into cells = serious danger. 😬
64
Which of the following statements best describes the "honeymoon period" in newly diagnosed type 1 diabetes?
A. It is a permanent phase where no insulin is needed due to full β cell recovery.
B. It lasts 3 to 12 months, during which insulin needs may temporarily decrease before rising again.
C. It occurs when insulin therapy is stopped to allow the pancreas to rest.
D. It allows patients to manage their diabetes with diet and exercise alone for life.
✅ Correct Answer: B.
The "honeymoon period" happens shortly after a person with type 1 diabetes starts insulin treatment. Their blood sugar improves, and for a little while, the remaining β cells produce just enough insulin that less injected insulin is needed. But this is temporary — as those cells continue to be destroyed, insulin needs go back up and become permanent.
So yeah, it's a honeymoon... but one that ends. 💔
65
Impaired glucose tolerance is also known as:
a. Type 2 diabetes
b. Type 1 diabetes
c. Prediabetes
d. Hypoglycemia
C. Prediabetes
Impaired glucose tolerance means your blood sugar is higher than normal but not high enough to be called diabetes — that’s what we call prediabetes.
It’s like your body’s waving a little red flag 🚩 saying, "Hey, watch out! Type 2 diabetes might be on the way if nothing changes."
66
People at risk for type 2 DM can cut that risk by 58% by exercising moderately for 30 minutes a day and by losing 5 to 7% of their body weight.
True or False?
True
The most powerful risk factor is believed to be obesity.
67
Which of the following statements is true regarding the relationship between schizophrenia and type 2 diabetes?
A. People with schizophrenia are less likely to develop type 2 diabetes due to medication side effects.
B. The incidence of type 2 diabetes is 3 times higher in people with schizophrenia.
C. Schizophrenia protects against insulin resistance due to increased activity levels.
D. There is no known link between schizophrenia and type 2 diabetes.
✅ Correct Answer: B. The incidence of type 2 diabetes is 3 times higher in people with schizophrenia.
🧠 Quick reason: Medications used to treat schizophrenia can lead to weight gain and obesity, which increases the risk for insulin resistance and type 2 diabetes.
68
Which variable best differentiates between type 1 and type 2 diabetes?
a. diagnostic tests
b. level of endogenous insulin
c. nutritional status
d. age at onset of disease
b. Level of endogenous insulin
🩸 Why this is the best differentiator:
Type 1 diabetes: Little to no endogenous insulin production because the body’s immune system destroys the insulin-producing β-cells in the pancreas.
Type 2 diabetes: The body still produces insulin, but there's insulin resistance and/or impaired insulin secretion — so endogenous insulin is present, just not used effectively.
69
Which value for glycated hemoglobin (A1C) level is a diagnostic test for diabetes mellitus (DM)?
≥5.0%
≥5.5%
≥6.0%
≥6.5%
6.5%
🩸 What does this mean?
A glycated hemoglobin (A1C) level of 6.5% or higher on two separate tests is one of the standard diagnostic criteria for diabetes mellitus.
Quick A1C breakdown:
Below 5.7% = Normal
5.7%–6.4% = Prediabetes
≥6.5% = Diabetes
70
Which information would the nurse include when teaching about secondary diabetes?
a. Can be resolved when the underlying condition is treated
b. Goes on to become classified as primary type 2 if it last longer than the condition that induced it
c. Occurs in neonates who acquire diabetes from a mother with gestational diabetes
d. Limited to only those with type 1 diabetes
✅ Correct Answer: Can be resolved when the underlying condition is treated
💡 Here's why:
Secondary diabetes happens because of another condition or factor (like certain meds, pancreatic disease, or hormone disorders). If you treat or remove the cause, the diabetes may improve or even resolve.
Why the other options are incorrect:
❌ “Goes on to become classified as primary type 2…” → Nope, it stays classified as secondary, even if it lasts.
❌ “Occurs in neonates who acquire diabetes from a mother with gestational diabetes” → That’s not secondary diabetes; that would be neonatal or possibly congenital diabetes.
❌ “Limited to only those with type 1 diabetes” → Not true! Secondary diabetes can happen in anyone, regardless of type 1 or 2 risk.
71
Which of the following are complications associated with insulin therapy?
A. Allergic reactions, lipodystrophy, Somogyi effect, and dawn phenomenon
B. Hyperthyroidism, dehydration, and pancreatitis
C. High blood pressure, edema, and renal failure
D. Anemia, bradycardia, and liver enlargement
✅ Correct Answer: A. Allergic reactions, lipodystrophy, Somogyi effect, and dawn phenomenon
72
Which statement best describes the Somogyi effect in a patient receiving insulin therapy?
A. A condition where insulin causes persistent morning hypoglycemia
B. Rebound morning hyperglycemia caused by overnight hypoglycemia and counter-regulatory hormone release
C. A drop in blood sugar due to delayed gastric emptying
D. A steady rise in blood glucose overnight due to growth hormone release
✅ Correct Answer: B. Rebound morning hyperglycemia caused by overnight hypoglycemia and counter-regulatory hormone release
73
Which benefit do oral antihyperglycemic agents (OHAs) provide for type 2 diabetes mellitus (DM) treatment?
a. Improve how insulin and glucose are produced and used by the body
b. Increase insulin production
c. Eliminate hypoglycemic episodes
d. Are meant to be a replacement for insulin
👉 Improve how insulin and glucose are produced and used by the body
Oral antihyperglycemic agents (OHAs) work in different ways depending on the class, but overall, they help the body:
Use insulin more effectively
Lower glucose production in the liver
Increase insulin release (when needed)
Improve glucose uptake in cells
They do not eliminate hypoglycemia, and they're not a replacement for insulin—some people with type 2 DM eventually still need insulin.
74
Which action of metformin makes it a first-line medication for use in patients with type 2 diabetes mellitus (DM)?
a. It reduces glucose production by the liver.
b. It reduces the import of glucose into cells.
c. Serum creatinine is maintained at normal levels.
d. It reduces insulin sensitivity at the tissue level.
👉 It reduces glucose production by the liver.
Metformin is the first-line med for type 2 diabetes because it:
- Decreases hepatic (liver) glucose production
- Improves insulin sensitivity (helps cells respond better to insulin)
- Does not cause weight gain
- Has a low risk of hypoglycemia
It does not reduce glucose import into cells or increase insulin resistance — it actually helps with the opposite.
75
Which other manifestation would the nurse anticipate if diabetic ketoacidosis (DKA) is suspected when a patient with type 1 diabetes presents to the emergency department with generalized weakness, mild disorientation, increased thirst, and a fruity breath odor?
a. Mood swings
b. Severe drowsiness
c. High blood pressure
d. Kussmaul’s respirations
d. Kussmaul's Respirations
In diabetic ketoacidosis (DKA), the body produces excess ketones leading to metabolic acidosis. To compensate, the patient develops:
Kussmaul’s respirations — deep, rapid breathing to blow off CO₂ and reduce acidity.
Other symptoms like fruity breath (due to acetone) and increased thirst are also classic signs.
76
Which of the following best describes macrovascular complications in people with diabetes mellitus (DM)?
A. Diseases affecting small blood vessels like capillaries and arterioles
B. Diseases of large and medium-sized blood vessels, including cerebrovascular, cardiovascular, and peripheral vascular disease
C. Complications caused only by genetic factors unrelated to lipid metabolism
D. Conditions that are not influenced by glucose control
Answer: B. Diseases of large and medium-sized blood vessels, including cerebrovascular, cardiovascular, and peripheral vascular disease
77
Which of the following is true about microvascular complications of diabetes mellitus (DM)?
A. They affect large and medium-sized blood vessels and are unrelated to DM.
B. They result from thickening of capillaries and arterioles and commonly affect the eyes, kidneys, nerves, and skin.
C. They appear immediately after diagnosis of type 1 DM in all patients.
D. They are prevented entirely by controlling blood pressure alone.
Answer: B. They result from thickening of capillaries and arterioles and commonly affect the eyes, kidneys, nerves, and skin.
78
Which of the following is true regarding the management of diabetic retinopathy in patients with diabetes mellitus (DM)?
A. Regular dilated-eye exams are unnecessary if blood sugar is controlled.
B. Prevention through good glycemic and blood pressure control is key, and treatments include laser photocoagulation, vitrectomy, and intraocular injections.
C. Diabetic retinopathy can only be treated with oral medications.
D. Eye examinations should only be done after vision loss occurs.
Answer: B. Prevention through good glycemic and blood pressure control is key, and treatments include laser photocoagulation, vitrectomy, and intraocular injections.
Regular eye exams should be completed with dilation for early detection and treatment
79
Which characteristic of aging is most closely associated with the development of diabetes mellitus (DM)?
A. Hypoglycemic unawareness
B. Frailty
C. Reduction in β-cell function
D. Poor psychomotor function
c. Reduction in b-cell function
