Download Concept 12: Glucose Regulation Test Bank MULTIPLE CHOICE 1

Concept 12: Glucose Regulation
Test Bank
MULTIPLE CHOICE
1. The nurse instructs a patient with type 1 diabetes mellitus to avoid which of the following
drugs while taking insulin?
a. Furosemide (Lasix)
b. Dicumarol (Bishydroxycoumarin)
c. Reserpine (Serpasil)
d. Cimetidine (Tagamet)
ANS: A
Furosemide is a loop diuretic and can increase serum glucose levels; its use is contraindicated
with insulin. Dicumarol, an anticoagulant; reserpine, an anti-hypertensive; and cimetidine, an
H2 receptor antagonist, do not affect blood glucose levels.
REF: 115
OBJ: NCLEX® Client Needs Category: Physiological Integrity
2. When a diabetic patient asks about maintaining adequate blood glucose levels, which of the
following statements by the nurse relates most directly to the necessity of maintaining blood
glucose levels no lower than about 74 mg/dl?
a. "Glucose is the only type of fuel used by body cells to produce the energy needed
for physiologic activity."
b. "The central nervous system cannot store glucose and needs a continuous supply of
glucose for fuel."
c. "Without a minimum level of glucose circulating in the blood, erythrocytes cannot
produce ATP."
d. "The presence of glucose in the blood counteracts the formation of lactic acid and
prevents acidosis."
ANS: B
The brain cannot synthesize or store significant amounts of glucose; thus a continuous supply
from the body's circulation is needed to meet the fuel demands of the central nervous system.
REF: 117
OBJ: NCLEX® Client Needs Category: Physiological Integrity
3. The nurse associates which assessment finding in the diabetic patient with decreasing renal
function?
a. Ketone bodies in the urine during acidosis
b. Glucose in the urine during hyperglycemia
c. Protein in the urine during a random urinalysis
d. White blood cells in the urine during a random urinalysis
ANS: C
Urine should not contain protein. Proteinuria in a diabetic heralds the beginning of renal
insufficiency or diabetic nephropathy with subsequent progression to end stage renal disease.
Chronic elevated blood glucose levels can cause renal hypertension and excess kidney
perfusion with leakage from the renal vasculature. This leaking allows protein to be filtered
into the urine.
REF: 116-117
OBJ: NCLEX® Client Needs Category: Physiological Integrity
4. What is the nurse's best response about developing diabetes to the patient whose father has
type 1 diabetes mellitus?
a. "You have a greater susceptibility for development of the disease because of your
family history."
b. "Your risk is the same as the general population, because there is no genetic risk
for development of type 1 diabetes."
c. "Type 1 diabetes is inherited in an autosomal dominant pattern. Therefore the risk
for becoming diabetic is 50%."
d. "Because you are a woman and your father is the parent with diabetes, your risk is
not increased for eventual development of the disease. However, your brothers will
become diabetic."
ANS: A
Even though type 1 diabetes does not follow a specific genetic pattern of inheritance, those
with one parent with type 1 diabetes are at an increased risk for development of the disease.
REF: 114-115
OBJ: NCLEX® Client Needs Category: Physiological Integrity
5. The nurse recognizes which patient as having the greatest risk for undiagnosed diabetes
mellitus?
a. Young white man
b. Middle-aged African-American man
c. Young African-American woman
d. Middle-aged Native American woman
ANS: D
The highest incidence of diabetes in the United States occurs in Native Americans. With age,
the incidence of diabetes increases in all races and ethnic groups.
REF: 114
OBJ: NCLEX® Client Needs Category: Physiological Integrity
6. A diabetic patient is brought into the emergency department unresponsive. The arterial pH is
7.28. Besides the blood pH, which clinical manifestation is seen in uncontrolled diabetes
mellitus and ketoacidosis?
a. Oral temperature of 38.9° Celsius
b. Severe orthostatic hypotension
c. Increased rate and depth of respiration
d. Extremity tremors followed by seizure activity
ANS: C
Ketoacidosis decreases the pH of the blood, stimulating the respiratory control area of the
brain to buffer the effects of the increasing acidosis. The rate and depth of respirations are
increased (Kussmaul's respirations) to excrete more acids by exhalation.
REF: 114
MULTIPLE RESPONSE
OBJ: NCLEX® Client Needs Category: Physiological Integrity
1. Which of the following would be included in the assessment of a patient with diabetes
mellitus who is experiencing a hypoglycemic reaction? (Select all that apply.)
a. Tremors
b. Nervousness
c. Extreme thirst
d. Flushed skin
e. Profuse perspiration
f. Constricted pupils
ANS: A, B, E
When hypoglycemia occurs, blood glucose levels fall, resulting in sympathetic nervous
system responses such as tremors, nervousness, and profuse perspiration. Dilated pupils
would also occur, not constricted pupils. Extreme thirst, flushed skin, and constricted pupils
are consistent with hyperglycemia.
REF: 114
OBJ: NCLEX® Client Needs Category: Physiological Integrity