NUR 6121 ENDOCRINE AND METABOLIC
DISORDERS — TYPE 2 DIABETES
MELLITUS (DM II)
Intensive NCLEX-Style Test Bank
1. Which of the following is NOT a cardinal sign of diabetes mellitus?
A. Polydipsia
B. Polyuria
C. Polyphagia
D. Polyarthritis
Correct Answer: D. Polyarthritis
Rationale:
The three cardinal signs of diabetes mellitus are:
Polyuria (excessive urination)
Polydipsia (excessive thirst)
Polyphagia (excessive hunger)
Polyarthritis refers to inflammation of multiple joints and is unrelated to diabetes
pathophysiology.
2. Type 2 diabetes mellitus accounts for approximately what percentage of all
diabetes cases?
A. 50–60%
B. 70–80%
C. 90–95%
D. 98–100%
Correct Answer: C. 90–95%
,Rationale:
Type 2 diabetes mellitus accounts for the vast majority of diabetes cases and is characterized
primarily by insulin resistance and progressive β-cell dysfunction.
3. At what blood glucose level does polyuria typically occur due to exceeding the
renal threshold?
A. >140 mg/dL
B. >160 mg/dL
C. >180 mg/dL
D. >200 mg/dL
Correct Answer: C. >180 mg/dL
Rationale:
The renal threshold for glucose is approximately 180 mg/dL. Above this level, glucose spills into
urine (glucosuria), causing osmotic diuresis and polyuria.
4. Which laboratory marker is typically elevated in Type 2 DM compared to
Type 1 DM?
A. C-peptide
B. β-cell autoantibodies
C. Ketones
D. Serum lactate
Correct Answer: A. C-peptide
Rationale:
C-peptide reflects endogenous insulin production. In Type 2 DM, insulin production is often
normal or elevated initially. In Type 1 DM, C-peptide is low due to β-cell destruction.
5. What is the recommended first-line pharmacologic therapy for Type 2 DM?
A. Sulfonylureas
B. Insulin
C. Metformin
D. GLP-1 receptor agonists
Correct Answer: C. Metformin
, Rationale:
Metformin is first-line therapy because it:
Improves insulin sensitivity
Reduces hepatic glucose production
Does not cause hypoglycemia
Promotes mild weight loss
6. At what age should asymptomatic diabetes screening begin in average-risk
adults?
A. 35 years
B. 40 years
C. 45 years
D. 50 years
Correct Answer: C. 45 years
Rationale:
Screening begins at age 45 because insulin resistance increases with age.
7. Which ethnic group uses a lower BMI cutoff (>23) for diabetes screening?
A. African American
B. Latino
C. Asian American
D. Native American
Correct Answer: C. Asian American
Rationale:
Asian populations develop diabetes at lower BMI due to increased visceral fat and insulin
resistance.
8. What is the target A1C for most non-pregnant adults with diabetes?
A. <6.0%
B. <7.0%
C. <8.0%
D. <9.0%
DISORDERS — TYPE 2 DIABETES
MELLITUS (DM II)
Intensive NCLEX-Style Test Bank
1. Which of the following is NOT a cardinal sign of diabetes mellitus?
A. Polydipsia
B. Polyuria
C. Polyphagia
D. Polyarthritis
Correct Answer: D. Polyarthritis
Rationale:
The three cardinal signs of diabetes mellitus are:
Polyuria (excessive urination)
Polydipsia (excessive thirst)
Polyphagia (excessive hunger)
Polyarthritis refers to inflammation of multiple joints and is unrelated to diabetes
pathophysiology.
2. Type 2 diabetes mellitus accounts for approximately what percentage of all
diabetes cases?
A. 50–60%
B. 70–80%
C. 90–95%
D. 98–100%
Correct Answer: C. 90–95%
,Rationale:
Type 2 diabetes mellitus accounts for the vast majority of diabetes cases and is characterized
primarily by insulin resistance and progressive β-cell dysfunction.
3. At what blood glucose level does polyuria typically occur due to exceeding the
renal threshold?
A. >140 mg/dL
B. >160 mg/dL
C. >180 mg/dL
D. >200 mg/dL
Correct Answer: C. >180 mg/dL
Rationale:
The renal threshold for glucose is approximately 180 mg/dL. Above this level, glucose spills into
urine (glucosuria), causing osmotic diuresis and polyuria.
4. Which laboratory marker is typically elevated in Type 2 DM compared to
Type 1 DM?
A. C-peptide
B. β-cell autoantibodies
C. Ketones
D. Serum lactate
Correct Answer: A. C-peptide
Rationale:
C-peptide reflects endogenous insulin production. In Type 2 DM, insulin production is often
normal or elevated initially. In Type 1 DM, C-peptide is low due to β-cell destruction.
5. What is the recommended first-line pharmacologic therapy for Type 2 DM?
A. Sulfonylureas
B. Insulin
C. Metformin
D. GLP-1 receptor agonists
Correct Answer: C. Metformin
, Rationale:
Metformin is first-line therapy because it:
Improves insulin sensitivity
Reduces hepatic glucose production
Does not cause hypoglycemia
Promotes mild weight loss
6. At what age should asymptomatic diabetes screening begin in average-risk
adults?
A. 35 years
B. 40 years
C. 45 years
D. 50 years
Correct Answer: C. 45 years
Rationale:
Screening begins at age 45 because insulin resistance increases with age.
7. Which ethnic group uses a lower BMI cutoff (>23) for diabetes screening?
A. African American
B. Latino
C. Asian American
D. Native American
Correct Answer: C. Asian American
Rationale:
Asian populations develop diabetes at lower BMI due to increased visceral fat and insulin
resistance.
8. What is the target A1C for most non-pregnant adults with diabetes?
A. <6.0%
B. <7.0%
C. <8.0%
D. <9.0%
