NSG-170: Metabolism || Answered Perfectly 100%.
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) correct answers 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.
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." correct answers 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.
,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 correct answers 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.
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." correct answers 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.
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 correct answers 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.
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 correct answers 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.
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 correct answers 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.
1.A nurse is teaching a client with diabetes mellitus who asks, "Why is it necessary to maintain
my blood glucose levels no lower than about 60 mg/dL?" How should the nurse respond?
a. "Glucose is the only fuel used by the body to produce the energy that it needs."
b. "Your brain needs a constant supply of glucose because it cannot store it."
c. "Without a minimum level of glucose, your body does not make red blood cells."
d. "Glucose in the blood prevents the formation of lactic acid and prevents acidosis." correct
answers ANS: B
Because the brain cannot synthesize or store significant amounts of glucose, a continuous supply
from the body's circulation is needed to meet the fuel demands of the central nervous system.
The nurse would want to educate the client to prevent hypoglycemia. The body can use other
sources of fuel, including fat and protein, and glucose is not involved in the production of red
blood cells. Glucose in the blood will encourage glucose metabolism but is not directly
responsible for lactic acid formation.
2.A nurse reviews laboratory results for a client with diabetes mellitus who presents with
polyuria, lethargy, and a blood glucose of 560 mg/dL. Which laboratory result should the nurse
correlate with the client's polyuria?
a. Serum sodium: 163 mEq/L
b. Serum creatinine: 1.6 mg/dL
c. Presence of urine ketone bodies
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) correct answers 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.
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." correct answers 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.
,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 correct answers 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.
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." correct answers 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.
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 correct answers 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.
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 correct answers 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.
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 correct answers 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.
1.A nurse is teaching a client with diabetes mellitus who asks, "Why is it necessary to maintain
my blood glucose levels no lower than about 60 mg/dL?" How should the nurse respond?
a. "Glucose is the only fuel used by the body to produce the energy that it needs."
b. "Your brain needs a constant supply of glucose because it cannot store it."
c. "Without a minimum level of glucose, your body does not make red blood cells."
d. "Glucose in the blood prevents the formation of lactic acid and prevents acidosis." correct
answers ANS: B
Because the brain cannot synthesize or store significant amounts of glucose, a continuous supply
from the body's circulation is needed to meet the fuel demands of the central nervous system.
The nurse would want to educate the client to prevent hypoglycemia. The body can use other
sources of fuel, including fat and protein, and glucose is not involved in the production of red
blood cells. Glucose in the blood will encourage glucose metabolism but is not directly
responsible for lactic acid formation.
2.A nurse reviews laboratory results for a client with diabetes mellitus who presents with
polyuria, lethargy, and a blood glucose of 560 mg/dL. Which laboratory result should the nurse
correlate with the client's polyuria?
a. Serum sodium: 163 mEq/L
b. Serum creatinine: 1.6 mg/dL
c. Presence of urine ketone bodies
