NR 443 CHAPTER 48: DIABETES
MELLITUS AND HYPOGLYCEMIA
Chapter 48: Diabetes Mellitus and Hypoglycemia
Linton: Introduction to Medical-Surgical Nursing, 6th 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. 1059 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?
a. Overweight and underactive people cannot simply use the insulin produced.
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.
DIF: Cognitive Level: Comprehension REF: p. 1059 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
The cells cannot use the glucose without insulin, so the patient with diabetes still feels hungry event
though abundant glucose is circulating in the blood.
DIF: Cognitive Level: Comprehension REF: p. 1059 OBJ: 3
TOP: Hunger in the Patient with Diabetes
, KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
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: p. 1059-1060
OBJ: 5 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 glucose levels rise, stimulating the production of insulin.
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.
DIF: Cognitive Level: Comprehension REF: p. 1059 OBJ: 3
TOP: Hyperglycemia KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
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.
DIF: Cognitive Level: Application REF: p. 1081 | p. 1083
OBJ: 8 TOP: Diabetes Lifestyle
KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
7. When a patient with type 2 diabetes says, “Why in the world are they looking at my hemoglobin? I
thought my problem was with my blood sugar.” What should the nurse explain about the level of
hemoglobin A1c?
a. Shows how a high level of glucose can cause a significant drop in the hemoglobin level
b. Shows what the glucose level has done during the past 3 months
MELLITUS AND HYPOGLYCEMIA
Chapter 48: Diabetes Mellitus and Hypoglycemia
Linton: Introduction to Medical-Surgical Nursing, 6th 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. 1059 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?
a. Overweight and underactive people cannot simply use the insulin produced.
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.
DIF: Cognitive Level: Comprehension REF: p. 1059 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
The cells cannot use the glucose without insulin, so the patient with diabetes still feels hungry event
though abundant glucose is circulating in the blood.
DIF: Cognitive Level: Comprehension REF: p. 1059 OBJ: 3
TOP: Hunger in the Patient with Diabetes
, KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
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: p. 1059-1060
OBJ: 5 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 glucose levels rise, stimulating the production of insulin.
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.
DIF: Cognitive Level: Comprehension REF: p. 1059 OBJ: 3
TOP: Hyperglycemia KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
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.
DIF: Cognitive Level: Application REF: p. 1081 | p. 1083
OBJ: 8 TOP: Diabetes Lifestyle
KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
7. When a patient with type 2 diabetes says, “Why in the world are they looking at my hemoglobin? I
thought my problem was with my blood sugar.” What should the nurse explain about the level of
hemoglobin A1c?
a. Shows how a high level of glucose can cause a significant drop in the hemoglobin level
b. Shows what the glucose level has done during the past 3 months
