ATI-DIABETES MELLITUS EXAM
WITH CORRECT ANSWERS
When instructing a patient regarding a urine study for free cortisol, it is most
important for the nurse to tell the patient to
A. Save the first voided urine in the am.
B. Maintain a high-sodium diet 3 days before collection.
C. Try to avoid stressful situations during the collection period.
D. Complete at least 30 minutes of strenuous exercise before collecting the urine
sample. - correct answers -C. Try to avoid stressful situations during the collection
period.
A urine study for free cortisol requires a 24-hour urine collection. The patient should
be instructed to avoid stressful situations and excessive physical exercise that could
unduly increase cortisol levels. The patient should also maintain a low-sodium diet
before and during the urine collection period.
Which of the following assessment parameters is of highest priority when caring for a
patient undergoing a water deprivation test?
A. Serum glucose
,B. Patient weight
C. Arterial blood gases
D. Patient temperature - correct answers -B. Patient weight
A patient is at risk for severe dehydration during a water deprivation test. The test
should be discontinued and the patient rehydrated if the patient's weight drops more
than 2 kg at any time. The other assessment parameters do not assess fluid
balance.
A patient has sought care because of a loss of 25 lb over the past 6 months, during
which the patient claims to have made no significant dietary changes. The nurse
should assess the patient for potential
A. Thyroid disorders.
B. Diabetes insipidus.
C. Pituitary dysfunction.
D. Parathyroid dysfunction. - correct answers -A. Thyroid disorders.
Hyperthyroidism is associated with weight loss. Alterations in pituitary function, such
as diabetes insipidus, and parathyroid dysfunction are not commonly associated with
this phenomenon.
The surgeon was unable to save a patient's parathyroid gland during a radical
thyroidectomy. The nurse should consequently pay particular attention to which of
the following components of the patient's laboratory values?
A. Calcium levels
B. Potassium levels
C. Blood glucose levels
D. Sodium and chloride levels - correct answers -A. Calcium levels
The parathyroid gland plays a key role in maintaining calcium levels. Potassium,
sodium, glucose, and chloride are not directly influenced by the loss of the
parathyroid gland.
A patient's recent medical history is indicative of diabetes insipidus. The nurse would
perform patient education related to which of the following diagnostic tests?
A. Thyroid scan
B. Fasting glucose test
C. Oral glucose tolerance
D. Water deprivation test - correct answers -D. Water deprivation test
A water deprivation test is used to diagnose the polyuria that accompanies diabetes
insipidus. Glucose tests and thyroid tests are not directly related to the diagnosis of
diabetes insipidus.
A 54-year-old patient admitted with type 2 diabetes, asks the nurse what "type 2"
means. Which of the following is the most appropriate response by the nurse?
A. "With type 2 diabetes, the body of the pancreas becomes inflamed."
B. "With type 2 diabetes, insulin secretion is decreased and insulin resistance is
increased."
, C. "With type 2 diabetes, the patient is totally dependent on an outside source of
insulin."
D. "With type 2 diabetes, the body produces autoantibodies that destroy b-cells in
the pancreas." - correct answers -B. "With type 2 diabetes, insulin secretion is
decreased and insulin resistance is increased."
In type 2 diabetes mellitus, the secretion of insulin by the pancreas is reduced and/or
the cells of the body become resistant to insulin.
The nurse caring for a 54-year-old patient hospitalized with diabetes mellitus would
look for which of the following laboratory test results to obtain information on the
patient's past glucose control?
A. Prealbumin level
B. Urine ketone level
C. Fasting glucose level
D. Glycosylated hemoglobin level - correct answers -D. Glycosylated hemoglobin
level
A glycosylated hemoglobin level detects the amount of glucose that is bound to red
blood cells (RBCs). When circulating glucose levels are high, glucose attaches to the
RBCs and remains there for the life of the blood cell, which is approximately 120
days. Thus the test can give an indication of glycemic control over approximately 2 to
3 months.
The nurse has been teaching a patient with diabetes how to perform self-monitoring
of blood glucose. During evaluation of the patient's technique, the nurse identifies a
need for additional teaching when the patient does which of the following?
A. Chooses a puncture site in the center of the finger pad
B. Washes hands with soap and water to cleanse the site to be used
C. Warms the finger before puncturing to obtain a drop of blood
D. Tells the nurse that the result of 120 mg/dl indicates good control of diabetes -
correct answers -A. Chooses a puncture site in the center of the finger pad
The patient should select a site on the sides of the fingertips, not on the center of the
finger pad. This area contains many nerve endings and would be unnecessarily
painful.
The nurse is teaching a 54-year-old patient with diabetes about proper composition
of the daily diet. The nurse explains that the guideline for carbohydrate intake is
which of the following?
A. 80% of daily intake
B. Minimum of 80 g/day
C. Minimum of 130 g/day
D. Maximum of 130 g/day - correct answers -C. Minimum of 130 g/day
The recommendation for carbohydrate intake is a minimum of 130 g/day. Low-
carbohydrate diets are not recommended for diabetes management.
The nurse is assigned to the care of a 64-year-old patient diagnosed with type 2
diabetes. In formulating a teaching plan that encourages the patient to actively
WITH CORRECT ANSWERS
When instructing a patient regarding a urine study for free cortisol, it is most
important for the nurse to tell the patient to
A. Save the first voided urine in the am.
B. Maintain a high-sodium diet 3 days before collection.
C. Try to avoid stressful situations during the collection period.
D. Complete at least 30 minutes of strenuous exercise before collecting the urine
sample. - correct answers -C. Try to avoid stressful situations during the collection
period.
A urine study for free cortisol requires a 24-hour urine collection. The patient should
be instructed to avoid stressful situations and excessive physical exercise that could
unduly increase cortisol levels. The patient should also maintain a low-sodium diet
before and during the urine collection period.
Which of the following assessment parameters is of highest priority when caring for a
patient undergoing a water deprivation test?
A. Serum glucose
,B. Patient weight
C. Arterial blood gases
D. Patient temperature - correct answers -B. Patient weight
A patient is at risk for severe dehydration during a water deprivation test. The test
should be discontinued and the patient rehydrated if the patient's weight drops more
than 2 kg at any time. The other assessment parameters do not assess fluid
balance.
A patient has sought care because of a loss of 25 lb over the past 6 months, during
which the patient claims to have made no significant dietary changes. The nurse
should assess the patient for potential
A. Thyroid disorders.
B. Diabetes insipidus.
C. Pituitary dysfunction.
D. Parathyroid dysfunction. - correct answers -A. Thyroid disorders.
Hyperthyroidism is associated with weight loss. Alterations in pituitary function, such
as diabetes insipidus, and parathyroid dysfunction are not commonly associated with
this phenomenon.
The surgeon was unable to save a patient's parathyroid gland during a radical
thyroidectomy. The nurse should consequently pay particular attention to which of
the following components of the patient's laboratory values?
A. Calcium levels
B. Potassium levels
C. Blood glucose levels
D. Sodium and chloride levels - correct answers -A. Calcium levels
The parathyroid gland plays a key role in maintaining calcium levels. Potassium,
sodium, glucose, and chloride are not directly influenced by the loss of the
parathyroid gland.
A patient's recent medical history is indicative of diabetes insipidus. The nurse would
perform patient education related to which of the following diagnostic tests?
A. Thyroid scan
B. Fasting glucose test
C. Oral glucose tolerance
D. Water deprivation test - correct answers -D. Water deprivation test
A water deprivation test is used to diagnose the polyuria that accompanies diabetes
insipidus. Glucose tests and thyroid tests are not directly related to the diagnosis of
diabetes insipidus.
A 54-year-old patient admitted with type 2 diabetes, asks the nurse what "type 2"
means. Which of the following is the most appropriate response by the nurse?
A. "With type 2 diabetes, the body of the pancreas becomes inflamed."
B. "With type 2 diabetes, insulin secretion is decreased and insulin resistance is
increased."
, C. "With type 2 diabetes, the patient is totally dependent on an outside source of
insulin."
D. "With type 2 diabetes, the body produces autoantibodies that destroy b-cells in
the pancreas." - correct answers -B. "With type 2 diabetes, insulin secretion is
decreased and insulin resistance is increased."
In type 2 diabetes mellitus, the secretion of insulin by the pancreas is reduced and/or
the cells of the body become resistant to insulin.
The nurse caring for a 54-year-old patient hospitalized with diabetes mellitus would
look for which of the following laboratory test results to obtain information on the
patient's past glucose control?
A. Prealbumin level
B. Urine ketone level
C. Fasting glucose level
D. Glycosylated hemoglobin level - correct answers -D. Glycosylated hemoglobin
level
A glycosylated hemoglobin level detects the amount of glucose that is bound to red
blood cells (RBCs). When circulating glucose levels are high, glucose attaches to the
RBCs and remains there for the life of the blood cell, which is approximately 120
days. Thus the test can give an indication of glycemic control over approximately 2 to
3 months.
The nurse has been teaching a patient with diabetes how to perform self-monitoring
of blood glucose. During evaluation of the patient's technique, the nurse identifies a
need for additional teaching when the patient does which of the following?
A. Chooses a puncture site in the center of the finger pad
B. Washes hands with soap and water to cleanse the site to be used
C. Warms the finger before puncturing to obtain a drop of blood
D. Tells the nurse that the result of 120 mg/dl indicates good control of diabetes -
correct answers -A. Chooses a puncture site in the center of the finger pad
The patient should select a site on the sides of the fingertips, not on the center of the
finger pad. This area contains many nerve endings and would be unnecessarily
painful.
The nurse is teaching a 54-year-old patient with diabetes about proper composition
of the daily diet. The nurse explains that the guideline for carbohydrate intake is
which of the following?
A. 80% of daily intake
B. Minimum of 80 g/day
C. Minimum of 130 g/day
D. Maximum of 130 g/day - correct answers -C. Minimum of 130 g/day
The recommendation for carbohydrate intake is a minimum of 130 g/day. Low-
carbohydrate diets are not recommended for diabetes management.
The nurse is assigned to the care of a 64-year-old patient diagnosed with type 2
diabetes. In formulating a teaching plan that encourages the patient to actively