DEPARTMENT OF MEDICAL-SURGICAL NURSING|HESI EXAMINATION:
DIABETES MELLITUS
ETIOLOGY, PATHOPHYSIOLOGY, COMPLICATIONS, AND EVIDENCE-
BASED MANAGEMENT
NSG 220 / MED-SURG -Bachelor of Science in Nursing (BSN)| Clinical
Nursing Assessment| NCLEX-Style Practice Examination
Academic Year: 2025/2026
The nurse is reviewing laboratory results for the clinic patients to be seen today. Which patient
meets the diagnostic criteria for diabetes mellitus?
a. A 48-year-old woman with a hemoglobin A1C of 8.4%
b. A 58-year-old man with a fasting blood glucose of 111 mg/dL
c. A 68-year-old woman with a random plasma glucose of 190 mg/dL
d. A 78-year-old man with a 2-hour glucose tolerance plasma glucose of 184 mg/dL
a. A 48-year-old woman with a hemoglobin A1C of 8.4%
Criteria for a diagnosis of diabetes mellitus include a hemoglobin A1C ≥ 6.5%, fasting plasma
glucose level =126 mg/dL, 2-hour plasma glucose level =200 mg/dL during an oral glucose
tolerance test, or classic symptoms of hyperglycemia or hyperglycemic crisis with a random
plasma glucose =200 mg/dL.
The nurse teaches a 38-year-old man who was recently diagnosed with type 1 diabetes mellitus
about insulin administration. Which statement by the patient requires an intervention by the
nurse?
1|Page
,a. "I will discard any insulin bottle that is cloudy in appearance."
b. "The best injection site for insulin administration is in my abdomen."
c. "I can wash the site with soap and water before insulin administration."
d. "I may keep my insulin at room temperature (75o F) for up to a month."
a. "I will discard any insulin bottle that is cloudy in appearance."
Intermediate-acting insulin and combination premixed insulin will be cloudy in appearance.
Routine hygiene such as washing with soap and rinsing with water is adequate for skin
preparation for the patient during self-injections. Insulin vials that the patient is currently using
may be left at room temperature for up to 4 weeks unless the room temperature is higher than
86° F (30° C) or below freezing (less than 32° F [0° C]). Rotating sites to different anatomic sites
is no longer recommended. Patients should rotate the injection within one particular site, such
as the abdomen.
The nurse instructs a 22-year-old female patient with diabetes mellitus about a healthy eating
plan. Which statement made by the patient indicates that teaching was successful?
a. "I plan to lose 25 pounds this year by following a high-protein diet."
b. "I may have a hypoglycemic reaction if I drink alcohol on an empty stomach."
c. "I should include more fiber in my diet than a person who does not have diabetes."
d. "If I use an insulin pump, I will not need to limit the amount of saturated fat in my diet."
b. "I may have a hypoglycemic reaction if I drink alcohol on an empty stomach."
The risk for alcohol-induced hypoglycemia is reduced by eating carbohydrates when drinking
alcohol. Intensified insulin therapy, such as the use of an insulin pump, allows considerable
flexibility in food selection and can be adjusted for alterations from usual eating and exercise
habits. However, saturated fat intake should still be limited to less than 7% of total daily
2|Page
, calories. Daily fiber intake of 14 g/1000 kcal is recommended for the general population and for
patients with diabetes mellitus. High-protein diets are not recommended for weight loss.
Which patient with type 1 diabetes mellitus would be at the highest risk for developing
hypoglycemic unawareness?
a. A 58-year-old patient with diabetic retinopathy
b. A 73-year-old patient who takes propranolol (Inderal)
c. A 19-year-old patient who is on the school track team
d. A 24-year-old patient with a hemoglobin A1C of 8.9%
b. A 73-year-old patient who takes propranolol (Inderal)
Hypoglycemic unawareness is a condition in which a person does not experience the warning
signs and symptoms of hypoglycemia until the person becomes incoherent and combative or
loses consciousness. Hypoglycemic awareness is related to autonomic neuropathy of diabetes
that interferes with the secretion of counterregulatory hormones that produce these
symptoms. Older patients and patients who use â-adrenergic blockers (e.g., propranolol) are at
risk for hypoglycemic unawareness.
The nurse is teaching a 60-year-old woman with type 2 diabetes mellitus how to prevent
diabetic nephropathy. Which statement made by the patient indicates that teaching has been
successful?
a. "Smokeless tobacco products decrease the risk of kidney damage."
b. "I can help control my blood pressure by avoiding foods high in salt."
c. "I should have yearly dilated eye examinations by an ophthalmologist."
d. "I will avoid hypoglycemia by keeping my blood sugar above 180 mg/dL."
3|Page
DIABETES MELLITUS
ETIOLOGY, PATHOPHYSIOLOGY, COMPLICATIONS, AND EVIDENCE-
BASED MANAGEMENT
NSG 220 / MED-SURG -Bachelor of Science in Nursing (BSN)| Clinical
Nursing Assessment| NCLEX-Style Practice Examination
Academic Year: 2025/2026
The nurse is reviewing laboratory results for the clinic patients to be seen today. Which patient
meets the diagnostic criteria for diabetes mellitus?
a. A 48-year-old woman with a hemoglobin A1C of 8.4%
b. A 58-year-old man with a fasting blood glucose of 111 mg/dL
c. A 68-year-old woman with a random plasma glucose of 190 mg/dL
d. A 78-year-old man with a 2-hour glucose tolerance plasma glucose of 184 mg/dL
a. A 48-year-old woman with a hemoglobin A1C of 8.4%
Criteria for a diagnosis of diabetes mellitus include a hemoglobin A1C ≥ 6.5%, fasting plasma
glucose level =126 mg/dL, 2-hour plasma glucose level =200 mg/dL during an oral glucose
tolerance test, or classic symptoms of hyperglycemia or hyperglycemic crisis with a random
plasma glucose =200 mg/dL.
The nurse teaches a 38-year-old man who was recently diagnosed with type 1 diabetes mellitus
about insulin administration. Which statement by the patient requires an intervention by the
nurse?
1|Page
,a. "I will discard any insulin bottle that is cloudy in appearance."
b. "The best injection site for insulin administration is in my abdomen."
c. "I can wash the site with soap and water before insulin administration."
d. "I may keep my insulin at room temperature (75o F) for up to a month."
a. "I will discard any insulin bottle that is cloudy in appearance."
Intermediate-acting insulin and combination premixed insulin will be cloudy in appearance.
Routine hygiene such as washing with soap and rinsing with water is adequate for skin
preparation for the patient during self-injections. Insulin vials that the patient is currently using
may be left at room temperature for up to 4 weeks unless the room temperature is higher than
86° F (30° C) or below freezing (less than 32° F [0° C]). Rotating sites to different anatomic sites
is no longer recommended. Patients should rotate the injection within one particular site, such
as the abdomen.
The nurse instructs a 22-year-old female patient with diabetes mellitus about a healthy eating
plan. Which statement made by the patient indicates that teaching was successful?
a. "I plan to lose 25 pounds this year by following a high-protein diet."
b. "I may have a hypoglycemic reaction if I drink alcohol on an empty stomach."
c. "I should include more fiber in my diet than a person who does not have diabetes."
d. "If I use an insulin pump, I will not need to limit the amount of saturated fat in my diet."
b. "I may have a hypoglycemic reaction if I drink alcohol on an empty stomach."
The risk for alcohol-induced hypoglycemia is reduced by eating carbohydrates when drinking
alcohol. Intensified insulin therapy, such as the use of an insulin pump, allows considerable
flexibility in food selection and can be adjusted for alterations from usual eating and exercise
habits. However, saturated fat intake should still be limited to less than 7% of total daily
2|Page
, calories. Daily fiber intake of 14 g/1000 kcal is recommended for the general population and for
patients with diabetes mellitus. High-protein diets are not recommended for weight loss.
Which patient with type 1 diabetes mellitus would be at the highest risk for developing
hypoglycemic unawareness?
a. A 58-year-old patient with diabetic retinopathy
b. A 73-year-old patient who takes propranolol (Inderal)
c. A 19-year-old patient who is on the school track team
d. A 24-year-old patient with a hemoglobin A1C of 8.9%
b. A 73-year-old patient who takes propranolol (Inderal)
Hypoglycemic unawareness is a condition in which a person does not experience the warning
signs and symptoms of hypoglycemia until the person becomes incoherent and combative or
loses consciousness. Hypoglycemic awareness is related to autonomic neuropathy of diabetes
that interferes with the secretion of counterregulatory hormones that produce these
symptoms. Older patients and patients who use â-adrenergic blockers (e.g., propranolol) are at
risk for hypoglycemic unawareness.
The nurse is teaching a 60-year-old woman with type 2 diabetes mellitus how to prevent
diabetic nephropathy. Which statement made by the patient indicates that teaching has been
successful?
a. "Smokeless tobacco products decrease the risk of kidney damage."
b. "I can help control my blood pressure by avoiding foods high in salt."
c. "I should have yearly dilated eye examinations by an ophthalmologist."
d. "I will avoid hypoglycemia by keeping my blood sugar above 180 mg/dL."
3|Page
