Diabetes Mellitus NCLEX Practice Exam PDF

Diabetes Mellitus NCLEX Practice Exam **1. What is the primary function of insulin in glucose metabolism?** A\) To break down glycogen into glucose\ B) To facilitate glucose transport into cells\ C) To increase glucose production in the liver\ D) To convert glucose into amino acids **Answer:** B)...

Diabetes Mellitus NCLEX Practice Exam **1. What is the primary function of insulin in glucose metabolism?** A\) To break down glycogen into glucose\ B) To facilitate glucose transport into cells\ C) To increase glucose production in the liver\ D) To convert glucose into amino acids **Answer:** B) To facilitate glucose transport into cells\ **Rationale:** Insulin acts as a key that allows glucose to enter cells for energy. Without insulin, glucose remains in the bloodstream, leading to hyperglycemia. **2. Which of the following clinical manifestations is most characteristic of Type 1 Diabetes Mellitus?** A\) Gradual weight gain\ B) Insidious onset of symptoms\ C) Polyuria, polydipsia, polyphagia\ D) No symptoms until complications arise **Answer:** C) Polyuria, polydipsia, polyphagia\ **Rationale:** The \"3 Ps\" (polyuria, polydipsia, polyphagia) are hallmark symptoms of Type 1 DM due to lack of insulin, leading to excessive thirst, hunger, and urination. **3. A patient with Type 2 Diabetes Mellitus is likely to exhibit which pathophysiological process?** A\) Complete destruction of pancreatic beta cells\ B) Increased insulin sensitivity\ C) Insulin resistance and decreased insulin secretion\ D) Autoimmune attack on pancreatic alpha cells **Answer:** C) Insulin resistance and decreased insulin secretion\ **Rationale:** Type 2 DM is characterized by insulin resistance and eventual beta-cell dysfunction, leading to inadequate glucose uptake. **4. A fasting blood glucose (FBS) level of 130 mg/dL is indicative of:** A\) Normal glucose metabolism\ B) Prediabetes\ C) Diabetes Mellitus\ D) Hypoglycemia **Answer:** C) Diabetes Mellitus\ **Rationale:** A fasting blood glucose ≥126 mg/dL on two separate occasions confirms diabetes. **5. Which lab test provides an average blood glucose level over the past 3 months?** A\) Fasting blood glucose\ B) Oral glucose tolerance test\ C) C-peptide test\ D) Hemoglobin A1C **Answer:** D) Hemoglobin A1C\ **Rationale:** HbA1C reflects the percentage of glucose attached to hemoglobin over the RBC lifespan (about 120 days). **6. A nurse is teaching a newly diagnosed patient with Type 1 DM about insulin. Which statement indicates understanding?** A\) \"I only need insulin if my blood sugar is over 200 mg/dL.\"\ B) \"I must take insulin because my body does not produce any.\"\ C) \"I can take oral medications to control my diabetes.\"\ D) \"My diabetes will go away if I lose weight.\" **Answer:** B) \"I must take insulin because my body does not produce any.\"\ **Rationale:** Type 1 DM results from autoimmune destruction of beta cells, requiring lifelong insulin therapy. **7. The nurse recognizes that which of the following medications can cause iatrogenic diabetes?** A\) Beta-blockers\ B) Glucocorticoids\ C) Antibiotics\ D) NSAIDs **Answer:** B) Glucocorticoids\ **Rationale:** Steroids like prednisone can cause hyperglycemia by increasing insulin resistance. **8. Which type of diabetes is associated with pregnancy and an increased risk of later developing Type 2 DM?** A\) Type 1 Diabetes\ B) Type 2 Diabetes\ C) Gestational Diabetes\ D) Maturity-Onset Diabetes of the Young (MODY) **Answer:** C) Gestational Diabetes\ **Rationale:** Gestational diabetes occurs due to hormonal changes and increased insulin resistance. Women with GDM have a higher risk of developing Type 2 DM. **9. Which of the following is NOT a risk factor for Type 2 Diabetes?** A\) Obesity\ B) Family history of diabetes\ C) Regular exercise\ D) Hypertension **Answer:** C) Regular exercise\ **Rationale:** Regular physical activity helps prevent insulin resistance and reduces the risk of Type 2 DM. **10. A nurse is assessing a patient with suspected hypoglycemia. Which symptom would they most likely find?** A\) Fruity breath odor\ B) Dry, flushed skin\ C) Shakiness and diaphoresis\ D) Deep, rapid respirations **Answer:** C) Shakiness and diaphoresis\ **Rationale:** Hypoglycemia causes autonomic symptoms such as tremors, sweating, irritability, and confusion. **11. The nurse should administer which intervention for a conscious patient with blood glucose of 60 mg/dL?** A\) Administer 1 mg glucagon IM\ B) Give 15 grams of carbohydrate\ C) Start an insulin drip\ D) Call a code blue **Answer:** B) Give 15 grams of carbohydrate\ **Rationale:** Follow the **\"15/15 rule\"**: give 15g of carbohydrates, then check glucose in 15 minutes. **12. What is the primary goal of insulin therapy?** A\) To prevent insulin resistance\ B) To allow the kidneys to excrete excess glucose\ C) To maintain blood glucose within target range\ D) To prevent the need for oral antidiabetic drugs **Answer:** C) To maintain blood glucose within target range\ **Rationale:** The main goal of insulin therapy is to mimic natural insulin release to keep blood glucose stable. **13. Diabetic Ketoacidosis (DKA) is primarily associated with which type of diabetes?** A\) Type 1 Diabetes\ B) Type 2 Diabetes\ C) Gestational Diabetes\ D) MODY **Answer:** A) Type 1 Diabetes\ **Rationale:** DKA occurs when there is a severe insulin deficiency, leading to ketosis and metabolic acidosis. **14. What is a hallmark sign of Hyperosmolar Hyperglycemic State (HHS)?** A\) Ketonuria\ B) Severe dehydration\ C) Metabolic acidosis\ D) Fruity breath odor **Answer:** B) Severe dehydration\ **Rationale:** HHS is characterized by extreme hyperglycemia (\>600 mg/dL) and dehydration but **without ketosis**. **15. Which of the following lifestyle modifications is recommended for managing Type 2 Diabetes?** A\) High-fat diet\ B) Daily exercise\ C) Skipping meals\ D) Avoiding all carbohydrates **Answer:** B) Daily exercise\ **Rationale:** Exercise increases insulin sensitivity and helps with glucose metabolism. **16. What is the first step in managing a patient with suspected Diabetic Ketoacidosis (DKA)?** A\) Administer sodium bicarbonate\ B) Start an insulin drip\ C) Administer IV fluids\ D) Give oral glucose **Answer:** C) Administer IV fluids\ **Rationale:** Fluid replacement is the first step in treating DKA to correct severe dehydration before starting insulin therapy. **17. A patient with Type 2 Diabetes is prescribed metformin. What important teaching should the nurse provide?** A\) \"Take this medication on an empty stomach.\"\ B) \"You may experience hypoglycemia frequently.\"\ C) \"Stop taking this medication before a CT scan with contrast dye.\"\ D) \"This medication works by increasing insulin secretion.\" **Answer:** C) \"Stop taking this medication before a CT scan with contrast dye.\"\ **Rationale:** Metformin should be held before contrast dye procedures to prevent **lactic acidosis**. **18. A diabetic patient is admitted with confusion and a blood glucose of 45 mg/dL. The nurse should:** A\) Administer IV dextrose\ B) Give an oral carbohydrate\ C) Encourage the patient to eat a meal\ D) Monitor blood glucose for 24 hours before treating **Answer:** A) Administer IV dextrose\ **Rationale:** In an unconscious or severely symptomatic patient, **IV dextrose** is the immediate intervention for hypoglycemia. **19. Which of the following is NOT a long-term complication of diabetes?** A\) Retinopathy\ B) Nephropathy\ C) Neuropathy\ D) Acute pancreatitis **Answer:** D) Acute pancreatitis\ **Rationale:** Diabetes increases the risk for eye, kidney, and nerve damage, but pancreatitis is not a direct chronic complication. **20. The nurse is teaching a diabetic patient about foot care. Which statement indicates correct understanding?** A\) \"I should soak my feet daily in warm water.\"\ B) \"I should walk barefoot to toughen my feet.\"\ C) \"I will check my feet daily for cuts or blisters.\"\ D) \"I should cut my toenails as short as possible.\" **Answer:** C) \"I will check my feet daily for cuts or blisters.\"\ **Rationale:** Diabetic neuropathy increases the risk of **wounds and infections**, so daily foot inspections are essential. **21. A patient with hyperglycemia has dry mucous membranes and poor skin turgor. What intervention is the priority?** A\) Provide insulin therapy\ B) Encourage fluid intake\ C) Administer oxygen\ D) Monitor potassium levels **Answer:** B) Encourage fluid intake\ **Rationale:** Dehydration is common in hyperglycemia; rehydration is a priority before insulin therapy. **22. Which of the following best describes Maturity-Onset Diabetes of the Young (MODY)?** A\) An autoimmune disorder\ B) Associated with obesity\ C) A monogenic form of diabetes\ D) Common in elderly patients **Answer:** C) A monogenic form of diabetes\ **Rationale:** MODY is caused by a **single gene mutation** and typically presents in young individuals. **23. A patient on insulin therapy develops lipodystrophy at injection sites. What should the nurse teach the patient?** A\) \"This reaction is permanent and unavoidable.\"\ B) \"Use the same site every time to reduce irritation.\"\ C) \"Rotate injection sites to prevent fat tissue changes.\"\ D) \"Massage the area after injection to improve absorption.\" **Answer:** C) \"Rotate injection sites to prevent fat tissue changes.\"\ **Rationale:** Lipodystrophy results from repeated injections in the same site. **Rotating sites** prevents this. **24. Which statement by a Type 1 diabetic patient indicates the need for further teaching?** A\) \"If I am sick, I should still take my insulin.\"\ B) \"I will monitor my blood glucose more frequently when I am ill.\"\ C) \"If my blood sugar is high, I will skip my insulin dose.\"\ D) \"I should drink extra fluids if I have a fever.\" **Answer:** C) \"If my blood sugar is high, I will skip my insulin dose.\"\ **Rationale:** Insulin should **never be skipped**, even during illness, as hyperglycemia can worsen. **25. A patient taking insulin reports frequent episodes of hypoglycemia. What advice should the nurse provide?** A\) \"Skip your evening insulin dose.\"\ B) \"Eat regular meals and snacks throughout the day.\"\ C) \"Reduce your carbohydrate intake.\"\ D) \"Increase your insulin dose.\" **Answer:** B) \"Eat regular meals and snacks throughout the day.\"\ **Rationale:** **Regular meals** prevent hypoglycemia by maintaining blood glucose levels. **26. Which statement about insulin administration is correct?** A\) \"Shake the insulin vial before drawing it up.\"\ B) \"Mix long-acting insulin with regular insulin in the same syringe.\"\ C) \"Administer insulin at room temperature to reduce discomfort.\"\ D) \"Give all insulin injections in the same site for consistency.\" **Answer:** C) \"Administer insulin at room temperature to reduce discomfort.\"\ **Rationale:** Cold insulin can **cause pain**, so it\'s best administered at **room temperature**. **27. A patient with a hemoglobin A1C of 9.0% is being educated about glycemic control. The nurse should emphasize:** A\) \"Your A1C level is within the target range.\"\ B) \"This indicates poor blood sugar control over the past 3 months.\"\ C) \"An A1C of 9.0% means your blood sugar has been too low.\"\ D) \"You should stop all carbohydrate intake immediately.\" **Answer:** B) \"This indicates poor blood sugar control over the past 3 months.\"\ **Rationale:** An **A1C above 6.5%** indicates **poor glycemic control** and increased risk of complications. **28. A nurse is caring for a diabetic patient who is experiencing nausea and vomiting. What should the nurse monitor for?** A\) Hypoglycemia\ B) Hyperkalemia\ C) Metabolic alkalosis\ D) Dehydration **Answer:** D) Dehydration\ **Rationale:** Nausea and vomiting can lead to **fluid loss and dehydration**, which worsens hyperglycemia. **29. The nurse is teaching a patient with diabetes about dietary management. Which food choice indicates proper understanding?** A\) White bread and fruit juice\ B) Fried chicken and soda\ C) Brown rice and grilled salmon\ D) Processed snack foods **Answer:** C) Brown rice and grilled salmon\ **Rationale:** Whole grains and **lean proteins** help maintain **stable blood glucose levels**. **30. Which of the following is the best indicator that diabetes management is effective?** A\) Normal fasting blood glucose levels\ B) Absence of ketones in urine\ C) Stable daily weight\ D) Hemoglobin A1C within target range **Answer:** D) Hemoglobin A1C within target range\ **Rationale:** **HbA1C** provides a long-term measure of **blood sugar control** over 3 months.