Diabetes Mellitus Exam Questions PDF

**NCLEX-Style Multiple-Choice & SATA Questions** **1. A nurse is caring for a client with Type 1 diabetes mellitus. Which of the following statements by the client requires further teaching?** A. "I need to check my blood sugar before meals and at bedtime."\ B. "I can stop taking insulin once my b...

**NCLEX-Style Multiple-Choice & SATA Questions** **1. A nurse is caring for a client with Type 1 diabetes mellitus. Which of the following statements by the client requires further teaching?** A. "I need to check my blood sugar before meals and at bedtime."\ B. "I can stop taking insulin once my blood sugar is under control."\ C. "I should always carry a snack in case my blood sugar drops."\ D. "I need to rotate injection sites to prevent lipodystrophy." **Answer:** B\ **Rationale:** Type 1 diabetes is an insulin-dependent condition. The client should not stop insulin even if their blood sugar is controlled. The other statements demonstrate correct understanding. **2. A nurse is teaching a client about the signs and symptoms of hypoglycemia. Which of the following should the nurse include? (Select all that apply.)** A. Sweating\ B. Irritability\ C. Bradycardia\ D. Hunger\ E. Pallor\ F. Hypertension **Answer:** A, B, D, E\ **Rationale:** Hypoglycemia symptoms include sweating, irritability, hunger, and pallor. Bradycardia and hypertension are not typical signs; rather, tachycardia and hypotension may be present. **3. Which of the following lab values confirms a diagnosis of diabetes mellitus?** A. A1C of 5.6%\ B. Fasting blood glucose of 85 mg/dL\ C. 2-hour glucose tolerance test result of 220 mg/dL\ D. Random glucose level of 125 mg/dL **Answer:** C\ **Rationale:** A 2-hour glucose tolerance test value ≥ 200 mg/dL confirms diabetes. The other values are within normal limits. **4. The nurse is providing education about gestational diabetes mellitus (GDM). Which of the following is a complication of GDM?** A. Increased risk of preeclampsia\ B. Decreased birth weight of the infant\ C. Hypoglycemia in the mother\ D. Early onset of menopause **Answer:** A\ **Rationale:** Preeclampsia is a known complication of GDM. Macrosomia (large birth weight) is a risk, not decreased birth weight. **5. A client with Type 2 diabetes mellitus asks why exercise is important. The nurse\'s best response is:** A. "Exercise increases insulin resistance."\ B. "Exercise reduces blood glucose levels by increasing insulin sensitivity."\ C. "Exercise should be avoided to prevent hypoglycemia."\ D. "Exercise decreases the need for carbohydrates." **Answer:** B\ **Rationale:** Exercise helps increase insulin sensitivity and reduce blood glucose levels. **6. Which of the following is an early sign of diabetic ketoacidosis (DKA)?** A. Kussmaul respirations\ B. Fruity breath\ C. Polyuria\ D. Coma **Answer:** C\ **Rationale:** Polyuria is an early sign. Kussmaul respirations and fruity breath occur later in DKA. **7. The nurse should teach a client that which of the following medications can induce iatrogenic diabetes? (Select all that apply.)** A. Glucocorticoids\ B. Antipsychotics\ C. Antiretrovirals\ D. Antihypertensives\ E. Immune inhibitors **Answer:** A, B, C, E\ **Rationale:** These medications can contribute to diabetes development. **8. Which of the following statements about Type 2 diabetes is correct?** A. It is caused by autoimmune destruction of beta cells.\ B. It is characterized by insulin resistance and beta-cell dysfunction.\ C. It primarily occurs in children.\ D. It requires insulin therapy at diagnosis. **Answer:** B\ **Rationale:** Type 2 diabetes is primarily characterized by insulin resistance. **9. A nurse is preparing to administer rapid-acting insulin. Which statement is correct?** A. "I should give this insulin 30 minutes before meals."\ B. "This insulin is given once daily for basal control."\ C. "I should administer this insulin immediately before meals."\ D. "This insulin does not cause hypoglycemia." **Answer:** C\ **Rationale:** Rapid-acting insulin should be given right before meals. **10. A client with Type 1 diabetes mellitus is found unconscious. The nurse should immediately:** A. Administer 1 mg glucagon intramuscularly.\ B. Give the client 15 grams of carbohydrates orally.\ C. Administer long-acting insulin.\ D. Check the client\'s urine for ketones. **Answer:** A\ **Rationale:** An unconscious hypoglycemic client should receive glucagon or IV dextrose. **11. Which insulin has no peak and provides basal glucose control?** A. Regular insulin\ B. NPH insulin\ C. Glargine insulin\ D. Aspart insulin **Answer:** C\ **Rationale:** Glargine has no peak and provides steady glucose control. **12. A client newly diagnosed with diabetes asks about lifestyle changes. Which recommendations should the nurse provide? (Select all that apply.)** A. Engage in at least 150 minutes of exercise weekly.\ B. Maintain a BMI of less than 25.\ C. Consume mostly carbohydrates in the diet.\ D. Avoid tobacco use.\ E. Eat a diet high in trans fats. **Answer:** A, B, D\ **Rationale:** Physical activity, weight management, and avoiding tobacco improve diabetes control. **13. The nurse should monitor which lab value to assess long-term blood glucose control?** A. Fasting blood glucose\ B. Hemoglobin A1C\ C. C-peptide level\ D. Urine glucose **Answer:** B\ **Rationale:** A1C reflects blood glucose levels over 3 months. **14. Which of the following symptoms are associated with hyperglycemia? (Select all that apply.)** A. Polyuria\ B. Weight gain\ C. Polydipsia\ D. Fatigue\ E. Blurred vision **Answer:** A, C, D, E\ **Rationale:** Hyperglycemia leads to excessive urination, thirst, fatigue, and vision changes. **15. The nurse should instruct a client with diabetes to seek medical attention if which occurs?** A. Blood glucose of 90 mg/dL\ B. Nausea and vomiting with ketones in the urine\ C. Mild dizziness that resolves with eating\ D. A single blood glucose reading of 140 mg/dL **Answer:** B\ **Rationale:** Nausea, vomiting, and ketones indicate DKA, requiring medical attention. **16. Which of the following clients is at highest risk for developing Type 2 diabetes mellitus?** A. A 28-year-old female with a BMI of 22\ B. A 45-year-old male with a history of hypertension and obesity\ C. A 32-year-old male who exercises regularly\ D. A 50-year-old female with a history of seasonal allergies **Answer:** B\ **Rationale:** Obesity and hypertension are strong risk factors for Type 2 diabetes. **17. The nurse is providing education to a newly diagnosed client with diabetes. Which statement indicates an understanding of foot care?** A. "I should soak my feet in warm water daily."\ B. "I will walk barefoot at home to improve circulation."\ C. "I should inspect my feet daily for sores or injuries."\ D. "I will use a heating pad to keep my feet warm." **Answer:** C\ **Rationale:** Diabetic clients should inspect their feet daily due to neuropathy risk. **18. Which of the following conditions is most commonly associated with Type 1 diabetes mellitus?** A. Insulin resistance\ B. Autoimmune destruction of beta cells\ C. Excessive glucagon production\ D. Metabolic syndrome **Answer:** B\ **Rationale:** Type 1 diabetes is an autoimmune disease causing beta-cell destruction. **19. A nurse is teaching a client with diabetes about dietary modifications. Which statement is correct?** A. "You should consume primarily high-glycemic index foods."\ B. "It is important to include fiber-rich foods in your diet."\ C. "A diet high in saturated fats is recommended."\ D. "You should avoid all sources of carbohydrates." **Answer:** B\ **Rationale:** Fiber helps control blood sugar and improves overall metabolic health. **20. A nurse is assessing a client with diabetic ketoacidosis (DKA). Which laboratory finding is expected?** A. Blood glucose of 90 mg/dL\ B. pH of 7.30\ C. Bicarbonate level of 28 mEq/L\ D. Serum ketones absent **Answer:** B\ **Rationale:** DKA is characterized by metabolic acidosis (low pH), high glucose, and ketones. **21. Which symptom is characteristic of hyperosmolar hyperglycemic state (HHS)?** A. Severe dehydration\ B. Ketone production\ C. Fruity breath\ D. Kussmaul respirations **Answer:** A\ **Rationale:** HHS causes extreme dehydration but lacks significant ketones. **22. A nurse is teaching about long-acting insulin. Which statement indicates correct understanding?** A. "I should take this insulin only when my blood sugar is high."\ B. "Long-acting insulin has a peak of 1-2 hours."\ C. "This insulin provides basal glucose control throughout the day."\ D. "I should mix long-acting insulin with short-acting insulin in the same syringe." **Answer:** C\ **Rationale:** Long-acting insulin provides steady blood glucose control. **23. The nurse is reviewing signs of metabolic syndrome. Which findings are consistent with this condition? (Select all that apply.)** A. Hypertension\ B. Low triglyceride levels\ C. Increased waist circumference\ D. Low HDL cholesterol\ E. Hyperglycemia **Answer:** A, C, D, E\ **Rationale:** Metabolic syndrome includes high blood pressure, large waist size, low HDL, and high blood sugar. **24. The nurse is caring for a client with a blood glucose of 52 mg/dL. What is the priority action?** A. Administer 1 mg glucagon IM\ B. Encourage the client to exercise\ C. Give 15 grams of carbohydrates\ D. Notify the provider immediately **Answer:** C\ **Rationale:** The first step in treating hypoglycemia is to give fast-acting carbohydrates. **25. A client with diabetes is prescribed metformin. What is an important teaching point?** A. "You should take this medication on an empty stomach."\ B. "Metformin may cause weight gain."\ C. "Avoid alcohol while taking this medication."\ D. "Metformin increases insulin production." **Answer:** C\ **Rationale:** Alcohol increases the risk of lactic acidosis when taken with metformin. **26. The nurse knows which statement about insulin therapy is correct?** A. "NPH insulin should be taken with meals."\ B. "Glargine insulin should not be mixed with other insulins."\ C. "Regular insulin peaks in 10 minutes."\ D. "Lispro is a long-acting insulin." **Answer:** B\ **Rationale:** Long-acting insulin (glargine) should not be mixed with other insulins. **27. The nurse should monitor for which complication in a client with diabetes?** A. Increased bone density\ B. Decreased risk of infections\ C. Retinopathy\ D. Hypotension **Answer:** C\ **Rationale:** Retinopathy is a common long-term complication of diabetes. **28. A client with Type 2 diabetes is experiencing hyperglycemia. What is the priority nursing intervention?** A. Encourage fluid intake\ B. Hold all medications\ C. Have the client rest in bed\ D. Provide additional carbohydrates **Answer:** A\ **Rationale:** Hydration helps prevent complications of hyperglycemia. **29. A nurse is teaching a diabetic client about exercise. Which recommendation is correct?** A. "Exercise should be avoided if blood glucose is below 100 mg/dL."\ B. "Exercise should be performed only after insulin administration."\ C. "Exercise has no effect on blood sugar levels."\ D. "Strenuous exercise increases insulin resistance." **Answer:** A\ **Rationale:** Blood glucose should be above 100 mg/dL before exercising to prevent hypoglycemia. **30. A nurse is providing education about the 15-15 rule for hypoglycemia. What does this involve?** A. Eating 15 grams of carbohydrates and checking blood glucose in 15 minutes\ B. Injecting 15 units of insulin for every 15 grams of carbohydrates\ C. Eating 15 grams of protein after 15 minutes of fasting\ D. Exercising for 15 minutes after taking insulin **Answer:** A\ **Rationale:** The 15-15 rule is used to treat hypoglycemia. **31. Which of the following is a symptom of diabetes?** A. Decreased urination\ B. Frequent infections\ C. Sudden weight gain\ D. Low blood pressure **Answer:** B\ **Rationale:** Frequent infections occur due to high blood sugar impairing immune function. **32. Which client should be evaluated for gestational diabetes?** A. A 25-year-old with no risk factors\ B. A 30-year-old with obesity and a family history of diabetes\ C. A 20-year-old who exercises regularly\ D. A 27-year-old with normal BMI and no family history **Answer:** B\ **Rationale:** Obesity and family history increase the risk for gestational diabetes. **33. A nurse is preparing to administer NPH insulin. Which statement is correct?** A. "NPH insulin is cloudy and requires mixing before administration."\ B. "NPH insulin has a peak of 30 minutes."\ C. "NPH insulin is given before meals for rapid action."\ D. "NPH insulin is used for emergency hyperglycemia treatment." **Answer:** A\ **Rationale:** NPH insulin is cloudy and must be mixed before use.