1. A patient arrives at the ED with a blood sugar of 578, serum osmolarity of 300, pH of 7.3, severe thirst, dehydration, and confusion.  The patient is breathing rapidly and has a fruity breath smell.  This patient has symptoms of......

  A. Diabetic ketoacidosis 

  B. hyperosmolar hyperglycemic noketotic coma

  C. Hypoglycemia

  D. diabetic neuropathy

Ans: A

 

2. What are the micro vascular complications of uncontrolled diabetes?

  A. Delayed gastric emptying (Missed.

  B. Diarrhea

  C. Glomuerular injury (Missed.

  D. Bleeding of retinal caplillaries (Missed.

  E. Numbness of feet

  F. Impotence (Missed.

Ans: B,E

 

3. The newly diagnosed diabetic patient asks the nurse why he needs to check his feet every day.  The nurse's best response is....

  A. To prevent leg amputation.

  B. To check for any cuts, sores, or dry cracked skin so they can be treated early to prevent infection or gangrene. 

  C. To see if they hurt.

  D. You just need to do it.

Ans: B

 

4. What are Macro vascular complications of uncontrolled diabetes? 

  A. Pain in lower legs

  B. Hyperlipidemia (Missed.

  C. Impotence

  D. Ischemic heart disease (Missed.

  E. Aortic disection

Ans: B,D

 

5. The nurse enters a patient's room and sees the patient breathing rapidly with a fruity breath smell.  This is known as... 

  A. Trousseau's

  B. Cullen's

  C. Kussmaul's 

  D. Bitot's

Ans: C

 

6. A patient with severe hypoglycemia arrives at the ED unconscious by ambulance.  The nurse would first... 

  A. Give regular insulin by IV

  B. Give NPH by IV

  C. Give 10-15 g CHO or Orange juice

  D. Give 1 mg glucagon 

Ans: D

 

7. The diabetic patient's lab work comes back with a pH of 7.4, serum blood sugar of 950, serum osmolarity of 460, pCO2 of 35, HCO3 of 25.  The patient is confused and dehydrated.  This patient is showing signs and symptoms of.... 

  A. Diabetic ketoacidosis

  B. hyperosmolar hyperglycemic noketotic coma 

  C. Hypoglycemia

  D. diabetic neuropathy

Ans: B

 

8. The nurse enters a diabetic patient's room at 11:30 and notices that the patient is diaphoretic, tachycardic, anxious, states she is hungry, and doesn't remember where she is.  This patient is most likely showing signs of what? 

  A. hyperglycemic

  B. hypoglycemic 

  C. diabetic ketoacidosis

  D. hyperosmolar hyperglycemic noketotic coma

Ans: B

 

9. The nurse's first action upon finding a patient with mild hypoglycemia is to... 

  A. Call the rapid response team

  B. Give 1 mg of glucagon

  C. Give 10-15 g of CHO or Orange juice 

  D. Give insulin

Ans: C

 

10. What is the number one complication of diabetes? 

  A. Diabetic ketoacidosis

  B. Obesity

  C. Hypertension

  D. Cardiovascular disease 

Ans: D

 

11. A urine test in an undiagnosed diabetic may show........ 

  A. glucose and ketones in the urine 

  B. glucose and high amounts of bilirubin in the urine

  C. ketones in the urine

  D. ketones and adrenaline in the urine

Ans: A

 

12. If a person has a fasting plasma glucose of 6.8mmol/L and a two-hour postprandial plasma glucose of 11.6mmol/L, should this person be suspected of having diabetes? 

  A. Yes 

  B. No

  C. Cannot decide

Ans: A

 

13. A woman has a fasting plasma glucose of 5.9mmol/L and a two-hour postprandial plasma glucose of 7.6mmol/L. Are these values normal? 

  A. No.

  B. Yes, according to the American Diabetes Association guidelines

  C. Yes, according to the World Health Organisation guidelines 

Ans: C

 

14. If a person has a random plasma glucose of 8mmol/L, is it normal? 

  A. Yes

  B. No

  C. Not possible to tell 

Ans: C

 

15. There are a range of glucose values called "impaired glucose tolerance". What is the significance to a person who has impaired glucose tolerance? 

  A. The person has an increased risk of developing diabetes

  B. The person has an increased cardiovascular risk

  C. Both the above 

  D. None of the above

Ans: C

 

16. Can the onset of new diabetes be prevented or delayed? 

  A. Yes 

  B. No

Ans: A

 

17. Are there any laboratory tests to distinguish between Type 1 and Type 2 diabetes? 

  A. Yes 

  B. No

Ans: A

 

18. Which statement below is CORRECT regarding initiation of long term insulin therapy in diabetes? 

  A. Patients with Type 1 diabetes should be initiated on basal insulin alone

  B. Patients with Type 1 diabetes should be initiated on prandial insulin alone

  C. Patients with Type 2 diabetes should be initiated on basal insulin alone 

  D. Patients with Type 2 diabetes should be initiated on prandial insulin alone

Ans: C

 

19. Which statement below is TRUE with regard to these two insulin preparations:

1. Insulatard Insulin (NPH insulin.

2. Mixtard insulin (a pre-mixed combination of short acting and long acting insulin. 

  A. Insulatard insulin and Mixtard insulin can be given at bedtime without the need for a bedtime snack

  B. Mixtard insulin can be given at bedtime without the need for a bedtime snack

  C. Insulatard insulin can be given at bedtime without the need for a bedtime snack 

Ans: C

 

20. Which of the statements below is true when initiating insulin in a Type 2 diabetic who is already on Metformin and Glibenclamide? 

  A. Both the oral drugs must be stopped

  B. Metformin must be stopped or the dose reduced

  C. Glibenclamide must be stopped or the dose reduced 

Ans: C

 

21. A patient with diabetes on Metformin and Glibenclamide is scheduled for a coronary angiogram. His diabetic control is good. Which of the statements below is TRUE? 

  A. Both the drugs must be stopped before the procedure and blood sugar must be controlled with insulin

  B. Metformin must be stopped before the procedure 

  C. Glibenclamide must be stopped before the procedure

  D. No changes need to be made. He can undergo the procedure.

Ans: B

 

22. Which statement below regarding the use of intravenous insulin for treating diabetic ketoacidosis is TRUE? 

  A. Insulin should be given IV until the blood sugar is normal

  B. Insulin should be given IV until the acidotic state is controlled 

  C. Insulin should be given IV until the patient is well hydrated

Ans: B

 

23. What is the best method of controlling blood sugar in a diabetic who cannot take orally? 

  A. Fixed dose insulin according to body weight given subcutaneously

  B. Insulin given subcutaneously according to a sliding scale

  C. Insulin given intravenously along with dextrose and potassium 

Ans: C

 

24. Is this statement true or false?

The glycosylated hemoglobin value is a useful parameter when making decisions regarding the need for insulin in a Type 2 diabetic. 

  A. True 

  B. False

Ans: A

 

25. Which type of diabetes is more common in children? 

  A. Diabetes I

  B. Diabetes II 

Ans: B

 

26. Mickey's insulin gives her the lowest CBG 5 hrs after injection.  Which insulin is Mickey taking? 

  A. Novolog

  B. NPH

  C. NovologR

  D. Lantus 

Ans: D

 

27. The nurse has to give the pt HumologR.  The nurse understands the medication when the nurse states the peak time is: 

  A. 1-3 hr

  B. 2-4 hr 

  C. 4-12 hr

  D. 5 hrs

Ans: B

 

28. Ben comes into the ED with blurred vision.  He has polyuria and complains of pain in his legs.  Labs show that he has elevated insulin levels and high triglyceride levels.  Ben also complains of always being thirsty.  What type of Diabetes does Ben have? 

  A. Diabetes I

  B. Diabetes II 

Ans: B

 

29. The nurse understands NovologR and when it ends by stating it ends: 

  A. 3-5 hrs

  B. 3-6.5 hrs

  C. 5-7 hrs 

  D. 18-24 hrs

  E. 24 hrs

Ans: C

 

30. Can an infection cause a rise in GLU? 

  A. Yes 

  B. No

Ans: A

 

31. Tony has to check his BG 5 days a week before breakfast and periodically at other times.  He notices a rise of BG when he is sick.  What type of diabetic is Tony?

 

  A. Diabetes I

  B. Diabetes II (Missed.

  C. Insulin Dependent

  D. Non Insulin Dependent (Missed.

Ans: A,C

 

32. Ted is taking NPH insulin.  The nurse knows Ted understands his medication when he states:

 

  A. It can start working in 10-30 minutes

  B. It can start working 1-2 hours after injection. (Missed.

  C. Peak action is 4-12 hours (Missed.

  D. It stays in the system 18-24 hrs. (Missed.

Ans: A

 

33. Which type of insulin cannot be manually mixed in a syringe?

 

  A. Novolog

  B. Humolog

  C. NPH

  D. Regular

  E. Lantus 

Ans: E

 

34. The nurse understands Novolog when the nurse states the end time is:

 

  A. 3-5 hrs

  B. 3-6.5 hrs 

  C. 5-7 hrs

  D. 18-24 hrs

Ans: B

 

35. Nick was given Novolog insulin.  The nurse knows that his breakfast should be available to Nick how many minutes after taking his meds?

 

  A. immediately to 2.5 hrs 

  B. 2-4 hrs

  C. 4-12 hrs

  D. 5 hrs

Ans: A

 

36. Mary has a skin infection that wont go away.  Her BP is 135/90.  She has dark amber urine.  She also reports that she has reoccurring vaginal infections. Her GLU comes back at 135.  What type of diabetes does she have?

 

  A. LADA

  B. Diabetes I

  C. Diabetes II

  D. Pre Diabetes 

Ans: D

 

37. NIDDM acounts for 90% of diabetics.  What are some thing that a NIDDM diabetic could do to help their disease?

 

  A. Avoid exercise

  B. reduce body fat by 5% (Missed.

  C. maintain excellent skin health (Missed.

  D. Rub lotion in their feet, but no in between their toes. (Missed.

Ans: A

 

38. Lucy has just given birth.  She had  gestational diabetes and did not have to take insulin.  She is very concerned that will now have to take insulin for the rest of her life.  What does a nurse say to educate Lucy about her condition?

 

  A. Proper instruction of foot care.

  B. 25-50% of women will eventually develop type 2 diabetes. (Missed.

  C. Losing the baby fat will help. (Missed.

  D. Education on what type of insulin she will need.

Ans: A,D

 

39. Bill is in the ED presenting with a BP of 60/45 and is responsive to painful stimuli.  His Na is 180 and BUN is 65.  His wife states he is a type 2 diabetic but has been sticking to his diet.  His insulin lab came back low.  What is wrong with Bill?

 

  A. Hyperosmolar Hyperglycemic Nonketoitic Syndrome 

  B. Diabetic Ketacidosis

  C. LADA

  D. Hyperglycemic

Ans: A

 

40. Ana is a long distance runner with diabetes.  She understands her need for testing when she states:

 

  A. i should test before and after exercise (Missed.

  B. I should test after exercise

  C. I should test before and after each meal and bedtime

  D. If I feel like my BG is low, I should test (Missed.

Ans: B,C

 

41. Cynthia is getting NovologR.  The nurse knows that Cynthia needs more education when she states:

 

  A. I need to check my BG throughout the day.

  B. I need to be consistent with insulin usage.

  C. I need to eat a large meal before taking my insulin 

  D. My insulin can be in my system for 5-7 hours.

Ans: C

 

42. Manifestations of hypoglycemia would entail:

 

  A. Anxiety (Missed.

  B. Hyperactions

  C. Tachycardia (Missed.

  D. Confusion (Missed.

Ans: B

 

43. Insulin is measure in:

 

  A. Ml

  B. Dl

  C. units 

  D. Tsp

Ans: C

 

44. Which is most dangerous?

 

  A. hypoglycemia 

  B. Hyperglycemia

Ans: A

 

45. Nathan's AIC comes back at 9%.  The nurse understands this value by stating to the pt:

 

  A. Your diabetes is under control.

  B. Your diabetes has shifted to Diabetes I.

  C. Your diabetes needs further intervention. 

  D. Call the coroner and make an appointment if you don't plan on taking this more seriously!

Ans: C

 

46. After giving insulin, what is the most critical observation that needs to be made?

 

  A. Tachycardia

  B. Bradycardia

  C. Hyperglycemia

  D. Hypoglycemia 

Ans: D

 

47. The nurse understand NPH when the nurse says NPH ends:

 

  A. after a heavy meal

  B. 18-24 hrs after injection 

  C. 12 hrs after injection

  D. When HumologR has been injected.

Ans: B

 

48. What risk factors increase diabetic foot problems?

 

  A. Sensory neuropathy (Missed.

  B. PVD (Missed.

  C. Smoking (Missed.

  D. Alcohol

Ans: D

 

49. Humolog begins to take affect:

 

  A. 15 min 

  B. 10-30 min

  C. 30-60 min

  D. 1-2 hrs

  E. 1.1 hrs (Your Answer.

Ans: A

 

50. Linda is taking Lantus.  She understands her medication when she states:

 

  A. it can start in 1.1 hr. (Missed.

  B. peaks 4-12 hours

  C. it ends in 24 hrs (Missed.

  D. it cannot be mixed with other insulins in the same syringe. (Missed.

Ans: B

 

51. Lupe is in the ED.  She has anorexia, abdominal pain, acetone breath, polyuria and is confused.  She has ketones present in her urine. She is pre diabetic with a glu of 650.  What is Lupe's problem?

 

  A. She was misdiagnosed and should be a type 1 diabetic.

  B. Hyperosmolar Hyperglycemic Nonketoitic Syndrome

  C. Diabetic Ketacidosis 

  D. LADA

Ans: C

 

52. Gladus is in for her physical.  She is a 54 year old woman with a lot of energy.  She is mildly overweight.  Her BP is 130/85.  As part of her physical, the doctor discovers her GLU is 350.  He orders a fasting plasma glucose and her levels come back 130 the first day and 275 the second day.  What does this indicate?

 

  A. Diabetes I

  B. Diabetes II 

  C. LADA

Ans: B

 

53. Nicole is a chronic alcoholic.  She drinks a bottle of wine every night and hard liquor on the weekends.  She has been fatigued and has blurry vision.  The doctor tells her she now has diabetes II.  She doesn't understand how she could have diabetes as it does not run in her family.  What education would the nurse give to the patient?

 

  A. Explain that the alcohol caused her diabetes. 

  B. Insulin will not be affected by her drinking

  C. Encourage her to attend AA meeting even though she doesn't want to.

  D. Using therapeutic communication, help her to see that this is her fault and must accept she has ruined her life.

Ans: A

 

54. Neuropathy occurs only in type 2 diabetics?

 

  A. Yes

  B. No 

Ans: B

 

55. Pat is a 45 year old female presenting with 83/60 BP, and elivated BUN and a GLU of 879.  She reports that she is not on a diet but has been losing weight rapidly and has fatigue.  What type of diabetes does she have?

 

  A. Diabetes I

  B. Diabetes II

  C. LADA 

Ans: C

 

56. NPH insulin has been prescribed to the pt.  The nurse understands NPH when the nurse states:

 

  A. NPH acts quickly.

  B. NPH peaks at 4-12 hrs (Missed.

  C. NPH is a mixture of rapid and slow acting (Missed.

  D. NPH low CBG will most likely be around 5 hrs.

Ans: A,D

 

57. Hypoglycemia is related to :

 

  A. reduced insulin and increased glucose

  B. increased insulin and reduced glucose (Missed.

  C. may occur when very high blood glucose falls too rapidly (Missed.

  D. failure to eat (Missed.

Ans: A

 

58. The nurse understands NPH and how quickly it starts when the nurse states:

 

  A. 10-30 min

  B. 30-60 min

  C. 1-2 hrs 

  D. 1.1 hours

Ans: C

 

59. HumologR has been given to Melisa at 13:30.  When would Melisa need her snack or lunch?

 

  A. 14:30

  B. 16:30

  C. 15:30 

  D. 14:00

Ans: C

 

60. Keith has just been diagnosed with diabetes.  His diabetes is an autoimmune disorder.  He has lost 15 lbs in two weeks and has polyuria.  His BP was 75/45 on admission.  What type of diabetes does Keith have?

 

  A. Diabetes I

  B. Diabetes II

Ans: A

 

61. What substance is found in the blood and urine of an undiagnosed diabetic?

 

  A. insulin

  B. adrenaline

  C. ketones 

  D. bilirubin

Ans: C

 

62. A normal FASTING blood glucose in a non-diabetic is

 

  A. 80 to 110 

  B. 40 to 80

  C. 120 to 150

  D. 150 to 200

Ans: A

 

63. Hyperglycemia is when......

 

  A. the blood sugar is too low

  B. the blood sugar is normal

  C. there is sugar in the urine

  D. the blood sugar is too high 

Ans: D

 

64. If diabetes goes untreated for a long time, what disease can develop? HINT:patients must be hospitalized for successful treatment of this condition

 

  A. hypoglycemia

  B. diabeticketoacidosis 

  C. ketosis

  D. hyperglycemia

  E. ketourina

Ans: B

 

65. What are the three  most COMMON  symptoms of diabetes?

 

  A. headaches vomiting constant illness

  B. intolerable thirst constant urination weight loss 

  C. double vision infections constant urination

  D. tingling of the feet slow healing wounds weight loss

  E. intolerable thirst vomiting heart burn

Ans: B

 

66. What is one cause of diabetes? MORE THAN ONE RIGHT ANSWER

 

  A. virus (Missed.

  B. antibody mistake (Missed.

  C. too much sweets

  D. genetics (Missed.

  E. bacteria

Ans: C,E

 

67. Name both types of diabetes SCIENTIFICLY

 

  A. Type 1 and Type 2

  B. Old Diabetes and Young Diabetes

  C. Juvenile Diabetes and Adult-Onset Diabetes 

  D. Brittle Diabetes and Insulin Dependant Diabetes

Ans: C

 

68. Can diabetes kill you?

 

  A. Yes 

  B. No

  C. Only if you're a certain race

Ans: A

 

69. An insulin pump's site must be changed......

 

  A. once a week

  B. never

  C. every three days 

  D. every day

  E. every five days

Ans: C

 

70. Aspart insulin is also referred to as......

 

  A. long acting insulin

  B. short acting insulin 

  C. intermediate acting insulin

Ans: B

 

71. Why does a  Long-Acting-Insulin shot hurt more than a Short-Acting-Insulin shot

 

  A. Because it is a bigger shot

  B. Because Long-Acting-Insulin has preservatives in it to keep it working the full 20 to 24 hours 

  C. Because you use a different needle to deliver Long-Acting-Insulin

Ans: B

 

72. If a person does not like the insulin needle or pump, they want might to try the......

 

  A. syringe

  B. moniter

  C. pen 

  D. inhaler

Ans: C

 

73. About how many Americans have diabetes

 

  A. 5 million

  B. 47 million

  C. 21 million 

  D. 16 million

  E. 33 million

Ans: C

 

74. What food can make you have a high blood sugar?

 

  A. nuts

  B. water

  C. yogurt

  D. pizza 

  E. bread

Ans: D

 

75. A urine test in an undiagnosed diabetic may show........

 

  A. glucose and ketones in the urine 

  B. glucose and high amounts of bilirubin in the urine

  C. ketones in the urine

  D. ketones and adrenaline in the urine

Ans: A

 

76. A slice of bread has about how many carbohydrates?

 

  A. 5 carbs

  B. 30 carbs

  C. 15 carbs 

  D. no carbs

  E. 25 carbs

Ans: C

 

77. Which is not true about Diabetes?

 

  A. the blood sugar may go out of control

  B. the person may be hospitalized if they are not treating the diabetes

  C. Diabetes can be completely cured 

  D. diabetes can be associated with nausea

Ans: C

 

78. When you are sick, the blood sugar may.......

 

  A. be normal

  B. very low

  C. higher than usual 

  D. lower than usual

Ans: C

 

79. In a newly-diagnosed patient who is in the hospital, their first major goal is to.....

 

  A. have their blood sugars go back to normal

  B. clear their ketones 

  C. get an insulin pump

Ans: B

 

80. Ketones are produced by.........

 

  A. not having insulin

  B. a high blood sugar

  C. fat breakdown 

  D. passing urine with sugar in it

Ans: C

 

81. What are the 3 main factors to success with diabetes?

 

  A. food exercise insulin 

  B. food insulin ketones

  C. exercise ketones insulin

Ans: A

 

82. People with diabetes can lead normal lives?

 

  A. Yes 

  B. No

  C. Only some

Ans: A

 

83. Diabetes is a world wide disease

 

  A. True 

  B. False

Ans: A

 

84. Which of the following is a symptom of diabetes?

 

  A. Pregnancy

  B. Mood Swings

  C. Blurred Vision 

  D. Loss of Hearing

Ans: C

 

85. What is the medicine that is injected into your body by a needle?

 

  A. Insulin 

  B. Sugar

  C. Glucose

  D. Diabetic Solution

Ans: A

 

86. What is a test you can get at the doctor to see if you have diabetes?

 

  A. Blood Test 

  B. X-ray

  C. MRI

  D. Diabetes test

Ans: A

 

87. How many different types of diabetes are there?

 

  A. 1

  B. 2 

  C. 3

  D. 5

Ans: B

 

88. 1.       Secretory product associated with pancreatic alpha cells:

 

  A. A. insulin

  B. B. proglucagon 

  C. C. somatostatin

  D. D. pancreatic polypeptide

  E. E. insulin and somatostatin

Ans: B

 

89. 1.       Major manisfestations of diabetes mellitus:

 

  A. A. inappropriate hyperglycemia

  B. B. disordered metabolism

  C. C. both 

  D. D. neither

Ans: C

 

90. 1.       Type I diabetes:

 

  A. A. most often presents in adults

  B. B. anabolic metabolic disorder

  C. C. circulating insulin is virtually absent 

  D. D. glucagon levels are low

  E. E. ketoacidosis is rarely seen

Ans: C

 

91. 1.       Extrinsic factors which may affect pancreatic B cell function:

 

  A. A. mumps virus

  B. B. toxic chemicals

  C. C. coxsackievirus

  D. D. mumps virus and toxic chemicals

  E. E. mumps virus, toxic chemicals and coxsakievirus 

Ans: E

 

92. What is prediabetes?

 

  A. When blood glucose levels are higher than normal but not high enough for diagnosis. (Correct Answer.

  B. When your diabetes is in submission until you turn forty

Ans: A

 

93. Type 1 diabetes was previously known as what?

 

  A. Endrino diabetes

  B. Juvenile diabetes 

Ans: B

 

94. What is the most common type of diabetes?

 

  A. Type 1 diabetes

  B. Type 2 diabetes 

  C. Pre-diabetes

Ans: B

 

95. There is always symptoms when you have diabetes.

 

  A. True

  B. False 

Ans: B

 

96. Type I diabetes is characterized by:

 

  A. resistance to insulin

  B. autoantibodies 

  C. complicated by HHS

Ans: B