DIABETES QUESTIONS

1. The client with diabetes is preparing for discharge. During discharge teaching, the nurse assesses the
client’s ability to care for himself. Which statement made by the client would indicate a need for follow-up
after discharge?
A. “I live by myself.”
B. “I have trouble seeing.”
C. “I have a cat in the house with me.”
D. “I usually drive myself to the doctor.”

2. A 60-year-old diabetic is taking glyburide (Diabeta) 1.25mg daily to treat Type II diabetes mellitus. Which
statement indicates the need for further teaching?
A. “I will keep candy with me just in case my blood sugar drops.”
B. “I need to stay out of the sun as much as possible.”
C. “I often skip dinner because I don’t feel hungry.”
D. “I always wear my medical identification.”

3. The physician has prescribed NPH insulin for a client with diabetes mellitus. Which statement indicates that
the client knows when the peak action of the insulin occurs?
A. “I will make sure I eat breakfast within 2 hours of taking my insulin.”
B. “I will need to carry candy or some form of sugar with me all the time.”
C. “I will eat a snack around three o’clock each afternoon.”
D. “I can save my dessert from supper for a bedtime snack.”

4. The nurse is teaching the client with insulin-dependent diabetes the signs of hypoglycemia. Which of the
following signs is associated with hypoglycemia?
A. Tremulousness
B. Slow pulse
C. Nausea
D. Flushed skin

5. A client with insulin-dependent diabetes takes 20 units of NPH insulin at 7 a.m. The nurse should observe
the client for signs of hypoglycemia at:
A. 8 a.m.
B. 10 a.m.
C. 3 p.m.
D. 5 a.m.

6. A client newly diagnosed with diabetes is started on Precose (acarbose). The nurse should tell the client that
the medication should be taken:
A. 1 hour before meals
B. 30 minutes after meals
C. With the first bite of a meal
D. Daily at bedtime

7. The glycosylated hemoglobin of a 40-year-old client with diabetes mellitus is 2.5%. The nurse understands
that:
A. The client can have a higher-calorie diet.
B. The client has good control of her diabetes.
C. The client requires adjustment in her insulin dose.
D. The client has poor control of her diabetes.
8. A client with diabetes mellitus has a prescription for Glucotrol XL (glipizide). The client should be instructed
to take the medication:
A. At bedtime
B. With breakfast
C. Before lunch
D. After dinner

9. A client with Type II diabetes has an order for regular insulin 10 units SC each morning. The client’s
breakfast should be served within:
A. 15 minutes
B. 20 minutes
C. 30 minutes
D. 45 minutes

10. The EEN is caring for a client with a diagnosis of diabetes insipidus. Which of the following clinical
manifestations is expected?
A. Polyuria
B. Nose bleed
C. Clot formation
D. Oliguria

11. A client with diagnosed diabetes visits the clinic complaining of shakiness and tingling sensations. Which of
the following questions is most important for the EEN to ask?
A. When did you last eat?
B. Did you bring your medication with you?
C. What was your blood glucose and when was it checked?
D. Is there anyone available to drive you home today?

12. What should be included in the nursing care plan for a client with diabetes insipidus?
A. Blood pressure every hour
B. Strict intake and output
C. Urine for ketone bodies
D. Glucose monitoring four times a day

13. An elderly woman has been recently diagnosed as having Type 2 diabetes. Which of the following
complaints that she has is most likely to be related to the diagnosis of diabetes mellitus?
A. Pruritus vulvae
B. Cough
C. Eructation
D. Singultus

14. A woman with newly diagnosed Type I diabetes mellitus says she wants to have children. She asks if she
will be able to have children and if they will be normal. What is the best answer for the nurse to give?
A. “Women with diabetes should not get pregnant because it is very difficult to control diabetes during
pregnancy.”
B. “Babies born to diabetic mothers are very apt to have severe and noncorrectable birth defects.”
C. “You should be able to safely have a baby if you go to your doctor regularly during pregnancy.”
D. “You should consult carefully with a geneticist before getting pregnant to determine how to prevent
your baby from developing diabetes.”
15. A 4-year-old child has recently been diagnosed with Type 1 diabetes. The parents tell the nurse that they do
not understand much about diabetes. Which is the best way to explain Type 1 diabetes to them? Type 1
diabetes is:
A. an inborn error of metabolism that makes the child unable to burn fatty acids without insulin
requirements.
B. a genetic disorder that makes the child unable to metabolize protein without insulin supplements.
C. a deficiency in the secretion of insulin by the pancreas that makes the child unable to metabolize
carbohydrates without insulin supplements.
D. a problem that occurs when children eat too many sweets early in life and then are unable to
metabolize sugar without insulin supplements.

16. An adolescent has been recently diagnosed as having Type 1 insulin-dependent diabetes. She asks the
nurse if she will ever be able to go out with her friends for pizza or ice cream. Which of these responses by
the nurse would give accurate information?
A. “You can go with the group, but you cannot eat pizza or ice cream.”
B. “You can have pizza but not ice cream.”
C. “If you eat when out with your friends, you will have to skip the next meal.”
D. “It is important for you to be with your friends. We will help you learn how to choose foods.”

17. A 17-year-old client has been recently diagnosed as having diabetes mellitus Type 1. Insulin is prescribed.
The client asks why insulin can’t be taken by mouth. What is the best answer for the nurse to give?
A. “Insulin is irritating to the stomach.”
B. “Oral insulin is too rapidly absorbed.”
C. “Gastric juices destroy insulin.”
D. “You can take it by mouth when the acute phase is over.”

18. A client who has Type 1 diabetes mellitus is admitted for alcohol detoxification. A moderate sliding scale for
insulin is ordered. How often should the nurse expect to take glucose levels?
A. Every time medication is administered
B. When the client is symptomatic
C. Before meals and at bedtime
D. Every two hours

19. Which test for diabetes measures the long-term management of the disease?
A. Fasting blood sugar
B. Glucose tolerance test
C. Finger stick glucose test
D. Glycosylated hemoglobin

20. A young adult has been diagnosed with Type 1 diabetes mellitus. The client asks how his condition differs
from that of his grandmother who has Type 2 diabetes mellitus. What should the nurse include when
replying?
A. In Type 1 diabetes, the pancreas does not secrete enough insulin; in Type 2 diabetes, the cells are
not able to pick up insulin.
B. Type 1 diabetes is always treated with insulin; Type 2 diabetes is never treated with insulin.
C. Type 1 diabetes comes before Type 2 diabetes. The client will develop Type 2 diabetes as he ages.
D. Type 1 diabetes is a result of overindulgence of sweets; Type 2 diabetes is related to
overindulgence of fats.
21. The nurse is giving home care to an elderly client with angina pectoris and Type 2 diabetes mellitus. Which
observation is of most concern and should be reported immediately?
A. The client reports chest discomfort yesterday while taking a walk.
B. The nurse observes several brown spots on the client’s arms and legs.
C. The client reports an ingrown toenail that is getting more painful.
D. The client reports shortness of breath when climbing stairs.

22. A man who has diabetes complains of hunger; is pale, shaky, and perspiring; and has cool skin. What is the
most appropriate initial action for the nurse?
A. Call the physician for orders
B. Give the client cola to drink
C. Have the client lie down
D. Administer the next dose of insulin

23. The nurse is working with a person who was just diagnosed with diabetes mellitus Type 2. What should the
nurse teach the client first?
A. How to self-inject insulin
B. How to follow a diabetic diet
C. Signs and symptoms of insulin reaction
D. Complications of diabetes

24. Which comment, if made by the client, indicates adjustment to the diagnosis of Type 1 diabetes mellitus?
A. “Will it ever get easier to give myself a shot?”
B. “This can’t be happening to me!”
C. “When I get over this, I’m going to eat chocolate cake every day.”
D. “At least no one at work will know what they say I have.”

25. At 10:30 A.M., a young woman who has diabetes calls the nurse and says she feels “funny.” The nurse
notes that she is cool to the touch but her skin is moist. When the nurse asks her if she is hungry, she
responds in an irritable manner that she is hungry. Which initial nursing action is appropriate?
A. Administer her noon dose of insulin early.
B. Call the lab to draw a blood glucose.
C. Have her drink a glass of cola.
D. Encourage her to drink lots of water.

26. A baby is delivered following a pregnancy complicated by gestational diabetes. What should the nurse
observe the baby for?
A. Infection
B. Hyperglycemia
C. Acidosis
D. Hypoglycemia
 ANSWER KEY
1. Answer B is correct. A client with diabetes who has trouble seeing would require follow-up after discharge. The lack of visual acuity
for the client preparing and injecting insulin might require help. Answers A, C, and D will not prevent the client from being able to
care for himself and, thus, are incorrect.

2. Answer C is correct. The client should be taught to eat his meals even if he is not hungry, to prevent a hypoglycemic reaction.
Answers A, B, and D are incorrect because they indicate an understanding of the nurse’s teaching.

3. Answer C is correct. NPH insulin peaks in 8–12 hours, so a snack should be offered at that time. NPH insulin onsets in 90–120
minutes, so answer A is incorrect. Answer B is untrue because NPH insulin is time released and does not usually cause sudden
hypoglycemia. Answer D is incorrect, but the client should eat a bedtime snack.

4. Answer A is correct. Tremulousness is an early sign of hypoglycemia. Answers B, C, and D are incorrect because they are
symptoms of hyperglycemia.

5. Answer C is correct. The client taking NPH insulin should have a snack mid-afternoon to prevent hypoglycemia. Answers A and B
are incorrect because the times are too early for symptoms of hypoglycemia. Answer D is incorrect because the time is too late and
the client would be in severe hypoglycemia.

6. Answer C is correct. Precose (acarbose) is to be taken with the first bite of a meal. Answers A, B, and D are incorrect because they
specify the wrong schedule for medication administration.

7. Answer B is correct. The client’s diabetes is well under control. Answer A is incorrect because it will lead to elevated blood sugar
levels and poorer control of the client’s diabetes. Answer C is incorrect because the diet and insulin dose are appropriate for the
client. Answer D is incorrect because the desired range for glycosylated haemoglobin in the adult client is 2.5%–5.9%.

8. Answer B is correct. Glucotrol XL is given once a day with breakfast. Answer A is incorrect because the client would develop
hypoglycemia while sleeping. Answers C and D are incorrect choices because the client would develop hypoglycemia later in the
day or evening.

9. Answer C is correct. The client’s breakfast should be served within 30 minutes to coincide with the onset of the client’s regular
insulin.

10. Answer A is correct. Symptoms of diabetes insipidus include excretion of large amounts of dilute urine and extreme thirst. The
clinical manifestations listed in options B, C, and D are not associated with diabetes insipidus so they are incorrect.

11. Answer C is correct. The client is exhibiting symptoms of hypoglycemia. The LPN needs to gather information related to the client’s
diagnosis. The questions in A, B, and D are appropriate. But the priority would be to find out the problem and treat it.

12. B. Diabetes insipidus is excessive urine output due to decreased amounts of antidiuretic hormone. Because of the excessive urine
output, it is necessary to monitor intake and output.

13. A. Pruritus vulvae (itching of the vulva) frequently accompanies diabetes. Monilial infections are common due to the change in pH.
Eructation is belching or burping, and singultus is hiccups. Neither of these is particularly related to diabetes.

14. C. Most diabetic women can safely have babies if they receive good medical supervision during pregnancy. There is a slightly higher
incidence of fetal loss and malformations in babies of diabetic mothers but not enough to preclude the chance of a normal baby.
There is no way to prevent the child from later developing diabetes. Diabetes is an inherited condition.

15. C. Type 1 diabetes is a lack of insulin secretion by the pancreas, which makes the child unable to metabolize carbohydrates without
additional insulin. Type 1 diabetes is not a metabolic error, and fatty acids are not primarily affected. Type 1 diabetes is not a genetic
disorder, although there may be a hereditary predisposition to the condition, and proteins are not primarily affected. Type 1 diabetes
is not caused by eating too many sweets early in life.

16. D. This answer recognizes the adolescent’s need to be with her friends and explains that she will learn how to choose foods. The
other answers do not give accurate information.

17. C. Gastric juices break down insulin, which is a protein.

18. C. The nurse should obtain glucose levels before meals and at bedtime.

19. D. Glycosylated hemoglobin measures the average blood sugar for the last several weeks. Fasting blood sugar and the fi nger stick
glucose test measure the glucose at the moment. The glucose tolerance test is the gold standard for diagnosing diabetes mellitus. It
measures baseline blood and urine glucose levels and how they respond to a specifi c dose of glucose.
20. A. In Type 1 diabetes, the pancreas does not secrete enough insulin; in Type 2 diabetes, the cells are not able to pick up insulin. The
other answers are not correct. Type 1 diabetes mellitus is treated with insulin. Type 2 diabetes is usually treated with oral
hypoglycemic agents. However, sometimes insulin is used in managing Type 2 diabetes, especially when the client has an infection.

21. C. An ingrown toenail in a person who has diabetes can be very serious. Diabetics have poor circulation and are prone to infection,
especially in the feet and legs. An ingrown toenail should be reported immediately to the nurse supervisor so an appropriate referral
can be made. Chest discomfort while exercising is a common occurrence in persons who have angina. Brown spots on the arms and
legs are common in elderly persons; these are sometimes called age spots. Shortness of breath when climbing stairs occurs
frequently in persons who are elderly and who have angina. The nurse should note this so that comparisons can be made to see if
the shortness of breath is getting worse. However, the greatest concern at the moment is the painful ingrown toenail.

22. B. The diabetic client has the classic signs of hypoglycemia. The treatment is to administer sugar. Cola has sugar. The nurse could
also do a glucose check, but that is not one of the options. Calling the physician is not the initial action. The nurse should be able to
handle the initial episode and then notify the physician if necessary. Having the client lie down will not help with hypoglycemia.
Insulin is not what is needed for hypoglycemia.

23. B. The key to controlling Type 2 diabetes mellitus is usually following a diet and losing weight. The client might also be on oral
medication. Most Type 2 diabetics do not need to self-inject insulin on a regular basis and do not need to know the signs and
symptoms of insulin reaction. They might need to know about hypoglycemia if they are taking oral hypoglycemic agents, but it would
not be referred to as an insulin reaction. The nurse will teach the client about the complications of diabetes, but not initially. First, the
nurse should teach the client what he or she needs to know to help control the disease. Later, the nurse can teach about the
complications.

24. A. This response indicates that the client is performing self-injection of insulin. This is the best indicator of acceptance of the
diagnosis. A person who says, “This can’t be happening to me” is in denial. The comment, “When I get over this” indicates that the
client has not accepted the diagnosis of Type 1 diabetes, which is not curable. Saying, “At least no one at work will know what they
say I have” indicates that the client has not accepted the diagnosis.

25. C. The data all suggest that the client is hypoglycemic. The appropriate intervention for hypoglycemia is to give something that has
sugar in it. Cola has sugar. Administering insulin would make the client worse. The client needs sugar. The nurse should be able to
determine from the client’s signs and symptoms that she is hypoglycemic. It would be appropriate for the nurse to do a blood glucose
check, but that is not one of the answer choices. It is not necessary for the nurse to call the lab and wait for the results. The nurse
should be able to determine the client’s condition and act immediately.

26. D. High blood sugar levels in the mother probably increased pancreatic production of insulin in the infant, and he may use his stores
of sugar quickly. He now has no infl ux of sugar from the mother and is at risk for hypoglycemia. The baby of a diabetic woman is not
at increased risk of infection. The mother may be, but the baby is not. The baby of a diabetic woman is not at increased risk for
hyperglycemia. The baby of a diabetic woman is not at increased risk for acidosis. The mother may be, but the baby is not.

REFERENCE:
NCLEX-PN® Practice Questions, Third Edition Copyright © 2012 by Pearson Education, Inc.
Delmar’s Practice Questions for NCLEX-PN®, Second Edition; Judith, C. Miller MS, RN; Janet Tompkins McMahon RN, MSN;
© 2011, 2003 Delmar, Cengage Learning