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WorksheetsMetabolism
Total questions: 50
Worksheet time: 2hrs 42mins
The nurse explains that the negative feedback system controls hormone release by communication between:
the pituitary and the target organ.
the thymus and the blood stream.
lymphatic system and the target organ.
central nervous system and the blood stream.
Which diagnostic test for diabetes mellitus provides a measure of glucose levels for the previous 8 to 12 weeks?
Fasting blood sugar (FBS)
Oral glucose tolerance test (OGT)
Glycosylated hemoglobin (HbA1c)
Postprandial glucose test (PPBG)
What is a long-term complication of diabetes mellitus?
Diverticulitis
Renal failure
Hypothyroidism
Hyperglycemia
The nurse discovers the type 1 diabetic (IDDM) patient drowsy and tremulous, the skin is cool and moist, and the respirations are 32 and shallow. These are signs of:
hypoglycemic reaction; give 6 oz of orange juice.
hyperglycemic reaction; give ordered regular insulin.
hyperglycemic hyperosmolar nonketotic reaction; squeeze glucagon gel in buccal cavity.
hypoglycemic reaction; give ordered insulin.
What instructions should a nurse give to a diabetic patient to prevent injury to the feet?
Soak feet in warm water every day.
Avoid going barefoot and always wear shoes with soles.
Use of commercial keratolytic agents to remove corns and calluses are preferred to cutting off corns and calluses.
Use a heating pad to warm feet when they feel cool to the touch.
The physician prescribes glyburide (Micronase, DiaBeta, Glynase) for a patient, age 57, when diet and exercise have not been able to control type 2 diabetes. What should the nurse include in the teaching plan about this medication?
It is a substitute for insulin and acts by directly stimulating glucose uptake into the cell.
It does not cause the hypoglycemic reactions that may occur with insulin use.
It is thought to stimulate insulin production and increase sensitivity to insulin at receptor sites.
It lowers blood sugar by inhibiting glucagon release from the liver, preventing gluconeogenesis.
What is the master gland of the endocrine system?
Thyroid
Parathyroid
Pancreas
Pituitary
Which of the following are signs and symptoms of hypoglycemia? (Select all that apply.)
Irritability
Dry mouth
Tremors
Diaphoresis
Fruity breath
The adrenal cortex secretes glucocorticoids. The most important is cortisol. What is it involved in? (Select all that apply.)
Glucose metabolism
Releasing androgens and estrogens
Providing extra reserve energy during stress
Decreasing the level of potassium in the blood stream
Increasing retention of sodium in the blood stream
Mineralocorticoids and glucocorticoids are the products of the:
adrenal cortex.
adrenal medulla.
pancreas.
hypothalamus.
The corticoid that counteracts the inflammatory response is:
thyroxine.
cortisol.
insulin.
norepinephrine.
The only gland that is both an endocrine gland and an exocrine gland is the:
thyroid.
hypothalamus.
pancreas.
parathyroid.
The nurse clarifies that endocrine glands, as opposed to exocrine glands:
can put their secretions directly into the bloodstream.
must use a duct to put their secretions into the bloodstream.
must hold their secretions in a reservoir until they are needed by the body.
can produce constantly for body needs.
The patient who has a glucose tolerance test scheduled for next week is instructed not to take which medication because it will adversely affect the test result?
Vitamin C
Antihypertensive agent
Birth control pills
Calcium supplement
The long-term diabetic has had a glycosylated hemoglobin (HbA1c) test done to evaluate the effectiveness of his glucose control. The nurse evaluates the laboratory report of 5% to indicate that the effectiveness of the glucose control is:
excellent.
good.
fair.
poor.
The nurse clarifies that the actual structural unit that secretes insulin is the:
pancreas.
islets of Langerhans.
beta cell.
alpha cell.
When the nurse is taking a patient’s temperature, which principle should the nurse remember? Regulation of body temperature primarily occurs in the:
Cerebrum
Brainstem
Hypothalamus
Pituitary gland
A nurse wants to teach about one of the primary organs responsible for heat production. Which organ should the nurse include?
Pancreas
Liver
Adrenal gland
Heart
A patient has researched lipid-soluble hormones on the Internet. Which information indicates the patient has a good understanding? Lipid-soluble hormone receptors cross the plasma membrane by:
Diffusion
Osmosis
Active transport
Endocytosis
A nurse providing care for a woman with gestational diabetes understands that a laboratory test for glycosylated hemoglobin Alc:
Is done for all pregnant women, not just those with or likely to have diabetes
Is a snapshot of glucose control at the moment
Levels should remain at less than 7
Is done on the woman’s urine, not her blood
The client with insulin-dependent type 2 diabetes and an HbA1c of 5.0% is planning to become pregnant soon. What anticipatory guidance should the nurse provide this client?
Insulin needs decrease in the first trimester and usually begin to rise late in the first trimester as glucose use and glycogen storage by the woman and fetus increase.
The risk of ketoacidosis decreases during the length of the pregnancy.
Vascular disease that accompanies diabetes slows progression.
The baby is likely to have a congenital abnormality because of the diabetes.
A newly diagnosed insulin-dependent type 1 diabetic with good blood sugar control is at 20 weeks’ gestation. She asks the nurse how her diabetes will affect her baby. What would the best explanation include?
“Your baby could be smaller than average at birth.”
“Your baby will probably be larger than average at birth.”
“As long as you control your blood sugar, your baby will not be affected at all.”
“Your baby might have high blood sugar for several days.”
A 26-year-old client is 26 weeks pregnant. Her previous births include two large-for-gestational-age babies and one unexplained stillbirth. Which tests would the nurse anticipate as being most definitive in diagnosing gestational diabetes?
A 50g, 1-hour glucose screening test
A single fasting glucose level
A 100g, 1-hour glucose tolerance test
A 100g, 3-hour glucose tolerance test
The nurse has written the nursing diagnosis Injury, Risk for for a diabetic pregnant client. Interventions for this diagnosis include which of the following? Select all that apply.
Assessment of fetal heart tones
Perform oxytocin challenge test, if ordered
Refer the client to a diabetes support group
Assist with the biophysical profile assessment
Develop an appropriate teaching plan
An example of catabolism is the
building of new muscle tissue during growth.
breakdown of glucose to provide energy.
synthesis of protein from amino acids.
use of enzymes to digest protein and release amino acids.
Peter has been very ill and has not eaten for 3 days. In order to provide carbohydrate for his brain and other cells, his body will break down
body fat.
liver glycogen.
blood glucose.
muscle protein.
The end product of starch digestion in the body is
sucrose.
maltose.
glycogen.
glucose.
The metabolic abnormalities that lead to type 2 diabetes include:
chronic overeating.
insulin resistance.
acute pancreatitis.
recurrent hypoglycemia.
Diabetic ketoacidosis (DKA) more commonly occurs in patients with type 1 diabetes, when the lack of insulin leads to the mobilization of _____ that causes excess ketone production by the liver.
cortisol
fatty acids
potassium
bicarbonate
In people with type 1 diabetes, the beneficial effects of exercise also carry an increased risk of:
rapid weight loss.
respiratory disorders.
rebound hyperglycemia.
profound hypoglycemia.
One of the first renal manifestations of diabetic nephropathy is:
microalbuminuria.
oliguria.
hypertension.
hyperlipidemia.
Diabetic retinopathy, the leading cause of acquired blindness in the United States, is characterized by retinal:
glaucoma.
hemorrhages.
dehydration.
infections.
Impaired and delayed healing in a person with diabetes is caused by chronic complications that include:
ketoacidosis.
Somogyi effect.
fluid imbalances.
chronic neuropathies.
A hospital patient with a diagnosis of type 1 diabetes has been administered a scheduled dose of regular insulin. Which of the following effects will result from the action of insulin?
Promotion of fat breakdown
Promotion of glucose uptake by target cells
Promotion of gluconeogenesis and protein synthesis
Initiation of glycogenolysis
A patient with longstanding type 2 diabetes is surprised at his high blood sugar readings while recovering from an emergency surgery. Which of the following factors may have contributed to the patient’s inordinately elevated blood glucose levels?
The tissue trauma of surgery resulted in gluconeogenesis.
Illness inhibited the release and uptake of glucagon.
The stress of the event caused the release of cortisol.
Sleep disruption in the hospital precipitated the dawn effect.
Which of the following assessment findings of a male patient constitutes a criterion for a diagnosis of metabolic syndrome?
The patient states that he does less than 30 minutes of strenuous physical activity each week.
The patient’s resting heart rate is typically 85 to 95 beats per minute.
The patient’s blood pressure is consistently in the range of 140/90 mm Hg.
The patient has a family history of type 2 diabetes.
Which of the following pregnant women likely faces the greatest risk of developing gestational diabetes?
A patient who was diagnosed with placenta previa early in her pregnancy.
A patient who is gravida five (in her fifth pregnancy)
A patient who has hypertension and elevated triglycerides
A patient who is morbidly obese
A patient’s primary care provider has ordered an oral glucose tolerance test (OGTT) as a screening measure for diabetes. Which of the following instructions should the patient be given?
The lab tech will give you a sugar solution and then measure your blood sugar levels at specified intervals.
You’ll have to refrain from eating after midnight and then go to the lab to have your blood taken first thing in the morning.
They’ll take a blood sample and see how much sugar is attached to your red blood cells.
You can go to the lab at any time; just tell the technician when you last ate before they draw a blood sample.
A hospital patient has been complaining of increasing fatigue for several hours and his nurse has entered his room to find him unarousable. The nurse immediately checked the patient’s blood glucose level, which is 22 mg/dL (1.2 mmol/L). The nurse should prepare to administer which of the following?
A snack that combines simple sugars, protein, and complex carbohydrates
A 50% glucose solution intravenously
Infusion of rapid-acting insulin
Oral solution containing glucagon and simple sugars
A diabetic patient’s most recent blood work indicated a decreased glomerular filtration rate and urine testing revealed microalbuminuria. Which of the following self-care measures should the patient’s care team suggest to the patient?
Use of over-the-counter diuretics
Increased fluid intake
Decreased oral sugar intake
Measures to lower blood pressure
A patient asks the nurse if stress can be a potential cause of type 2 diabetes. What should be included in the response provided by the nurse?
Stress decreases the number of alpha cells in the pancreas, thus increasing the workload on the beta cells.
Periods of stress cause increases in glycogen production by the adrenal cortex.
Stress is directly associated with decreased insulin tolerance.
The inhibition of beta cells to glucose is increased in periods of stress.
A patient recently diagnosed with type 1 diabetes mellitus questions the nurse about her increased thirst level. What should be included in the response by the nurse?
Diabetes results in a lack of protein absorption causing reduced amino acids, resulting in thirst.
Elevated levels of blood glucose pull cellular water into circulating volume.
Thirst results from the body’s increased loss of fluids through polyuria.
Appetites of both food and water signal the changes of diabetes.
The nurse is caring for a patient who was hospitalized with ketosis. The nurse recognizes that the patient correctly understands the phenomenon when she reports what about the condition?
“I had taken too much insulin to decrease my body’s levels of glucose.”
“The condition resulted when my body tried to break down and use my stores of fats.”
“When my blood glucose goes over 150 mg/dL, I am at risk for this condition.”
“I was exercising too much and had too sharp reductions in my blood glucose level.”
At 2:00 AM, the CNA reports that a patient with type 1 diabetes is extremely wet with perspiration, is cool to the touch, and is complaining of hunger. The nurse should:
give insulin by sliding scale based on glucometer reading.
notify the night supervisor of the patient’s deteriorating condition.
give 6 ounces of orange juice.
ambulate the patient in the hall to use up excess glucose with exercise.
The patient comes to the emergency room with dry hot skin, fruity breath, and deep respirations and is complaining of abdominal pain. The nurse interprets these signs and symptoms as:
an insulin reaction.
ketoacidosis.
rebound hyperglycemia.
hypoglycemia.
The nurse notes that the HbA1c level of an assigned patient demonstrated a drop from 9.4% to 5.4%. What inference can best be made about this patient?
The patient is demonstrating improved control of hyperglycemia over the last several months.
The patient has been less compliant with the prescribed treatment regimen.
The patient is experiencing a reduction in insulin sensitivity.
The patient has less need for insulin.
The patient takes his NovoLog 70-30 at 7:00 AM. The nurse suggests the best time to schedule exercise would be at:
7:30 AM before peak action of insulin.
10:00 AM at peak action of insulin.
1:00 PM after peak action of insulin.
any time after injection.
The nurse is discussing insulin administration with an assigned patient. The patient reports that she prefers to use only certain sites for insulin injections. The patient questions why rotation of the sites is important. What response by the nurse is most appropriate?
“Rotating your injection sites will help to reduce your risk of infection.”
“If you do not rotate injection sites you are at risk for an erratic absorption of your medication.”
“Unsightly fatty tumors can develop when you do not adequately rotate injection sites.”
“Failing to rotate injection sites will improve your ability prevent an insulin reaction.”
A long-term diabetic patient reports that the physician has told him he has the early symptoms of cardiovascular disease. The nurse correctly understands that diabetes predisposes the patient to cardiovascular complications for which reason?
The periods of hyperglycemia that result in diabetes damage the basement membrane causing atherosclerosis.
Hypoglycemic periods result in increased release of cortisol resulting in hypertension.
Insulin constricts the cardiovascular vessels.
Diabetes causes a decrease in the body’s ability to digest fats by the pancreas.
A patient with type 1 diabetes mellitus is preparing for a moderate 30-minute exercise period. Which action best indicates understanding of condition management?
The patient reduces insulin use during days when exercise periods are planned.
The patient administers insulin after exercise rather than before exercise.
The patient eats a high-carbohydrate snack before the exercise period.
The patient consumes a simple carbohydrate snack after 30 minutes of activity.
