Chapter 46

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Chapter 46: Diabetes Mellitus and Hypoglycemia MULTIPLE CHOICE 1. The nurse explains that type 1 diabetes mellitus is a disease in which the body does not pro- duce enough insulin so my blood glucose is elevated because of: 1. prolonged elevation of stress hormone levels (cortisol, epinephrine, glucagon, growth hormone). 2. malfunction of the glycogen-storing capabilities of the liver. 3. destruction of the beta cells in the pancreas. 4. insulin resistance of the receptor cells of the muscle tissue. ANS: 3 Type 1 diabetes mellitus is a disease in which the pancreas does not produce adequate in- sulin because of the destruction of beta cells. PTS: 1 DIF: Cognitive Level: Comprehension REF: 1002 OBJ: 6 TOP: Type 1 Diabetes KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 2. When a newly diagnosed type 2 diabetes mellitus patient asks the nurse why she has to take a pill instead of insulin, you reply that in type 2 diabetes, the body makes insulin but: 1. overweight and underactive people simply cannot use the insulin produced. 2. metabolism is slowed in some people so they have to take a pill to speed up their metabolism. 3. sometimes the autoimmune system works against the action of the insulin. 4. the cells become resistant to the action of insulin. Pills are given to increase the sensitivity. ANS: 4 Type 2 diabetes mellitus is a disease in which the cells become resistant to the action of in- sulin and the blood glucose level rises. Oral hyperglycemic agents make the cells more sens- itive. PTS: 1 DIF: Cognitive Level: Application REF: 1002 OBJ: 6 TOP: Type 2 Diabetes KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance 3. A patient tells the nurse that she eats “huge” amounts of food but stays hungry most of the time. The nurse explains that hunger experienced by persons with type 1 diabetes is caused by the: 1. excess amount of glucose 2. need for additional calories to correct the increased metabolism. 3. fact that the cells cannot use the blood glucose. 4. need for exercise to stimulate insulin secretion. ANS: 3
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The cells cannot use the glucose without insulin, so the diabetic client still feels hungry al- though there is abundant glucose circulating in the blood. PTS: 1 DIF: Cognitive Level: Comprehension REF: 1002 OBJ: 1 TOP: Hunger in the Diabetic KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 4. The nurse stresses that the type 1 diabetic is at risk for cardiovascular disorders because lack of insulin causes: 1. high glucose levels that irritate and shrink the vessels. 2. inadequate metabolism of proteins, which causes ketosis. 3. increased fatty acid levels.
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