Welcome future nurses! As you gear up to conquer the NCLEX, understanding how to answer NCLEX questions on Type 1 Diabetes is paramount to ensuring your success. Let’s dive in.
Question 1:
A 10-year-old child diagnosed with type 1 diabetes presents to the emergency department with symptoms of diabetic ketoacidosis (DKA). The initial assessment reveals deep and rapid breathing, fruity breath odor, and dry mucous membranes. Blood glucose levels are significantly elevated. Which intervention should the nurse prioritize initially?
A) Administering regular insulin
B) Initiating intravenous fluids
C) Obtaining an electrocardiogram (ECG)
D) Providing a high-carbohydrate snack
E) Performing a neurological assessment
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Rationale
In DKA, fluid and electrolyte imbalance is critical due to severe dehydration. Administering intravenous fluids is the priority to restore circulating volume, correct dehydration, and improve perfusion. Insulin administration is important but should follow fluid resuscitation. ECG and neurological assessment may be important but are not the initial priorities in managing DKA. Providing a high-carbohydrate snack is contraindicated as it can exacerbate the condition.
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Question 2:
A 25-year-old woman newly diagnosed with type 1 diabetes is being educated on insulin administration. She is prescribed a regimen of long-acting insulin at bedtime. Which statement by the patient indicates a need for further teaching?
A) “I should always rotate my injection sites within the same anatomical area.”
B) “I can administer this type of insulin at any time of the day as long as it’s consistent.”
C) “I’ll monitor my blood sugar before bedtime and eat a snack if it’s low.”
D) “I’ll expect this insulin to act over a 24-hour period.”
E) “I understand the importance of regular follow-ups for my diabetes management.”
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Rational: Long-acting insulin, given at bedtime, needs to be administered consistently at the same time each day to maintain a steady basal insulin level. It’s not interchangeable in timing as it might lead to fluctuations in blood glucose levels. Rotating injection sites, monitoring blood sugar before bedtime, understanding the insulin’s action over 24 hours, and recognizing the importance of regular follow-ups indicate correct understanding and management of the insulin regimen.
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Question 3
A 16-year-old adolescent with type 1 diabetes mellitus arrives at the clinic for a routine check-up. The healthcare provider emphasizes the importance of maintaining blood glucose levels within the target range. Which action best aids in preventing long-term complications associated with type 1 diabetes?
A) Administering rapid-acting insulin only when the blood sugar is extremely high
B) Maintaining blood glucose levels consistently below 70 mg/dL
C) Checking blood glucose levels only when symptoms of hypoglycemia are present
D) Monitoring blood glucose levels regularly and adhering to an individualized management plan
E) Administering a fixed dose of long-acting insulin every morning
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Rationale:
Regular monitoring of blood glucose levels allows for timely adjustments in insulin doses, diet, and exercise, reducing the risk of acute complications and long-term complications like retinopathy or neuropathy. Administering insulin only when blood sugar is extremely high or maintaining levels below 70 mg/dL can lead to hypoglycemia or inadequate control. Checking blood sugar only when symptoms arise may miss fluctuations that could contribute to complications. A fixed dose of long-acting insulin without adjustment does not cater to individual variations in glucose levels.\
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Question 4
A 30-year-old woman with type 1 diabetes mellitus seeks advice on managing her diet. Which dietary recommendation is most appropriate for this patient?
A) Consuming a diet high in refined sugars to prevent hypoglycemia
B) Limiting carbohydrate intake while emphasizing protein and fats
C) Focusing on high-carbohydrate meals to balance insulin requirements
D) Avoiding fruits and vegetables due to their natural sugar content
E) Consuming meals with a consistent carbohydrate distribution throughout the day
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Rationale:
Consistent carbohydrate intake assists in more predictable insulin dosing, promoting stable blood glucose levels. A diet high in refined sugars can lead to fluctuations in glucose levels and exacerbate hyperglycemia. Limiting carbohydrates too drastically may lead to inadequate energy and nutritional intake. Fruits and vegetables, despite their natural sugar content, provide essential nutrients and should be part of a balanced diet.
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Question 5
A 45-year-old man with type 1 diabetes mellitus is scheduled for a dental procedure. He usually takes insulin before meals. What advice should the nurse provide regarding insulin administration on the day of the procedure?
A) Skip the insulin dose to avoid hypoglycemia during the procedure
B) Take the insulin dose as prescribed before the procedure
C) Take half the prescribed insulin dose before the procedure
D) Only take insulin if the blood glucose is elevated before the procedure
E) Consult the healthcare provider for specific instructions regarding insulin
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Rationale:
Individualized recommendations for insulin adjustments before a procedure are crucial and should be provided by the healthcare provider. Skipping or altering insulin doses without guidance may lead to uncontrolled blood glucose levels, potentially impacting the
patient’s health during and after the procedure. Following prescribed insulin doses or making arbitrary changes without professional advice could result in hypo- or hyperglycemia during the procedure.
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Question 6
A 12-year-old child with type 1 diabetes presents to the emergency department with complaints of excessive thirst, frequent urination, and weakness. On assessment, the nurse notes deep and labored breathing. The child’s blood glucose level is 520 mg/dL, and urine tests positive for ketones. What intervention should the nurse prioritize initially?
A) Administering a rapid-acting insulin injection
B) Starting an insulin pump infusion
C) Providing intravenous fluids
D) Offering a carbohydrate-rich snack
E) Initiating oral diabetic medications
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Rationale:
In this scenario of hyperglycemia and ketosis indicating diabetic ketoacidosis (DKA), the priority is correcting dehydration and electrolyte imbalances by initiating intravenous fluids. While insulin is crucial in managing DKA, fluid resuscitation takes precedence to restore volume and perfusion. Insulin pump infusion, a snack, or oral diabetic medications are not immediate interventions for DKA.
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Question 7
A 30-year-old woman newly diagnosed with type 1 diabetes is being educated on insulin administration. She asks about the difference between rapid-acting and long-acting insulins. Which statement best describes the action of long-acting insulin?
A) “Long-acting insulin acts quickly to reduce high blood sugar levels.”
B) “Long-acting insulin helps control blood sugar during meals.”
C) “Long-acting insulin provides a basal level of insulin over an extended period.”
D) “Long-acting insulin is used to correct low blood sugar levels immediately.”
E) “Long-acting insulin should be taken multiple times a day for optimal effect.”
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Rationale:
Long-acting insulin, such as glargine or detemir, is designed to provide a steady release of insulin over an extended time, maintaining a baseline or basal level of insulin between meals and overnight. It is not intended for rapid correction of high blood sugar levels or for use during meal times. It typically requires once-daily administration and is not used for immediate correction of hypoglycemia.
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Question 8
A 25-year-old man with type 1 diabetes is planning to engage in vigorous exercise. What guidance should the nurse provide regarding insulin and exercise?
A) “Take an extra dose of long-acting insulin before exercise to prevent high blood sugar.”
B) “Reduce the dose of short-acting insulin before exercise to prevent hypoglycemia.”
C) “Avoid insulin injections before exercise to prevent complications.”
D) “Ensure you have a high-carbohydrate meal before exercising to stabilize blood sugar.”
E) “Monitor blood sugar before, during, and after exercise; adjust insulin based on levels and activity duration.”
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Rationale:
Vigorous exercise can impact blood sugar levels, and individuals with type 1 diabetes should monitor levels before, during, and after exercise. Adjusting insulin based on blood sugar levels and the duration and intensity of the activity helps prevent both hyper- and hypoglycemia. Simply taking extra or reducing insulin doses without monitoring can lead to imbalances and complications. Eating a high-carbohydrate meal before exercising may not suffice in managing blood sugar fluctuations during exercise.
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Question 9
A 40-year-old woman with type 1 diabetes visits the healthcare provider for a medication review. She’s currently prescribed a rapid-acting insulin analog to manage her postprandial blood glucose levels. Which statement accurately describes the action of rapid-acting insulin analogs?
A) “Rapid-acting insulin analogs provide a peak effect within 2 hours of administration.”
B) “Rapid-acting insulin analogs have an extended duration of action up to 24 hours.”
C) “Rapid-acting insulin analogs are best taken once daily before bedtime.”
D) “Rapid-acting insulin analogs mimic endogenous insulin secretion patterns.”
E) “Rapid-acting insulin analogs are most effective for controlling fasting blood sugar levels.”
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Rationale:
Rapid-acting insulin analogs, like insulin aspart or lispro, closely mimic the body’s natural insulin response after meals, providing a rapid onset of action (within 15-30 minutes) and peaking in about 1-2 hours. Their action is tailored to manage postprandial blood glucose elevations, unlike long-acting insulins used for basal coverage (not necessarily fasting levels). They’re typically administered multiple times a day before meals, not once daily. Describing their action in mimicking natural insulin secretion patterns best explains their purpose.
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Question 10
A 55-year-old man with type 1 diabetes asks about the mechanism of action of glucagon.
Which explanation accurately describes the role of glucagon in diabetes management?
A) “Glucagon stimulates insulin release from the pancreas, lowering blood sugar levels.”
B) “Glucagon promotes glycogen storage in the liver, reducing blood glucose levels.”
C) “Glucagon inhibits the breakdown of glycogen to increase blood glucose levels.”
D) “Glucagon inhibits the production of glucose by the liver, lowering blood sugar levels.”
E) “Glucagon stimulates the release of glucose into the bloodstream, increasing blood sugar levels.”
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Rationale:
Glucagon acts as a counter-regulatory hormone to insulin. When blood sugar levels drop, glucagon is released by the pancreas to stimulate the liver to convert stored glycogen into glucose and release it into the bloodstream, thereby raising blood sugar levels. This mechanism helps prevent hypoglycemia by increasing available glucose in the circulation. Options A, B, C, and D provide incorrect information about the actions of glucagon in diabetes management, making option E the correct choice.
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