LEHNE 6th---Edition: NCLEX-Style questions for Diabetes Mellitus

9 questions total

1) A nurse administers oral medications that enhance insulin action to a

patient with diabetes. Which type of diabetes does this patient have?
a) Type I Diabetes
b) Type II Diabetes
c) Diabetes insipidus
d) Ketosis

Ans: B; oral agents are effective ONLY with Type II diabetes 

2) When administering 30 Units of Regular Insulin and 70 Units of NPH

insulin, a nurse will:
a) Draw up the Regular Insulin into the syringe first, followed by the
cloudy NPH insulin
b) Inform the patient that mixing insulin helps increase insulin
production
c) Rotate sites at least once a week and label the sites used on a
diagram
d) Use a 23-25 gauge syring with a 1-inch needle for maximum
absorption

Ans: A; drawing up the regular insulin into the syringe first prevents
accidental mixture of NPH insulin into the vial of regular insulin,
which could cause an alteration in the onset of action of the
regular insulin 

3) Which long-acting insulin mimics natural basal insulins with its duration
of 24 hours?
a) Insulin Glargine (Lantus)
b) Insulin aspart (NovoLog)
c) Regular Insulin (Humulin R)
d) Ultralente insulin (Humulin U)

Ans: A; Insulin glargine has a duration of action of 24 hours with NO

peaks, which mimics the natural basal insulin secretion of the
pancreas 

4) An operating room nurse prepares a patient with Type II diabetes for

surgery. Which types of insulin will the surgical nurse have available?
a) Regular Insulin (Humulin R)
b) Isophane insulin suspension (NPH insulin)
c) Insulin zinc suspension (Lente insulin)
d) Insulin Glargine (Lantus)
 Ans: A; Regular insulin is the ONLY insulin that can be given
Intravenously 

5) For the most consistent absorption, into which site should the insulin be
injected?
a) Abdomen
b) Deltoid
c) Vastus Lateralis
d) Gluteus maxius

Ans: A; the abdomen provides the most consistent absorption

because the blood flow to subcutaneous tissue typically is not as
affected by muscular movements. The other options are all
intramuscular sites and should not be used for insulin administration.


6) A patient receives NPH insulin at 8 am. The patient eats breakfast at

830 am, lunch at noon and dinner at 6 pm. At what time is this patient
at the highest risk for hypoglycemia?
a) 10 AM
b) 2 PM
c) 5 PM
d) 8 PM

Ans: C; Breakfast eaten at 8:30am would cover the onset of NPH

insulin, and lunch covers the 2 PM time frame. However, if the
patient does not eat a midafternoon snack, the NPH insulin may be
peaking just before dinner, without sufficient glucose on hand to
prevent hypoglycemia. 

7) A nurse would include which statement when teaching a patient about

insulin Glargine (Lantus)?
a) “You should inject this insulin just before meals because it is very
fast acting.”
b) “The duration of action for this insulin is about 8-10 hours, so
you’ll need to take it twice a day.”
c) “You can mix this insulin with Lente insulin to enhance its effects.”
d) “You cannot mix this insulin in the same syringe with Regular
insulin.”

Ans: D; Insulin Glargine is a long-acting insulin with a duration of up

to 24 hours. It should not be mixed with any other insulin. 

8) A patient newly diagnosed with diabetes asks, “How does insulin

normally work in my body?” The Nurses response should be based on
which understanding of the action f insulin? Normal Insulin:
a) Stimulates the pancreas to reabsorb glucose
b) Promotes synthesis of amino acids into glucose
c) Stimulates the liver to convert glycogen into glucose
d) Promotes the passage of glucose into cells for energy
 Ans: D; Insulin promotes the passage of glucose into the cells, where
it is metabolized for energy. 

9) To achieve the most beneficial effect, the nurse plans to administer

glipizide (Glucotrol);
a) With food
b) 30 minutes before a meal
c) 15 minutes postprandial
d) At bedtime

Ans: B; Food inhibits the absorption of Glipizide. It is the ONLY

sulfonylurea agent that should be given 30 Minutes before a meal. 