This set of Diabetes NCLEX questions is intended to help nurses brush up on the concepts of managing patients with this chronic disease.
The topic of diabetes mellitus care and management is one of the most challenging ones that nurses face because you are expected to know about the disease process and how to ensure that the patient will have the ability to function optimally in the face of chronic illness.
Questions asked mostly consist of patient education, medication administration, determining signs and symptoms of diabetic emergencies, and complications of the disease process. These topics are included in this practice test to help you understand care for these patients with diverse and sometimes specialized care requirements.
Read and analyze each question carefully and chose the best answer/s from the choices provided. At the end of these practice tests, correct answers along with the explanation are given.
Diabetes NCLEX-RN Practice Questions
1. An external insulin pump is prescribed for a client with diabetes mellitus. When the client asks the nurse about the functioning of the pump, the nurse bases the response on which information about the pump?
A. It is timed to release programmed doses of either short-duration or NPH insulin into the bloodstream at specific intervals.
B. It continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels.
C. It is surgically attached to the pancreas and infuses regular insulin into the pancreas. This releases insulin into the bloodstream.
D. It administers a small continuous dose of short-duration insulin subcutaneously. The client can self-administer an additional bolus dose from the pump before each meal.
2. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department. Which findings support this diagnosis? Select all that apply.
A. Increase in pH
B. Comatose state
C. Deep, rapid breathing
D. Decreased urine output
E. Elevated blood glucose level
3. The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose should be taken if which symptom or symptoms develop? Select all that apply.
D. Blurred vision
F. Fruity breath odor
4. A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the treatment of hyperglycemia. What is the appropriate intervention to decrease the client’s anxiety?
A. Administer a sedative.
B. Convey empathy, trust, and respect toward the client.
C. Ignore the signs and symptoms of anxiety, anticipating that they will soon disappear.
D. Make sure that the client is familiar with the correct medical terms to promote understanding of what is happening.
5. The nurse provides instructions to a client newly diagnosed with type 1 diabetes mellitus. The nurse recognizes an accurate understanding of measures to prevent diabetic ketoacidosis when the client makes which statement?
A. “I will stop taking my insulin if I’m too sick to eat.”
B. “I will decrease my insulin dose during times of illness.”
C. “I will adjust my insulin dose according to the level of glucose in my urine.”
D. “I will notify my health care provider (HCP) if my blood glucose level is higher than 250 mg/dL (14.2 mmol/L).”
6. A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose level is 950 mg/dL (54.2 mmol/L). A continuous intravenous (IV) infusion of short-acting insulin is initiated, along with IV rehydration with normal saline. The serum glucose level is now decreased to 240 mg/dL (13.7 mmol/L). The nurse would next prepare to administer which medication?
A. An ampule of 50% dextrose
B. NPH insulin subcutaneously
C. IV fluids containing dextrose
D. Phenytoin for the prevention of seizures
7. The nurse is monitoring a client newly diagnosed with diabetes mellitus for signs of complications. Which sign or symptom, if exhibited in the client, indicates that the client is at risk for chronic complications of diabetes if the blood glucose is not adequately managed?
C. Pedal edema
D. Decreased respiratory rate
8. The nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The nurse places priority on which client problem?
A. Lack of knowledge
B. Inadequate fluid volume
C. Compromised family coping
D. Inadequate consumption of nutrients
9. The home health nurse visits a client with a diagnosis of type 1 diabetes mellitus. The client relates a history of vomiting and diarrhea and tells the nurse that no food has been consumed for the last 24 hours. Which additional statement by the client indicates a need for further teaching?
A. “I need to stop my insulin.”
B. “I need to increase my fluid intake.”
C. “I need to monitor my blood glucose every 3 to 4 hours.”
D. “I need to call the health care provider (HCP) because of these symptoms.”
10. The nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include a fasting blood glucose level of 120 mg/dL (6.8 mmol/L), a temperature of 101 °F (38.3 °C), a pulse of 102 beats/minute, respirations of 22 breaths/minute, and blood pressure of 142/72 mm Hg. Which finding would be the priority concern to the nurse?
D. Blood pressure
11. The nurse is teaching a client how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, indicates the need for further teaching?
A. Withdraws the NPH insulin first
B. Withdraws the regular insulin first
C. Injects air into NPH insulin vial first
D. Injects an amount of air equal to the desired dose of insulin into each vial
12. The home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse should tell the client to take which action?
A. Freeze the insulin.
B. Refrigerate the insulin.
C. Store the insulin in a dark, dry place.
D. Keep the insulin at room temperature.
13. Glimepiride is prescribed for a client with diabetes mellitus. The nurse instructs the client that which food items are most acceptable to consume while taking this medication? Select all that apply.
B. Red meats
C. Whole-grain cereals
D. Low-calorie desserts
E. Carbonated beverages
14. A client with diabetes mellitus visits a health care clinic. The client’s diabetes mellitus previously had been well controlled with glyburide daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL (10.2 to 11.4 mmol/L). Which medication, if added to the client’s regimen, may have contributed to the hyperglycemia?
15. A client with diabetes mellitus is told that amputation of the leg is necessary to sustain life. The client is agitated and tells the nurse, “This is all my health care provider’s fault. I have done everything I’ve been asked to do!” Which nursing interpretation is best for this situation?
A. An expected coping mechanism
B. An ineffective defense mechanism
C. A need to notify the hospital lawyer
D. An expression of guilt on the part of the client
16. The nurse teaches a client newly diagnosed with type 1 diabetes about storing Humulin N insulin. Which statement indicates to the nurse that the client understood the discharge teaching?
A. “I should keep the insulin in the cabinet during the day only.”
B. “I know I have to keep my insulin in the refrigerator at all times.”
C. “I can store the open insulin bottle in the kitchen cabinet for 1 month.”
D. “The best place for my insulin is on the windowsill, but in the cupboard is just as good.”
17. Metformin is prescribed for a client with type 2 diabetes mellitus. What is the most common side effect that the nurse should include in the client’s teaching plan?
A. Weight gain
C. Flushing and palpitations
D. Gastrointestinal disturbances
18. When teaching the diabetic client about foot care, the nurse should instruct the client to do which of the following?
A. Avoid going barefoot.
B. Buy shoes a half size larger.
C. Cut toenails at angles.
D. Use heating pads for sore feet.
19. A client with diabetes mellitus comes to the clinic for a regular 3-month follow-up appointment. The nurse notes several small bandages covering cuts on the client’s hands. The client says, “I’m so clumsy. I’m always cutting my finger cooking or burning myself on the iron.” Which of the following responses by the nurse would be most appropriate?
A. “Wash all wounds in isopropyl alcohol.”
B. “Keep all cuts clean and covered.”
C. “Why don’t you have your children do the cooking and ironing?”
D. “You really should be fine as long as you take your daily medication.”
20. The client with diabetes mellitus says, “If I could just avoid what you call carbohydrates in my diet, I guess I would be okay.” The nurse should base the response to this comment on the knowledge that diabetes affects the metabolism of which of the following?
A. Carbohydrates only.
B. Fats and carbohydrates only.
C. Protein and carbohydrates only.
D. Proteins, fats, and carbohydrates.
21. The nurse should caution the client with diabetes mellitus who is taking a sulfonylurea that alcoholic beverages should be avoided while taking these drugs because they can cause which of the following?
D. Disulfiram (Antabuse)–like symptoms.
22. Which of the following indicates a potential complication of diabetes mellitus?
A. Inflamed, painful joints.
B. Blood pressure of 160/100 mm Hg.
C. Stooped appearance.
D. Hemoglobin of 9 g/dL.
23. The client with type 1 diabetes mellitus is taught to take isophane insulin suspension NPH (Humulin N) at 5 p.m. each day. The client should be instructed that the greatest risk of hypoglycemia will occur at about what time?
A. 11 a.m., shortly before lunch.
B. 1 p.m., shortly after lunch.
C. 6 p.m., shortly after dinner.
D. 1 a.m., while sleeping.
24. A client with type 1 diabetes mellitus has influenza. The nurse should instruct the client to:
A. Increase the frequency of self-monitoring (blood glucose testing).
B. Reduce food intake to diminish nausea.
C. Discontinue that dose of insulin if unable to eat.
D. Take half of the normal dose of insulin.
25. Which of the following is a priority nursing diagnosis for the diabetic client who is taking insulin and has nausea and vomiting from a viral illness or influenza?
A. Imbalanced nutrition: Less than body requirements.
B. Ineffective health maintenance related to ineffective coping skills.
C. Acute pain.
D. Activity intolerance.
26. During a home visit, a diabetic client, begins to cry and says, “I just cannot stand the thought of having to give myself a shot every day.” Which of the following would be the best response by the nurse?
A. “If you do not give yourself your insulin shots, you will die.”
B. “We can teach your daughter to give the shots so you will not have to do it.”
C. “I can arrange to have a home care nurse give you the shots every day.”
D. “What is it about giving yourself the insulin shots that bothers you?”
27. The nurse is instructing the client on insulin administration. The client is performing a return demonstration for preparing the insulin. The client’s morning dose of insulin is 10 units of regular and 22 units of NPH. The nurse checks the dose accuracy with the client. The nurse determines that the client has prepared the correct dose when the syringe reads how many units?
28. Angiotensin-converting enzyme (ACE) inhibitors may be prescribed for the client with diabetes mellitus to reduce vascular changes and possibly prevent or delay development of:
A. Chronic obstructive pulmonary disease.
B. Pancreatic cancer.
C. Renal failure.
D. Cerebrovascular accident.
29. The nurse should teach the diabetic client that which of the following is the most common symptom of hypoglycemia?
C. Kussmaul’s respirations.
30. The nurse is assessing the client’s use of medications. Which of the following medications may cause a complication with the treatment plan of a client with diabetes?
D. Angiotensin-converting enzyme (ACE) inhibitors.