10 Diabetes NCLEX QuestionsFor answers, see the link at the bottom of the page.Question 1The nurse is caring for a client who has normal glucose levels at bedtime, hypoglycemia at 2am and hyperglycemia in the morning. What is this client likely experiencing?Answers:A. Dawn phenomenonB. Somogyi effectC. An insulin spikeD. Excessive corticosteroidsQuestion 2The nurse is caring for a patient whose blood glucose level is 55mg/dL. What is the likely nursing response?Answers:A. Administer a glucagon injectionB. Give a small mealC. Administer 10-15 grams of a carbohydrateD. Give a small snack of high protein foodQuestion 3What insulin type can be given by IV? Select all that apply:Answers:A. Glipizide (Glucotrol)B. Lispro (Humalog)C. NPH insulinD. Glargine (Lantus)E. Regular insulinQuestion 4A client with type II diabetes is being educated about what to do if he catches the flu or a cold. What is something he should be informed of?Answers:A. Discontinue Metformin (glucophage)B. Expect hyperglycemiaC. Add 2-3 more snacks to dietD. Come into the hospital for monitoringQuestion 5In educating a client about Type II Diabetes, what would be a proper explanation for poor wound healing?Answers:A. High blood glucose damages capillariesB. Swings in blood sugar prevent proper clottingC. The pancreas fails to secrete the proper chemicalsD. Ketosis prevents proper healingQuestion 6When does regular insulin generally have peak action after application?Answers:A. 30-45 minutesB. 45-60 minutesC. 1-2 hoursD. 2-3 hoursQuestion 7In educating a client with diabetes, what response would reveal need for further education?Answers:A. I should avoid tightsB. I should take good care of my toe nailsC. I should not go more than 3 days without washing my feetD. I should avoid going barefoot and should wear clean socksQuestion 8A client with diabetes and coronary heart disease is being evaluated for treatment. In light of the heart condition, which medication option is more likely to be an issue?Answers:A. Metformin (Glucophage)B. Pioglitazone (Actos)C. InsulinD. Sitagliptin (Januvia)Question 9What is NOT true of hyperglycemic hyperosmolar nonketotic syndrome (HHNS) compared to diabetic ketoacidosis (DKA)?Answers:A. HHNS is found mainly in Type II DiabetesB. Both have high levels of hyperglycemiaC. Both typically are treated with insulinD. In HHNS, blood pH tends to dropQuestion 10Insulin lipodystrophy should be treated in part by:Answers:A. Alternating insulin injection sitesB. Balancing diet and snack routineC. Reduction of insulin doseD. Adding an oral glycemic medication

Here are the answers to the sample questions. If anything seems fishy, so to speak, please let me know!1. BThe Somogyi effect is when blood sugar drops too low in the morning causing rebound hyperglycemia in the morning. The hypoglycemia at 2am is highly indicative. The Dawn phenomenon is similar but would not have the hypoglycemia at 2am.2. CThe client has low hypoglycemia. This is generally treated with a small snack.3. EThe only insulin that can be given by IV is regular insulin.4. BThe body's natural reaction to illness is to release glucose. As such, diabetics can expect to face increased hyperglycemia in addition to their illness.5. AHigh blood glucose damages capillaries which prevent proper healing.6. DThe exact details depend on various factors, but 2-3 hours for peak action of regular insulin is an accepted range.7. CThe recommended self-care routine is to wash feet on a daily basis without soaking and carefully cleaning.8. BCardiac safety of diabetes meds is a very complex subject. That said, pioglitazone is known to possibly have issues.9. DIn HHNS, you tend to avoid the decrease in pH and ketosis (hence nonketotic) that often occurs in diabetic ketoacidosis. Remember that the two are very similar otherwise.10. AAlternating insulin injection sites helps avoid lipodystrophy, which is a lump or dent in the skin that can be caused by using the same site for injections.