#1. Which of the following mechanisms does not lead to hyperglycemia in diabetic patients?
a. Exogenous administration of insulin
b. Increased hepatic glucose production
c. Decreased insulin secretion
d. Decreased peripheral glucose uptake
Rationale: The correct answer is exogenous administration of insulin. Administration of insulin would increase the body’s available insulin and lead to normal or lower blood glucose levels. Increased hepatic glucose production leads to hyperglycemia because there is more glucose for insulin to uptake into the cell for excretion. Decreased insulin secretion leads to hyperglycemia because there is not enough insulin to meet the body’s needs for glucose uptake into the cell for excretion. Decreased peripheral glucose uptake leads to hyperglycemia because the glucose isn’t being pulled into the cell for excretion (McCance & Huether, 2019).
#2. Which of the following would not indicate the diagnosis of diabetes mellitus?
a. Fasting plasma glucose of 120 mg/dL
b. Random plasma glucose of 250 mg/dL with symptoms of hyperglycemia
c. Fasting plasma glucose of 145 mg/dL
d. 2 hour plasma glucose of 220 mg/dL
Rationale: The correct answer is fasting plasma glucose of 120 mg/dL. Criteria for diagnosis of DM includes fasting plasma glucose of ≥126 mg/dL. A fasting plasma glucose of 145 mg/dL would indicate DM because it is greater than the criteria of ≥126 mg/dL. Criteria for DM for a random plasma glucose with symptoms of hyperglycemia is ≥ 200 mg/dL. Criteria for DM in a 2 hour plasma glucose is ≥ 200 mg/dL (McCance & Huether, 2019).
#3. Which of the following hemoglobin A1c laboratory values is in a normal, healthy range?
a. 7.0%
b. 8.5%
c. 6.8%
d. 5.1%
Rationale: The correct answer is 5.1%. A person diagnosed with diabetes mellitus will have a hemoglobin A1c of ≥ 6.5%, so a hemoglobin A1c level of 5.1% is within healthy, normal limits, where as 7.0%, 8.5% and 6.8% would all indicate DM (McCance & Huether, 2019).
#4. Which of the following cell types is responsible for secreting insulin in the body in response to elevated glucose in the bloodstream?
a. Alpha pancreatic cells
b. Beta pancreatic cells
c. Kupffer cells
d. Adipose cells
Rationale: The correct answer is beta pancreatic cells. Beta pancreatic cells are located in the islets of Langerhans in the pancreas. They are responsible for producing insulin and the insulin then takes up glucose into the cells for excretion. Kupffer cells are macrophages that are important for lipid metabolism, bilirubin production, and healing liver damage. Alpha pancreatic cells are responsible for secreting glucagon. Glucagon is the antagonist to insulin and increased blood glucose levels. Adipose cells are fat cells that produce adipokines. Increased adipokines in the blood contributes to decreased insulin production (McCance & Huether, 2019).
#5. Which activity would lead to the progression of the disease for type two diabetes?
a. Participating in regular physical activity
b. Eating a balanced and healthy diet
c. Closely monitoring blood sugar levels
d. Adopting a sedentary lifestyle
Rationale: The correct answer is adopting a sedentary lifestyle. Having a sedentary lifestyle is a risk factor for DM. After diagnosis, if a patient maintained a sedentary lifestyle, the disease would progress. Participating in regular physical activity and eating a balanced diet are associated with weight loss. Since obesity is a major contributor to DM, decreasing body weight would slow the progression of DM. Closely monitoring blood glucose levels is associated with controlling DM and slowing the progression of the disease (McCance & Huether, 2019; Bellou, Belbasis, Tzoulaki, & Evangelos, 2018).