Which client is at risk for developing type 2 diabetes mellitus DM Select all that apply

QUESTION ONE

When Mr. Johnson was first diagnosed with Type 2 Diabetes Mellitus what classic symptoms should he have been told he would exhibit?  Select all that apply.

a. Visual changes, recurrent infections, and pruritis

b. Nausea, hypotension, and mental confusion

c. Polyuria, polyphagia, and polydipsia

d. Sweet fruity breath, Kussmaul breathing, and vomiting

QUESTION TWO

What risk factors increase the chances of developing Type II diabetes?

a. Smoking, race, diet, family history, and height

b. Family history, hygiene, smoking, increased age, and hypertension

c. Hygiene, lifestyle, genetics, smoking, and obesity

d. Family history, increased age, obesity, hypertension, and smoking

QUESTION THREE

What does insulin resistance mean?

a. The pancreas is underactive and can keep up with the production of insulin needed to overcome the high amount of glucose in the blood.

b. Glucose is raised above normal levels.

c. The inability for cells to absorb and use blood sugar for energy.

d. The pancreas is overactive and cannot keep up with the insulin demands due to an abundance of glucose in the blood.

QUESTION FOUR

What evidence-based suggestions can you provide your patients to prevent or manage Type II diabetes?

a. Eating whatever you desire as long as you work out.

b. Eating a healthy diet and exercising.

c. Eating a healthy diet only.

d. Staying inside all day under the blankets.

QUESTION FIVE

What are the long term effects of untreated Type 2 Diabetes Mellitus? [Select all that apply]

a. Blindness

b. Kidney Disease

c. Tinnitus

d. Peripheral Neuropathy

QUESTION ONE

Answer:  A & C

Rationale

Visual changes, recurrent infections, and pruritis are all complications of Type 2 Diabetes Mellitus. Although polyuria, polyphagia, and polydipsia are known as the classic symptoms for Type 1 Diabetes Mellitus, they are also present in Type 2 Diabetes Mellitus. Nausea, hypotension and mental confusion are signs of hypoglycemia.  Sweet fruity breath, Kussmaul respirations, and vomiting are signs of diabetic ketoacidosis.

Reference: McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2019). Pathophysiology: the biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Elsevier.

QUESTION TWO

Answer: D, risk factors for type II diabetes include obesity, diet, lack of exercise, race, increased age, and family history.

Rationale

Maintaining a healthy weight and engaging in physical activity helps to control weight, uses glucose for energy and allows cells to be more sensitive to insulin. Having a family history increases the risk of type II diabetes.  For unclear reasons, African Americans, Hispanics, American Indians, and Asian Americans have an increased risk of developing type II diabetes. An increase in age is also a risk factor due to weight gain and the tendency to be less active.  A diet high in red meats, processed carbohydrates, sugar, and saturated and trans fat increases the risk of type II diabetes. Options A, B, and C are incorrect. Height and hygiene are not contributing factors.

Reference

Type 2 diabetes. (2019, January 9). Retrieved from https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193.

QUESTION THREE

Answer: C. Insulin resistance is the inability for cells to absorb and use blood sugar for energy due to cells being desensitized to insulin.

Rationale

Cells that are desensitized to insulin do not take up insulin thus not taking up glucose to use for energy. Option A is incorrect, the pancreas becomes overactive when there is a high level of glucose in the blood but does not define insulin resistance. Option B is the lab value result of a patient with diabetes. Option D is what happens with type II diabetes but does not define insulin resistance.

Reference

Felman, A. (2019, March 26). Insulin resistance: Causes, symptoms, and prevention. Retrieved from https://www.medicalnewstoday.com/articles/305567.php.

QUESTION FOUR

Answer: B. Eating a healthy diet and exercising to maintain a healthy weight or lose weight.

Rationale

Eating a healthy diet, high in fruits and vegetables and low in carbs helps the pancreas not get overworked creating insulin thus keeping blood glucose levels in a normal range. Exercising allows for hypertrophy of the muscles which respond better to insulin after exercise. Therefore, an active person can help prevent or reverse insulin resistance. Option A does not help a patient manage their diabetes if the same high carb, high sugar foods are being consumed. Option C should be complimented with exercise to help the muscles respond better to insulin. Option D will only worsen diabetes due to a lack of exercise.

References

Felman, A. (2019, March 26). Insulin resistance: Causes, symptoms, and prevention. Retrieved from https://www.medicalnewstoday.com/articles/305567.php.

The Diabetes Diet. (2019, June 19). Retrieved from https://www.helpguide.org/articles/diets/the-diabetes-diet.htm.

QUESTION FIVE

Answers: A, B, C & D

Rationale

This patient already wears glasses, so he is at risk for blindness due to the risk of glaucoma, cataracts, and diabetic retinopathy from persistent hyperglycemia. Kidney disease can occur from untreated diabetes due to persistent hypertension and strain on the kidneys. Diabetes is the leading cause of kidney failure in the U.S. Tinnitus is ringing in the ears caused by inadequate blood flow to vessels in the ear due to hyperglycemia. Peripheral neuropathy occurs from nerve damage as well from high levels of glucose in the bloodstream. This increases the risk of infection and amputation of feet.

References

Felson, S. (Ed.). (2019, May 6). Diabetes Complications: How Uncontrolled Diabetes Affects Your Body. Retrieved from https://www.webmd.com/diabetes/guide/risks-complications-uncontrolled-diabetes#1.Holcát,

M. (2007, May). Tinnitus and diabetes. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17642439.

McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2018). Pathophysiology: the biologic basis for disease in adults and children. St. Louis, MO: Elsevier.