Essentials Of Pathophysiology Concepts of Altered States 4th Edition By Porth
Essentials Of Pathophysiology Concepts of Altered States 4th Edition By Porth
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Chapter 33- Diabetes Mellitus and the Metabolic Syndrome
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | A hospital client with a diagnosis of type 1 diabetes has been administered a scheduled dose of regular insulin. Which of the following effects will result from the action of insulin? | |
| A) | Promotion of fat breakdown | |
| B) | Promotion of glucose uptake by target cells | |
| C) | Promotion of gluconeogenesis | |
| D) | Initiation of glycogenolysis | |
| Ans: | B | |
| Feedback: | ||
| The actions of insulin are threefold: (1) it promotes glucose uptake by target cells and provides for glucose storage as glycogen; (2) it prevents fat and glycogen breakdown; and (3) it inhibits gluconeogenesis and increases protein synthesis. Glucagon, not insulin, promotes glycogenolysis. | ||
| 2. | A client with long-standing type 2 diabetes is surprised at his high blood sugar readings while recovering from an emergency surgery. Which of the following factors may have contributed to the client’s inordinately elevated blood glucose levels? | |
| A) | The tissue trauma of surgery resulted in gluconeogenesis. | |
| B) | Illness inhibited the release and uptake of glucagon. | |
| C) | The stress of the event caused the release of cortisol. | |
| D) | Sleep disruption in the hospital precipitated the dawn effect. | |
| Ans: | C | |
| Feedback: | ||
| Elevation of glucocorticoid levels, such as during stressful events, can lead to hyperglycemia. Tissue trauma does not cause gluconeogenesis, and illness does not inhibit the action of glucagon. The dawn phenomenon is not a likely cause of the client’s disruption in blood sugar levels. | ||
| 3. | Which of the following clients would be considered to be exhibiting manifestations of “prediabetes”? | |
| A) | A middle-aged overweight adult with a fasting plasma glucose level of 122 with follow-up OGTT of 189 mg/dL. | |
| B) | A school-aged child who had a blood glucose level of 115 following lunch. | |
| C) | A retired female registered nurse with a fasting plasma glucose level of 92 mg/dL. | |
| D) | An elderly client who got “light-headed” when he skipped his lunch. Blood glucose level was 60 mg/dL at this time. | |
| Ans: | A | |
| Feedback: | ||
| Persons with IFG (impaired fasting plasma glucose [IFG] defined by an elevated FPG of 100 to 125 mg/dL) and/or IGT (impaired glucose tolerance [IGT] plasma glucose levels of 140 to 199 mg/dL with an OGTT) are often referred to as having prediabetes, meaning they are at relatively high risk for the future development of diabetes as well as cardiovascular disease. | ||
| 4. | A young child develops type 1A diabetes. The parents ask, “They tell us this is genetic. Does that mean our other children will get diabetes?” The best response by the health care provider would be: | |
| A) | “Probably not since genetically your other children have a different cellular makeup, they just might not become diabetic.” | |
| B) | “If you put all your children on a low-carbohydrate diet, maybe they won’t get diabetes.” | |
| C) | “We don’t know what causes diabetes, so we will just have to wait and see.” | |
| D) | “This autoimmune disorder causes destruction of the beta cells, placing your children at high risk of developing diabetes.” | |
| Ans: | D | |
| Feedback: | ||
| Type 1 diabetes is subdivided into two types: type 1A, immune-mediated diabetes, and type 1B, idiopathic diabetes. Type 1A diabetes is characterized by autoimmune destruction of beta cells. The other choices are not absolutely correct. The fact that type 1 diabetes is thought to result from an interaction between genetic and environmental factors led to research into methods directed at prevention and early control of the disease. These methods include the identification of genetically susceptible persons and early intervention in newly diagnosed persons with type 1 diabetes. | ||
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