Question 1

Which of the following glycated hemoglobin values is normal?

Accepted Answer

A) 6% 
C) >7% 
D) >8% 
A) 6% 
C) >7% 
D) >8%

Question 2

A Hispanic pregnant woman is visiting the community clinic for her first prenatal visit.She has a family history of diabetes, she is obese, and her last baby weighed 9 pounds, 8 ounces.The nurse realizes that she is at risk for:

Accepted Answer

A) poor weight gain. 
B) gestational diabetes. 
C) anemia. 
D) malnutrition. 
A) poor weight gain. 
B) gestational diabetes. 
C) anemia. 
D) malnutrition.

Question 3

The simplest and most flexible approach to teaching Mr.Joiner the principles of the diet for optimal management of his blood glucose level is:

Accepted Answer

A) carbohydrate counting. 
B) the exchange lists. 
C) MyPlate. 
D) a high-protein diet plan.
Use the following case study to answer questions 56-61.
A 60-year-old client, Mr.Hummel, has had type 2 DM for several years.Because of a change in insurance coverage, Mr.Hummel changes doctors and at his first appointment, a comprehensive medical exam and dietary history are performed.At the next few appointments, the certified diabetes educator, a registered dietitian, takes a full dietary history.
Mr)Hummel works part-time in a seasonal sporting goods store, having retired last year from 35 years working for a manufacturing plant as a supervisor.He is married to a nurse who works full-time.He does most of the cooking and grocery shopping.He and his wife go for walks on weekends, but he does not exercise otherwise, except for doing chores around the house and occasional yard work or gardening.He is 5'9" tall and weighs 200 lbs., though when his diabetes was initially diagnosed, he weighed more.
Mr)Hummel is interested in weight reduction, especially if it will help him manage his blood glucose, and provides the following 24-hour food recall that typifies how he usually eats:
Breakfast (eats after taking morning blood glucose): Pancakes with diet syrup or a bowl of cereal (usually corn flakes, Chex, or instant oatmeal) with Sweet 'N' Low and nonfat milk.Drinks coffee throughout the day starting at breakfast with 2 nondairy coffee creamer packets per cup.May or may not have 4 oz.of 100% fruit juice depending on hunger.
Lunch (eats after taking afternoon blood glucose): Sandwich (rye or wheat bread), deck of cards-size portion of lunch meat (salami, ham, bologna, turkey, or chicken) with thinly spread mayonnaise; coffee with nondairy creamers.May or may not eat a can of soup (cream of tomato, cream of chicken, or Italian wedding soup) instead of a sandwich, with two slices of buttered rye or wheat bread.
Afternoon Snack: Canned fruit or occasionally a cookie, doughnut, a piece of pizza, or a treat, depending on availability, hunger, blood sugar, and situation.Drinks coffee with nondairy coffee creamer.Usually also has a glass of ice water before dinner.
Dinner (eats after taking evening blood glucose): Roast beef, meat loaf, steak, or another red meat; occasionally eats poultry or fish-approximate amount 8 oz.; plain baked potato, au gratin potatoes, or boiled buttered potatoes; a salad with bottled salad dressing or a vegetable, such as canned green beans; and a slice of rye or wheat bread with butter.May use ketchup, steak sauce, salt, and pepper.Drinks water with dinner.
Evening Snack: Varies-may eat a few handfuls of a bagged snack food, such as Doritos; a bag of buttered microwave popcorn; or cookies.
Labs are as follows:
$\bullet$Fasting glucose: 140-150 mg/dL
$\bullet$Glucose one to two hours after mealtime: 200 mg/dL
$\bullet$Average bedtime glucose: 152 mg/dL
$\bullet$Glycosylated hemoglobin (hemoglobin A1
C) : 7.5% 
A) carbohydrate counting. 
B) the exchange lists. 
C) MyPlate. 
D) a high-protein diet plan.
Use the following case study to answer questions 56-61.
A 60-year-old client, Mr.Hummel, has had type 2 DM for several years.Because of a change in insurance coverage, Mr.Hummel changes doctors and at his first appointment, a comprehensive medical exam and dietary history are performed.At the next few appointments, the certified diabetes educator, a registered dietitian, takes a full dietary history.
Mr)Hummel works part-time in a seasonal sporting goods store, having retired last year from 35 years working for a manufacturing plant as a supervisor.He is married to a nurse who works full-time.He does most of the cooking and grocery shopping.He and his wife go for walks on weekends, but he does not exercise otherwise, except for doing chores around the house and occasional yard work or gardening.He is 5'9" tall and weighs 200 lbs., though when his diabetes was initially diagnosed, he weighed more.
Mr)Hummel is interested in weight reduction, especially if it will help him manage his blood glucose, and provides the following 24-hour food recall that typifies how he usually eats:
Breakfast (eats after taking morning blood glucose): Pancakes with diet syrup or a bowl of cereal (usually corn flakes, Chex, or instant oatmeal) with Sweet 'N' Low and nonfat milk.Drinks coffee throughout the day starting at breakfast with 2 nondairy coffee creamer packets per cup.May or may not have 4 oz.of 100% fruit juice depending on hunger.
Lunch (eats after taking afternoon blood glucose): Sandwich (rye or wheat bread), deck of cards-size portion of lunch meat (salami, ham, bologna, turkey, or chicken) with thinly spread mayonnaise; coffee with nondairy creamers.May or may not eat a can of soup (cream of tomato, cream of chicken, or Italian wedding soup) instead of a sandwich, with two slices of buttered rye or wheat bread.
Afternoon Snack: Canned fruit or occasionally a cookie, doughnut, a piece of pizza, or a treat, depending on availability, hunger, blood sugar, and situation.Drinks coffee with nondairy coffee creamer.Usually also has a glass of ice water before dinner.
Dinner (eats after taking evening blood glucose): Roast beef, meat loaf, steak, or another red meat; occasionally eats poultry or fish-approximate amount 8 oz.; plain baked potato, au gratin potatoes, or boiled buttered potatoes; a salad with bottled salad dressing or a vegetable, such as canned green beans; and a slice of rye or wheat bread with butter.May use ketchup, steak sauce, salt, and pepper.Drinks water with dinner.
Evening Snack: Varies-may eat a few handfuls of a bagged snack food, such as Doritos; a bag of buttered microwave popcorn; or cookies.
Labs are as follows:
$\bullet$Fasting glucose: 140-150 mg/dL
$\bullet$Glucose one to two hours after mealtime: 200 mg/dL
$\bullet$Average bedtime glucose: 152 mg/dL
$\bullet$Glycosylated hemoglobin (hemoglobin A1
C) : 7.5%

Question 4

Intensive insulin therapy can cause:

Accepted Answer

A) hyperglycemia. 
B) a loss of appetite. 
C) weight gain. 
D) low albumin levels. 
A) hyperglycemia. 
B) a loss of appetite. 
C) weight gain. 
D) low albumin levels.

Question 5

Which insulin has the longest duration of action?

Accepted Answer

A) lispro 
B) regular 
C) NPH 
D) glargine 
A) lispro 
B) regular 
C) NPH 
D) glargine

Question 6

Four months later Mr.Joiner returns to his physician for a follow-up appointment.He has lost 10 pounds, but his fasting blood glucose level is now 131 mg/dL.Mr.Joiner's prediabetes has progressed to:

Accepted Answer

A) type 1 diabetes. 
B) type 2 diabetes. 
C) gestational diabetes. 
D) hyperosmolar hyperglycemic syndrome. 
A) type 1 diabetes. 
B) type 2 diabetes. 
C) gestational diabetes. 
D) hyperosmolar hyperglycemic syndrome.

Question 7

Matching

Accepted Answer

1.m
2.j
3.a
4.f
5.k

Question 8

Women with gestational diabetes who are overweight or obese should be encouraged to:

Accepted Answer

A) engage in strenuous exercise. 
B) severely restrict carbohydrate intake. 
C) adjust energy intake as needed. 
D) limit protein intake.
Use the following case study to answer questions 50-55.
Jared Joiner is a 56-year-old African American insurance agent.He is single, eats most meals at restaurants, and leads a sedentary lifestyle.He is 5'9" tall and weighs 204 pounds.Mr.Joiner has been feeling particularly fatigued lately and decided to make an appointment with his physician for a check-up.The results of his laboratory tests include a fasting blood glucose level of 121 mg/dL. 
A) engage in strenuous exercise. 
B) severely restrict carbohydrate intake. 
C) adjust energy intake as needed. 
D) limit protein intake.
Use the following case study to answer questions 50-55.
Jared Joiner is a 56-year-old African American insurance agent.He is single, eats most meals at restaurants, and leads a sedentary lifestyle.He is 5'9" tall and weighs 204 pounds.Mr.Joiner has been feeling particularly fatigued lately and decided to make an appointment with his physician for a check-up.The results of his laboratory tests include a fasting blood glucose level of 121 mg/dL.

Question 9

Diet therapy for a pregnant type 1 diabetic includes all of the following except:

Accepted Answer

A) decreased kcalories to aid in blood glucose control. 
B) regular meals and snacks. 
C) an evening snack. 
D) monitoring of insulin therapy. 
A) decreased kcalories to aid in blood glucose control. 
B) regular meals and snacks. 
C) an evening snack. 
D) monitoring of insulin therapy.

Question 10

Mr.Hummel had been taking oral hypoglycemic agents for 3 months prior to this visit.Based on his _____ measurement, his glycemic control over this period needed improvement.

Accepted Answer

A) glycemic index 
B) hemoglobin A1C 
C) weight 
D) fasting glucose 
A) glycemic index 
B) hemoglobin A1C 
C) weight 
D) fasting glucose

Question 11

Describe the appropriate medical nutrition therapy for pregnant women with type 1 or type 2 diabetes.

Accepted Answer

Pregnant women with type 1 or type 2 dia

Question 12

Mr.Joiner's blood glucose level meets the criteria for a diagnosis of:

Accepted Answer

A) type 1 diabetes. 
B) type 2 diabetes. 
C) prediabetes. 
D) ketoacidosis. 
A) type 1 diabetes. 
B) type 2 diabetes. 
C) prediabetes. 
D) ketoacidosis.

Question 13

The nurse recognizes that the diabetic client understands the principles of her diet when she states:

Accepted Answer

A) "I need to restrict my carbohydrate intake and avoid concentrated sweets." 
B) "I need to severely limit my fat intake and choose only complex carbohydrates." 
C) "I need to eat about the same amount of carbohydrate at about the same time each day." 
D) "I need to restrict my carbohydrate and fat intakes, but increase my protein intake." 
A) "I need to restrict my carbohydrate intake and avoid concentrated sweets." 
B) "I need to severely limit my fat intake and choose only complex carbohydrates." 
C) "I need to eat about the same amount of carbohydrate at about the same time each day." 
D) "I need to restrict my carbohydrate and fat intakes, but increase my protein intake."

Question 14

Characteristics of an appropriate diet for diabetes include all of the following except:

Accepted Answer

A) low in carbohydrate. 
B) adequate in fiber. 
C) low in saturated fat. 
D) moderate in protein. 
A) low in carbohydrate. 
B) adequate in fiber. 
C) low in saturated fat. 
D) moderate in protein.

Question 15

The CDE teaches Mr.Hummel how to reduce his kcalories by increasing high-fiber foods in place of foods such as bagged snack chips.A higher intake of fiber could also:

Accepted Answer

A) increase his glycemic control. 
B) increase the glycemic index of his diet. 
C) increase his glycosylated hemoglobin. 
D) increase his blood glucose. 
A) increase his glycemic control. 
B) increase the glycemic index of his diet. 
C) increase his glycosylated hemoglobin. 
D) increase his blood glucose.

Question 16

The nurse teaches a newly diagnosed diabetic patient to treat an episode of hypoglycemia by:

Accepted Answer

A) eating 15 jelly beans. 
B) drinking a 12-oz.Coke. 
C) eating a candy bar. 
D) sucking slowly on a hard candy. 
A) eating 15 jelly beans. 
B) drinking a 12-oz.Coke. 
C) eating a candy bar. 
D) sucking slowly on a hard candy.

Question 17

Type 2 diabetes is associated with:

Accepted Answer

A) autoimmune diseases. 
B) insulin resistance. 
C) destruction of pancreatic beta cells. 
D) viral infection. 
A) autoimmune diseases. 
B) insulin resistance. 
C) destruction of pancreatic beta cells. 
D) viral infection.

Question 18

A diabetic client is placed on a 2500-kcalorie diet with the following distribution of kcalories: 55% carbohydrate, 15% protein, and 30% fat.The nurse recognizes that these percentages translate into:

Accepted Answer

A) 250 grams CHO; 100 grams protein; 75 grams fat. 
B) 343 grams CHO; 94 grams protein; 83 grams fat. 
C) 360 grams CHO; 86 grams protein; 89 grams fat. 
D) 374 grams CHO; 92 grams protein; 81 grams fat. 
A) 250 grams CHO; 100 grams protein; 75 grams fat. 
B) 343 grams CHO; 94 grams protein; 83 grams fat. 
C) 360 grams CHO; 86 grams protein; 89 grams fat. 
D) 374 grams CHO; 92 grams protein; 81 grams fat.

Question 19

The first sign of type 1 diabetes is often:

Accepted Answer

A) ketoacidosis. 
B) hypoglycemia. 
C) high blood lipids. 
D) microalbuminuria. 
A) ketoacidosis. 
B) hypoglycemia. 
C) high blood lipids. 
D) microalbuminuria.

Question 20

A patient with diabetes is allowed 60 grams of carbohydrate for lunch.This equals _____ portions of carbohydrate foods.

Accepted Answer

A) 2 
B) 3 
C) 4 
D) 5 
A) 2 
B) 3 
C) 4 
D) 5

Exam 20: Nutrition and Diabetes Mellitus

Which of the following glycated hemoglobin values is normal?

A Hispanic pregnant woman is visiting the community clinic for her first prenatal visit.She has a family history of diabetes, she is obese, and her last baby weighed 9 pounds, 8 ounces.The nurse realizes that she is at risk for:

The simplest and most flexible approach to teaching Mr.Joiner the principles of the diet for optimal management of his blood glucose level is:

Intensive insulin therapy can cause:

Which insulin has the longest duration of action?

Four months later Mr.Joiner returns to his physician for a follow-up appointment.He has lost 10 pounds, but his fasting blood glucose level is now 131 mg/dL.Mr.Joiner's prediabetes has progressed to:

Matching

Women with gestational diabetes who are overweight or obese should be encouraged to:

Diet therapy for a pregnant type 1 diabetic includes all of the following except:

Mr.Hummel had been taking oral hypoglycemic agents for 3 months prior to this visit.Based on his _____ measurement, his glycemic control over this period needed improvement.

Describe the appropriate medical nutrition therapy for pregnant women with type 1 or type 2 diabetes.

Mr.Joiner's blood glucose level meets the criteria for a diagnosis of:

The nurse recognizes that the diabetic client understands the principles of her diet when she states:

Characteristics of an appropriate diet for diabetes include all of the following except:

The CDE teaches Mr.Hummel how to reduce his kcalories by increasing high-fiber foods in place of foods such as bagged snack chips.A higher intake of fiber could also:

The nurse teaches a newly diagnosed diabetic patient to treat an episode of hypoglycemia by:

Type 2 diabetes is associated with:

A diabetic client is placed on a 2500-kcalorie diet with the following distribution of kcalories: 55% carbohydrate, 15% protein, and 30% fat.The nurse recognizes that these percentages translate into:

The first sign of type 1 diabetes is often:

A patient with diabetes is allowed 60 grams of carbohydrate for lunch.This equals _____ portions of carbohydrate foods.

Overview of Nutrition and Health

Digestion and Absorption

Carbohydrates

Lipids

Protein

Energy Balance and Body Composition

Weight Management

The Vitamins

Water and the Minerals

Nutrition Through the Life Span: Pregnancy and Infancy

Nutrition Through the Life Span: Childhood and Adolescence

Nutrition Through the Life Span: Later Adulthood

Nutrition Care and Assessment

Nutrition Intervention and Diet-Drug Interactions

Enteral and Parenteral Nutrition Support

Nutrition in Metabolic and Respiratory Stress

Nutrition and Upper Gastrointestinal Disorders

Nutrition and Lower Gastrointestinal Disorders

Nutrition and Liver Diseases

Nutrition and Disorders of the Heart and Blood Vessels

Nutrition and Renal Diseases

Nutrition, Cancer, and Hiv Infection

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