Diabetes Mellitus Fundamentals: A Review and Current Update

~ Exam ~

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This test has 45 questions.

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1. Diabetes is:

  a. Curable with weight loss

  b. A fatal disease

  c. A disorder of protein metabolism

  d. A disorder of (predominantly) carbohydrate metabolism


2. Which of the following is NOT a cardinal sign of uncontrolled/undiagnosed type 1 diabetes?

  a. Polyuria

  b. Polyphagia

  c. Polydipsia

  d. Weight gain


3. A sign of uncontrolled/undiagnosed type 1 diabetes includes changes in the urine. Identify one such sign from the list below.

  a. Absence of glucosuria

  b. Presence of ketonuria

  c. Presence of cloudy urine

  d. Presence of albuminuria


4. A sign of uncontrolled/undiagnosed type 1 diabetes is that the pH of the blood:

  a. Increase

  b. Decreases

  c. Is greater than 7.6

  d. Does not change


5. A lab test used to diagnose diabetes is the:

  a. Three-hour post-prandial blood glucose

  b. Fasting blood glucose > 126 mg/dL obtained on two different days

  c. Tonicity of the blood

  d. Test for glucosuria


6. Which of the following accurately describes the body's physiologic response when it is deprived of sufficient insulin to meet its metabolic needs?

  a. Inability to metabolize glucose leads to an increased blood pH.

  b. Protein anabolism leads to gluconeoge.

  c. Breakdown of fat creates ketonemia which leads to acidosis.

  d. Carbohydrate catabolism creates hyperglycemia.


7. Explain why body weight decreases in uncontrolled/undiagnosed DMT1.

  a. Protein and fat catabolism occur to meet energy needs unmet by normal carbohydrate metabolism due to an absolute lack of insulin.

  b. Since glucose cannot be transported across the cell membrane, fat cannot be manufactured resulting in a loss of body weight.

  c. Hyperglycemia reduces the tonicity of the blood leading to excessive loss of fluid through excretion of urine resulting in a loss of body weight.

  d. Hyperglycemia leads to loss of appetite resulting in less food eaten. Weight loss results from reduced intake of calories.


8. Physiologically, the underlying metabolic pathway utilized by the body in uncontrolled/undiagnosed DMT1 is similar to that used during periods of starvation.

  a. True

  b. False


9. Ketones are:

  a. Responsible for kidney damage in diabetes

  b. End-products of fat breakdown

  c. Buffering agents in an acidic environment

  d. Beneficial in high concentrations


10. Glycogen is defined as:

  a. Abnormal products in the urine reflective of fat metabolis

  b. A stored form of glucose

  c. Excessive drinking

  d. Hormone that leads to an increase in blood glucose


11. Polydipsia is defined as:

  a. Abnormal products in the urine reflective of fat metabolis

  b. Stored carbohydrate

  c. Excessive drinking

  d. A hormone that leads to an increase in blood glucose


12. Ketonuria is defined as:

  a. Abnormal products in the urine reflective of fat metabolis

  b. Stored carbohydrate

  c. Excessive drinking

  d. Hormone that leads to an increase in blood glucose


13. Glucagon is defined as:

  a. Abnormal products in the urine reflective of fat metabolis

  b. Stored carbohydrate

  c. Excessive drinking

  d. A hormone that leads to an increase in blood glucose


14. Which of the following is a true statement concerning comparisons between diabetes type 1 (DMT1) and DMT2?

  a. Both typically include the development of ketones prior to effective treatment.

  b. Obesity is a common element in both conditions.

  c. DMT2 is treated with diet, exercise, and oral agents, only, whereas DMT1 is treated exclusively with insulin.

  d. Ketonuria is typically not found in DMT2.


15. Insulin is a:

  a. Digestive enzyme produced by special cells in the pancreas

  b. Hyperglycemic agent produced in the pancreas but stored in the liver

  c. Hormone produced by special cells in the islets of langerhans

  d. Hormone produced by the anterior pituitary gland


16. The hormone produced in the alpha cells of the pancreas which has opposite effects of insulin is:

  a. Glycogen

  b. Lipase

  c. Glucagon

  d. Pancreatase


17. Insulin's functions include each of the following EXCEPT:

  a. Facilitating the passage of glucose across cell membrane

  b. Inhibiting the conversion of glycogen to glucose

  c. Promoting the breakdown of protein to glucose and inhibiting protein synthesis

  d. Promoting the conversion of fatty acids to fat and inhibiting the breakdown of fat


18. The net effect of all of the functions of insulin is to:

  a. Decrease blood glucos

  b. Increase blood glucos

  c. Stimulate the breakdown of glycogen

  d. Inhibit the development of metabolic alkalosis


19. Which of the following produces an increase in blood glucose?

  a. Insulin

  b. Thyroxine

  c. Calcitonin

  d. Glucagon


20. Which of the following statements provides rationale for encouraging the diabetic to avoid excessive stress (physical and emotional) and/or coping with stress effectively?

  a. Excessive stress causes people to overeat leading to problems with glucose control.

  b. The stress response leads to a systemic outpouring of glucocorticoids and epinephrine which lead to increased BG.

  c. People with diabetes become forgetful when stressed, so may forget such things as medications and self-monitoring of BG.

  d. Such stress leads to gastric ulcers which compromise diabetes control.


21. The four cornerstones of diabetes management are proper nutrition, exercise, insulin, and self-monitoring of blood glucose (SMBG).

  a. True

  b. False


22. Weight loss can cure diabetes type 2.

  a. True

  b. False


23. The net effect on the diabetic's blood glucose of ingesting more carbohydrate than recommended is:

  a. Increased BG

  b. Decreased BG

  c. Profound decrease in BG

  d. No change expected


24. The net effect on blood glucose of increasing insulin and exercising more than usual is:

  a. Increased BG

  b. Decreased BG

  c. Profound decrease in BG

  d. No change expected


25. If the type 1 diabetic reduces her/his usual dosage of insulin intake with no other changes, what outcomes might occur as a result?

  a. Hypoglycemia

  b. Ketonemia

  c. Glucagon production

  d. Weight gain


26. Which of the following circumstances is likely to lead to hypoglycemia in the individual taking medication for diabetes?

  a. A meal contains more fat than is recommended.

  b. Less carbohydrate is ingested than is recommended.

  c. A dose of medication is missed.

  d. Usual exercise is not performed.


27. Which of the following could result in hyperosmolar hyperglycemic state (HHS) in the person with diabetes? The person with:

  a. DMT1 forgets to take his insulin

  b. DMT2 exercises more than usual

  c. DMT1 takes too much insulin

  d. DMT2 eats an entire cherry pie


28. Diabetic ketoacidosis can develop in the person with DMT2 when she/he:

  a. Overeats carbohydrates

  b. Has an infection

  c. Forgets to take his/her oral anti-diabetes me

  d. None of the choices is correct


29. Hospitalization is usually required for which of the following conditions in the person with diabetes:

  a. Hypoglycemia

  b. Hyperosmolar hyperglycemic state (HHS)

  c. Hyperglycemia

  d. Infection


30. A primary complaint of people with undiagnosed DMT2 is often fatigue.

  a. True

  b. False


31. Which of the following blood glucose values suggests impaired glucose tolerance (IGT)?

  a. Blood glucose of 190 mg/dL two hours after having ingested a specific amount of glucose in a standardized oral glucose tolerance test (OGTT)

  b. Blood glucose of 135 mg/dL two hours after having ingested a specific amount of glucose in a standard OGTT

  c. Fasting blood glucose of 120 mg/dL

  d. Fasting blood glucose of 95 mg/dL


32. Which of the following blood glucose values suggests impaired fasting glucose (IFG)?

  a. Blood glucose of 190 mg/dL two hours after having ingested a specific amount of glucose in a standard OGTT

  b. Blood glucose of 135 mg/dL two hours after having ingested a specific amount of glucose in a standard OGTT

  c. Fasting blood glucose level of 120 mg/dL

  d. Fasting blood glucose level of 95 mg/dL


33. The presence of gestational diabetes in a woman represents a risk factor for her later development of diabetes.

  a. True

  b. False


34. A child is considered overweight when which of the following conditions is present? The child's:

  a. Body mass index (BMI) is over the 5th percentile for age and gender

  b. Weight by height is greater than the 8th percentile

  c. Current weight is 150% of his/her ideal weight for height

  d. Waist circumference exceeds 30"


35. The American Diabetes Association recommends testing overweight children for diabetes and pre-diabetes if they have at least two risk factors for diabetes.

  a. True

  b. False


36. A child whose mother had gestational diabetes when she was pregnant with him/her is at risk for the development of diabetes.

  a. True

  b. False


37. Which of the following testing methods is recommended for screening children for diabetes?

  a. Oral glucose tolerance test

  b. Fasting blood sugar

  c. Hemoglobin a1c

  d. 2-hour post-prandial blood glucose


38. An adult male's waist circumference measures 46 inches. This has been found to be associated with what condition?

  a. Metabolic syndrome

  b. Hypertension

  c. Hyperosmolar hyperglycemic state (HHS)

  d. No condition. This is within normal limit.


39. The American Diabetes Association recommends which of the following as the initial intervention for the patient diagnosed with DMT2?

  a. Life style management, only

  b. Metformin, only

  c. Rosiglitazone and life style management

  d. Metformin and life style management


40. The American Diabetes Association recommends which of the following as the goal for A1c for non-pregnant adults with diabetes?

  a. Less than 8.5%

  b. Less than 8.0%

  c. Less than 7.5%

  d. Less than 7.0%


41. Barry is a 62 year old male. He has not been feeling well for some time, so he sees his healthcare provider on Monday. The healthcare provider sends him to a standardized lab for a hemoglobin A1c. The result is 7.0%. On Friday, a second hemoglobin A1c is drawn at the same lab. The result is 6.8%. What conclusion can be drawn from these two results? Barry:

  a. Has diabetes

  b. Has pre-diabetes

  c. Must have a fasting blood glucose to confirm the results

  d. Should return in three months to have the tests repeated


42. Researchers/authors cited within the self-study reported figures which indicated that between 2009 and 2034 the number of people with diagnosed and undiagnosed diabetes in the United States would _____.

  a. Nearly double

  b. Increase by one million

  c. Include 50% children

  d. Stabilize at 30 million


43. There is an epidemic of obesity in this country at this time.

  a. True

  b. False


44. There is an epidemic of DMT2 in this country at this time.

  a. True

  b. False


45. Professional nurses have an obligation to assure that the newly diagnosed diabetic is effectively educated for self-care.

  a. True

  b. False