Deck 21: Carbohydrate-Controlled Diets for Diabetes Mellitus

Question 1

Case Study
HR Manager with Stroke: Steve Daniels is a 53-year-old male who works as a human resource manager.He is obese (BMI of 34), has a history of hypertension, and has smoked a pack of cigarettes a day for the past 32 years.He recently had an episode in which he experienced weakness on one side, double vision, and slurred speech for approximately 20 minutes.His wife called 911 and he was taken to the emergency room.Examination by emergency room personnel determined his blood pressure to be 172/105.A serum lipid profile was performed and the results were as follows: Triglycerides 250 mg/dL; Total cholesterol 265 mg/dL; LDL 217 mg/dL; HDL 29 mg/dL.The physician diagnosed Mr.Daniels as having had a stroke.
Prediabetes is diagnosed when a person has a fasting blood glucose level that falls between 100 and 125 mg/dL.

Answer 1

True

Question 2

Acetone breath is characteristic of hypoglycemia.

Answer 2

False

Question 3

It is appropriate for clients diagnosed with type 2 diabetes to take oral antidiabetic agents and ignore their prescribed diet.

Answer 3

False

Question 4

Physical activity has not been shown to aid blood glucose control in people with type 1 diabetes.

Question 5

The presence of ketones can be detected in both the blood and the urine.

Question 6

In severe cases of diabetic ketoacidosis, blood glucose levels can exceed 1000 mg/dL.

Question 7

a person does not produce sufficient insulin, he is prone to have:

A)hyperglycemia.
B)poor appetite.
C)low albumin levels.
D)hypoglycemia.

Question 8

Diabetes mellitus describes a group of metabolic disorders characterized by:

A)elevated blood glucose.
B)low hemoglobin.
C)dumping syndrome.
D)lactose intolerance.

Question 9

In people with diabetes, claudication may be due to polyuria.

Question 10

Weight-loss diets are often prescribed for people with type 2 diabetes.

Question 11

The primary defect in type 2 diabetes is autoimmune destruction of the beta cells in the pancreas.

Question 12

Routine checks for microalbuminuria help to determine if diabetes is affecting the eyes.

Question 13

Chronic complications of diabetes typically affect the blood vessels and the bones.

Question 14

Glycosuria generally occurs when blood glucose exceeds _____ milligrams per deciliter.

A)120
B)140
C)160
D)200

Question 15

The hyperosmolar hyperglycemic syndrome is usually a complication of type 2 diabetes.

Question 16

People with diabetes are prone to _____ due to poor circulation and weakened immune function.

A)ketoacidosis
B)hyperglycemia
C)infections
D)fatigue

Question 17

Close monitoring of glucose levels is especially important for the pregnant woman with diabetes.

Question 18

Obesity alone can cause some degree of insulin resistance.

Question 19

first sign of type 1 diabetes is often:

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

Question 20

Clinical trials have demonstrated that intensive treatment can keep blood glucose levels tightly controlled and reduce the incidence and severity of the chronic complications of diabetes.

Question 21

2 diabetes often goes undiagnosed in overweight children and teens because:

A)their glucose levels vary with their stage of growth.
B)there are frequently no symptoms.
C)blood glucose tests are not accurate in children and teens.
D)their lifestyles are not conducive to screening for the disease.

Question 22

Intensive insulin therapy can cause:

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

Question 23

Which of the following is the most important goal for both medical and nutrition therapy for diabetes?

A)blood glucose control
B)blood pressure control
C)optimal blood lipid levels
D)prevention of complications

Question 24

Which of the following is not one of the chronic complications of diabetes?

A)nephropathy
B)neuropathy
C)retinopathy
D)myopathy

Question 25

Hypoglycemia is frequently caused by:

A)overeating.
B)skipping insulin doses.
C)eating too many carbohydrates.
D)poor management of diabetes.

Question 26

A disadvantage of intensive therapy for type 1 diabetes is:

A)a greater risk of severe hypoglycemia.
B)greater expense due to lack of insurance reimbursement.
C)fewer incidences of severe hypoglycemia.
D)more rapid progression of chronic complications.

Question 27

Patients diagnosed with diabetes need education in all of the following areas except:

A)meal planning.
B)blood glucose monitoring.
C)physical activity.
D)dialysis.

Question 28

risk of developing type 2 diabetes is increased by all of the following except:

A)abdominal obesity.
B)aging.
C)sedentary lifestyle.
D)hypertension.

Question 29

glycemic control requires:

A)eating small amounts of food.
B)restricting carbohydrate in the diet.
C)self-monitoring of blood glucose.
D)frequent visits to the doctor.

Question 30

nutrient that has the greatest influence on blood glucose levels is:

A)protein.
B)fat.
C)carbohydrate.
D)calcium.

Question 31

2 diabetes is associated with:

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

Question 32

major cause of disability among people with diabetes is:

A)foot amputation.
B)hypertension.
C)hypoglycemia.
D)foot ulcers.

Question 33

People with diabetes are at increased risk for cardiovascular diseases because they:

A)tend to eat poorly.
B)have an increased tendency for thrombosis and abnormal ventricle function.
C)experience claudication and foot ulcers.
D)are usually unable to participate in any form of physical activity.

Question 34

HbA1C test is used to determine:

A)average blood glucose over the preceding two weeks.
B)glycemic control for the preceding two to three months.
C)the level of fructose in the blood.
D)the presence of ketones in the blood.

Question 35

Diabetic ketoacidosis is characterized by all of the following except:

A)severe ketosis.
B)blood glucose > 250 mg/dL.
C)acidosis.
D)blood cholesterol > 250 mg/dL.

Question 36

major cause of death in people with diabetes is:

A)neuropathy.
B)cardiovascular disease.
C)infections.
D)gangrene.

Question 37

Generally, the initial treatment for type 2 diabetes is:

A)nutrition therapy and exercise.
B)antidiabetic medications.
C)insulin therapy.
D)enzyme replacement therapy.

Question 38

Which of the following glycated hemoglobin values is normal?

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

Question 39

People with type 2 diabetes are prone to:

A)ketosis.
B)weight loss.
C)acidosis.
D)hyperosmolar hyperglycemic syndrome.

Question 40

predominant type of diabetes:

A)usually results from an autoimmune disorder.
B)develops most often in people over 40.
C)is called type 1 diabetes.
D)develops as a result of drastic weight loss.

Question 41

Which insulin has the quickest onset of action?

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

Question 42

patient's diabetic diet prescription is for 1800 kcalories with 50% of kcalories from carbohydrate.How many portions of carbohydrates is the patient allowed each day?

A)15
B)60
C)12
D)23

Question 43

Protein needs for people with diabetes are estimated using:

A)0.6 g/kg body weight.
B)0.8 g/kg body weight.
C)1.0 g/kg body weight.
D)1.2 g/kg body weight.

Question 44

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

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

Question 45

All of the following foods would be appropriate to include in the diet of a person with diabetes except:

A)dried beans and peas.
B)fruits.
C)whole milk.
D)whole-grain breads.

Question 46

Which of the following statements best describes the appropriate use of alcohol by individuals with diabetes who use insulin or medications that promote insulin secretion?

A)It should not be used.
B)It should be used 3-4 times/week only.
C)It should be consumed in moderation with meals.
D)It should be consumed on an empty stomach.

Question 47

Which food would have the least effect on blood glucose levels?

A)fruit juice
B)whole-grain cereal
C)biscuit
D)vanilla wafer

Question 48

Which of the following receives a high priority in the treatment of type 2 diabetes because of its beneficial effects in improving blood glucose control, improving blood lipids, and reducing blood pressure?

A)physical activity
B)a low-fat diet
C)sulfonylureas
D)a sodium-controlled diet

Question 49

Consistent carbohydrate intake:

A)can be varied as the client desires.
B)is important for glycemic control.
C)is only important if a client is overweight.
D)is only important in the treatment of type 1 diabetes.

Question 50

Diet therapy for the pregnant woman with diabetes includes all of the following except:

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

Question 51

mode of action of sulfonylureas is to:

A)stimulate insulin secretion by the pancreas.
B)decrease insulin resistance.
C)improve glucose utilization.
D)delay carbohydrate digestion and absorption.

Question 52

Dietary supplements that contain ginseng, garlic, fenugreek, coriander, and celery should not be taken with the:

A)alpha-glucosidase inhibitors.
B)biguanides.
C)thiazolidinediones.
D)sulfonylureas.

Question 53

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

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

Question 54

Which of the following statements is true regarding carbohydrate in the diabetic diet?

A)Low-carbohydrate diets are recommended.
B)All concentrated sweets should be avoided.
C)High-fiber, minimally processed carbohydrates should be emphasized.
D)Simple carbohydrates should be emphasized.

Question 55

Which insulin has the longest duration of action?

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

Question 56

of the following examples represent one portion of a carbohydrate-containing food except:

A)1 medium apple.
B)1 slice of bread.
C)1 cup cooked pasta.
D)1 small baked potato.

Question 57

benefit to using the carbohydrate counting method of education over exchange lists is:

A)it is easier to learn.
B)the portion sizes are larger in the carbohydrate counting method.
C)a person doesn't have to restrict their fat intake with the carbohydrate counting method.
D)exchange lists only allow a limited number of foods.

Question 58

diet for diabetes should provide less than _____ milligrams of cholesterol per day.

A)100
B)200
C)300
D)500

Question 59

To reduce the saturated fat content of the diabetic diet, all of the following should be emphasized except:

A)lean meats.
B)legumes.
C)cheese.
D)vegetable oils.

Question 60

antidiabetic agents work in all of the following ways except:

A)stimulating the pancreas to produce insulin.
B)inhibiting liver production of glucose.
C)delaying carbohydrate digestion and absorption.
D)stimulating the liver to produce insulin.

Question 61

12-year-old girl is diagnosed with type 1 diabetes and is placed on insulin.Her mother expresses concern about the ability of her daughter to administer the injections.The nurse reassures the mother that:

A)she can't do it wrong.
B)most children can be taught to administer the insulin they require.
C)most children aren't afraid of needles.
D)too much insulin can't hurt her.

Question 62

Sam is an African-American male who is obese and has a family history of diabetes.The nurse recognizes that Sam has _____ of the major risk factors for type 2 diabetes.

A)1
B)2
C)3
D)4

Question 63

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.
Individuals with hypertriglyceridemia should reduce their intake of:

A)desserts.
B)fruit.
C)fatty fish.
D)nuts.

Question 64

Case Study Questions
Use the following case study to answer questions
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.
All of the following are practical recommendations that Mr.Joiner can follow to reduce his risk of developing diabetes except:

A)lose weight.
B)increase physical activity.
C)learn to make better food choices at restaurants.
D)learn to cook.

Question 65

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.
Metabolic syndrome consists of a cluster of disorders that increase the risk of developing type 2 diabetes and:

A)liver disease.
B)cardiovascular disease.
C)gout.
D)renal failure.

Question 66

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.
Though the exact cause of metabolic syndrome is unknown, it is believed to be associated with:

A)poverty.
B)obesity.
C)hypoglycemia.
D)liver disease.

Question 67

nurse understands that a patient on a 1500-kilocalorie diabetic diet should limit her carbohydrate intake to approximately _____ grams per day.

A)150
B)375
C)190
D)210

Question 68

progression of metabolic syndrome is worsened by:

A)a sedentary lifestyle.
B)low-carbohydrate diets.
C)low blood lipids.
D)drug therapy.

Question 69

Case Study Questions
Use the following case study to answer questions
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.
How many risk factors does Mr.Joiner have for type 2 diabetes?

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

Question 70

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.
Which group of symptoms is characteristic of the metabolic syndrome?

A)obesity, reduced HDL cholesterol levels, hyperglycemia
B)hypertension, hypoglycemia, abdominal obesity
C)elevated liver enzymes, insulin resistance, microalbuminuria
D)polyuria, polydipsia, polyphagia

Question 71

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:

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 72

educating a patient on intensive insulin therapy, the nurse stresses that the amount of insulin required before each meal will depend on all of the following except:

A)the patient's blood glucose level before eating.
B)the carbohydrate content of the meal.
C)the patient's weight.
D)the fat content of the meal.

Question 73

patient with diabetes asks the nurse for ice cream.The nurse is aware that this will count as a carbohydrate portion and the amount that equals 1 portion is:

A)¼ cup.
B)1/3 cup.
C)½ cup.
D)1 cup.

Question 74

Case Study Questions
Use the following case study to answer questions
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.
Joiner's blood glucose level meets the criteria for a diagnosis of:

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

Question 75

Case Study Questions
Use the following case study to answer questions
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.
How many of his risk factors for type 2 diabetes can Mr.Joiner control?

A)1
B)2
C)3
D)4

Question 76

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

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 77

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

A)carbohydrate counting.
B)exchange lists.
C)MyPyramid.
D)a high-protein diet.

Question 78

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 disease has progressed to:

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

Question 79

patient with diabetes is admitted to the hospital with symptoms of headache, sweating, shakiness, confusion, and slurred speech.The nurse recognizes these as symptoms of:

A)hypoglycemia.
B)hyperglycemia.
C)alcohol intoxication.
D)ketosis.

Question 80

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

A)engage in strenuous exercise.
B)severely restrict carbohydrate intake.
C)adjust energy intake as needed.
D)limit protein intake.