A 15-year-old boy presents to the nurse practitioner with polyuria, polydipsia, and weight loss. The NP diagnoses diabetic ketoacidosis resulting from undiagnosed type 1 diabetes mellitus (T1DM). What is the pathophysiology underlying T1DM?
Type 1 diabetes mellitus is caused by insulin resistance.
Type 1 diabetes mellitus is caused by a single genetic mutation in an autosomal dominant gene
Type 1 diabetes mellitus is a complication of other diseases affecting the pancreas (e.g., pancreatitis), hormone disturbances (e.g., Cushing’s disease), or due to medications (e.g., corticosteroids)
Type 1 diabetes mellitus is an autoimmune disease that leads to the destruction of insulin-producing pancreatic beta cells
The Correct Answer is D
Choice A reason: Insulin resistance is the hallmark of type 2 diabetes mellitus, not type 1. In type 1 diabetes, the issue is not resistance to insulin but rather a lack of insulin production due to destruction of beta cells.
Choice B reason: Type 1 diabetes is not caused by a single genetic mutation nor is it inherited in an autosomal dominant fashion. While genetic predisposition plays a role, it involves multiple genes and environmental triggers leading to autoimmune destruction.
Choice C reason: Secondary diabetes can result from pancreatic diseases, hormonal disorders, or medications, but this is classified as type 3c diabetes or drug-induced diabetes. It is not the mechanism underlying classic type 1 diabetes.
Choice D reason: Type 1 diabetes is an autoimmune condition where the immune system mistakenly attacks and destroys insulin-producing beta cells in the pancreas. This leads to absolute insulin deficiency, hyperglycemia, and in severe cases, diabetic ketoacidosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: A ventricular septal defect (VSD) is the most common congenital heart defect and typically presents with a harsh, holosystolic murmur best heard at the lower left sternal border. A systolic thrill may also be palpable due to turbulent blood flow from the left to right ventricle. This matches the described auscultatory findings.
Choice B reason: An atrial septal defect (ASD) usually produces a soft systolic murmur due to increased flow across the pulmonary valve and a fixed split of the second heart sound. It does not typically produce a harsh murmur or systolic thrill.
Choice C reason: Transposition of the great arteries is a cyanotic congenital heart defect that presents with severe hypoxemia in neonates. It does not produce a harsh systolic murmur or thrill and is usually diagnosed based on cyanosis and imaging.
Choice D reason: Patent ductus arteriosus (PDA) produces a continuous "machinery" murmur, not a harsh systolic murmur. It is best heard at the left infraclavicular area and is associated with bounding pulses and widened pulse pressure.
Correct Answer is D
Explanation
Choice A reason: Stiffness, especially after periods of inactivity or in the morning, is a hallmark symptom of osteoarthritis. It typically improves with gentle movement.
Choice B reason: Limited mobility is common in osteoarthritis due to joint degeneration, pain, and structural changes such as osteophyte formation and cartilage loss.
Choice C reason: Joint swelling may occur due to synovial inflammation or effusion, although it is typically mild compared to inflammatory arthritides like rheumatoid arthritis.
Choice D reason: Bruising is not a feature of osteoarthritis. It suggests trauma or a bleeding disorder and is not associated with the degenerative changes seen in OA.
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