A patient with type 2 diabetes has hyperglycemia despite high insulin levels.
What is the primary issue?
Increased glucose excretion.
Lack of insulin production.
Autoimmune destruction of pancreas.
Insulin resistance at cellular level.
The Correct Answer is D
Choice A rationale
Increased glucose excretion occurs in diabetes as a symptom, not the primary cause of hyperglycemia. When blood glucose levels exceed the renal threshold, which is typically about 180 mg/dL, the kidneys can no longer reabsorb all the glucose, and it spills into the urine. This is known as glucosuria. While this process helps lower blood sugar slightly, the underlying problem in type 2 diabetes remains the body's inability to effectively use the insulin that is already present.
Choice B rationale
A total lack of insulin production is the hallmark of type 1 diabetes, where autoimmune destruction of beta cells occurs. In type 2 diabetes, the pancreas usually produces insulin, and in the early to middle stages, levels can actually be higher than normal as the body tries to compensate for resistance. The scenario explicitly states the patient has high insulin levels, which rules out a production deficiency as the primary issue. High insulin with high glucose confirms a utilization problem.
Choice C rationale
Autoimmune destruction of the pancreas is the underlying mechanism for type 1 diabetes mellitus. In this condition, the body's immune system mistakenly attacks the insulin-producing beta cells in the Islets of Langerhans. This leads to an absolute insulin deficiency. Type 2 diabetes is generally considered a metabolic disorder influenced by genetics and lifestyle, characterized by insulin resistance and relative insulin deficiency, rather than an autoimmune attack on the pancreatic tissue itself. This patient's high insulin levels contradict this.
Choice D rationale
Insulin resistance is the primary pathophysiological defect in type 2 diabetes. In this state, the body's cells, particularly in muscle, fat, and the liver, do not respond normally to insulin. Consequently, glucose cannot easily enter the cells and builds up in the blood. To compensate, the pancreas secretes even more insulin, leading to the hyperinsulinemia mentioned in the question. Despite the abundance of insulin, the "key" no longer fits the "lock" of the cellular receptors effectively. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["2"]
Explanation
31 Step 1 is 200 mg ÷ 100 mg/mL = 2 mL.
Correct Answer is D
Explanation
Choice D rationale
Amblyopia, often called lazy eye, occurs when the brain favors one eye over the other during the critical period of visual development. If one eye provides a blurry or misaligned image, the brain suppresses the input from that eye to avoid double vision or confusion. This lack of stimulation leads to permanent changes in the visual cortex. Early intervention is necessary because the brain eventually loses the ability to process signals from the suppressed eye if not corrected.
Choice A rationale
Degeneration of retinal photoreceptor cells is the primary mechanism for conditions like retinitis pigmentosa or macular degeneration. These disorders involve the physical breakdown of the cells that detect light and color in the eye. Amblyopia, however, is a functional disorder of the visual processing centers in the brain rather than a degenerative disease of the retina. In amblyopia, the eye structure and the retina are often completely healthy, but the brain ignores the signal.
Choice B rationale
Inflammation of the optic nerve, known as optic neuritis, causes acute vision loss and pain with eye movement. It is often associated with autoimmune conditions like multiple sclerosis. While it blocks the transmission of visual signals, it is an inflammatory process rather than a developmental suppression. Amblyopia is characterized by a lack of visual acuity development in childhood due to refractive errors or strabismus, not an acute inflammatory attack on the nerve fibers themselves.
Choice C rationale
Increased intraocular pressure damaging the optic nerve is the defining characteristic of glaucoma. This pressure causes mechanical damage to the nerve fibers, leading to peripheral vision loss and eventual blindness if untreated. Amblyopia does not involve elevated pressure within the eye. Instead, it is a neurological adaptation to poor quality visual input during the years when the brain is learning to interpret images, making it a developmental rather than a mechanical ocular disease. .
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