ABFM ITE EXAM | QUESTIONS AND
VERIFED ANSWERS WITH RATIONALE |
100% CORRECT | RATED A+ | 2026
LATEST GUIDE
A 60-year-old male with a long-standing history of type 2 diabetes is
admitted to the hospital. He takes four oral medications for the treatment of
diabetes at home. You decide to switch him to insulin instead of continuing
oral medications while he is hospitalized. He is eating his meals well.
After calculating the total daily insulin dose, which one of the following
would be most appropriate?
A) Administer the total daily dose as long-acting insulin in equal doses
every 12 hours
B) Administer half of the total daily dose of insulin as long-acting insulin and
the other half as short-acting insulin in three divided doses, given with each
meal
C) Administer the total daily dose as short-acting insulin in three divided
doses, given with each meal
D) Administer the total daily dose as short-acting insulin in four divided
doses, given with each meal and at bedtime
E) Administer the total daily dose as a short-acting sliding scale regimen
based on bedside glucose readings, in four divided doses
-CORRECT ANSWER-B
Frequently patients taking oral medications for the treatment of diabetes
,mellitus need to be switched to insulin while hospitalized. There are
formulas to calculate the total daily dose based on weight, renal
function, insulin resistance, and other factors. The recommended regimen
is half of the calculated total daily dose given as long-acting insulin such as
glargine to provide basal insulin and half given as short-acting insulin such
as lispro to provide prandial insulin. The short-acting insulin is divided into
thirds to be given with each meal.
The American Diabetes Association (ADA) recommends an insulin regimen
with a basal and a prandial component for non-critically ill patients in the
hospital with good nutritional intake. A correction component can be added
to this regimen. The ADA strongly discourages the use of only a sliding
scale insulin regimen. The reactive nature of sliding scale does not control
glucose levels well and does not address the basal insulin needs of
patients.
A 60-year-old male presents with dyspnea on exertion, occasional
wheezing, and a chronic cough that is productive. He has never been
hospitalized. He has smoked one pack of cigarettes
per day since the age of 20. An examination reveals diminished breath
sounds but no crackles, jugular venous distention, gallop, or edema.
Spirometry shows a postbronchodilator FEV1 that
is 45% of the predicted value, and the severity of his disease is rated as
Global Initiative for Chronic Obstructive Lung Disease (GOLD) group C.
In addition to albuterol as needed for symptomatic relief and smoking
cessation, the initial treatment should include
A) beclomethasone
,B) budesonide/formoterol (Symbicort)
C) roflumilast (Daliresp)
D) theophylline
E) tiotropium (Spiriva)
-CORRECT ANSWER-E
The goals for treatment of this patient's COPD should include prevention of
or a reduction in hospitalizations, a decrease in dyspnea, slowing
progression of the disease, and a decrease in mortality.
Disease severity is categorized by spirometry results, the severity of
symptoms such as cough and dyspnea,
and the number of exacerbations, including those requiring hospitalization.
Classifying patients into Global Initiative for Chronic Obstructive Lung
Disease (GOLD) groups A through D helps guide treatment
initiation and modification over time.
The initial treatment for patients in GOLD group A is a short- or long-acting
bronchodilator. Patients in GOLD group B should begin treatment with a
single long-acting muscarinic antagonist (LAMA) or a
long-acting -agonist (LABA). A LAMA is the initial recommendation for
patients in GOLD group C, although a combination inhaled corticosteroid
plus a LABA can be considered for treating persistent exacerbations.
Individuals classified in GOLD group D can begin treatment with a LAMA or
a combination of an inhaled corticosteroid plus a LABA.
A 63-year-old female presents to your office with a sudden onset of
lightheadedness and mild nausea that she first noted when getting out of
bed this morning. She has had repeated episodes of a spinning sensation
, when tilting her head up or down. Her symptoms have been so severe
that she could not go to work today. She has a history of essential
hypertension that is well controlled on hydrochlorothiazide. She has not
had any headache, hearing loss, tinnitus, or
recent illness or trauma. She has a temperature of 36.8°C (98.2°F), a blood
pressure of 136/80 mm Hg, a heart rate of 80 beats/min, a respiratory rate
of 12/min, and an oxygen saturation of 96% on room air. You perform the
Dix-Hallpike maneuver with her right ear down and in the dependent
position and note a latent torsional, upbeating nystagmus.
The most appropriate intervention at this time would be
A) prolonged upright positioning
B) canalith repositioning procedures
C) vestibular function testing
D) vestibular suppressant medication
E) MRI of the brain
-CORRECT ANSWER-B
This patient presents with symptoms consistent with right benign
paroxysmal positional vertigo (BPPV) and torsional, upbeating nystagmus
provoked by the Dix-Hallpike maneuver. Diagnostic criteria include
both patient history and physical examination findings. Symptoms
suggesting BPPV include an acute onset of brief episodic vertigo triggered
by positional changes relative to gravity. In the 2017 clinical practice
guidelines on BPPV, the American Academy of Otolaryngology-Head and
Neck Surgery Foundation strongly recommended accurate diagnosis of
posterior semicircular canal BPPV by performing the Dix-Hallpike
maneuver (B recommendation). The guidelines also strongly recommend
VERIFED ANSWERS WITH RATIONALE |
100% CORRECT | RATED A+ | 2026
LATEST GUIDE
A 60-year-old male with a long-standing history of type 2 diabetes is
admitted to the hospital. He takes four oral medications for the treatment of
diabetes at home. You decide to switch him to insulin instead of continuing
oral medications while he is hospitalized. He is eating his meals well.
After calculating the total daily insulin dose, which one of the following
would be most appropriate?
A) Administer the total daily dose as long-acting insulin in equal doses
every 12 hours
B) Administer half of the total daily dose of insulin as long-acting insulin and
the other half as short-acting insulin in three divided doses, given with each
meal
C) Administer the total daily dose as short-acting insulin in three divided
doses, given with each meal
D) Administer the total daily dose as short-acting insulin in four divided
doses, given with each meal and at bedtime
E) Administer the total daily dose as a short-acting sliding scale regimen
based on bedside glucose readings, in four divided doses
-CORRECT ANSWER-B
Frequently patients taking oral medications for the treatment of diabetes
,mellitus need to be switched to insulin while hospitalized. There are
formulas to calculate the total daily dose based on weight, renal
function, insulin resistance, and other factors. The recommended regimen
is half of the calculated total daily dose given as long-acting insulin such as
glargine to provide basal insulin and half given as short-acting insulin such
as lispro to provide prandial insulin. The short-acting insulin is divided into
thirds to be given with each meal.
The American Diabetes Association (ADA) recommends an insulin regimen
with a basal and a prandial component for non-critically ill patients in the
hospital with good nutritional intake. A correction component can be added
to this regimen. The ADA strongly discourages the use of only a sliding
scale insulin regimen. The reactive nature of sliding scale does not control
glucose levels well and does not address the basal insulin needs of
patients.
A 60-year-old male presents with dyspnea on exertion, occasional
wheezing, and a chronic cough that is productive. He has never been
hospitalized. He has smoked one pack of cigarettes
per day since the age of 20. An examination reveals diminished breath
sounds but no crackles, jugular venous distention, gallop, or edema.
Spirometry shows a postbronchodilator FEV1 that
is 45% of the predicted value, and the severity of his disease is rated as
Global Initiative for Chronic Obstructive Lung Disease (GOLD) group C.
In addition to albuterol as needed for symptomatic relief and smoking
cessation, the initial treatment should include
A) beclomethasone
,B) budesonide/formoterol (Symbicort)
C) roflumilast (Daliresp)
D) theophylline
E) tiotropium (Spiriva)
-CORRECT ANSWER-E
The goals for treatment of this patient's COPD should include prevention of
or a reduction in hospitalizations, a decrease in dyspnea, slowing
progression of the disease, and a decrease in mortality.
Disease severity is categorized by spirometry results, the severity of
symptoms such as cough and dyspnea,
and the number of exacerbations, including those requiring hospitalization.
Classifying patients into Global Initiative for Chronic Obstructive Lung
Disease (GOLD) groups A through D helps guide treatment
initiation and modification over time.
The initial treatment for patients in GOLD group A is a short- or long-acting
bronchodilator. Patients in GOLD group B should begin treatment with a
single long-acting muscarinic antagonist (LAMA) or a
long-acting -agonist (LABA). A LAMA is the initial recommendation for
patients in GOLD group C, although a combination inhaled corticosteroid
plus a LABA can be considered for treating persistent exacerbations.
Individuals classified in GOLD group D can begin treatment with a LAMA or
a combination of an inhaled corticosteroid plus a LABA.
A 63-year-old female presents to your office with a sudden onset of
lightheadedness and mild nausea that she first noted when getting out of
bed this morning. She has had repeated episodes of a spinning sensation
, when tilting her head up or down. Her symptoms have been so severe
that she could not go to work today. She has a history of essential
hypertension that is well controlled on hydrochlorothiazide. She has not
had any headache, hearing loss, tinnitus, or
recent illness or trauma. She has a temperature of 36.8°C (98.2°F), a blood
pressure of 136/80 mm Hg, a heart rate of 80 beats/min, a respiratory rate
of 12/min, and an oxygen saturation of 96% on room air. You perform the
Dix-Hallpike maneuver with her right ear down and in the dependent
position and note a latent torsional, upbeating nystagmus.
The most appropriate intervention at this time would be
A) prolonged upright positioning
B) canalith repositioning procedures
C) vestibular function testing
D) vestibular suppressant medication
E) MRI of the brain
-CORRECT ANSWER-B
This patient presents with symptoms consistent with right benign
paroxysmal positional vertigo (BPPV) and torsional, upbeating nystagmus
provoked by the Dix-Hallpike maneuver. Diagnostic criteria include
both patient history and physical examination findings. Symptoms
suggesting BPPV include an acute onset of brief episodic vertigo triggered
by positional changes relative to gravity. In the 2017 clinical practice
guidelines on BPPV, the American Academy of Otolaryngology-Head and
Neck Surgery Foundation strongly recommended accurate diagnosis of
posterior semicircular canal BPPV by performing the Dix-Hallpike
maneuver (B recommendation). The guidelines also strongly recommend
