CDCES Exam Collective Questions
What are the moderate intensity statins? -
✅1. Atorvastatin 10-20 mg
2. Rosuvastatin 5-10 mg
3. Simvastatin 20-40 mg
4. Pravastatin 40-80 mg
5. Lovastatin 40-80 mg
6. Fluvastatin 80 mg
7. Pitavastatin 2-4 mg
Which of the following measurements would indicate that JR has healthy kidney function?
A. Urinary albumin creatinine ratio of 30-299 mg/g with GFR of 45.
B. GFR of 60 or greater and urinary albumin creatinine ratio of 12 mg/g.
C. Urinary albumin creatinine ratio less than 30 mg/g and GFR of 30-45.
D Creatinine of 1.5 and urinary albumin creatinine ratio of 300 mg/g or greater -
✅B. GFR of 60 or greater and urinary albumin creatinine ratio of 12 mg/g.
What is the target range of UACR? -
✅< 30 mg/g
Urinary Albumin Creatinine ratio
What is UACR checked? -
✅At diagnosis in T2DM and within 5 years in T1DM. Then anually!
What is the new 2023 standard if a pt has a GFR of =/> 20 and a UACR =/> 200 mg/g? -
✅Start a SGL2 to reduce chronic kidney disease progression and cardiovascular events
What is the new 2023 standard if with type 2 diabetes and established CKD? -
✅Start nonsteroidal mineralocorticoid receptor antagonist nsMRA (finerenone) and/or
GLP-1 RA recommended forcardiovascular risk reduction.
Nutrition recommendations to help decrease UACR? -
✅- People with non-dialysis dependent stage 3 diabetes or higher CKD: Dietary protein
intake aimed to a target level of 0.8 g/kg body weight per day
- For those on dialysis: consider higher levels of dietary protein intake since protein energy wasting
is a major problem in some individuals on dialysis
Smoking increases risk of diabetes by __% -
✅30%
1
,AJ has been instructed to take Dapaglifozin (Farxiga) 5 mg once daily. Which of the following
would you review during your teaching session.
1) Signs of urinary tract infection
2) Take the Dapaglifozin (Farxiga) only if blood glucose levels are greater than 110mg/dl.
3) Only take Dapaglifozin (Farxiga) if AJ plans to eat a meal.
4) Double the dose if blood glucose levels are greater than 150mg/dl. -
✅Signs of urinary tract infection
Individuals taking sulfonylureas or meglitinides should be counseled about which of the
following?
1) take medication, even if they are not able to eat
2) make sure to eat after taking medication
3) medications may cause nausea and weight loss
4) take extra medications if glucose levels are elevated -
✅2) make sure to eat after taking medication
BT has been on glipizide (Glucotrol) 10 mg BID for the past four years, but BTs A1c has
progressively increased and is now 7.8%. Pioglitazone (Actos) 45 mg daily was added to BTs
regimen a month ago. During your initial assessment, BT complains that she has had a recent
weight gain of 6 lbs and can not figure out why. The most likely cause of BTs weight gain is:
1) recent stressful life events
2) fluid retention
3) decreasing frequency of exercise
4) acute renal failure -
✅2) fluid retention
Indicate which of the following conditions is a contraindication for metformin (Glucophage)
therapy.
1) low B12 levels
2) hypertriglyceridemia
3) gout
4) binge drinking -
✅4) binge drinking
LS is being started on a DPP-IV Inhibitor. Which of the following would you include in your
instructions?
1) take only if blood glucose is elevated
2) sudden joint pain is a potential side effect
3) hold medication if blood glucose is less than 80
4) if experience hypoglycemia, eat 6-8 lifesavers -
✅2) sudden joint pain is a potential side effect
People with diabetes taking GLP-1 Receptor Agonists should:
1) report signs of intestinal blockage
2) have renal function studies done at the start of therapy and yearly
3) have cystoscopy performed to rule out bladder cancer
4) take with meals to avoid GI upset -
✅1) report signs of intestinal blockage
2
,LK is taking canagliflozin (Invokana) daily. Which of the following should they report
immediately?
1) Increased urination
2) Nausea
3) Sudden weight loss
4) Positive ketones -
✅4) Positive ketones
GLP-1 Receptor Agonist
SGLT-2 Inhibitor
Sulfonylureas
Metformin
Match
Increase insulin release from pancreas
Decrease glycogen release from liver
Incretin Mimetic
"Glucoretic" -
✅GLP-1 Receptor Agonist - Incretin Mimetic
SGLT-2 Inhibitor - "Glucoretic"
Sulfonylureas - Increase insulin release from pancreas
Metformin - Decrease glycogen release from liver
Basal insulin therapy is best described as which of the following:
1) Long acting insulin therapy that helps manage blood glucose levels between meals and
overnight.
2) Long acting insulin administered to lower post prandial blood glucose levels.
3) Intermediate acting insulin that is given twice daily.
4) A premixed insulin solution to control pre and post prandial blood glucose levels. -
✅1) Long acting insulin therapy that helps manage blood glucose levels between meals
and overnight.
A biosimilar insulin is best described as:
1) Insulin derived from beef pancreatic extract.
2) Insulin that has active properties similar to previously licensed insulin.
3) C-peptide endogenous measurements.
4) Inhaled insulin. -
✅2) Insulin that has active properties similar to previously licensed insulin.
Mary takes 4 units lispro (Humalog) before breakfast. Which BG result reflects that it was the
right dose?
1) Before breakfast BG of 97
2) 1 hr post breakfast BG of 153
3) Before lunch BG of 69
4) 2 hour post breakfast BG of 183 -
✅2) 1 hr post breakfast BG of 153
Which of the following is an accurate insulin teaching statement?
3
, 1) Never inject insulin through clothes
2) Monitor BG, Inject insulin, Eat
3) Insulin must always be refrigerated
4) If reusing needles, wipe off first with alcohol pad -
✅2) Monitor BG, Inject insulin, Eat
Mr. Pasteur is started on the following insulin regimen: 22uNPH/10uReg before breakfast, 5u Reg
before dinner and 10uNPH before bedtime. His BMI is 33. His evening blood glucose levels are
running 180 - 210 mg/dl. Which of the following changes would best help get his bedtime glucose
levels to goal?
1) Increase before dinner NPH insulin
2) Increase am NPH insulin
3) Increase the dose of regular insulin before dinner by 30%
4) Evaluate carbohydrate intake at dinner -
✅4) Evaluate carbohydrate intake at dinner
MZ is started on glargine (Basaglar) insulin at bedtime. Circle the most important teaching point.
1) Importance of eating within a half hour of injection.
2) How to adjust glargine (Basaglar) insulin dose based on post dinner glucose.
3) Recognition of when morning blood glucose levels are on target.
4) How to adjust insulin dose based on type and quantity of carbohydrates. -
✅3) Recognition of when morning blood glucose levels are on target.
AT is a 43-year old newly started on insulin. Circle the survival topic that is essential for AT to
know before discharge.
1) managing insulin across time zones
2) how to adjust his insulin dose before exercise
3) signs and symptoms of hypoglycemia
4) insulin dose adjustment based on carbohydrates consumed -
✅3) signs and symptoms of hypoglycemia
Which of the following are the most recent ADA recommended blood pressure goals?
1) B/P < 140/80
2) Start ACE Inhibitor for people with type 1 diabetes
3) B/P targets are based on degree of proteinuria
4) Blood pressure less than 130/80 if it is safe for that individual -
✅4) Blood pressure less than 130/80 if it is safe for that individual
According to the ADA, people with type 2 diabetes should be screened for Urinary Albumin
Creatinine Ratio (UACR) and GFR:
1) five years after diagnosis and then yearly
2) at diagnosis and then yearly
3) the onset of renal failure and then yearly
4) with the first signs of hypertension and then yearly -
✅2) at diagnosis and then yearly
Keeping glucose on target reduces the risk of diabetes-related complications. Choose from the list
below the blood glucose targets as outlined by the American Diabetes Association.
1) before meal glucose 80mg/dl - 120mg/dl, post prandial glucose 100mg/dl - 140mg/dl
4
What are the moderate intensity statins? -
✅1. Atorvastatin 10-20 mg
2. Rosuvastatin 5-10 mg
3. Simvastatin 20-40 mg
4. Pravastatin 40-80 mg
5. Lovastatin 40-80 mg
6. Fluvastatin 80 mg
7. Pitavastatin 2-4 mg
Which of the following measurements would indicate that JR has healthy kidney function?
A. Urinary albumin creatinine ratio of 30-299 mg/g with GFR of 45.
B. GFR of 60 or greater and urinary albumin creatinine ratio of 12 mg/g.
C. Urinary albumin creatinine ratio less than 30 mg/g and GFR of 30-45.
D Creatinine of 1.5 and urinary albumin creatinine ratio of 300 mg/g or greater -
✅B. GFR of 60 or greater and urinary albumin creatinine ratio of 12 mg/g.
What is the target range of UACR? -
✅< 30 mg/g
Urinary Albumin Creatinine ratio
What is UACR checked? -
✅At diagnosis in T2DM and within 5 years in T1DM. Then anually!
What is the new 2023 standard if a pt has a GFR of =/> 20 and a UACR =/> 200 mg/g? -
✅Start a SGL2 to reduce chronic kidney disease progression and cardiovascular events
What is the new 2023 standard if with type 2 diabetes and established CKD? -
✅Start nonsteroidal mineralocorticoid receptor antagonist nsMRA (finerenone) and/or
GLP-1 RA recommended forcardiovascular risk reduction.
Nutrition recommendations to help decrease UACR? -
✅- People with non-dialysis dependent stage 3 diabetes or higher CKD: Dietary protein
intake aimed to a target level of 0.8 g/kg body weight per day
- For those on dialysis: consider higher levels of dietary protein intake since protein energy wasting
is a major problem in some individuals on dialysis
Smoking increases risk of diabetes by __% -
✅30%
1
,AJ has been instructed to take Dapaglifozin (Farxiga) 5 mg once daily. Which of the following
would you review during your teaching session.
1) Signs of urinary tract infection
2) Take the Dapaglifozin (Farxiga) only if blood glucose levels are greater than 110mg/dl.
3) Only take Dapaglifozin (Farxiga) if AJ plans to eat a meal.
4) Double the dose if blood glucose levels are greater than 150mg/dl. -
✅Signs of urinary tract infection
Individuals taking sulfonylureas or meglitinides should be counseled about which of the
following?
1) take medication, even if they are not able to eat
2) make sure to eat after taking medication
3) medications may cause nausea and weight loss
4) take extra medications if glucose levels are elevated -
✅2) make sure to eat after taking medication
BT has been on glipizide (Glucotrol) 10 mg BID for the past four years, but BTs A1c has
progressively increased and is now 7.8%. Pioglitazone (Actos) 45 mg daily was added to BTs
regimen a month ago. During your initial assessment, BT complains that she has had a recent
weight gain of 6 lbs and can not figure out why. The most likely cause of BTs weight gain is:
1) recent stressful life events
2) fluid retention
3) decreasing frequency of exercise
4) acute renal failure -
✅2) fluid retention
Indicate which of the following conditions is a contraindication for metformin (Glucophage)
therapy.
1) low B12 levels
2) hypertriglyceridemia
3) gout
4) binge drinking -
✅4) binge drinking
LS is being started on a DPP-IV Inhibitor. Which of the following would you include in your
instructions?
1) take only if blood glucose is elevated
2) sudden joint pain is a potential side effect
3) hold medication if blood glucose is less than 80
4) if experience hypoglycemia, eat 6-8 lifesavers -
✅2) sudden joint pain is a potential side effect
People with diabetes taking GLP-1 Receptor Agonists should:
1) report signs of intestinal blockage
2) have renal function studies done at the start of therapy and yearly
3) have cystoscopy performed to rule out bladder cancer
4) take with meals to avoid GI upset -
✅1) report signs of intestinal blockage
2
,LK is taking canagliflozin (Invokana) daily. Which of the following should they report
immediately?
1) Increased urination
2) Nausea
3) Sudden weight loss
4) Positive ketones -
✅4) Positive ketones
GLP-1 Receptor Agonist
SGLT-2 Inhibitor
Sulfonylureas
Metformin
Match
Increase insulin release from pancreas
Decrease glycogen release from liver
Incretin Mimetic
"Glucoretic" -
✅GLP-1 Receptor Agonist - Incretin Mimetic
SGLT-2 Inhibitor - "Glucoretic"
Sulfonylureas - Increase insulin release from pancreas
Metformin - Decrease glycogen release from liver
Basal insulin therapy is best described as which of the following:
1) Long acting insulin therapy that helps manage blood glucose levels between meals and
overnight.
2) Long acting insulin administered to lower post prandial blood glucose levels.
3) Intermediate acting insulin that is given twice daily.
4) A premixed insulin solution to control pre and post prandial blood glucose levels. -
✅1) Long acting insulin therapy that helps manage blood glucose levels between meals
and overnight.
A biosimilar insulin is best described as:
1) Insulin derived from beef pancreatic extract.
2) Insulin that has active properties similar to previously licensed insulin.
3) C-peptide endogenous measurements.
4) Inhaled insulin. -
✅2) Insulin that has active properties similar to previously licensed insulin.
Mary takes 4 units lispro (Humalog) before breakfast. Which BG result reflects that it was the
right dose?
1) Before breakfast BG of 97
2) 1 hr post breakfast BG of 153
3) Before lunch BG of 69
4) 2 hour post breakfast BG of 183 -
✅2) 1 hr post breakfast BG of 153
Which of the following is an accurate insulin teaching statement?
3
, 1) Never inject insulin through clothes
2) Monitor BG, Inject insulin, Eat
3) Insulin must always be refrigerated
4) If reusing needles, wipe off first with alcohol pad -
✅2) Monitor BG, Inject insulin, Eat
Mr. Pasteur is started on the following insulin regimen: 22uNPH/10uReg before breakfast, 5u Reg
before dinner and 10uNPH before bedtime. His BMI is 33. His evening blood glucose levels are
running 180 - 210 mg/dl. Which of the following changes would best help get his bedtime glucose
levels to goal?
1) Increase before dinner NPH insulin
2) Increase am NPH insulin
3) Increase the dose of regular insulin before dinner by 30%
4) Evaluate carbohydrate intake at dinner -
✅4) Evaluate carbohydrate intake at dinner
MZ is started on glargine (Basaglar) insulin at bedtime. Circle the most important teaching point.
1) Importance of eating within a half hour of injection.
2) How to adjust glargine (Basaglar) insulin dose based on post dinner glucose.
3) Recognition of when morning blood glucose levels are on target.
4) How to adjust insulin dose based on type and quantity of carbohydrates. -
✅3) Recognition of when morning blood glucose levels are on target.
AT is a 43-year old newly started on insulin. Circle the survival topic that is essential for AT to
know before discharge.
1) managing insulin across time zones
2) how to adjust his insulin dose before exercise
3) signs and symptoms of hypoglycemia
4) insulin dose adjustment based on carbohydrates consumed -
✅3) signs and symptoms of hypoglycemia
Which of the following are the most recent ADA recommended blood pressure goals?
1) B/P < 140/80
2) Start ACE Inhibitor for people with type 1 diabetes
3) B/P targets are based on degree of proteinuria
4) Blood pressure less than 130/80 if it is safe for that individual -
✅4) Blood pressure less than 130/80 if it is safe for that individual
According to the ADA, people with type 2 diabetes should be screened for Urinary Albumin
Creatinine Ratio (UACR) and GFR:
1) five years after diagnosis and then yearly
2) at diagnosis and then yearly
3) the onset of renal failure and then yearly
4) with the first signs of hypertension and then yearly -
✅2) at diagnosis and then yearly
Keeping glucose on target reduces the risk of diabetes-related complications. Choose from the list
below the blood glucose targets as outlined by the American Diabetes Association.
1) before meal glucose 80mg/dl - 120mg/dl, post prandial glucose 100mg/dl - 140mg/dl
4
