NR 601
FINAL EXAM PREP
Verified Questions & Answers With Rationales
(Primary Care of the Maturing and
Aged Family Practicum)
Chamberlain
CONSISTS OF 200+ QUESTIONS
WEEKS 5 – 8 COVERED
,1. A 58-year-old woman presents with polyuria, fatigue, and blurred vision. Labs
show fasting plasma glucose of 132 mg/dL on two occasions. What is the correct
diagnosis?
a. Prediabetes
b. Type 1 diabetes mellitus
c. Type 2 diabetes mellitus
d. Stress hyperglycemia
Correct Answer:
c. Type 2 diabetes mellitus
Rationale:
A fasting plasma glucose ≥126 mg/dL on two separate occasions meets diagnostic
criteria for diabetes mellitus.
2. Which laboratory value alone meets diagnostic criteria for type 2 diabetes?
a. HgA1C 5.6%
b. HgA1C 6.6%
c. Fasting glucose 110 mg/dL
d. Random glucose 150 mg/dL without symptoms
Correct Answer:
b. HgA1C 6.6%
Rationale:
An A1C of 6.5% or higher is diagnostic of diabetes when confirmed or when
consistent with clinical presentation.
3. A patient has random glucose of 212 mg/dL and polyuria. What is the correct
interpretation?
a. Normal glucose response
b. Prediabetes only
c. Diagnostic of diabetes due to symptoms plus glucose ≥200
d. Requires no follow-up
Correct Answer:
c. Diagnostic of diabetes due to symptoms plus glucose ≥200
Rationale:
,Classic hyperglycemia symptoms plus random plasma glucose ≥200 mg/dL
supports a diagnosis of diabetes.
4. Which physical exam finding is most associated with insulin resistance?
a. Xanthelasma
b. Acanthosis nigricans
c. Clubbing
d. Petechiae
Correct Answer:
b. Acanthosis nigricans
Rationale:
Acanthosis nigricans is a velvety hyperpigmented skin change associated with
insulin resistance and obesity.
5. First-line pharmacologic therapy for most patients with newly diagnosed type 2
diabetes is:
a. Insulin glargine
b. Metformin
c. Pioglitazone
d. Glyburide
Correct Answer:
b. Metformin
Rationale:
Metformin is commonly first-line because it lowers glucose, is weight-neutral or
modestly weight-reducing, and has low hypoglycemia risk.
6. Metformin lowers glucose primarily by:
a. Increasing renal glucose excretion
b. Stimulating pancreatic insulin release
c. Decreasing hepatic glucose production
d. Blocking carbohydrate absorption only
Correct Answer:
c. Decreasing hepatic glucose production
, Rationale:
Metformin primarily reduces hepatic gluconeogenesis and improves insulin
sensitivity.
7. Which patient should NOT receive metformin?
a. eGFR 85 mL/min
b. eGFR 60 mL/min
c. eGFR 45 mL/min
d. eGFR 25 mL/min
Correct Answer:
d. eGFR 25 mL/min
Rationale:
Metformin is contraindicated in severe renal impairment because of increased
lactic acidosis risk.
8. A patient with T2DM and heart failure would benefit MOST from adding which
medication?
a. Sulfonylurea
b. SGLT2 inhibitor
c. Meglitinide
d. Acarbose
Correct Answer:
b. SGLT2 inhibitor
Rationale:
SGLT2 inhibitors provide glucose-lowering benefits and reduce heart failure
hospitalization risk.
9. A patient on empagliflozin presents with nausea, abdominal pain, glucose 158,
and metabolic acidosis. What complication is suspected?
a. Hyperosmolar hyperglycemic state
b. Euglycemic diabetic ketoacidosis
c. Lactic acidosis from metformin
d. Hypoglycemic shock
FINAL EXAM PREP
Verified Questions & Answers With Rationales
(Primary Care of the Maturing and
Aged Family Practicum)
Chamberlain
CONSISTS OF 200+ QUESTIONS
WEEKS 5 – 8 COVERED
,1. A 58-year-old woman presents with polyuria, fatigue, and blurred vision. Labs
show fasting plasma glucose of 132 mg/dL on two occasions. What is the correct
diagnosis?
a. Prediabetes
b. Type 1 diabetes mellitus
c. Type 2 diabetes mellitus
d. Stress hyperglycemia
Correct Answer:
c. Type 2 diabetes mellitus
Rationale:
A fasting plasma glucose ≥126 mg/dL on two separate occasions meets diagnostic
criteria for diabetes mellitus.
2. Which laboratory value alone meets diagnostic criteria for type 2 diabetes?
a. HgA1C 5.6%
b. HgA1C 6.6%
c. Fasting glucose 110 mg/dL
d. Random glucose 150 mg/dL without symptoms
Correct Answer:
b. HgA1C 6.6%
Rationale:
An A1C of 6.5% or higher is diagnostic of diabetes when confirmed or when
consistent with clinical presentation.
3. A patient has random glucose of 212 mg/dL and polyuria. What is the correct
interpretation?
a. Normal glucose response
b. Prediabetes only
c. Diagnostic of diabetes due to symptoms plus glucose ≥200
d. Requires no follow-up
Correct Answer:
c. Diagnostic of diabetes due to symptoms plus glucose ≥200
Rationale:
,Classic hyperglycemia symptoms plus random plasma glucose ≥200 mg/dL
supports a diagnosis of diabetes.
4. Which physical exam finding is most associated with insulin resistance?
a. Xanthelasma
b. Acanthosis nigricans
c. Clubbing
d. Petechiae
Correct Answer:
b. Acanthosis nigricans
Rationale:
Acanthosis nigricans is a velvety hyperpigmented skin change associated with
insulin resistance and obesity.
5. First-line pharmacologic therapy for most patients with newly diagnosed type 2
diabetes is:
a. Insulin glargine
b. Metformin
c. Pioglitazone
d. Glyburide
Correct Answer:
b. Metformin
Rationale:
Metformin is commonly first-line because it lowers glucose, is weight-neutral or
modestly weight-reducing, and has low hypoglycemia risk.
6. Metformin lowers glucose primarily by:
a. Increasing renal glucose excretion
b. Stimulating pancreatic insulin release
c. Decreasing hepatic glucose production
d. Blocking carbohydrate absorption only
Correct Answer:
c. Decreasing hepatic glucose production
, Rationale:
Metformin primarily reduces hepatic gluconeogenesis and improves insulin
sensitivity.
7. Which patient should NOT receive metformin?
a. eGFR 85 mL/min
b. eGFR 60 mL/min
c. eGFR 45 mL/min
d. eGFR 25 mL/min
Correct Answer:
d. eGFR 25 mL/min
Rationale:
Metformin is contraindicated in severe renal impairment because of increased
lactic acidosis risk.
8. A patient with T2DM and heart failure would benefit MOST from adding which
medication?
a. Sulfonylurea
b. SGLT2 inhibitor
c. Meglitinide
d. Acarbose
Correct Answer:
b. SGLT2 inhibitor
Rationale:
SGLT2 inhibitors provide glucose-lowering benefits and reduce heart failure
hospitalization risk.
9. A patient on empagliflozin presents with nausea, abdominal pain, glucose 158,
and metabolic acidosis. What complication is suspected?
a. Hyperosmolar hyperglycemic state
b. Euglycemic diabetic ketoacidosis
c. Lactic acidosis from metformin
d. Hypoglycemic shock
