NR 565 final EXAM QUESTIONS WITH ACTUAL CORRECT
DETAILED ANSWERS GRADED A +
Type 1 diabetes results from autoimmune destruction of the beta cells. Eighty-five to 90% of
type 1 diabetics have: - ANSWER-Autoantibodies to two tyrosine phosphatases
Diagnostic criteria for diabetes include: - ANSWER-Symptoms of diabetes plus a casual blood
glucose greater than 200 mg/dl
Routine screening of asymptomatic adults for diabetes is appropriate for: - ANSWER-Native
Americans, African Americans, and Hispanics
Screening for children who meet the following criteria should begin at age 10 and occur every 3
years thereafter: - ANSWER-Any of the above
Insulin is used to treat both types of diabetes. It acts by: - ANSWER-Increasing peripheral
glucose uptake by skeletal muscle and fat
Adam has type 1 diabetes and plays tennis for his university. He exhibits a knowledge deficit
about his insulin and his diagnosis. He should be taught that: - ANSWER-He should increase his
carbohydrate intake during times of exercise.
Insulin preparations are divided into categories based on onset, duration, and intensity of action
following subcutaneous injection. Which of the following insulin preparations has the shortest
onset and duration of action? - ANSWER-Glulisine
,The drug of choice for type 2 diabetics is metformin. Metformin: - ANSWER-Decreases
glycogenolysis by the liver
Sulfonylureas may be added to a treatment regimen for type 2 diabetics when lifestyle
modifications and metformin are insufficient to achieve target glucose levels. Sulfonylureas have
been moved to Step 2 therapy because they: - ANSWER-Have a significant risk for hypoglycemia
Dipeptidyl peptidase-4 inhibitors (gliptins) act on the incretin system to improve glycemic
control. Advantages of these drugs include: - ANSWER-Low risk for hypoglycemia
Control targets for patients with diabetes include: - ANSWER-3. Blood pressure less than 130/80
mm Hg
Establishing glycemic targets is the first step in treatment of both types of diabetes. For type 1
diabetes: - ANSWER-Conventional therapy has a fasting plasma glucose target between 120 and
150 mg/dl.
Treatment with insulin for type 1 diabetics: - ANSWER-Starts with a total daily dose of 0.2 to 0.4
units per kg of body weight
When the total daily insulin dose is split and given twice daily, which of the following rules may
be followed? - ANSWER-Give two-thirds of the total dose in the morning and one-third in the
evening.
Studies have shown that control targets that reduce the HbA1C to less than 7% are associated
with fewer long-term complications of diabetes. Patients who should have such a target include:
- ANSWER-Those with no significant cardiovascular disease
,Prevention of conversion from prediabetes to diabetes in young children must take highest
priority and should focus on: - ANSWER-Fostering LDL levels less than 100 mg/dl and total
cholesterol less than 170 mg/dl to prevent cardiovascular disease
The drugs recommended by the American Academy of Pediatrics for use in children with
diabetes (depending upon type of diabetes) are: - ANSWER-Metformin and insulin
Unlike most type 2 diabetics where obesity is a major issue, older adults with low body weight
have higher risks for morbidity and mortality. The most reliable indicator of poor nutritional
status in older adults is: - ANSWER-Involuntary loss of 10% of body weight in less than 6 months
The drugs recommended for older adults with type 2 diabetes include: - ANSWER-Third-
generation sulfonylureas
Ethnic groups differ in their risk for and presentation of diabetes. Hispanics: - ANSWER-Both 1
and 2
The American Heart Association states that people with diabetes have a 2- to 4-fold increase in
the risk of dying from cardiovascular disease. Treatments and targets that do not appear to
decrease risk for micro- and macro-vascular complications include: - ANSWER-Glycemic targets
between 7% and 7.5%
All diabetic patients with known cardiovascular disease should be treated with: - ANSWER-
Angiotensin-converting enzyme inhibitors and aspirin to reduce risk of cardiovascular events
All diabetic patients with hyperlipidemia should be treated with: - ANSWER-HMG-CoA reductase
inhibitors
Both angiotensin converting enzyme inhibitors and some angiotensin II receptor blockers have
been approved in treating: - ANSWER-Both 1 and 2
, Diabetic autonomic neuropathy (DAN) is the earliest and most common complication of
diabetes. Symptoms associated with DAN include: - ANSWER-Resting tachycardia, exercise
intolerance, and orthostatic hypotension
The American Diabetic Association has recommended which of the following tests for ongoing
management of diabetes? - ANSWER-HbA1C
Allison is an 18-year-old college student with type 1 diabetes. She is on NPH twice daily and
Novolog before meals. She usually walks for 40 minutes each evening as part of her exercise
regimen. She is beginning a 30-minute swimming class three times a week at 1 p.m. What is
important for her to do with this change in routine? - ANSWER-Check glucose level before,
during, and after swimming.
Allison is an 18-year-old college student with type 1 diabetes. Allison's pre-meal BG at 11:30
a.m. is 130. She eats an apple and has a sugar-free soft drink. At 1 p.m. before swimming her BG
is 80. What should she do? - ANSWER-Eat a granola bar or other snack with CHO.
Bart is a patient is a 67-year-old male with T2 DM. He is on glipizide and metformin. He presents
to the clinic with confusion, sluggishness, and extreme thirst. His wife tells you Bart does not
follow his meal plan or exercise regularly, and hasn't checked his BG for 1 week. A random
glucose is drawn and it is 500. What is a likely diagnosis based on preliminary assessment? -
ANSWER-Hyperglycemic hyperosmolar syndrome (HHS)
What would one expected assessment finding be for hyperglycemic hyperosmolar syndrome? -
ANSWER-pH of 7.35
A patient on metformin and glipizide arrives at her 11:30 a.m. clinic appointment diaphoretic
and dizzy. She reports taking her medication this morning and ate a bagel and coffee for
breakfast. BP is 110/70 and random finger-stick glucose is 64. How should this patient be
treated? - ANSWER-8 oz milk or 4 oz orange juice
DETAILED ANSWERS GRADED A +
Type 1 diabetes results from autoimmune destruction of the beta cells. Eighty-five to 90% of
type 1 diabetics have: - ANSWER-Autoantibodies to two tyrosine phosphatases
Diagnostic criteria for diabetes include: - ANSWER-Symptoms of diabetes plus a casual blood
glucose greater than 200 mg/dl
Routine screening of asymptomatic adults for diabetes is appropriate for: - ANSWER-Native
Americans, African Americans, and Hispanics
Screening for children who meet the following criteria should begin at age 10 and occur every 3
years thereafter: - ANSWER-Any of the above
Insulin is used to treat both types of diabetes. It acts by: - ANSWER-Increasing peripheral
glucose uptake by skeletal muscle and fat
Adam has type 1 diabetes and plays tennis for his university. He exhibits a knowledge deficit
about his insulin and his diagnosis. He should be taught that: - ANSWER-He should increase his
carbohydrate intake during times of exercise.
Insulin preparations are divided into categories based on onset, duration, and intensity of action
following subcutaneous injection. Which of the following insulin preparations has the shortest
onset and duration of action? - ANSWER-Glulisine
,The drug of choice for type 2 diabetics is metformin. Metformin: - ANSWER-Decreases
glycogenolysis by the liver
Sulfonylureas may be added to a treatment regimen for type 2 diabetics when lifestyle
modifications and metformin are insufficient to achieve target glucose levels. Sulfonylureas have
been moved to Step 2 therapy because they: - ANSWER-Have a significant risk for hypoglycemia
Dipeptidyl peptidase-4 inhibitors (gliptins) act on the incretin system to improve glycemic
control. Advantages of these drugs include: - ANSWER-Low risk for hypoglycemia
Control targets for patients with diabetes include: - ANSWER-3. Blood pressure less than 130/80
mm Hg
Establishing glycemic targets is the first step in treatment of both types of diabetes. For type 1
diabetes: - ANSWER-Conventional therapy has a fasting plasma glucose target between 120 and
150 mg/dl.
Treatment with insulin for type 1 diabetics: - ANSWER-Starts with a total daily dose of 0.2 to 0.4
units per kg of body weight
When the total daily insulin dose is split and given twice daily, which of the following rules may
be followed? - ANSWER-Give two-thirds of the total dose in the morning and one-third in the
evening.
Studies have shown that control targets that reduce the HbA1C to less than 7% are associated
with fewer long-term complications of diabetes. Patients who should have such a target include:
- ANSWER-Those with no significant cardiovascular disease
,Prevention of conversion from prediabetes to diabetes in young children must take highest
priority and should focus on: - ANSWER-Fostering LDL levels less than 100 mg/dl and total
cholesterol less than 170 mg/dl to prevent cardiovascular disease
The drugs recommended by the American Academy of Pediatrics for use in children with
diabetes (depending upon type of diabetes) are: - ANSWER-Metformin and insulin
Unlike most type 2 diabetics where obesity is a major issue, older adults with low body weight
have higher risks for morbidity and mortality. The most reliable indicator of poor nutritional
status in older adults is: - ANSWER-Involuntary loss of 10% of body weight in less than 6 months
The drugs recommended for older adults with type 2 diabetes include: - ANSWER-Third-
generation sulfonylureas
Ethnic groups differ in their risk for and presentation of diabetes. Hispanics: - ANSWER-Both 1
and 2
The American Heart Association states that people with diabetes have a 2- to 4-fold increase in
the risk of dying from cardiovascular disease. Treatments and targets that do not appear to
decrease risk for micro- and macro-vascular complications include: - ANSWER-Glycemic targets
between 7% and 7.5%
All diabetic patients with known cardiovascular disease should be treated with: - ANSWER-
Angiotensin-converting enzyme inhibitors and aspirin to reduce risk of cardiovascular events
All diabetic patients with hyperlipidemia should be treated with: - ANSWER-HMG-CoA reductase
inhibitors
Both angiotensin converting enzyme inhibitors and some angiotensin II receptor blockers have
been approved in treating: - ANSWER-Both 1 and 2
, Diabetic autonomic neuropathy (DAN) is the earliest and most common complication of
diabetes. Symptoms associated with DAN include: - ANSWER-Resting tachycardia, exercise
intolerance, and orthostatic hypotension
The American Diabetic Association has recommended which of the following tests for ongoing
management of diabetes? - ANSWER-HbA1C
Allison is an 18-year-old college student with type 1 diabetes. She is on NPH twice daily and
Novolog before meals. She usually walks for 40 minutes each evening as part of her exercise
regimen. She is beginning a 30-minute swimming class three times a week at 1 p.m. What is
important for her to do with this change in routine? - ANSWER-Check glucose level before,
during, and after swimming.
Allison is an 18-year-old college student with type 1 diabetes. Allison's pre-meal BG at 11:30
a.m. is 130. She eats an apple and has a sugar-free soft drink. At 1 p.m. before swimming her BG
is 80. What should she do? - ANSWER-Eat a granola bar or other snack with CHO.
Bart is a patient is a 67-year-old male with T2 DM. He is on glipizide and metformin. He presents
to the clinic with confusion, sluggishness, and extreme thirst. His wife tells you Bart does not
follow his meal plan or exercise regularly, and hasn't checked his BG for 1 week. A random
glucose is drawn and it is 500. What is a likely diagnosis based on preliminary assessment? -
ANSWER-Hyperglycemic hyperosmolar syndrome (HHS)
What would one expected assessment finding be for hyperglycemic hyperosmolar syndrome? -
ANSWER-pH of 7.35
A patient on metformin and glipizide arrives at her 11:30 a.m. clinic appointment diaphoretic
and dizzy. She reports taking her medication this morning and ate a bagel and coffee for
breakfast. BP is 110/70 and random finger-stick glucose is 64. How should this patient be
treated? - ANSWER-8 oz milk or 4 oz orange juice
