Question 1

Both angiotensin-converting enzyme inhibitors and some angiotensin II receptor blockers have been approved in treating:

Accepted Answer

A)  Hypertension in diabetic patients
B)  Diabetic nephropathy
C)  Both 1 and 2
D)  Neither 1 nor 2E) A) and D)
F) B) and D)

Question 2

Routine screening of asymptomatic adults for diabetes is appropriate for:

Accepted Answer

A)  Individuals who are older than 45 and have a body mass index (BMI)  of less than 25 kg/m2
B)  Native Americans, African Americans, and Hispanics
C)  Persons with high-density lipoprotein (HDL)  cholesterol greater than 100 mg/dL
D)  Persons with prediabetes confirmed on at least two occasionsE) A) and B)
F) All of the above

Question 3

Type 1 diabetes results from autoimmune destruction of the beta cells. Eighty-five to ninety percent of type 1 diabetics have:

Accepted Answer

A)  Autoantibodies to two tyrosine phosphatases
B)  Mutation of the hepatic transcription factor on chromosome 12
C)  A defective glucokinase molecule due to a defective gene on chromosome 7p
D)  Mutation of the insulin promoter factorE) All of the above
F) B) and C)

Question 4

What would one expect to find during an assessment for HHS?

Accepted Answer

A)  Low hemoglobin
B)  Ketones in the urine
C)  Deep, labored breathing
D)  pH of 7.35E) B) and C)
F) All of the above

Question 5

All diabetic patients with known cardiovascular disease should be treated with:

Accepted Answer

A)  Beta blockers to prevent myocardial infarctions (MIs) 
B)  Angiotensin-converting enzyme inhibitors and aspirin to reduce risk of cardiovascular events
C)  Sulfonylureas to decrease cardiovascular mortality
D)  Pioglitazone to decrease atherosclerotic plaque buildupE) B) and D)
F) C) and D)

Question 6

Diagnostic criteria for diabetes include:

Accepted Answer

A)  Fasting blood glucose greater than 140 mg/dL on two occasions
B)  Postprandial blood glucose greater than 140 mg/dL
C)  Fasting blood glucose 100 to 125 mg/dL on two occasions
D)  Symptoms of diabetes plus a casual blood glucose greater than 200 mg/dLE) B) and C)
F) A) and B)

Question 7

The drugs recommended for older adults with type 2 diabetes include:

Accepted Answer

A)  Second-generation sulfonylureas
B)  Metformin
C)  Pioglitazone
D)  Third-generation sulfonylureasE) B) and D)
F) A) and D)

Question 8

When the total daily insulin dose is split and given twice daily, which of the following rules may be followed?

Accepted Answer

A)  Give two-thirds of the total dose in the morning and one-third in the evening.
B)  Give 0.3 units per kilogram of premixed 70/30 insulin with one-third in the morning and two-thirds in the evening.
C)  Give 50% of an insulin glargine dose in the morning and 50% in the evening.
D)  Give long-acting insulin in the morning and short-acting insulin at bedtime.E) A) and B)
F) A) and C)

Question 9

Dipeptidyl peptidase-4 inhibitors (gliptins)  act on the incretin system to improve glycemic control. Advantages of these drugs include:

Accepted Answer

A)  Better reduction in glucose levels than other classes
B)  Less weight gain than with sulfonylurea use
C)  Low risk for hypoglycemia
D)  Can be given twice dailyE) A) and B)
F) A) and C)

Question 10

Which type of insulin is used in insulin pumps?

Accepted Answer

A)  Only regular insulin
B)  Basal insulin
C)  Rapid acting insulin
D)  Any type is okay depending on rate and pattern of infusion
E)   Diabetes MellitusF) A) and B)
G) B) and E)

Question 11

Prevention of conversion from prediabetes to diabetes in young children must take highest priority and should focus on:

Accepted Answer

A)  Aggressive dietary manipulation to prevent obesity
B)  Fostering LDL levels less than 100 mg/dL and total cholesterol less than 170 mg/dL to prevent cardiovascular disease
C)  Maintaining a blood pressure that is less than 80% based on weight and height to prevent hypertension
D)  All of the aboveE) A) and B)
F) A) and C)

Question 12

The drug of choice for type 2 diabetics is metformin. Metformin:

Accepted Answer

A)  Decreases glycogenolysis by the liver
B)  Increases the release of insulin from beta cells
C)  Increases intestinal uptake of glucose
D)  Prevents weight gain associated with hyperglycemiaE) A) and D)
F) None of the above

Question 13

Insulin preparations are divided into categories based on onset time, duration of action, and intensity of action following subcutaneous injection. Which of the following insulin preparations has the shortest onset and duration of action?

Accepted Answer

A)  Lispro
B)  Glulisine
C)  Glargine
D)  DetemirE) B) and D)
F) All of the above

Question 14

Before prescribing metformin, the provider should:

Accepted Answer

A)  Draw a serum creatinine level to assess renal function.
B)  Try the patient on insulin.
C)  Prescribe a thyroid preparation if the patient needs to lose weight.
D)  All of the aboveE) All of the above
F) B) and C)

Question 15

Type 2 diabetes is a complex disorder involving:

Accepted Answer

A)  Absence of insulin production by the beta cells
B)  A suboptimal response of insulin-sensitive tissues in the liver
C)  Increased levels of glucagon-like peptide in the postprandial period
D)  Too much fat uptake in the intestineE) A) and B)
F) None of the above

Question 16

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:

Accepted Answer

A)  He should increase his carbohydrate intake during times of exercise.
B)  Each brand of insulin is equal in bioavailability, so he can buy the least expensive.
C)  Alcohol produces hypoglycemia and can help control his diabetes when taken in small amounts.
D)  If he does not want to learn to give himself injections, he may substitute an oral hypoglycemic to control his diabetes.E) All of the above
F) B) and D)

Question 17

Protein restriction helps slow the progression of albuminuria, glomerular filtration rate, decline, and end stage renal disease in some patients with diabetes. It is useful for patients who:

Accepted Answer

A)  Cannot tolerate angiotensin-converting enzyme inhibitors or angiotensin receptor blockers
B)  Have uncontrolled hypertension
C)  Have HbA1C levels above 7%
D)  Show progression of diabetic nephropathy despite optimal glucose and blood pressure controlE) A) and D)
F) C) and D)

Question 18

Ethnic groups differ in their risk for and presentation of diabetes. Hispanics:

Accepted Answer

A)  Have a high incidence of obesity, elevated triglycerides, and hypertension
B)  Do best with drugs that foster weight loss, such as metformin
C)  Both 1 and 2
D)  Neither 1 nor 2E) A) and C)
F) B) and D)

Question 19

Documented reduction in cardiovascular (CV)  risk is linked with:

Accepted Answer

A)  Selective sodium-dependent glucose cotransporters-2 (SGLT-2)  medications
B)  Metformin replacement with insulin
C)  Early adoption of basal insulin
D)  Sulfonylurea reductionE) B) and D)
F) A) and B)

Question 20

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:

Accepted Answer

A)  Those with long-standing diabetes
B)  Older adults
C)  Those with no significant cardiovascular disease
D)  Young children who are early in their diseaseE) A) and B)
F) A) and C)

Exam 35: Diabetes Mellitus

Ethnic groups differ in their risk for and presentation of diabetes. Hispanics:

Correct AnswerverifiedShow Answer

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:

Correct AnswerverifiedShow Answer

All diabetic patients with known cardiovascular disease should be treated with:

Correct AnswerverifiedShow Answer

The drug of choice for type 2 diabetics is metformin. Metformin:

Correct AnswerverifiedShow Answer

When the total daily insulin dose is split and given twice daily, which of the following rules may be followed?

Correct AnswerverifiedShow Answer

The drugs recommended for older adults with type 2 diabetes include:

Correct AnswerverifiedShow Answer

Routine screening of asymptomatic adults for diabetes is appropriate for:

Correct AnswerverifiedShow Answer

Both angiotensin-converting enzyme inhibitors and some angiotensin II receptor blockers have been approved in treating:

Correct AnswerverifiedShow Answer

Documented reduction in cardiovascular (CV) risk is linked with:

Correct AnswerverifiedShow Answer

Type 1 diabetes results from autoimmune destruction of the beta cells. Eighty-five to ninety percent of type 1 diabetics have:

Correct AnswerverifiedShow Answer

Insulin preparations are divided into categories based on onset time, duration of action, and intensity of action following subcutaneous injection. Which of the following insulin preparations has the shortest onset and duration of action?

Correct AnswerverifiedShow Answer

Protein restriction helps slow the progression of albuminuria, glomerular filtration rate, decline, and end stage renal disease in some patients with diabetes. It is useful for patients who:

Correct AnswerverifiedShow Answer

Prevention of conversion from prediabetes to diabetes in young children must take highest priority and should focus on:

Correct AnswerverifiedShow Answer

Which type of insulin is used in insulin pumps?

Correct AnswerverifiedShow Answer

Diagnostic criteria for diabetes include:

Correct AnswerverifiedShow Answer

Before prescribing metformin, the provider should:

Correct AnswerverifiedShow Answer

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:

Correct AnswerverifiedShow Answer

Type 2 diabetes is a complex disorder involving:

Correct AnswerverifiedShow Answer

What would one expect to find during an assessment for HHS?

Correct AnswerverifiedShow Answer

Dipeptidyl peptidase-4 inhibitors (gliptins) act on the incretin system to improve glycemic control. Advantages of these drugs include:

Correct AnswerverifiedShow Answer

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