Diabetes Mellitus: Management of Diabetes

~ Exam ~

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This test has 40 questions.

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1. In developing a treatment plan for the newly diagnosed diabetic, which of the following is the first step?

  a. Determining current knowledge

  b. Assessing readiness to learn

  c. Identifying learning style

  d. Conferring with the patient's doctor


2. If intermediate-acting insulin is given at 7 am, when should one anticipate that an insulin reaction might occur?

  a. 3 pm to 7 pm

  b. 7:30 am to 9:30 am

  c. 10 am to 12 noon

  d. 5 pm to 9 pm


3. Lipohypertrophy:

  a. Is inevitable with daily insulin injections.

  b. Occurs only in the legs.

  c. Results from failure to adequately rotate sites of injections.

  d. Increases the absorption of insulin injected into effected tissue.


4. The usefulness of the Exchange Program of Dietary Management is that it:

  a. Eliminates carbohydrates while maintaining the recommended intake of other nutrients.

  b. Allows for exchange of foods between food groups.

  c. Distributes a wide variety of foods into four food groups.

  d. Provides for balanced nutrition.


5. The following is an accurate list of foods (and amounts) in the Starch List of Food Exchanges: 1 slice of bread, ½ cup of baked beans, ½ cup of winter squash, ½ cup of corn, ½ cup of mashed potatoes, 1 cup of cooked cereal

  a. True

  b. False


6. The following is an accurate list of foods (and amounts) in the Medium-Fat Meat List: 1 oz of top loin pork, 1 oz. of dark chicken (with skin), 1 oz of ground beef, one egg

  a. True

  b. False


7. While blood glucose control has been shown to be beneficial, tight control is not recommended for young children.

  a. True

  b. False


8. Guidelines of dietary management in diabetes with regard to the Exchange Program include which of the following?

  a. Include milk at every meal.

  b. Only sugar free sweets are to be eaten.

  c. Bake or broil; avoid frying.

  d. Eat a high carbohydrate snack at bedtime


9. The determination of insulin dosage by grams of carbohydrate to be ingested reflects what regimen of diabetes control?

  a. The exchange program

  b. The weighing method

  c. Carbohydrate counting

  d. Calorie counting


10. Prior to unplanned exercise, the diabetic should:

  a. Eat a snack of complex carbohydrate and protein.

  b. Take additional fast-acting insulin to assure that energy needs will be met.

  c. Rest to conserve glucose.

  d. Eat a snack of simple carbohydrate such as candy or a Coke.


11. Urine tests for sugar are valid indicators of blood glucose.

  a. True

  b. False


12. Which of the following recommendations for foot care by the diabetic is false?

  a. Examine feet daily for open areas.

  b. Do not walk barefoot at any time.

  c. Cut toe nails straight across.

  d. Trim corns or calluses with sterile equipment.


13. Early retinopathy can be detected by visual changes noted by the diabetic

  a. True

  b. False


14. Blood and urinalyses performed at least annually are considered adequate diabetes monitoring.

  a. True

  b. False


15. Hospitalization is usually required for which of the following conditions in the person with diabetes:

  a. Hypoglycemia

  b. Hyperosmolar hyperglycemic state (HHS)

  c. Hyperglycemia

  d. Infection


16. Which of the following interventions is appropriate first-aid for suspected hypoglycemia in the known diabetic who is unconscious?

  a. Test the blood glucose to verify hypoglycemia.

  b. Give the person 1/2 cup of orange juice.

  c. Turn the person on his/her side and give sublingual glucose.

  d. None of the choices is correct.


17. The person with DMT1 who is unable to eat due to illness should discontinue taking insulin while sipping sugared drinks to maintain fluid and glucose needs.

  a. True

  b. False


18. Which of the following is classified as a long-term complication of diabetes?

  a. Hypoglycemia

  b. Renal insufficiency

  c. Hyperglycemia

  d. Ketoacidosis


19. Islet cell transplantation has been shown to be a reliable way to treat DMT1.

  a. True

  b. False


20. The American Diabetes Association recommends which of the following as the initial intervention for the patient diagnosed with DMT2:

  a. Lifestyle management, only

  b. Metformin, only

  c. Rosiglitazone and lifestyle management

  d. Metformin and lifestyle management


21. The American Diabetes Association recommends which of the following BP goals for people with diabetes?

  a. < 130/85 mm Hg

  b. < 140/80 mm Hg

  c. < 150/80 mm Hg

  d. < 135/90 mm Hg


22. The American Diabetes Association recommends which of the following as the goal for A1C for non-pregnant adults with diabetes?

  a. < 8.5%

  b. < 8.0%

  c. < 7.5%

  d. < 7.0%


23. The net effect on the diabetic's blood glucose of ingesting more The American Diabetes Association recommends which of the following as the goal for LDL (low-density lipoproteins) for people with diabetes and no cardiovascular disease?

  a. < 100 mg/dL

  b. < 70 mg/dL

  c. > 50 mg/dL

  d. < 150 mg/dL


24. The American Diabetes Association recommends which of the following as the goal for LDL (low-density lipoproteins) for people with diabetes and overt cardiovascular disease?

  a. < 100 mg/dL

  b. < 70 mg/dL

  c. > 50 mg/dL

  d. < 150 mg/dL


25. The American Diabetes Association recommends which of the following as the goal for HDL (high-density lipoproteins) for males with diabetes?

  a. < 100 mg/dL

  b. < 70 mg/dL

  c. > 40 mg/dL

  d. < 150 mg/dL


26. The American Diabetes Association recommends which of the following as the goal for TG (triglycerides) for people with diabetes and no cardiovascular disease?

  a. < 100 mg/dL

  b. < 70 mg/dL

  c. > 50 mg/dL

  d. < 150 mg/dL


27. The American Diabetes Association recommends for individuals who have diabetes which of the following values (mg/dL) as the goal for the blood glucose level 1-2 hours after the start of a meal (post-prandial)?

  a. 70-130

  b. < 180

  c. < 140

  d. < 200


28. Sugar-free foods may include those made with nutritive sweeteners that can actually raise the blood glucose.

  a. True

  b. False


29. Sugar-free foods are carbohydrate-free, too.

  a. True

  b. False


30. Sam is to take one unit of Novolog insulin for every 15 grams of carbohydrate he consumes at lunch. The carbohydrate he intends to eat is as follows: two slices of bread in a low-fat turkey sandwich, one cup of 2% milk, and one small apple. How many units (U) of Novolog should he take?

  a. 1.5 U

  b. 3.8 U

  c. 6.2 U

  d. 10.0 U


31. Which of the following newer diabetes medications can be part of the treatment regimen for both DMT1 and DMT2?

  a. Exenatide

  b. Sitagliptin

  c. Canagliflozin

  d. Pramlintide


32. Helen is 68 years old. She has had diabetes for the past twenty years. Helen received a pneumococcal immunization when she was 60 years old. Based on the American Diabetes Association's recommendations, does Helen need another pneumococcal immunization?

  a. Yes

  b. No


33. The American Diabetes Association recommends an annual influenza vaccine for all persons with diabetes who are > 6 months of age.

  a. True

  b. False


34. Which of the following reflects the recommendation by the US Department of Health and Human Services and the American Diabetes Association in terms of exercise for adults over the age of 18? Adults over the age of 18 should perform exercise of:

  a. Moderate intensity at least 30 minutes every day of the week.

  b. Moderate intensity at least 150 minutes each week.

  c. Low intensity at least 30 minutes every day of the week.

  d. Low intensity at least 150 minutes each week.


35. Art is an 82 year old man with DMT2. He admits he has trouble seeing close up but wears his bifocals "when I need to.” He tells you he takes two 500 mg tablets of metformin p.o. BID and 20 units of Lente at 9 pm every evening along with a small snack. His blood glucose record shows blood glucose levels within normal levels at bedtime but fasting results are typically over 200mg/dL. Which of the following could explain these findings? Art may be:

  a. Actually taking too little Lente at bedtime.

  b. Eating too much at bedtime.

  c. Experiencing the Somogyi effect.

  d. All of the above.


36. Intensive lifestyle management programs and the use of pharmacologic agents such as metformin have been shown to delay the onset of diabetes.

  a. True

  b. False


37. One of the newest drugs for treating diabetes is canagliflozin (Invokana®). Which of the following statements about this new drug is true?

  a. It can be used to treat both DMT1 and DMT2.

  b. It has been shown to significantly decrease A1C levels.

  c. It is in the pharmaceutical category of the sulfonylureas.

  d. It is known to be effective in children under the age of 18 years.


38. Because they have nephroprotective effects, an ACEI inhibitor or an ARB should be prescribed to anyone with diabetes, regardless of whether she/he has hypertension or not.

  a. True

  b. False


39. The normotensive person with diabetes should be prescribed an ACEI inhibitor or an ARB if she/he shows albuminuria.

  a. True

  b. False


40. Professional nurses have an obligation to assure that the newly diagnosed diabetic is effectively educated for self-care.

  a. True

  b. False