Management of DM

Question 1

Signs of hypoglycemia include all of the following except:

Answer 1

Bradycardia.

Question 2

The thiazolidinediones should not be used concomitantly with a(n):

Answer 2

Nitrate

Question 3

Consequences of hyperinsulinemia include all of the following except:

Answer 3

Less response to angiotensin II.

Question 4

The mechanism of action of sulfonylureas is as a(n):

Answer 4

Product that enhances insulin release.

Question 5

Which of the following is consistent with the diagnosis of diabetes mellitus?

Answer 5

Hemoglobin A1C =6.5%

Question 6

SGLT2 inhibitors exert their clinical effect by:

Answer 6

Increasing glucose excretion in the urine.

Question 7

Delayed gastric emptying is noted with the use of:

Answer 7

Exenatide (Byetta®).

Question 8

In a healthy person, basal insulin accounts for what percentage of the body’s total daily physiologic insulin secretion?

Answer 8

50%

Question 9

Which of the following best describes a component of sitagliptin’s (Januvia®) mechanism of action?

Answer 9

Increases insulin release by slowing inactivation of incretin hormones

Question 10

Using metformin in a person with advanced renal impairment potentially increases the risk of:

Answer 10

Lactic acidosis

Question 11

For a patient who is newly-diagnosed with type 2 diabetes and A1C >10%, intensive insulin therapy should be considered to reverse the effects of glucose toxicity. The recommended duration of intensive insulin therapy is:

Answer 11

2 to 3 weeks.

Question 12

The presence of microalbuminuria is typically an indication of:

Answer 12

Altered renal function.

Question 13

The NP is evaluating a 36-year-old woman with type 2 diabetes mellitus currently being treated with metformin. She also has a history of recurrent UTIs. Her BMI is 38 kg/m2 and her A1C today is 7.6%. She expresses a desire to lose weight. In considering adding a new antihyperglycemic medication to her regimen, the most appropriate choice would be a:

Answer 13

GLP-1 agonist.

Question 14

The NP is evaluating a 58-year-old man with type 2 diabetes mellitus that is being treated with metformin monotherapy. Today, his A1C is 7.3%. The patient expresses concern about hypoglycemia. In considering adding a new antihyperglycemic agent to her regimen, the NP considers which of the following to be the least appropriate option?

Answer 14

Sulfonylurea

Question 15

Mrs. B. is a 46-year-old woman with type 2 diabetes who is receiving a single 10-unit daily dose of long-acting insulin glargine. Her fasting blood glucose has ranged between 170 to 180 mg/dL (9.4–10.0 mmol/L). Which of the following best describes the next step in her therapy?

Answer 15

Increase glargine dose by 4 units

Question 16

The NP is called to evaluate a 45-year-old man who is experiencing a hypoglycemic episode. He is alert with a blood glucose level of 50 mg/dL (3.33 mmol/L). The most appropriate course of action is:

Answer 16

Administer 1 tube of 15 g glucose orally and re-check blood sugar in 15 minutes.

Question 17

In counseling a patient on the use of short-acting insulin to better manage post-prandial hyperglycemia, the NP advises:

Answer 17

It should be administered 10 minutes prior to each meal

Question 18

Which of the following is not a characteristic of basal insulin?

Answer 18

Should not be combined with GLP-1 agonists

Question 19

Unless contraindicated, an additional therapy to be routinely prescribed for the patient with type 2 diabetes includes all of the following except:

Answer 19

Fibrate.

Question 20

According to the American Diabetes Association Standards of Diabetes Care, the use of sliding-scale insulin therapy to treat hyperglycemia is:

Answer 20

Discouraged for individuals admitted to the hospital and in the outpatient setting.