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69 Cards in this Set

  • Front
  • Back

A patient with diabetes has been on Humalog and Levemir. He currently uses a total of 66 units per day. Using a typical basal-bolus regimen, how much Levemir would he inject at bedtime? Enter the number only in your answer; do not enter units.


33

What are the serum creatinine and creatinine clearance cut-offs for the use of metformin therapy?


Answer


A> 1.1 mg/dL (males) or > 1 mg/dL (females); CrCl < 90 mL/min


B≥ 1.2 mg/dL (males) or ≥ 1.1 mg/dL (females); CrCl < 60 mL/min


C> 1.5 mg/dL (males) or > 1.4 mg/dL (females); CrCl < 90 mL/min


D≥ 1.5 mg/dL (males) or ≥ 1.4 mg/dL (females); CrCl < 60 mL/min


E> 2 mg/dL (males) or > 1.8 mg/dL (females); CrCl < 60 mL/min

D≥ 1.5 mg/dL (males) or ≥ 1.4 mg/dL (females); CrCl < 60 mL/min

Which of the following is a DPP-4 inhibitor?


Answer


ALiraglutide


BLinagliptin


CBromocriptine


DAcarbose


EExenatide

BLinagliptin

What is the boxed warning associated with Symlin?


Answer


AHypoglycemia


BLactic acidosis


CPancreatitis


DHyperglycemia


EThyroid cancer


AHypoglycemia

What is the most common side effect when starting metformin therapy?


Answer


ARash


BSevere headache


CMild diarrhea


DConstipation


ENeuritis

CMild diarrhea

A patient with an initial hemoglobin A1C of 7.9% is started on Glucophage XR 500 mg once daily. Which of the following statements is correct?


Answer


AThis is an incorrect starting dose.


BThis is the maximum effective dose.


CThe dose can be increased to 1 gram daily.


DThe maximum effective dose is 2 grams daily.


EThe maximum effective dose is 5 grams daily.

DThe maximum effective dose is 2 grams daily.

Alpha cells of the pancreas secrete which of the following:


Answer


AGlycogen


BInsulin


CGlucagon


DGLP-1


EAmylin

CGlucagon

A 42 year-old male has newly diagnosed type 2 diabetes. The hemoglobin A1C is 7.9%. He has normal renal function and a BMI of 20. The patient's only other medical condition is hypertension. Choose the best option for initial treatment of the diabetes:


Answer


AInsulin glulisine


BMetformin


CSitagliptin


DGlyburide


EExenatide


BMetformin

A 43 year-old female patient with type 2 diabetes and normal renal function started taking Januvia 100 mg daily in the morning. Which of the following is correct regarding Januvia?


Answer


AThe dose is incorrect.


BJanuvia causes weight gain.


CJanuvia is better at reducing fasting glucose, rather than postprandial glucose.


DJanuvia works by blocking dipeptidyl peptidase-4 (DPP-4), an enzyme that inactivates incretins.


EThe generic name is exenatide.


DJanuvia works by blocking dipeptidyl peptidase-4 (DPP-4), an enzyme that inactivates incretins.

A hospitalized patient has been using Novolin 70/30, 46 units in the morning and 24 units at night. He is going to be switched to a regimen of lispro and glargine. Convert the NPH to glargine and round your answer to the nearest whole unit. Enter the number only in your answer; do not enter units.


39

A patient injects himself with regular human insulin. He currently injects 5 units with breakfast, 7 units with lunch, and 11 units with dinner. He is going to be switched to insulin glulisine. How much glulisine will he inject with his dinner? Enter the number only in your answer; do not enter units.


11

Which of the following medications when used alone rarely cause hypoglycemia? (Select ALL that apply.)


Answer


AAcarbose


BPioglitazone


CMetformin


DGlimepiride


EPramlintide

AAcarbose


BPioglitazone


CMetformin

A patient with diabetes has been taking Novolog 70/30, 42 units twice daily. How many units of insulin aspart protamine does this patient inject each morning? Round to nearest whole unit. Enter the number only in your answer; do not enter units.



29

Which of the following are diagnostic values for diabetes? (Select ALL that apply.)


Answer


AHyperglycemic crisis and a random plasma glucose ≥ 200 mg/dL


BFasting plasma glucose > 129 mg/dL


CPlasma glucose < 150 mg/dL


D2-hour OGTT > 220 mg/dL after a 75 gram oral glucose load


EA1C greater than or equal to 6.5%


AHyperglycemic crisis and a random plasma glucose ≥ 200 mg/dL




EA1C greater than or equal to 6.5%

Factors that the prescriber should take into consideration when selecting an oral agent for initial therapy to treat type 2 diabetes include which of the following? (Select ALL that apply.)


Answer


AKidney function of the patient


BBody composition of the patient


CBlood glucose levels at the time of diagnosis


DHemoglobin A1C value


EInitial blood pressure

AKidney function of the patient


BBody composition of the patient


CBlood glucose levels at the time of diagnosis


DHemoglobin A1C value

All of the following are considered rapid-acting insulins except:


Answer


AGlulisine


BLispro


CGlargine


DAspart


EApidra


CGlargine

A patient uses an insulin pen injection to administer an insulin dose and reports a "wet spot" on his skin after administration. What is the most likely cause of this "wet spot"?


Answer


ABleeding


BPerspiration


CAlcohol swab


DIncomplete insulin injection


EOverhydration

DIncomplete insulin injection

A patient is currently using U-500 insulin and will be transitioned to U-100 regular human insulin. He currently uses 4 units of the U-500 insulin with breakfast, 5 units with lunch, and 8 units with dinner. How many mL of U-100 regular human insulin is needed to cover his lunch dose? Enter the number only in your answer; do not enter units.


0.05

Which of the following statements related to the use of glucagon are correct? (Select ALL that apply.)


Answer


AGlucagon is a hormone secreted by the pancreas, which triggers the liver to release glucose stores into the blood.


BAdminister carbohydrates to the patient as soon as possible after response to treatment.


CGlucagon cannot be re-administered.


DGlucagon is administered via intravenous injection only.


EGlucagon is a drug of choice in unconscious hypoglycemic patients.

AGlucagon is a hormone secreted by the pancreas, which triggers the liver to release glucose stores into the blood.


BAdminister carbohydrates to the patient as soon as possible after response to treatment.



EGlucagon is a drug of choice in unconscious hypoglycemic patients.

The proper sequence of drawing up regular and NPH insulin into a single syringe is:


Answer


AFirst regular, then NPH


BFirst NPH, then regular


CThese insulins should not be used together


DEither insulin may be drawn up first


ENone of the above

AFirst regular, then NPH

Drug-induced diabetes may be due to the following medications: (Select ALL that apply.)


Answer


ADaptomycin


BPrednisone


CProtease Inhibitors


DClozapine


ETheophylline

BPrednisone


CProtease Inhibitors


DClozapine

What are the three natural hormones that our bodies make to regulate glucose that are replaced or replicated as medications?


Answer


AGIP, exenatide, insulin


BGIP, GLP-1, exenatide


CAmylin, symlin, insulin


DAmylin, GLP-1, insulin


EInsulin, amylin, GIP

DAmylin, GLP-1, insulin

A patient begins acarbose therapy but cannot tolerate it due to the side effects. She has primarily high postprandial blood glucose. She is also using insulin glargine and says she eats two meals each day and does not mind injecting insulin. She wants her blood glucose tightly controlled. Which of the following insulins would be best to help control her postprandial blood glucose levels?


Answer


ANovolog


BHumulin N


CLantus


DInsulin 75/25


ENovolin R

ANovolog

A patient can no longer afford his U-100 regular insulin. He is going to start using U-500 insulin. He currently uses 100 units of U-100 regular insulin with his evening meal. How many mL of U-500 insulin will he need with his evening meal to get the same dose? Enter the number only in your answer; do not enter units.


0.2

Which of the following are correct regarding insulin? (Select ALL that apply.)


Answer


AInsulin stimulates glucose uptake from the blood


BInsulin is released from alpha cells in the pancreas


CInsulin stimulates glucagon secretion


DInsulin is a peptide hormone


EInsulin stimulates formation of glycogen

AInsulin stimulates glucose uptake from the blood



DInsulin is a peptide hormone


EInsulin stimulates formation of glycogen

A patient with diabetes has been taking Novolog 70/30, 34 units twice daily. How many units of insulin aspart does this patient inject each evening? Round to nearest whole unit. Enter the number only in your answer; do not enter units.


10

Which of the following syringes has the thickest needle?


Answer


A22 G


B18 G


C32 G


D36 G


E31 G


B18 G

Which of the following characteristics are associated with biguanides? (Select ALL that apply.)


Answer


AThese agents should not be used in females with a SCr > 1.4 mg/dL or males with a SCr > 1.5 mg/dL.


BThese agents lower A1C by 1-2%.


CThese agents work by slowing the absorption of complex carbohydrates in the small intestine.


DThese agents can be used to teat type 1 and type 2 diabetes.


EThese agents can cause vitamin B12 deficiency when used long-term.

AThese agents should not be used in females with a SCr > 1.4 mg/dL or males with a SCr > 1.5 mg/dL.


BThese agents lower A1C by 1-2%.



EThese agents can cause vitamin B12 deficiency when used long-term.

A type I diabetic patient injects herself with 70 units of insulin each day. Using the rule of 500, determine how many grams of carbohydrates are covered with this regimen per 1 unit of insulin. Round to the nearest whole unit. Enter the number only in your answer; do not enter units.


7

A 42 year old female patient has been newly diagnosed with type 2 diabetes. She has been started on sitagliptin therapy. At initial diagnosis her hemoglobin A1C was 9.5%. Over the next two years, the hemoglobin A1C has risen to 11.2%. The doctor decides to initiate insulin therapy. Which of the following insulin options is the best choice?


Answer


AInsulin 70/30, dosed TID


BHumalog alone, with meals and carbohydrate-heavy snacks


CApidra, taken at bedtime


DLantus, taken at bedtime


EInsulin pump, using Humalog


DLantus, taken at bedtime

Which of the following diabetes medications have a significant risk of hypoglycemia when used by itself? (Select ALL that apply.)


Answer


ATradjenta


BDiabeta


CWelchol


DStarlix


EGlycet


BDiabeta



DStarlix

Which one of the following agents does not have a significant impact on postprandial glucose lowering in patients with type 2 diabetes?


Answer


AInsulin lispro


BRepaglinide


CMiglitol


DInsulin glargine


EExenatide

DInsulin glargine

An elderly female with renal insufficiency presents with newly diagnosed diabetes. She has primarily high postprandial blood glucose, with an A1C of 7.1%. The doctor begins repaglinide therapy. Which of the following statements is correct?


Answer


AThe brand name is Starlix.


BThe starting dose is 0.5 mg TID, taken 15 minutes before meals.


CIf a meal is missed, you must still take the dose.


DThese agents do not cause hypoglycemia.


EThese agents treat primarily preprandial, elevated blood glucose.

BThe starting dose is 0.5 mg TID, taken 15 minutes before meals.

A pharmacist wishes to review the new guidelines for diabetes treatment. Guidelines for this condition are written by: (Select ALL that apply.)


Answer


AThe American Dietetic Association


BThe Joint National Comittee


CThe American Association of Clinical Endocrinologists


DThe American Diabetes Association


EThe American College of Cardiology

CThe American Association of Clinical Endocrinologists


DThe American Diabetes Association

Using U-500 insulin can create a high potential for hypoglycemia in patients with diabetes. Which of the following are correct in regards to U-500 insulin? (Select ALL that apply.)


Answer


AU-500 Insulin is more convenient to use as it does not require a strict learning curve


BU-500 Insulin is more likely to cause hypoglycemia due to the high concentration


CU-100 Insulin is preferred to U-500 due to the accuracy of the dosing


DU-500 Insulin is less prone to dosing errors


EThe patient should be counseled on the size of syringe they are using


BU-500 Insulin is more likely to cause hypoglycemia due to the high concentration


CU-100 Insulin is preferred to U-500 due to the accuracy of the dosing



EThe patient should be counseled on the size of syringe they are using

If a person consumes 60 grams of carbohydrate per meal and it takes 6 units of insulin at meal time to keep the blood glucose levels within target, what is the carbohydrate to insulin ratio?


Answer


A2:1


B3:1


C5:1


D10:1


E1:1

D10:1

Which of the following is a correct statement regarding alpha-glucosidase inhibitor therapy?


Answer


AHypoglycemic episodes should be treated with glucose tablets or gel, or plain table sugar (sucrose).


BThis medicine can be used in patients with significant gastrointestinal conditions.


CTake on an empty stomach 30 minutes before eating.


DThe most common side effect is hypoglycemia.


EThese medications are used to lower post-prandial hyperglycemia.

EThese medications are used to lower post-prandial hyperglycemia.

Which of the following is a likely cause of Diabetic Ketoacidosis (DKA)?


Answer


AA patient stops taking metformin


BA patient stops taking insulin


CA patient stops taking repaglinide


DA patient doesn't eat for 2 days


EA patient eats more carbohydrates for 24 hours

BA patient stops taking insulin

Which of the following combinations is correct?


Answer


AEzetimibe-Pravastatin (Vytorin)


BGlyburide-Metformin (Glucovance)


CSitagliptin-Metformin (Kombiglyze)


DGlipizide-Metformin (Glucotrol)


EPioglitazone-Metformin (Avandamet)

BGlyburide-Metformin (Glucovance)

According to the American Diabetes Association, the treatment hemoglobin A1C goal for non-pregnant adults with diabetes should be:


Answer


A< 8%


B< 7%


C< 6.5%


D< 6%


E< 5.5%

B< 7%

Patients using exenatide should be counseled regarding the rare, but possible risk of:


Answer


ASevere headache due to risk of stroke


BSevere abdominal pain, with or without nausea due to risk of acute pancreatitis


CMore talkative than usual or pressure to keep talking due to risk of bipolar symptoms


DRacing heartbeat due to risk of arrhythmia


ESudden fecal discharge due to lack of fat absorption

BSevere abdominal pain, with or without nausea due to risk of acute pancreatitis

A female patient in the diabetes clinic has heard that Byetta can cause weight loss in some patients. She wishes to try it. You are going to counsel her on using Byetta. Which of the following instructions are correct?


Answer


ATake twice daily - with the first bite of your morning and evening meals (or before the two main meals of the day, at least 6 or more hours apart).


BTake three times daily; after breakfast, lunch and dinner.


CTake twice daily - within an hour after your morning and evening meals (or after the two main meals of the day, at least 6 or more hours apart).


DTake twice daily - within half hour after your morning and evening meals (or one-half hour before the two main meals of the day, at least 6 or more hours apart).


ETake twice daily - within an hour before your morning and evening meals (or before the two main meals of the day, at least 6 or more hours apart).

ETake twice daily - within an hour before your morning and evening meals (or before the two main meals of the day, at least 6 or more hours apart).

A patient is given insulin glargine and experiences hypoglycemia. Which of the following statements is correct?


Answer


AIt can be treated with ½ glass diet soda.


BThe hypoglycemia is likely to reappear and the blood glucose should be frequently monitored.


CInsulin glargine is more likely to cause hypoglycemia than NPH Insulin.


DInsulin glargine, unlike other insulins, does not cause hypoglycemia.


EInsulin glargine causes higher incidence of hypoglycemia compared to NPH


BThe hypoglycemia is likely to reappear and the blood glucose should be frequently monitored.

Which of the following are risk factors for type 2 diabetes? (Select ALL that apply.)


Answer


ANative American


BBMI ≥ 25 kg/m2


CNormotensive


DFirst-degree relative with diabetes


ETG > 150 mg/dL and/or HDL < 60 mg/dL

ANative American


BBMI ≥ 25 kg/m2



DFirst-degree relative with diabetes

An effective strategy for achieving blood glucose goals in a person with type 1 diabetes is:


Answer


ASevere caloric restriction


BEating meals and snacks at specific times


CIncreasing NPH insulin if carbohydrate intake exceeds usual consumption


DIntegrating insulin regimen into usual eating habits


EAdding Starlix or Prandin 15 minutes before each meal

DIntegrating insulin regimen into usual eating habits

JT is a 35 y/o, 5'5", 65 kg female with a history of type 1 diabetes. Her current insulin regimen is:



8 units NPH and 2 units lispro before breakfast (7 am)


2 units lispro before lunch (12 pm)


2 units lispro before dinner (6 pm)


4 units NPH at bedtime (10 pm).



Her blood glucose value ranges are as follows:



Before breakfast: 100-120 mg/dL


After lunch: 200-220 mg/dL


After dinner: 110-130 mg/dL


At bedtime: 130-150 mg/dL



Using the above case, which of the following would be the most appropriate recommendation?


Answer


AIncrease bedtime NPH dose


BIncrease before breakfast lispro dose


CIncrease before lunch lispro dose


DIncrease bedtime lispro dose


EIncrease before breakfast NPH dose


CIncrease before lunch lispro dose

Which of the following are true regarding the Novolog Flexpen? (Select ALL that apply.)


Answer


AThe Flexpen should not be used if the insulin is cloudy or viscous.


BAfter the Flexpen has been used once, it can be stored at room temperature outside of the refrigerator.


CPatients are able to give themselves an accurate dose of insulin simply by dialing the correct number.


DThe Flexpen has disposable needles so that it can be reused on different patients in the hospital setting.


EEach Flexpen contains 5 milliliters of insulin.

AThe Flexpen should not be used if the insulin is cloudy or viscous.


BAfter the Flexpen has been used once, it can be stored at room temperature outside of the refrigerator.


CPatients are able to give themselves an accurate dose of insulin simply by dialing the correct number.

Angela, a patient with diabetes, complains to her doctor that she has trouble sleeping because her feet “burn so badly.” The physician explains that she may be experiencing neuropathic pain, a microvascular complication of diabetes. Other types of microvascular complications could include: (Select ALL that apply.)


Answer


ARetinopathy


BCoronary artery disease


CErectile dysfunction


DCerebrovascular accident


ENephropathy

ARetinopathy



CErectile dysfunction



ENephropathy

The current American Diabetes Association (ADA) guidelines for goals of therapy in type 2 diabetes are as follows:


Answer


APreprandial blood glucose 90-150 mg/dL and peak postprandial blood glucose < 180 mg/dL


BPreprandial blood glucose 70-130 mg/dL and peak postprandial blood glucose < 180 mg/dL


CPreprandial blood glucose 80-110 mg/dL and peak postprandial blood glucose < 180 mg/dL


DPreprandial blood glucose 100-120 mg/dL and peak postprandial blood glucose < 140 mg/dL


ENone of the above

BPreprandial blood glucose 70-130 mg/dL and peak postprandial blood glucose < 180 mg/dL

What is the primary mechanism of action of metformin?


Answer


ADecreasing appetite


BImproving insulin sensitivity in the skeletal muscle cells


CDecreasing the amount of glucose released by the liver


DIncreasing glucagon production


EImproving insulin sensitivity in the gut lining


CDecreasing the amount of glucose released by the liver

A newly diagnosed type 1 diabetes patient is going to be started on insulin at 0.6 units/kg/day. The patient is 5'6" and weighs 70 kg. The physician wants to use a basal-bolus strategy with Levemir and NovoLog. What would be the recommended starting doses using Levemir and NovoLog?


Answer


ALevemir 28 units QHS and NovoLog 5 units before breakfast, lunch and dinner


BLevemir 39 units QHS and NovoLog 1 unit before breakfast, lunch and dinner


CLevemir 20 units QHS and NovoLog 10 units before breakfast, lunch and dinner


DLevemir 14 units QHS and NovoLog 9 units before breakfast, lunch and dinner


ELevemir 21 units QHS and NovoLog 7 units before breakfast, lunch and dinner

ELevemir 21 units QHS and NovoLog 7 units before breakfast, lunch and dinner

Which of the following drugs stimulates insulin secretion from functioning beta cells?


Answer


AAmaryl


BFortamet


CCycloset


DOnglyza


ESymlin

AAmaryl

What is the primary cause of type 1 diabetes?


Answer


AObesity


BFamily history


CAutoimmune destruction of pancreatic beta cells


DAutoimmune destruction of hypothalamic beta cells


EAutoimmune destruction of pancreatic alpha cells

CAutoimmune destruction of pancreatic beta cells

Which of the following statements regarding Lantus therapy is correct? (Select ALL that apply.)


Answer


AIt comes in a 500 units/mL vial


BIt is cloudy in color


CIt is a long-acting, basal insulin


DIt should not be mixed with other insulins


EIt may be more easily administered using the SoloStar pen

CIt is a long-acting, basal insulin


DIt should not be mixed with other insulins


EIt may be more easily administered using the SoloStar pen

Which of the following statements are true regarding amylin? (Select ALL that apply.)


Answer


AAmylin slows gastric emptying.


BAmylin suppresses glucagon output by the pancreatic alpha cells.


CAmylin increases satiety.


DAmylin is secreted from pancreatic beta cells.


EAmylin secretion controls fasting plasma glucose more than post-prandial plasma glucose.

AAmylin slows gastric emptying.


BAmylin suppresses glucagon output by the pancreatic alpha cells.


CAmylin increases satiety.


DAmylin is secreted from pancreatic beta cells.

A patient currently uses 30 units of Lantus daily and 10 units of lispro with breakfast, lunch, and dinner. She is going to be started on pramlinitide and needs to be counseled on how to adjust her dose of insulin. Select the correct adjustments.


Answer


AReduce Lantus to 10 units and lispro to 5 units with meals


BReduce Lantus to 15 units and keep lispro at 10 units with meals


CDo not adjust Lantus and reduce lispro to 5 units with meals


DDo not adjust Lantus or lispro


EReduce Lantus to 15 units and lispro to 5 units with meals

CDo not adjust Lantus and reduce lispro to 5 units with meals

Which of the following brand/generic pairs is correct?


Answer


AMiglitol - Glucophage


BNateglinide - Starlix


CAcarbose -Actos


DSaxagliptin - Januvia


EExenatide IR - Bydureon

BNateglinide - Starlix

If stored properly, how many days can a Levemir Flexpen be used for, counting the day it was first opened?


Answer


A30 days


B28 days


C14 days


D42 days


E15 days


D42 days

Which of the following is true about using an ACE inhibitor or ARB in patients with diabetes according to the ADA guidelines? (Select ALL that apply.)


Answer


APatients with diabetes should be screened for albuminuria at least yearly.


BACE inhibitors or ARBs are recommended for primary prevention of nephropathy in patients with diabetes who have normal blood pressure and no albuminuria.


CACE inhibitors or ARBs are recommended for primary prevention of nephropathy in patients with diabetes who have normal blood pressure and albuminuria.


DACE inhibitors or ARBs are recommended for secondary prevention of nephropathy in patients with diabetes who have normal blood pressure and albuminuria.


EAn ACE inhibitor combined with an ARB is recommended for primary prevention of nephropathy in patients with diabetes who have normal blood pressure and no albuminuria.

APatients with diabetes should be screened for albuminuria at least yearly.



CACE inhibitors or ARBs are recommended for primary prevention of nephropathy in patients with diabetes who have normal blood pressure and albuminuria.

Simon is hospitalized for Diabetic Ketoacidosis (DKA). Treatment of DKA generally includes which of the following therapies: (Select ALL that apply.)


Answer


AFurosemide


BNS or 1/2 NS


CInsulin


DPotassium


ED50W given IV


BNS or 1/2 NS


CInsulin


DPotassium

Ben comes to the pharmacy with a prescription for Invokana. Which of the following statements regarding Invokana are correct? (Select ALL that apply.)


Answer


AInvokana's site of action is at the proximal tubule of the kidney.


BInvokana is a sodium glucose co-transporter 2 agonist.


CInvokana is dosed 100 mg BID initially.


DInvokana can cause vaginal yeast infections and hyperkalemia.


EInvokana is contraindicated in patients with a CrCl < 30 mL/min.

AInvokana's site of action is at the proximal tubule of the kidney.



DInvokana can cause vaginal yeast infections and hyperkalemia.


EInvokana is contraindicated in patients with a CrCl < 30 mL/min.

In which of the following patients should daily low-dose aspirin be considered for primary prevention?


Answer


A43 year-old black female with T2DM


B54 year-old white male with T2DM and a history of heart attack


C61 year-old white female with T2DM and Framingham Risk Assessment of 15%


D66 year-old black male with T2DM and a history of GERD and ED


E49 year-old black male with T2DM and a history of hypertension

C61 year-old white female with T2DM and Framingham Risk Assessment of 15%

Which of the following is the correct brand name for metformin combined with sitagliptin?


Answer


AJentadueto


BMetaglip


CKombiglyze XR


DJanumet


EJuvisync


DJanumet

A hospitalized patient has been using Humulin 70/30, 70 units in the morning and 20 units at night. He is going to be switched to a regimen of lispro and detemir. Convert the NPH to detemir and round your answer to the nearest whole unit. Enter the number only in your answer; do not enter units.


63

Which of the following can precipitate hypoglycemia?


Answer


ALarge amounts of caffeine


BRapid weight gain


CInsufficient food intake


DElevations in liver enzymes caused by statins


ELarge amounts of Gatorade right after intense exercise

CInsufficient food intake

Maria is a 74 year old female with diabetes who presents with a non-healing ulcer on her left toe. Her physician states that it will be difficult to heal the ulcer unless her blood glucose (BG) values are tightly controlled. He writes the following order and discontinues her long-acting insulin:



BG < 60 mg/dL, hold insulin and contact MD


BG 150-200 mg/dL, give 2 units insulin


BG 201-250 mg/dL, give 4 units insulin


BG > 250 mg/dL, call MD.



What is this name for this type of order?


Answer


ATitrated log


BStep approach


CSliding scale


DCharting


EResponse rate treatment

CSliding scale

A patient with diabetes is using Humulin N twice daily and Humulin R three times daily. He currently uses a total of 90 units of insulin per day. Using a standard NPH-regular insulin regimen, how much NPH does he inject in the morning? Enter the number only in your answer; do not enter units.



30

When hyperosmolar hyperglycemic syndrome (HHS) occurs:


Answer


AThere is no insulin in the bloodstream


BThere is some insulin in the bloodstream that reduces hyperglycemia


CSevere dehydration and decreased renal function occur, which further increase hyperglycemia


DHyperglycemia is not as severe as that seen in diabetic ketoacidosis


EIt does not need to be treated as a medical emergency.

CSevere dehydration and decreased renal function occur, which further increase hyperglycemia

According to the American Diabetes Association (ADA), a person with diabetes should keep their fasting blood glucose within this range:


Answer


A60-100 mg/dL


B100-150 mg/dL


C70-130 mg/dL


D110-140 mg/dL


E130-180 mg/dL

C70-130 mg/dL