18 Oct Which of the following medical conditions will determine Helen’s diabetes treatment regimen?

I understand the value of doing my own work and learning this skill to support my future independent practice as a nurse practitioner.  I understand that while there may be opportunities beyond my faculty’s control to collaborate or share answers with peers, that it would not benefit my own personal and professional growth to do so.  I agree to do my own work and take personal responsibility for my learning. 

 

Question 2 Use the Helen Smith case study to answer the following question.

 

Which of the following medical conditions will determine Helen’s diabetes treatment regimen?

 

   Dyslipidemia

 

   Obesity

 

   Heart Failure

 

   Osteoarthritis

 

Question 3 Use the Helen Smith case study to answer the following question.

 

Which of the following agents should be prescribed for Helen? (Independent searching may be required to find the answer to this question)

 

   Glimepiride

 

   Pioglitazone

 

Dapagliflozin

 

   Glipizide

 

Question 4 What are the Black Box Warnings associated with NSAIDs? Select all that apply.

 

Increases risk for serious skin reactions

 

   Increases all-cause mortality

 

Increases risk for cardiovascular thrombotic event

 

   Increases risk for GI bleeding, ulceration, and perforation

 

Black Box warning on NSAIDs:

 

Question 5 Use the Helen Smith case study to answer the following question.

 

There is still one important issue to address with Helen today.  Which of the following concerns requires addressing?

 

 Cholesterol

 

Weight

 

   Fatigue

 

   Heart failure

 

Question 6 Use the Helen Smith case study to answer the following question.

 

If the standard starting dose of levothyroxine 1.6 mcg/kg/dose is prescribed for Helen, what is the correct dose?

 

175mcg

 

   200mcg

 

   300mcg

 

   150mcg

 

Question 7 Use the Helen Smith case study to answer the following question.

 

Helen’s has abnormal thyroid values:

 

TSH 24 mU/L

 

Free T4 0.2 ng/dl

 

What condition do these tests indicate?

 

   Hashimoto’s thyroiditis

 

   Hyperthyroidism

 

Hypothyroidism

 

   Grave’s Disease

 

 Question 8 Use the Helen Smith case study to answer the following question.

 

What is the daily maximum dose of levothyroxine?

 

1000mcg/day

 

300mcg/day

 

500mcg/day

 

700mcg/day

 

Question 9 Use the Helen Smith case study to answer the following question.

 

Which of the following lab values require consideration for possible treatment?

 

LDL?120mg/dl

 

   Free T4 0.2 ng/dl

 

   TSH 24 mU/L

 

Hgb?15.3?g/dL

 

Hct?48%

 

AST?(aspartate aminotransferase): 20

 

HDL?35?mg/dl

 

Triglycerides?260?mg/dl

 

Total?Cholesterol?240?mg/dl

 

   ALT?(alanine aminotransferase): 18 U/L

 

   Alkaline phosphatase: 50 U/L

 

The following lab values require consideration for possible treatment as they are not within normal limits:

 

Total?Cholesterol?240?mg/dl?

 

HDL?35?mg/dl?

 

LDL?120mg/dl?

 

Triglycerides?260?mg/dl?

 

TSH 24 mU/L

 

Free T4 0.2 ng/dl

 

 Question 10 Use the Helen Smith case study to answer the following question.

 

Which of the following drug classes should be prescribed for Helen? 

 

SGLTi

 

DPP-4i

 

GLP-1

 

   Biguanide

 

Question 11 Use the Helen Smith case study to answer the following question.

 

Which medication should be prescribed for Helen to address her thyroid levels?

 

Triiodothyronine

 

   Propylthiouracil

 

Methimazole

 

Levothyroxine

 

Question 12 Use the Helen Smith case study to answer the following question.

 

Why is caution indicated if metformin was prescribed for Helen?

 

 Because heart failure can predispose patients to lactic acidosis.

 

   Because metformin interacts with her Irbesartan.

 

Because only diabetic medication should be prescribed.

 

Because metformin is contraindicated with her age.

 

Question 13 Use the Helen Smith case study to answer the following question.

 

Which DM drug class is contraindicated in patients with heart failure?

 

GLP-1

 

Sulfonylurea

 

Biguanide

 

TZD

 

Question 14 Use the Helen Smith case study to answer the following question.

 

Which of the following criteria support’s Helen’s diagnosis of DM? Select all that apply.

 

Triglycerides?260?mg/dl

 

nocturia

 

polyuria

 

T.?Cholesterol?240?mg/dl

 

HgbA1C: 9.2%

 

Question 15 Use the Helen Smith case study to answer the following question.

 

Medication lists should always be reviewed for evidence-based prescribing practices. Helen is taking Naproxen 500 mg PO every 12 hours.

 

 What is the maximum dose of Naproxen per day (for 6 months)?

 

   2000mg per day

 

   1500mg per day

 

   1000mg per day

 

   2500mg per day

 

Question 16 Use the Helen Smith case study to answer the following question.

 

Which of the following is the recommended initial dose of levothyroxine for the general population?  

 

1.2mcg/kg/dose daily

 

1.6 mcg/kg/dose daily

 

1.8 mcg/kg/dose daily

 

2.0 mcg/kg/dose daily

 

Question 17 Which of the following diabetic drug classes should be prescribed with metformin for a patient with a BMI of 52? Select all that apply. 

 

TZD

 

SGLT2i

 

Insulin

 

GLP-1

 

   DPP-4i

 

Question 18 Exercise is recommended for all youth with type 1 diabetes with the goal of ____ min of moderate-to-vigorous intensity aerobic activity daily, with vigorous muscle-strengthening and bone-strengthening activities at least __ days per week.?

 

   45;5

 

30;3

 

50;5

 

60;3

 

Question 19 Which of the following agents are recommended when hypoglycemia is a concern? Select all that apply, 

 

SGLT2i

 

TZD

 

GLP-1

 

DPP-4i

 

Sulfonylurea

 

Insulin

 

Question 20 Which of the following is the preferred medication for treating hyperglycemia in gestational diabetes? 

 

Metformin

 

GLP-1

 

SGLT2i

 

Insulin

 

TZD

 

Glyburide

 

DPP-4i

 

 Question 21 Match the A1C testing recommendations to the correct patient.  

 

Perform the A1C test?at least?two times a year

 

Perform the A1C test quarterly

 

A1C Testing

 

Recommendations

 

6.1?Perform the A1C test?at least?two times a year in patients who are meeting treatment goals (and who have stable glycemic control).?E

 

6.2?Perform the A1C test quarterly in patients whose therapy has changed or who are not meeting glycemic goals.?E

 

6.3?Point-of-care testing for A1C provides the opportunity for more timely treatment changes.?E

 

Question 22 When considering older adults in the treatment and management of diabetes, what special considerations apply? Select all that apply. 

 

Social geriatric domains

 

Screening for geriatric syndromes

 

   Mini-Cognitive Assessment Instrument

 

Self-management abilities

 

Question 23 According to the ADA Standards of Medical Care in Diabetes-2020, what are the goals of care for diabetes? Select all that apply.

 

Empower patients to manage their own disease process

 

   Prevent diabetic complications

 

Maintain constant control of blood sugar

 

   Optimize quality of life

 

 Question 24 Which of the following DM drug class has a warning that it can cause severe and disabling joint pain at any point in time during treatment?

 

 Glyburide

 

GLP-1

 

TZD

 

   SGLT2i

 

   Metformin

 

Insulin

 

DPP-4i

 

DPP-4i has a warning that these medications can cause severe and disabling joint pain at any point in time during treatment.

 

 Question 25 In youth who are overweight or obese and have a new onset of diabetes with an A1C>8.5%, how much basal insulin is recommended? 

 

1 unit/kg/day

 

0.5 units/kg/day

 

0.1 units/kg/day

 

   0.8 units/kg/day

 

Question 26 Which of the following hypertension drug classes are NOT recommended for the primary prevention of chronic kidney disease in patients who have diabetes with normal blood pressure and GFR?  (Select all that apply)

 

Thiazide diuretics

 

Angiotensin converting enzyme inhibitors

 

Calcium channel blockers

 

Angiotensin II receptor blockers

 

11.9?

 

Question 27 A diabetic construction worker is seen for follow-up care. He has been taking metformin 1000mg PO twice daily for the last 3 months and his A1C is 8.7.  Which section of the Standards of Medical Care in Diabetes—2020 best describes his treatment plan? 

 

Compelling need to minimize weight gain or promote weight loss

 

Compelling need to minimize hypoglycemia

 

ASCVD Predominates

 

Cost is a major issue

 

Question 28 Which of the following exams is important for diabetics and requires a referral? 

 

Foot exam

 

Eye exam

 

   Gait evaluation

 

   Colonoscopy

 

Question 29 A single mom who makes minimum wage and struggles financially needs an additional diabetic medication after experiencing minimal A1C improvement with metformin.  Which of the following DM drugs is appropriate? Select all that apply. 

 

Sitagliptin

 

Dulaglutide

 

   Glucophage

 

Canagliflozin

 

Pioglitazone

 

Glyburide

 

Humalog

 

Question 30 Which classes of oral diabetic drugs carry a higher risk for hypoglycemia?

 

   SGLT-2 inhibitors

 

α-glucosidase inhibitors

 

Sulfonylureas

 

Biguanides

 

Glinides