Ambulatory Care Test Ambulatory Care Chronic Disease Management 2

Question 1

A patient with type 2 diabetes has an A1C of 9.2% despite metformin monotherapy. Which medication class is MOST appropriate to add given the patient also has established cardiovascular disease?

Accepted Answer

GLP-1 receptor agonist

Answer

GLP-1 receptor agonists (e.g., semaglutide, liraglutide) have demonstrated cardiovascular mortality benefit in patients with established CVD and are preferred add-on therapy per ADA guidelines.

Question 2

Which parameter is the BEST indicator of long-term glycemic control when monitoring a patient with diabetes in the ambulatory setting?

Accepted Answer

Hemoglobin A1C

Answer

Hemoglobin A1C reflects average blood glucose over the prior 2-3 months and is the standard measure for assessing long-term glycemic control.

Question 3

A 58-year-old with COPD uses a SABA inhaler daily and wakes with symptoms twice a week. According to GOLD guidelines, what is the MOST appropriate next step?

Accepted Answer

Step up to a LAMA or LABA

Answer

Frequent SABA use and nighttime symptoms indicate inadequate control; GOLD guidelines recommend adding a long-acting bronchodilator (LAMA or LABA) as first-line maintenance therapy.

Question 4

A patient with chronic kidney disease (CKD stage 3b) and hypertension is started on an ACE inhibitor. Which lab value requires close monitoring within 1-2 weeks of initiation?

Accepted Answer

Serum potassium and creatinine

Answer

ACE inhibitors can cause hyperkalemia and an acute rise in creatinine, particularly in CKD patients, requiring potassium and creatinine monitoring within 1-2 weeks of initiation.

Question 5

Which blood pressure target is recommended by ACC/AHA guidelines for most patients with hypertension and confirmed cardiovascular disease?

Accepted Answer

Less than 130/80 mmHg

Answer

ACC/AHA 2017 guidelines recommend a BP target of less than 130/80 mmHg for patients with established cardiovascular disease or high cardiovascular risk.

Ambulatory Care Test Practice Test

Ambulatory Care Test Practice Test

Ambulatory Care Test Ambulatory Care Chronic Disease Management 2