Safety & Risk Management Flashcards
7 cards from real BC ADM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Safety & Risk Management flashcards as text
A patient with type 2 diabetes and heart failure is being considered for an SGLT2 inhibitor. Which safety concern requires evaluation BEFORE initiating therapy?
Answer: eGFR below 20 mL/min/1.73 m², which may limit efficacy and safety
SGLT2 inhibitors lose glycemic efficacy at very low eGFR and carry risks of volume depletion and genitourinary infections that must be weighed against cardiovascular benefits.
Which patient scenario represents the HIGHEST risk for glucagon kit failure in an emergency?
Answer: The patient's glucagon kit has expired and caregivers have not received training
An expired kit combined with untrained caregivers represents a compounding safety failure that could result in a fatal hypoglycemic event.
When counseling a patient with diabetes about sick-day management, which instruction is MOST important regarding insulin?
Answer: Never stop taking insulin even if not eating, as illness raises glucose and increases insulin demand
Counter-regulatory hormones released during illness increase glucose and can precipitate DKA, so insulin should never be withheld even when oral intake is reduced.
A patient reports driving long distances and using CGM for glucose monitoring. What safety recommendation is MOST appropriate?
Answer: Confirm glucose ≥ 90 mg/dL with a fingerstick before driving and every 2 hours on long trips
CGM can have calibration lag, so fingerstick confirmation before driving is recommended; glucose should be above 90 mg/dL to provide a safety buffer.
Which complication is MOST associated with prolonged undetected hyperglycemia in a patient using an insulin pump?
Answer: Diabetic ketoacidosis due to subcutaneous infusion set occlusion
Pump users receive only rapid-acting insulin; an occlusion eliminates all insulin delivery and rapidly leads to DKA within hours.
A hospitalized patient with diabetes is transitioned from an IV insulin infusion to subcutaneous insulin. When should the first subcutaneous dose be given relative to discontinuing the infusion?
Answer: Administer subcutaneous basal insulin 1–2 hours before stopping the infusion
Subcutaneous basal insulin requires 1–2 hours to begin working, so it must overlap with the IV infusion to prevent a gap in insulin coverage and rebound hyperglycemia.
Which of the following medications used in diabetes management carries a Black Box Warning for risk of lower limb amputation?
Answer: Canagliflozin (Invokana)
Canagliflozin carries an FDA Black Box Warning for increased risk of lower limb amputations, primarily at the toe and midfoot level.