BC ADM Insulin Therapy 5

Question 1

A patient with CKD stage 4 (eGFR 22 mL/min) requires insulin dose adjustment because:

Accepted Answer

Reduced renal insulin clearance prolongs insulin action and increases hypoglycemia risk

Answer

The kidneys clear approximately 30–40% of circulating insulin; as renal function declines, insulin half-life is prolonged, increasing hypoglycemia risk and requiring dose reduction.

Question 2

Which technique most effectively prevents insulin leakage after subcutaneous pen injection?

Accepted Answer

Hold the pen in place for 10 seconds after delivering the full dose before withdrawing

Answer

Keeping the needle in place for at least 10 seconds after dose delivery allows the insulin to disperse and prevents backflow through the needle track.

Question 3

Intravenous insulin infusion protocols in the ICU are preferred over subcutaneous insulin primarily because IV administration:

Accepted Answer

Allows precise, titratable glucose control with rapid dose adjustments

Answer

IV insulin has immediate onset and offset, enabling precise glycemic control with rapid titration in response to the rapidly changing metabolic state of critically ill patients.

Question 4

A patient is prescribed concentrated insulin glargine U-300. Compared to U-100 glargine, which statement is accurate?

Accepted Answer

U-300 glargine has a flatter, more prolonged action profile than U-100 glargine

Answer

U-300 glargine forms a more compact subcutaneous depot that dissolves more slowly, yielding a flatter pharmacodynamic profile and longer duration (up to 36 hours) than U-100 glargine.

Question 5

The extended-release insulin icodec (once-weekly basal insulin) achieves its prolonged half-life primarily through:

Accepted Answer

Strong reversible binding to albumin via a fatty acid chain, reducing free insulin fraction

Answer

Insulin icodec contains a C20 fatty di-acid moiety that allows strong, reversible albumin binding, dramatically reducing free insulin and extending its half-life to ~196 hours.

(BC ADM) Advanced Diabetes Management Certification Practice Test

(BC ADM) Advanced Diabetes Management Certification Practice Test

BC ADM Insulin Therapy 5