BC ADM Medication & Therapeutic Interventions 3

Question 1

Which rapid-acting insulin analog has the fastest onset of action and is approved for dosing up to 20 minutes after meal start?

Accepted Answer

Faster insulin aspart (Fiasp)

Answer

Faster insulin aspart (Fiasp) contains niacinamide and L-arginine that accelerate initial absorption, giving it an onset of 2.5 minutes and FDA approval for dosing at the start of or up to 20 minutes after meal initiation.

Question 2

A patient on insulin pump therapy presents with persistent hyperglycemia despite multiple bolus corrections. The most likely cause and immediate intervention is:

Accepted Answer

Infusion site occlusion or catheter failure; change the infusion set and site

Answer

Persistent hyperglycemia unresponsive to bolus corrections in pump therapy most commonly indicates an infusion set or catheter problem, requiring immediate set and site change and often a corrective injection.

Question 3

Colesevelam's glucose-lowering mechanism in T2DM is best described as:

Accepted Answer

Altering bile acid metabolism to improve FXR-mediated glucose homeostasis

Answer

Colesevelam binds bile acids in the intestine, altering the enterohepatic bile acid pool and activating farnesoid X receptor (FXR) pathways that improve hepatic and peripheral glucose metabolism.

Question 4

When initiating a GLP-1 receptor agonist, the primary reason for starting at the lowest dose and titrating slowly is to:

Accepted Answer

Minimize gastrointestinal side effects including nausea and vomiting

Answer

GLP-1 receptor agonists commonly cause dose-dependent nausea and vomiting due to delayed gastric emptying; slow titration allows GI accommodation and improves adherence.

Question 5

A 68-year-old patient with T1DM on multiple daily injections frequently experiences nocturnal hypoglycemia. Which intervention is most appropriate?

Accepted Answer

Transition to a hybrid closed-loop insulin delivery system

Answer

Hybrid closed-loop systems automatically suspend or reduce basal insulin delivery when glucose is predicted to drop, significantly reducing nocturnal hypoglycemia in T1DM patients.

(BC ADM) Advanced Diabetes Management Certification Practice Test

(BC ADM) Advanced Diabetes Management Certification Practice Test

BC ADM Medication & Therapeutic Interventions 3