BC ADM Standards & Best Practices 5 — Questions and Answers
Question 1: According to ADA standards, what is the recommended frequency for foot examinations in patients with diabetes who have established peripheral neuropathy?
- Every 5 years
- Every 2 years
- Annually
- At every clinical visit (Correct answer)
Correct answer: At every clinical visit
Patients with established peripheral neuropathy are at high risk for foot ulceration and should receive a comprehensive foot exam at every clinical visit.
Question 2: Which of the following best describes the standard of care recommendation for aspirin use in primary prevention among adults with diabetes?
- Aspirin 81 mg daily is recommended for all adults with diabetes over age 40
- Aspirin should be considered for adults with diabetes at high cardiovascular risk with low bleeding risk (Correct answer)
- Aspirin is contraindicated in all patients with diabetes due to GI bleeding risk
- Aspirin 325 mg daily is the preferred dose for cardiovascular prevention in diabetes
Correct answer: Aspirin should be considered for adults with diabetes at high cardiovascular risk with low bleeding risk
Current ADA standards recommend low-dose aspirin for primary prevention only in adults with diabetes at increased cardiovascular risk where benefits outweigh bleeding risk.
Question 3: When counseling a patient with type 2 diabetes about carbohydrate intake, which approach is most consistent with current evidence-based nutrition standards?
- Prescribe a fixed 45g carbohydrate per meal for all patients
- Eliminate all carbohydrates for optimal glycemic control
- Individualize carbohydrate intake based on patient preferences, metabolic goals, and cultural patterns (Correct answer)
- Recommend only whole grains and restrict all other carbohydrate sources
Correct answer: Individualize carbohydrate intake based on patient preferences, metabolic goals, and cultural patterns
Current ADA nutrition standards emphasize individualized approaches that respect patient preferences and cultural practices rather than a single prescribed diet.
Question 4: In accordance with diabetes management standards, which vaccine is specifically recommended for all adults with diabetes regardless of age?
- Varicella (chickenpox) vaccine
- Hepatitis B vaccine (Correct answer)
- Meningococcal vaccine
- Japanese encephalitis vaccine
Correct answer: Hepatitis B vaccine
ADA recommends hepatitis B vaccination for unvaccinated adults with diabetes because they are at increased risk for hepatitis B outbreaks.
Question 5: According to quality improvement standards in diabetes care, which metric is most commonly used as a process measure to evaluate diabetes care quality in a clinical setting?
- Rate of emergency department visits for hypoglycemia
- Percentage of patients with HbA1c measured in the past year (Correct answer)
- Average weight loss achieved across the patient panel
- Number of diabetes education classes offered per quarter
Correct answer: Percentage of patients with HbA1c measured in the past year
The percentage of patients with at least one HbA1c measurement in the past year is a widely used HEDIS process measure for evaluating diabetes care quality.
Question 6: A clinician is reviewing standards for continuous glucose monitoring (CGM) in type 1 diabetes. Which time-in-range (TIR) target (70–180 mg/dL) is recommended for most adults with type 1 diabetes?
- Greater than 50%
- Greater than 60%
- Greater than 70% (Correct answer)
- Greater than 90%
Correct answer: Greater than 70%
International consensus guidelines and ADA recommend a TIR goal of greater than 70% (70–180 mg/dL) for most adults with type 1 diabetes.
Question 7: According to best practice standards for hypoglycemia management, what is the recommended initial treatment for a conscious adult patient with a blood glucose of 58 mg/dL?
- Administer 1 mg glucagon intramuscularly
- Consume 15–20 grams of fast-acting carbohydrate and recheck in 15 minutes (Correct answer)
- Drink 8 oz of whole milk and recheck in 30 minutes
- Eat a full meal immediately to stabilize blood glucose
Correct answer: Consume 15–20 grams of fast-acting carbohydrate and recheck in 15 minutes
The Rule of 15 recommends 15–20 grams of fast-acting carbohydrate followed by recheck in 15 minutes for conscious patients with mild to moderate hypoglycemia.
BC ADM Standards & Best Practices 5
According to ADA standards, what is the recommended frequency for foot examinations in patients with diabetes who have established peripheral neuropathy?