Diabetes Test 3

Question 1

Take into account the following patient: a 46-year-old male with type 2 diabetes, moderate hypertension, hyperlipidemia, and a BMI of 26 who was previously sedentary.
If this patient intends to begin a moderate-intensity exercise plan, what additional assessment may be warranted?

Accepted Answer

Stress test with ECG (electrocardiogram)

Answer

DEXA scan to assess bone density and strength

Answer

None, as BP and cholesterol are being controlled and exercise is only moderate intensity

Answer

Ankle-brachial index to rule out peripheral arterial disease

Question 2

Your DSME program should include the following guidelines: inviting family members to join, asking patients about any food preferences or limits, and being mindful of your speaking rate and tone of voice. What particular type of consideration are these policies addressing?

Accepted Answer

Cultural characteristics/barriers of your population

Answer

Readiness for change variation among your patients

Answer

Poor family and social support

Answer

Potential low literacy/numeracy levels among your patients

Question 3

It's critical to identify any potential obstacles to patients who are not following the instructions in their care plan when it comes to self-monitoring blood glucose. Which of the following was not a barrier that patients in recent research mentioned?

Accepted Answer

Misplacement of small items

Answer

Cost of testing supplies

Answer

Discomfort of finger sticks

Answer

Lack of instruction and support

Question 4

Which of the following behaviors is the surest sign that the patient is only very minimally change-ready?

Accepted Answer

The patient denies that she has diabetes and disagrees with the doctor’s referral for DSME

Answer

The patient watches your demonstration but does not say anything

Answer

The patient volunteers to answer a review question at the end of class but gets the answer totally wrong

Answer

The patient becomes tearful as you explain how to keep a food diary

Question 5

You evaluate patients in your capacity as a clinic's diabetes educator while also educating them on a range of self-care techniques. Which instructional approach offers the best chance to evaluate and instruct students on insulin self-administration?

Accepted Answer

A demonstration and return demonstration of insulin administration

Answer

A written quiz in which the patient puts insulin administration steps in order

Answer

A printed handout with pictures depicting steps of insulin administration, followed by verbal acknowledgement of understanding

Answer

A video that can be viewed and reviewed on proper insulin administration technique

Question 6

Which of the following related medical nutrition therapy and diabetes is untrue, as per ADA Standards?

Accepted Answer

Medical nutrition therapy is recommended for only those persons with diabetes who are underweight, overweight, or obese

Answer

Medical nutrition therapy is recommended for anyone who has diabetes, regardless of nutritional status

Answer

Because nutrition in the hospital setting is complex, a registered dietitian should be part of the inpatient diabetes care team to provide medical nutrition therapy

Answer

Children with diabetes and celiac disease should consult with a registered dietitian familiar with both conditions

Question 7

What is the ideal glycemic target for pregnant women with previous diabetes (provided the target can be attained without extreme hypoglycemia) as per the ADA consensus statement on managing preexisting diabetes for pregnancy (2008)?

Accepted Answer

Pre-meal/fasting glucose: 60 to 99 mg/dL; peak postprandial: <129 mg/dL; A1c <6%

Answer

Pre-meal/fasting glucose: 70 to 100 mg/dL; peak postprandial: <120 mg/dL; A1c <6.5%

Answer

Pre-meal/fasting glucose: 70 to 110 mg/dL; peak postprandial: <140 mg/dL; A1c <7%

Answer

Pre-meal/fasting glucose: 60 to 90 mg/dL; peak postprandial: <120 mg/dL; A1c <5.5%

Question 8

Which teaching approach is most likely to increase patient retention?

Accepted Answer

Small group discussion around a table where patients teach each other a skill after seeing it explained and demonstrated by the educator

Answer

Current, well-referenced booklets with colorful diagrams, written at a patient’s optimal reading level, that can be reviewed as desired

Answer

PowerPoint presentation with funny visuals and bullet list of main points

Answer

One-on-one conversation over the phone where the educator presents information and then rephrases the information using analogies to ensure understanding

Question 9

Which patient record component is most crucial to take into account when determining the risk of hypoglycemia in relation to exercise?

Accepted Answer

Medication regimen: types, dose, and timing

Answer

The patient’s typical signs and symptoms with hypoglycemia

Answer

Current patient physical/glycemic status (wt., BMI, A1c)

Answer

Timing and content (i.e. carb content) of meals in relation to the activity

Question 10

A patient with gestational diabetes (GDM) believes she got the condition as a result of overindulging in her favorite snack, popcorn, in the first trimester. She is adamant that if she doesn't eat anything else while she is pregnant, she won't need to start taking insulin, and her blood glucose levels will go back to normal. What emotional stage (akin to the Kubler-Ross phases of grief) is connected to the diagnosis of a chronic condition that you evaluate in your patient?

Accepted Answer

Bargaining

Answer

Anger

Answer

Frustration & depression

Answer

Denial

Take into account the following patient: a 46-year-old male with type 2 diabetes, moderate hypertension, hyperlipidemia, and a BMI of 26 who was previously sedentary.If this patient intends to begin a moderate-intensity exercise plan, what additional assessment may be warranted?

Take into account the following patient: a 46-year-old male with type 2 diabetes, moderate hypertension, hyperlipidemia, and a BMI of 26 who was previously sedentary.
If this patient intends to begin a moderate-intensity exercise plan, what additional assessment may be warranted?