Mixed Deck — All Diabetes Topics Flashcards

A patient with Type 1 diabetes is starting on an insulin pump. Which insulin type is exclusively used in most insulin pumps?

Answer: Rapid-acting insulin (e.g., lispro, aspart, or glulisine)

Insulin pumps use only rapid-acting insulin, delivering small continuous doses for basal coverage and larger boluses for meals.

Which enzyme system is used in most modern electrochemical blood glucose test strips?

Answer: Glucose oxidase or glucose dehydrogenase

Most modern test strips use glucose oxidase (GOx) or glucose dehydrogenase (GDH) to catalyze the electrochemical reaction that quantifies glucose.

When evaluating a patient's diabetes distress, which validated screening instrument is specifically designed for this purpose?

Answer: Diabetes Distress Scale (DDS)

The Diabetes Distress Scale (DDS) specifically measures emotional burden related to diabetes self-management, unlike general mental health tools.

A child with Type 1 diabetes has a blood glucose of 55 mg/dL and is conscious. What is the first action?

Answer: Give 15g of fast-acting carbohydrates orally

The 15-15 rule states: give 15g of fast-acting carbs, wait 15 minutes, recheck; oral treatment is first-line for a conscious patient.

Which of the following is NOT a symptom of hyperglycemia?

Answer: Trembling and diaphoresis

Trembling and diaphoresis (sweating) are classic symptoms of hypoglycemia, not hyperglycemia.

The nurse's top goal when a patient with hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is to offer:

Answer: Fluid replacement

Hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is characterized by extreme hyperglycemia, severe dehydration, and hyperosmolarity. The most critical initial intervention is aggressive intravenous fluid replacement to correct the profound dehydration and restore circulatory volume. This also helps to gradually lower blood glucose levels and improve overall patient stability.

What is the key benefit of evidence-based decision making in Diabetes management?

Answer: It improves accuracy and reduces bias in decisions

Evidence-based decision making uses data and research to improve the accuracy of decisions and reduce the influence of personal bias.

How can educators help patients overcome diabetes-related misconceptions?

Answer: By addressing misconceptions and providing clear information

To help patients overcome diabetes-related misconceptions, educators must directly address these beliefs with empathy and provide accurate, clear, and evidence-based information. Simply ignoring misconceptions or using complex jargon can lead to confusion and hinder effective self-management. A clear, factual approach builds trust and promotes understanding.

According to ADCES professional practice standards, what is the minimum recommended frequency for reviewing individualized diabetes education goals with a patient?

Answer: At least annually

DSMES standards recommend reviewing and updating individualized goals at least annually to reflect changes in health status and life circumstances.

NPH insulin is classified as which type of insulin?

Answer: Intermediate-acting

NPH (Neutral Protamine Hagedorn) is an intermediate-acting insulin with onset in 1–2 hours and peak at 4–12 hours.

Which approach best demonstrates mastery of nutrition and diet in Diabetes practice?

Answer: Applying principles to novel situations with sound judgment

True mastery involves understanding underlying principles well enough to apply them to new and unfamiliar situations with professional judgment.

What physiological change primarily explains why postprandial glucose spikes are higher in type 2 diabetes compared to healthy individuals?

Answer: Impaired first-phase insulin secretion

In type 2 diabetes, the rapid first-phase insulin burst that normally blunts postprandial glucose is blunted or absent, causing exaggerated glucose peaks after eating.

Which statement about premixed insulin (e.g., 70/30) is accurate?

Answer: It combines a fixed ratio of intermediate and rapid- or short-acting insulin, limiting dose flexibility

Premixed insulins contain a fixed ratio of components, which limits the ability to independently adjust basal and bolus portions to match varying meal sizes and activity levels.

Which foundational principle is MOST important for success in the Diabetes profession?

Answer: Commitment to continuous learning, ethical practice, and quality outcomes

Success in any professional field requires a commitment to continuous learning to stay current, ethical practice to maintain trust and integrity, and a focus on quality outcomes that serve stakeholders and the public interest.

A patient asks why their insulin pump uses only rapid-acting insulin for both boluses and basal delivery. What is the correct explanation?

Answer: The pump mimics the pancreas by delivering small continuous doses of rapid-acting insulin, eliminating the need for long-acting formulations

Insulin pumps deliver rapid-acting insulin continuously in micro-doses to replicate basal secretion and larger boluses at mealtimes, making separate long-acting insulin unnecessary.

A patient using rapid-acting insulin analog should inject it at what time relative to meals?

Answer: 0–15 minutes before or immediately after starting a meal

Rapid-acting analogs (lispro, aspart, glulisine) have a rapid onset and should be given just before or at the start of a meal.

What is the recommended daily sodium intake for adults with diabetes who also have hypertension?

Answer: Less than 1,500 mg

The ADA recommends limiting sodium to less than 1,500 mg per day for people with diabetes and hypertension to protect cardiovascular health.

A patient with type 2 diabetes presents with tingling and numbness in both feet symmetrically. Which complication is most likely?

Answer: Distal symmetric polyneuropathy

Distal symmetric polyneuropathy is the most common form of diabetic nerve damage, causing bilateral tingling, numbness, and pain starting in the feet.

A patient's fasting blood glucose is consistently elevated despite adequate evening basal insulin. The most likely explanation is:

Answer: The Somogyi effect — nocturnal hypoglycemia followed by rebound

The Somogyi effect (rebound hyperglycemia) occurs when nocturnal hypoglycemia triggers counter-regulatory hormone release, raising morning glucose.

A patient reports genital mycotic infections since starting a new diabetes medication. Which drug class is most likely responsible?

Answer: SGLT-2 inhibitors

SGLT-2 inhibitors increase urinary glucose excretion, creating a favorable environment for genital yeast infections.