NAECB Patient Assessment 4 — Questions and Answers
Question 1: A patient reports using herbal supplements to 'control blood sugar.' Which supplement has the MOST evidence for potential hypoglycemic interaction with diabetes medications?
- Echinacea
- Ginseng (Correct answer)
- St. John's Wort
- Valerian root
Correct answer: Ginseng
Ginseng has documented evidence of lowering blood glucose and can potentiate the effects of insulin and oral hypoglycemic agents.
Question 2: When assessing a pediatric patient with type 1 diabetes, which developmental consideration is MOST important for self-management assessment?
- Parent's knowledge of carbohydrate counting
- Child's cognitive developmental stage and capacity for self-care (Correct answer)
- School nurse availability
- Number of daily insulin injections
Correct answer: Child's cognitive developmental stage and capacity for self-care
Assessing the child's developmental stage determines what aspects of diabetes management they can reasonably handle independently.
Question 3: A patient with gastroparesis and type 1 diabetes reports unpredictable postprandial glucose spikes. Which assessment finding MOST explains this pattern?
- Delayed gastric emptying causing mismatch between insulin peak and glucose absorption (Correct answer)
- Excessive carbohydrate intake at meals
- Incorrect insulin-to-carb ratio
- Dawn phenomenon effect
Correct answer: Delayed gastric emptying causing mismatch between insulin peak and glucose absorption
Gastroparesis delays gastric emptying, causing glucose absorption to be unpredictable and mismatched with the timing of rapid-acting insulin.
Question 4: During a comprehensive diabetes assessment, the CDCES notes the patient has a BMI of 38. Which additional assessment is MOST clinically relevant?
- Thyroid function tests
- Sleep quality and obstructive sleep apnea screening (Correct answer)
- Bone density screening
- Pulmonary function testing
Correct answer: Sleep quality and obstructive sleep apnea screening
Obstructive sleep apnea is highly prevalent in people with obesity and diabetes and negatively impacts glucose control; screening is essential.
Question 5: A CDCES is reviewing a patient's time-in-range (TIR) CGM data. A TIR of 70% or above indicates glucose levels within which target range for most adults with diabetes?
- 54–140 mg/dL
- 70–180 mg/dL (Correct answer)
- 80–200 mg/dL
- 100–160 mg/dL
Correct answer: 70–180 mg/dL
The standard TIR target range for most adults with diabetes is 70–180 mg/dL, with a goal of spending at least 70% of time in this range.
Question 6: Which finding during a diabetes eye assessment referral triage would require the MOST urgent ophthalmology referral?
- Background (nonproliferative) diabetic retinopathy
- Microaneurysms noted on last exam
- Sudden vision changes and floaters (Correct answer)
- No eye exam in the past 12 months
Correct answer: Sudden vision changes and floaters
Sudden vision changes and floaters may indicate vitreous hemorrhage or retinal detachment, which are emergencies requiring urgent ophthalmology care.
Question 7: A patient recently started a GLP-1 receptor agonist. Which assessment finding would require IMMEDIATE clinical follow-up?
- Nausea and decreased appetite in week one
- Mild injection site redness
- Severe persistent abdominal pain radiating to the back (Correct answer)
- Weight loss of 2 lbs in two weeks
Correct answer: Severe persistent abdominal pain radiating to the back
Severe persistent abdominal pain radiating to the back may indicate pancreatitis, a serious adverse effect associated with GLP-1 receptor agonists.
NAECB Patient Assessment 4
A patient reports using herbal supplements to 'control blood sugar.' Which supplement has the MOST evidence for potential hypoglycemic interaction with diabetes medications?