Integrated Chronic care Management For Diabetes: Pre-test

1.

Which statement is true about the incidence and prevalence of diabetes in the United States?
- A.
  
  Diabetes incidence is approximately two fold greater in Asian Americans, Native Americans and Hispanic Americans
- B.
  
  Many people are unaware they have diabetes until they experience diabetes related complications
- C.
  
  Diabetes type2 is more prevalent than DM type 1
- D.
  
  A. and B.
- E.
  
  B. and C.
Correct Answer
E. B. and C.

Explanation
The correct answer is B. and C. This is because the statement "Many people are unaware they have diabetes until they experience diabetes-related complications" is true, as diabetes can often go undiagnosed until symptoms become severe. Additionally, the statement "Diabetes type 2 is more prevalent than DM type 1" is also true, as type 2 diabetes is more common in the United States compared to type 1 diabetes.

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2.

The American Diabetes Association standards of care for diabetes is annual exam is:
- A.
  
  Hemoglobin A-1C
- B.
  
  Dilated eye exam
- C.
  
  BP and weight
- D.
  
  Comprehensive foot exam by a physician
- E.
  
  B. and C.
- F.
  
  B. and D.
Correct Answer
F. B. and D.

Explanation
The correct answer is B. and D. The American Diabetes Association recommends an annual dilated eye exam to detect any eye problems caused by diabetes. They also recommend regular monitoring of blood pressure and weight to manage and prevent complications associated with diabetes. Additionally, a comprehensive foot exam by a physician is also recommended to identify any foot-related issues that may arise due to diabetes. Therefore, options B. and D. are the correct choices as they include the recommended annual dilated eye exam and comprehensive foot exam.

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3.

The ADA guidelines specify...
- A.
  
  A blood pressure of > 130/80mmhg
- B.
  
  Triglycerides < 150mg/dl
- C.
  
  All of the above
- D.
  
  Hemoglobin A-1C < 7%
- E.
  
  None of the above
Correct Answer
E. None of the above
4.

A patient with Type 1 DM will need insulin due to absolute insulin deficiency.
- A.
  
  True
- B.
  
  False
Correct Answer
A. True

Explanation
A patient with Type 1 DM, also known as insulin-dependent diabetes mellitus, will need insulin due to absolute insulin deficiency. In Type 1 DM, the body's immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas, leading to a complete lack of insulin production. Without insulin, glucose cannot enter the cells to be used as energy, resulting in high blood sugar levels. Therefore, patients with Type 1 DM require external insulin administration to regulate their blood sugar levels and prevent complications.

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5.

Oral agents for Diabetes treatment:
- A.
  
  Can reduce HGA1C by up to 4%
- B.
  
  Two or more drug regimens are common to achieve goals
- C.
  
  Sulfonylureas are considered to be most effective
- D.
  
  Can reduce BP and lipids
- E.
  
  B. and C.
- F.
  
  A. and D.
- G.
  
  A. and D.
Correct Answer
E. B. and C.

Explanation
The correct answer is B. and C. The given options state that oral agents for diabetes treatment can reduce HGA1C by up to 4% and can also reduce blood pressure (BP) and lipids. This implies that both options B and C are correct. Option A is not correct because it only includes the first statement about reducing HGA1C but does not mention anything about reducing BP and lipids. Option D is not correct because it only includes the second statement about reducing BP and lipids but does not mention anything about reducing HGA1C.

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6.

Metformin can cause lactic acidosis and should be used with caution with patients with heart failure and renal impairment
- A.
  
  True
- B.
  
  False
Correct Answer
A. True

Explanation
Metformin, a commonly prescribed medication for diabetes, has been associated with the risk of lactic acidosis, a potentially life-threatening condition. Lactic acidosis occurs when there is an accumulation of lactic acid in the body. Patients with heart failure and renal impairment are already at a higher risk of developing lactic acidosis, and the use of metformin in these patients can further increase that risk. Therefore, it is important to exercise caution when prescribing metformin to patients with heart failure and renal impairment.

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7.

Which of the following should be included in sick day management instructions to Diabetes patients?
- A.
  
  Discontinue diabetes medication
- B.
  
  Test blood glucose less often than every 2 to 4 hours
- C.
  
  Try to eat foods from their meal plan and drink plenty of fluids
- D.
  
  All of the above
Correct Answer
C. Try to eat foods from their meal plan and drink plenty of fluids

Explanation
During sick days, it is important for diabetes patients to try to eat foods from their meal plan and drink plenty of fluids. This is because maintaining a balanced diet and staying hydrated can help regulate blood sugar levels and prevent complications. Discontinuing diabetes medication is not recommended as it can lead to uncontrolled blood sugar levels. Testing blood glucose less often than every 2 to 4 hours is also not advisable as it is important to monitor and adjust medication or insulin doses accordingly. Therefore, the correct answer is to try to eat foods from their meal plan and drink plenty of fluids.

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8.

Which of the following is true regarding exercise guidelines for Diabetes patients?
- A.
  
  They should not exercise if blood glucose >250mg/dl with ketosis
- B.
  
  They should postpone exercise and treat hypoglycemia if blood glucose is below 70mg/dl
- C.
  
  A. and B.
- D.
  
  None of the above
Correct Answer
C. A. and B.

Explanation
The correct answer is A. and B. This means that both statements A and B are true regarding exercise guidelines for Diabetes patients. Statement A states that Diabetes patients should not exercise if their blood glucose is above 250mg/dl with ketosis. Statement B states that Diabetes patients should postpone exercise and treat hypoglycemia if their blood glucose is below 70mg/dl.

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9.

Insulin resistance is usually seen with a body mass index (BMI) of 25 kg/m2 or lower.
- A.
  
  True
- B.
  
  False
Correct Answer
B. False

Explanation
Insulin resistance is actually associated with a higher body mass index (BMI) rather than a lower one. Individuals with a BMI of 25 kg/m2 or higher are more likely to experience insulin resistance. This means that their body cells are less responsive to the effects of insulin, leading to higher levels of glucose in the blood. Therefore, the correct answer is False.

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10.

A one percent reduction in HgA1-C results in:
- A.
  
  A 14% decrease in all- cause mortality
- B.
  
  A 43% decrease in amputations
- C.
  
  A 24% decrease in renal failure
- D.
  
  A 21% decrease in diabetes related deaths
- E.
  
  All of the above
Correct Answer
E. All of the above

Explanation
A one percent reduction in HgA1-C, which is a measure of long-term blood sugar control, has been found to have significant positive effects on various health outcomes. It is associated with a 14% decrease in all-cause mortality, indicating a reduction in overall death rates. Additionally, it leads to a 43% decrease in amputations, highlighting the prevention of severe complications. Moreover, there is a 24% decrease in renal failure, indicating a reduced risk of kidney damage. Lastly, a 21% decrease in diabetes-related deaths suggests a lower likelihood of death specifically related to diabetes. Therefore, all of the above health benefits can be achieved with a one percent reduction in HgA1-C.

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Integrated Chronic care Management For Diabetes: Pre-test

Which statement is true about the incidence and prevalence of diabetes in the United States?

The American Diabetes Association standards of care for diabetes is annual exam is:

The ADA guidelines specify...

A patient with Type 1 DM will need insulin due to absolute insulin deficiency.

Oral agents for Diabetes treatment:

Metformin can cause lactic acidosis and should be used with caution with patients with heart failure and renal impairment

Which of the following should be included in sick day management instructions to Diabetes patients?

Which of the following is true regarding exercise guidelines for Diabetes patients?

Insulin resistance is usually seen with a body mass index (BMI) of 25 kg/m2 or lower.

A one percent reduction in HgA1-C results in: