Question 1

A patient diagnosed with diabetes has a blood pressure of 140/90 mm Hg and albuminuria. Which initial action by the primary care provider is indicated for management of this patient?&#10;A) Consulting with a nephrologist&#10;B) Limiting protein intake&#10;C) Prescribing an antihypertensive medication&#10;D) Referring to an ophthalmologist

Accepted Answer

A

Question 2

An obese patient has recurrent urinary tract infections and reports feeling tired most of the time. What initial diagnostic test will the provider order in the clinic at this visit?&#10;A) C-peptide level&#10;B) Hemoglobin A1C&#10;C) Random serum glucose&#10;D) Thyroid studies

Accepted Answer

Recurrent urinary tract infections and fatigue are common symptoms of uncontrolled diabetes. Therefore, the provider would likely order a Hemoglobin A1C test to screen for diabetes in an obese patient presenting with these symptoms. C-peptide level, random serum glucose, and thyroid studies may be ordered if diabetes is ruled out or if additional testing is needed to determine the underlying cause of the symptoms.

Question 3

A patient diagnosed with type 2 diabetes mellitus becomes insulin dependent after a year of therapy with oral diabetes medications. When explaining this change in therapy, the provider will tell the patient

A) it is necessary because the patient cannot comply with the previous regimen.
B) that strict diet and exercise measures may be relaxed with insulin therapy.
C) the use of insulin therapy may be temporary.
D) this is because of the natural progression of the disease.

D

Accepted Answer

The natural progression of type 2 diabetes mellitus often results in the need for insulin therapy, as the pancreas becomes less able to produce sufficient amounts of insulin.

Question 4

A patient recently diagnosed with type 1 diabetes mellitus is in clinic for a follow-up evaluation. The provider notes that the patient appears confused and irritable and is sweating and shaking. What intervention will the provider expect to perform once the point of care blood glucose level is known?

A) Dipstick urinalysis for ketones
B) Giving a rapid-acting carbohydrate
C) Injection of rapid-acting insulin
D) Performing a hemoglobin A1C

Accepted Answer

The patient is displaying symptoms of hypoglycemia, which can be quickly corrected by giving a rapid-acting carbohydrate such as juice or candy. Dipstick urinalysis for ketones and performing a hemoglobin A1C are not urgent interventions for hypoglycemia. While administering rapid-acting insulin is a treatment for hyperglycemia, it would be contraindicated in this situation when the patient is displaying symptoms of hypoglycemia.

Deck 186: Diabetes Mellitus