NR NR601 WEEK 5 QUIZ

Score for this quiz: 10 out of 10 Submitted Feb 4 at 9:52am This attempt took 7 minutes.

Question 1 2 / 2 pts The nurse practitioner student is reviewing the lab results from an annual exam. The CMP fasting glucose was 128 mg/dL. The patient does complain of polyphagia. What is the nurse practitioner student’s next action?

• repeat fasting glucose in 3 months
• Repeat fasting glucose in 1 week.
• Prescribe Metformin 500 mg once a day.
• Order a HGA1C today. (CORRECT ANSWER) Rationale: A fasting plasma glucose > 126 mg/dL requires further testing. In the absence of unequivocal hyperglycemia, the result should be confirmed by repeat testing. An HgbA1C is the correct answer because the repeat testing should be completed without delay. Retesting in a week or a year is a delay. Metformin should not be initiated until the diagnosis is confirmed.

Question 2 2 / 2 pts Which of the following laboratory results meets criteria for diagnosis of diabetes?

• positive urine ketones
• random glucose greater than 200 mg/dL with classic symptoms of hyperglycemia (CORRECT ANSWER)
• Hgb A1C 6.4%
• random blood glucose greater than 126 mg/dL with classic symptoms of hyperglycemia Rationale: The criterion for the diagnosis of diabetes is either two fasting blood glucose readings with results greater than or equal to 126 mg/dL or a random blood glucose reading greater than or equal to 200 mg/dL if symptoms of diabetes are present. Random glucose is not the appropriate test. In older adults, the glucose reading after a 2-hour oral glucose tolerance test (OGTT) rises more rapidly than the fasting glucose.

Question 3 2 / 2 pts Which of the following occurs commonly in Type 2 diabetes?

• elevated high-density lipoprotein cholesterol (HDL)
• anorexia
• yeast infection (CORRECT ANSWER)
• fluid overload Rationale: Persons with diabetes are at increased risk of all types of infection, especially yeast infections. T2DM patients are typically obese, not anorexic. The LDL is elevated due to dyslipidemia. HDL is the “good” cholesterol, and a higher level is desirable.

Question 4 2 / 2 pts A newly diagnosed patient with Type 2 diabetes mellitus (DM) is 66 inches in height. The patient’s weight is 200 lbs, and the A1C is 7.1%. What is the best initial treatment?

• diet, exercise, and insulin
• diet, exercise, and metformin (CORRECT ANSWER)
• no treatment necessary at this time
• diet and exercise Rationale: At 66 inches and a weight of 200 lbs, the patient has a BMI of 32.3, indicating obesity. The ADA and AACE recommend that patients with recent onset T2DM (A1C < 7.5%) start with lifestyle changes and monotherapy.

Question 5 2 / 2 pts Which statement, made by a patient with Type 1 Diabetes, indicates successful teaching regarding general guidelines for exercise?

• “I will check my blood glucose before, every 30-60 minutes during, and after I’m done exercising.” (CORRECT ANSWER)
• “I should eat more carbohydrates if my blood glucose is less than 200.”
• “I will not exercise if my blood sugar is 215.”
• “I will exercise when my urine ketones are positive, but blood sugar is 260.” Rationale: The metabolic adjustments that maintain normal glucose levels are impaired in T1DM. Exercise can exacerbate hyperglycemia if the patient has too little insulin available. Review the guidelines listed on Dunphy p. 919. Check blood sugar before, every 30 to 60 minutes during, and after exercise.

Submission Details: Quiz Score: 10 out of 10