1
ADVANCED DIABETES MANAGEMENT NURSE (ADM-
BC) BOARD CERTIFICATION EXAM PRACTICE
QUESTIONS AND ANSWERS WITH RATIONALES
2026-28 JUST RELEASED VERSION
• The best indicator of hypoglycemia risk using CGM data is:
A. Time in range
B. Time below range (<70 mg/dL)
C. Average glucose
D. Standard deviation alone
Rationale: Time below range quantifies hypoglycemia burden.
• A patient with CKD stage 3 and T2DM would benefit most from:
A. Sulfonylurea
,2
B. SGLT2 inhibitor with renal benefit
C. Meglitinide
D. Acarbose
Rationale: Certain SGLT2 inhibitors slow CKD progression.
• Which symptom suggests autonomic neuropathy affecting the GI
system?
A. Polyuria
B. Blurred vision
C. Early satiety and nausea
D. Foot pain
Rationale: Gastroparesis presents with early satiety and nausea.
• In patients on insulin therapy, lipohypertrophy leads to:
A. Faster insulin absorption
B. Unpredictable insulin absorption
C. Increased pain only
D. Hyperkalemia
Rationale: Repeated injections into same site alter absorption patterns.
,3
, 4
• Which is recommended during acute illness (“sick day rules”)?
A. Stop insulin
B. Avoid glucose monitoring
C. Monitor glucose and ketones every 4 hours
D. Restrict fluids
Rationale: Frequent monitoring prevents DKA during illness.
• The strongest modifiable risk factor for type 2 diabetes is:
A. Age
B. Family history
C. Obesity
D. Ethnicity
Rationale: Obesity is the leading modifiable risk factor.
• Which is a feature of proliferative retinopathy?
A. Microaneurysms only
B. Neovascularization
C. Cotton wool spots only
D. Hard exudates only
Rationale: Abnormal new vessel growth defines proliferative disease.
ADVANCED DIABETES MANAGEMENT NURSE (ADM-
BC) BOARD CERTIFICATION EXAM PRACTICE
QUESTIONS AND ANSWERS WITH RATIONALES
2026-28 JUST RELEASED VERSION
• The best indicator of hypoglycemia risk using CGM data is:
A. Time in range
B. Time below range (<70 mg/dL)
C. Average glucose
D. Standard deviation alone
Rationale: Time below range quantifies hypoglycemia burden.
• A patient with CKD stage 3 and T2DM would benefit most from:
A. Sulfonylurea
,2
B. SGLT2 inhibitor with renal benefit
C. Meglitinide
D. Acarbose
Rationale: Certain SGLT2 inhibitors slow CKD progression.
• Which symptom suggests autonomic neuropathy affecting the GI
system?
A. Polyuria
B. Blurred vision
C. Early satiety and nausea
D. Foot pain
Rationale: Gastroparesis presents with early satiety and nausea.
• In patients on insulin therapy, lipohypertrophy leads to:
A. Faster insulin absorption
B. Unpredictable insulin absorption
C. Increased pain only
D. Hyperkalemia
Rationale: Repeated injections into same site alter absorption patterns.
,3
, 4
• Which is recommended during acute illness (“sick day rules”)?
A. Stop insulin
B. Avoid glucose monitoring
C. Monitor glucose and ketones every 4 hours
D. Restrict fluids
Rationale: Frequent monitoring prevents DKA during illness.
• The strongest modifiable risk factor for type 2 diabetes is:
A. Age
B. Family history
C. Obesity
D. Ethnicity
Rationale: Obesity is the leading modifiable risk factor.
• Which is a feature of proliferative retinopathy?
A. Microaneurysms only
B. Neovascularization
C. Cotton wool spots only
D. Hard exudates only
Rationale: Abnormal new vessel growth defines proliferative disease.
