NR 601 MATURE AND AGING ADULT
Question 1
pts
Which of the following laboratory results meets criteria for diagnosis of
diabetes?
random blood glucose greater than 126 mg/dL with classic symptoms of
hyperglycemia
positive urine ketones
random glucose greater than 200 mg/dL with classic symptoms of
hyperglycemia
Hgb A1C 6.4%
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. Kennedy p.370
Question 2
pts
Which “P” is a component of “the 3 P’s” of diabetes mellitus?
polygraphia
polyphagia
pain
,paresthesia
The 3 Ps of diabetes are polyphagia, polyuria and polydipsia. Kennedy p. 370
Question 3
pts
A patient with Type 2 diabetes comes to the clinic after reading a magazine
article about metformin and has some concerns about taking metformin.
Which condition listed below would be a contraindication to taking
metformin?
chronic obstructive pulmonary disease
ulcerative colitis
renal disease
inflammatory bowel disease
Metformin is contraindicated in renal disease, abnormal creatnine clearance,
acute myocardial infarction or septicemia. Dunphy p. 927
Question 4
pts
The nurse practitioner student is reviewing the lab results from an annual an
annual exam. The CMP fasting glucose was 128 mg/dL. What is the nurse
practitioner student's next action?
Correct Answer
order a Hgb A1c
,prescribe Metformin 500 mg po daily
repeat fasting glucose in 1 week
repeat fasting glucose in 1 year
A fasting plasma glucose > 126 mg/dL requires further testing. In the absense
of unequivocal hyperglycemia, result should be confirmed by repeat testing .
A HgbA1C is the correct answer becasue the repeat testing should be
completed without delay.
Retesting in a week or a year is a delay. Metformin should not be initatiated
until the diagnosis is confirmed . Dunphy p.925
Question 5
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?
Correct Answer
diet, exercise, and metformin
diet, exercise, and insulin
diet and exercise
no treatment necessary at this time
At 66 in and a weight of 200 lbs. the patient has a BMI of 32.3. If you did not
have an ability to calculate, the weight of 200 is higher than a normal BMI.
The ADA and AACE recommend that patients with recent onset T2DM (A1C <
7.5%) start with lifestyle changes and monotherapy. Dunphy p.927
, Week 6 DE QS 106 Endocrine and Metabolic Problems and Urgent Care
Issues
Question 1
pts
Which of the following laboratory results meets criteria for diagnosis of
diabetes?
random blood glucose greater than 126 mg/dL with classic symptoms of
hyperglycemia
positive urine ketones
random glucose greater than 200 mg/dL with classic symptoms of
hyperglycemia
Hgb A1C 6.4%
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. Kennedy p.370
Question 2
pts
Which “P” is a component of “the 3 P’s” of diabetes mellitus?
polygraphia
polyphagia
pain
,paresthesia
The 3 Ps of diabetes are polyphagia, polyuria and polydipsia. Kennedy p. 370
Question 3
pts
A patient with Type 2 diabetes comes to the clinic after reading a magazine
article about metformin and has some concerns about taking metformin.
Which condition listed below would be a contraindication to taking
metformin?
chronic obstructive pulmonary disease
ulcerative colitis
renal disease
inflammatory bowel disease
Metformin is contraindicated in renal disease, abnormal creatnine clearance,
acute myocardial infarction or septicemia. Dunphy p. 927
Question 4
pts
The nurse practitioner student is reviewing the lab results from an annual an
annual exam. The CMP fasting glucose was 128 mg/dL. What is the nurse
practitioner student's next action?
Correct Answer
order a Hgb A1c
,prescribe Metformin 500 mg po daily
repeat fasting glucose in 1 week
repeat fasting glucose in 1 year
A fasting plasma glucose > 126 mg/dL requires further testing. In the absense
of unequivocal hyperglycemia, result should be confirmed by repeat testing .
A HgbA1C is the correct answer becasue the repeat testing should be
completed without delay.
Retesting in a week or a year is a delay. Metformin should not be initatiated
until the diagnosis is confirmed . Dunphy p.925
Question 5
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?
Correct Answer
diet, exercise, and metformin
diet, exercise, and insulin
diet and exercise
no treatment necessary at this time
At 66 in and a weight of 200 lbs. the patient has a BMI of 32.3. If you did not
have an ability to calculate, the weight of 200 is higher than a normal BMI.
The ADA and AACE recommend that patients with recent onset T2DM (A1C <
7.5%) start with lifestyle changes and monotherapy. Dunphy p.927
, Week 6 DE QS 106 Endocrine and Metabolic Problems and Urgent Care
Issues
