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Exam & Evaluation (Diabetes Treatments: Insulin and Oral Drugs)
 
Questions: Please respond to following statements.

1 The American Diabetes Association recommended A1C goal for persons with diabetes is:
  ≥ 3%
  ≥5%
  ≤ 6.5%
  ≤10%
2 Approximately what percentage of people with diabetes will need pharmacological therapy, in addition to diet and exercise management, to reach blood glucose goals?
  27%
  60%
  81%
  90%
3 All of the following are physiological effects of insulin except:
  Insulin promotes anabolism.
  Insulin stimulates the conversion of glycogen stored in the liver to glucose.
  Insulin blocks the formation of glucose from non-carbohydrate sources.
  Insulin enhances protein synthesis and fat storage.
4 Which of the following factors affects basal insulin requirements?
  Physical or emotional stress
  Illness
  Physical activity
  All of the above
5 Release of which of the following hormones will raise blood glucose?
  Cortisol
  Progesterone
  Anti-diuretic hormone
  Testosterone
6 All of the following statements are correct about type 2 diabetes except:
  People with type 2 diabetes must have a source of exogenous insulin for survival.
  Type 2 diabetes was previously known as "non-insulin dependent diabetes mellitus."
  Over time, people with type 2 diabetes may need exogenous insulin plus oral anti-diabetes meds.
  People with type 2 diabetes may need exogenous insulin during periods of acute illness.
7 Which of the following statements about insulin is correct?
  The type of insulin a patient uses should not be changed indiscriminately.
  Human, pork, and beef sources of insulin are available in the U.S.
  Pork insulin is recommended for pregnant women and those beginning insulin therapy.
  There are few differences in reaction to the onset, peak time, and duration of insulin products.
8 Which action should a patient take if a vial of insulin appears to have clumping or a frosted appearance?
  Agitate the insulin vial
  Return the vial to the pharmacy
  Use the insulin as usual
  Refrigerate the insulin vial
9 What is the most common complication of insulin therapy?
  Lipodystrophy
  Hives
  Fatigue
  Hypoglycemia
10 Insulin is normally absorbed most rapidly from which of the following areas of the body?
  Abdomen
  Arm
  Buttocks
  Leg
For questions 11 - 15, match the insulin preparations with their length of action.
11 Humulin® R
  Rapid acting
  Short acting
  Intermediate acting
  Long acting
12 Humalog®/ (lispro)
  Rapid acting
  Short acting
  Intermediate acting
  Long acting
13 Novolin® N / (insulin NPH)
  Rapid acting
  Short acting
  Intermediate acting
  Long acting
14 Levemir® (determir)
  Rapid acting
  Short acting
  Intermediate acting
  Long acting
15 Novolog®/ (aspart)
  Rapid acting
  Short acting
  Intermediate acting
  Long acting
16 A patient should eat a meal immediately after injecting which type of insulin?
  Novolog ® aspart
  Velosulin ® BR
  Humulin ® (Lente)
  Humulin ® (Ultralente)
17 Which of the following types of insulin provides basal coverage over a 24 hour period?
  Humulin® R
  Humalog® lispro
  Lantus® glargine
  Humulin® N
18 Which of the following are disadvantages of insulin pump therapy?
  Rapid development of diabetic ketoacidosis if insulin flow is interrupted.
  Skin infection at the infusion site.
  A decrease in hypoglycemia awareness.
  All of the above
19 Which of the following types of insulin is most often used for intravenous use?
  Short acting insulin
  Regular acting insulin
  Long acting insulin
  Intermediate acting insulin
20 Insulin therapy may be required to manage blood glucose for which of the following patients?
  A type 2 diabetic whose other forms of therapy aren’t adequately controlling his blood glucose.
  A non-diabetic patient receiving parenteral nutrition.
  A patient with pancreatitis whose pancreas isn’t producing enough insulin.
  All of the above
21 A primary action of the thiazolidinedione drugs is to:
  Stimulate the pancreas to produce more insulin
  Inhibit absorption of carbohydrates from the gastrointestinal tract
  Decrease insulin resistance
  Decrease the conversion of glycogen to glucose in the liver
22 A 72 year old patient with type 2 diabetes is taking rosiglitazone. This patient should be monitored regularly for:
  Total cholesterol
  Renal function
  Liver function
  Triglycerides
23 The most acutely serious complication of therapy with sulfonyurea drugs is:
  Hypoglycemia
  Weight gain
  Gastrointestinal disturbances
  Photosensitivity
24 Which of the following oral anti-diabetes drugs would be especially useful for a patient with type 2 diabetes and elevated triglycerides and low density lipoprotein (LDL) cholesterol?
  Glimperide
  Miglitol
  Metformin
  Rosiglitazone
25 The Joslin Diabetes Center advised that insulin resistance can be decreased in type 2 diabetics with exercise.
True     False
26 The Interactive Beta Cell Tour instructs that the amino acid MOST effective in causing insulin to be secreted is:
  lysine
  alanine
  arginine
  glycine
27 According to the ADA's Clinical Diabetes online journal, in general, changes to an insulin regimens are usually unnecessary if crossing fewer than how many time zones?
  3
  2
  5
  6
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