ada standards questions€¦ · most people with type 1 diabetes have access to insulin pump...

Diabetes Education Services© 1998-2019 DiabetesEd.net

ADA Standards Questions

2019

www.DiabetesEd.net

Beverly Dyck Thomassian, RN, MPH, BC-ADM, CDEPresident, Diabetes Education Services

Getting Ready for the Exam• Assess your knowledge (NCBDE outline)

• Listen to Preparing for CDE FREE Webcast

• Fill in knowledge gaps with books, articles and online classes

• Take as many practice tests as possible

• At exam, imagine your self calm but energized

• Keep breathing, stand up and stretch, write it down

Pitfalls to Avoid

� Choosing a “good” answer, but not the right one for the stem � key intent of question

� Failing to read an important words (always, never, most, probably, usually)

� Choosing an answer you did not understand because the others seem too easy

� Make sure to read EVERY word


Thinking Pitfalls

� Imaging a right answer and getting thrown when it is not among the choices

� Over thinking question/answers

� Choosing an answer that did not fit the situation

� Using the goals in your clinical setting. Focus on national goals.

Take a Practice Test – Learn how to

“work” test questions

� Weed through the details

� Make sure you REALLY understand key intent of question

� Find the stem� Identifies key intent of the question

� Read all the options or answers

� Eliminate obvious wrong answers

� Select BEST option

Look for Clues in The Answers

� Answers with the following

words are usually incorrect:

always, never, all, none, only,

must, and completely

� Answers with the following

words are usually correct:

seldom, most, generally, tend

to, probably, usually


Getting to the

Right Answers

� Do not leave any answers blank

� Look for clues in the question

� Don’t get lured in by juicy answers

� Avoid imposing your life experience into the question/answer

� Keep breathing – Get up and move

� Even simple math problem should be worked

out on scratch paper

Question

1. For optimal diabetes care and population health, which of the following is true?

A. Assist all people with diabetes in reaching an A1c less than 7%

B. Improve care at a systems level to improve individual outcomes

C. Refer people with diabetes to mental health counseling

D. Remind people with diabetes that uncontrolled blood glucose levels lead to complications

Question

2. What best describes the chronic care model?

a. Move from proactive to reactive care

b. Focus on the importance adherence

c. Provide self-management and decision

support

d. Assure that every participant sees a diabetes

educator


Question

6. Which of the following test result indicates

diagnosis of prediabetes?

a. A1c of 5.1 to 5.6%

b. Fasting BG 132

c. Post meal glucose of 127

d. Fasting BG 101

Question

9. What does a fructosamine test measure?

a. Levels of fructose in blood

b. Average blood glucose for past 2-3 weeks

c. Endogenous insulin production

d. Cell stability

Question

11. Who should be screened for type 2

diabetes?

a. 38 yr old Asian American, BMI of 22

b. Anyone 45 years old or older

c. 32-year-old whose mom has diabetes

d. 43-year-old with celiac disease


Question

15. A woman is 8 weeks pregnant and her

fasting blood sugar is 132 mg/dl. What is the

most likely diagnosis?

a. Gestational diabetes

b. Latent autoimmune diabetes in adults

c. PreDiabetes

d. Type 2 Diabetes

Question

18. Which of the following is true about

Diabetes Self-Management Education (DSME)

training?

a. Medicare Part D covers 100% of DSME

training

b. Medicare covers 9 hours of group education

annually

c. Medicare part A covers 80% of DSME training

d. Medicare part B covers 80% of DSME training

Question

20. What statement is accurate regarding carbohydrates?

a. Individualize approach and encourage incorporating a variety of healthy carbohydrates

b. The goal is to aim for 45-60 gms of carbohydrate per meal

c. All added sugar should be avoided

d. Glycemic index is something all patients should be familiar with


Question

21. What statement is accurate regarding protein?

a. For people with kidney disease, restrict protein intake

b. Protein foods can contribute to hyperglycemia

c. Protein foods do not affect blood glucose levels

d. Patients with diabetes should limit protein intake to less than 30%

Question

24. Choose the most accurate statement

regarding exercise and diabetes.

a. Exercise always causes weight loss

b. Exercise increases visceral fat stores

c. Exercise decreases counteregulatory

hormones

d. Exercise increases insulin sensitivity

Question

26. What statement reflects pre-exercise evaluation guidelines?

a. Routine exercise testing for asymptomatic adults is not recommended.

b. An EKG should be performed before person with diabetes engages in an exercise program.

c. High risk people with diabetes should avoid exercise

d. People with diabetes should refrain from exercise until they are cleared by their Provider


Question

30. Which of the following comorbidities are people with diabetes at risk for?

a. Hearing impairment, fatty liver disease and Parkinson's

b. Periodontal disease, cancer and increased bone density

c. Sleep apnea, hearing impairment and Meniere’s disease

d. Heart disease, fatty liver disease and cognitive impairment

Question

31. What did the Diabetes Prevention Program Demonstrate?

a. Losing weight and exercising reduces diabetes risk by 58%

b. Losing 10 pounds reduces diabetes risk by 38%

c. Exercising 30 minutes a day reduces diabetes risk by decreasing belly fat

d. Taking metformin daily reduced diabetes risk by 58%

Question

42. What is the most accurate definition of

severe hypoglycemia?

a. Hypoglycemia requiring assistance

b. Blood glucose less than 54 mg/dl

c. Hypoglycemia that results in a coma

d. Person with diabetes has to self-inject

glucagon


Question

44. Which patient needs a prescription for a glucagon emergency kit?

a. 17-year-old with type 2 diabetes on metformin

b. 29-year-old with type 1 on intensive insulin therapy

c. Elderly type 2 patient taking 5 units Lantus once daily

d. Person with diabetes and obesity taking 70/30 inulin

Question

51. What were the results of the Diabetes

Control and Complications Trial?

a. Sulfonylureas increased cardiac remodeling

b. Metformin therapy decreased risk of heart

disease

c. Insulin therapy is the most effective

treatment for type 2 diabetes

d. Intensive insulin therapy improves outcomes

for type 1 diabetes

Question

57. Which of the following is true about

metformin (Glucophage)?

a. Can increase risk of kidney failure

b. Increases risk of hearing loss

c. Does not cause hypoglycemia

d. Is associated with B12 elevations


Question

59. For new type 2 diabetes, which of the

following is the preferred initial class of

pharmacologic intervention?

a. Sulfonylureas

b. SGLT-2 Inhibitors

c. GLP-1 RAs

d. Biguanides

Question

60. When determining which pharmacologic

agent to use for a patient, which of the following

is the most important factor to consider?

a. Patient’s needs, preferences and values

b. Pathophysiologic defects

c. Efficacy of medication

d. Medication side effects

Question

62. Which of the following medications can

cause hypoglycemia?

a. Glimepiride (Amaryl)

b. Exenatide (Byetta)

c. Pioglitazone (Actos)

d. Canagliflozin (Invokana)


Question

68. Which of the following medication slows

gastric emptying and promotes satiation?

� Dapagliflozin (Farxiga)

� Dulaglutide (Trulicity)

� Precose (Acarbose)

� Bromocriptine (Cycloset)

Question

73. Which of the following blood glucose levels

indicate that basal insulin is at the correct dose?

a. Morning blood glucose of 126

b. Post lunch blood glucose of 148

c. Pre dinner blood glucose of 118

d. Post dinner blood glucose of 138

Question

77. A person with diabetes weighs 60 kg and is

on 30 units glargine (Lantus) and 2000 mg

metformin (Glucophage) daily. A1c is 8.9%.

What would be the best next step?

a. Increase the glargine by 30 - 40%

b. Decrease caloric intake by 7%

c. Limit concentrated sweets

d. Add bolus insulin or GLP-1 RA


Question

80. Who is the most appropriate candidate for continuous subcutaneous insulin infusion?

a. Person with type 2, A1c of 7.3% on glipizide (Glucotrol) 10mg daily

b. Person with type 1 who is struggling with addiction

c. Person with type 2 and A1c of 8.3% who is on basal bolus insulin therapy

d. Patient with type 1 diabetes who wants to simplify their insulin management

Question

85. Which of the following is first line blood

pressure therapy for someone with type 2

diabetes and albuminuria?

a. Beta Blocker

b. Angiotensin Receptor Blockers (ARBs) or ACE

Inhibitors

c. Statins

d. Aspirin therapy

Question

94. For a person over the age of 65, with diabetes, intact cognition and few coexisting chronic illness, which would be an appropriate treatment goal?

a. A1c less than 6.5%, hold statin

b. A1c less than 7%, Blood Pressure less than 150/90

c. A1c less than 7.5%, continue statin if not contraindicated

d. Fasting Blood glucose 70 – 140, B/P less than 140/90


Question

95. For children under the age of 18 with type 1

diabetes, what are the glucose targets?

a. Before meal BG less than 130, A1c less than

6.5%

b. Before meal BG 90-150, A1c less than 7.5%

c. Before meal glucose 80-130, A1c less than 7%

d. Before meal glucose 70-150, A1c less than 6%

Question

101. Which medications are teratogenic if a

woman with type 2 diabetes becomes

pregnant?

a. Metformin, sulfonylureas

b. ACE Inhibitors, statins

c. Regular and NPH Insulin

d. Lispro (Humalog), Aspart (Novolog)

Question

100. A 26-year-old with type 1 is admitted for

treatment of DKA. Before stopping the insulin drip,

what action is necessary?

a. Give an amp of D50 IV, followed by basal insulin

b. Administer oral potassium and give IV push of

bolus insulin

c. Give subq insulin 1-2 hours before IV is stopped

d. Oral metformin plus 10 units glargine (Lantus)


Question

106. Which of the following is true about insulin pump therapy?

A. Insulin pumps should be considered for pediatrics with type 1 diabetes

B. Common reasons to start pump therapy include inability to manage basal bolus therapy

C. Most people with type 1 diabetes have access to insulin pump therapy

D. Pump therapy decreases A1c by 1-2%

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