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Nurse Practitioner:
doi: 10.1097/01.NPR.0000352284.74358.fb
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Signs of improvement: Diabetes update 2009

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INSTRUCTIONS Diabetes management: 2009 update

TEST INSTRUCTIONS

* To take the test online, go to our secure Web site at http://www.nursingcenter.com/ce/NP.

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* You will receive your CE certificate of earned contact hours and an answer key to review your results.There is no minimum passing grade.

* Registration deadline is June 30, 2011.

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PROVIDER ACCREDITATION

Lippincott Williams & Wilkins, publisher of The Nurse Practitioner journal, will award 2.6 contact hours for this continuing nursing education activity.

Lippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.6 contact hours. Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia and Florida #FBN2454. LWW home study activities are classified for Texas nursing continuing education requirements as Type I.

Your certificate is valid in all states. This activity has been assigned 0.5 pharmacology credits.

Diabetes management: 2009 Update

General Purpose: To provide NPs with updated management guidelines for adults diagnosed with T2DM. Learning Objectives: After reading the article and taking this test, NPs should be able to: 1. Discuss the risk factors, newly developed guidelines, and diagnostic testing for adults with prediabetes and T2DM. 2. Identify evidence-based management recommendations and treatment goals for adults with prediabetes and T2DM.

1. In the United States by 2025, it is projected that T2DM will affect

a. 5 million people.

b. 15 million people.

c. 25 million people.

d. 57 million people.

2. In 2008, the ACE and the AACE

a. developed guidelines for pregnant adults with T2DM.

b. released a consensus algorithm on medical management of hyperglycemia for T2DM patients.

c. released the revised “Clinical Practice Recommendations 2009” for patients with T2DM.

d. joined together to revise the “Treat-To-Target Road Map.”

3. Which of the following is true about the A1C test?

a. It is highly sensitive.

b. It is limited by a lack of specificity.

c. There is a lack of standardization in A1C assays.

d. It should be evaluated quarterly once glycemic target goals are reached.

4. Currently, the ACE/AACE encourage A1C levels less than or equal to

a. 6%.

b. 6.5%.

c. 7%.

d. 7.5%.

5. The ADA encourages the use of which diagnostic test for prediabetes screening?

a. FPG

b. A1C

c. 2-hour OGTT

d. 3-hour OGTT

6. If there is suspicion of T2DM despite a normal screening test result, which test should be ordered?

a. A1C

b. FPG

c. 2-hour OGTT

d. 3-hour OGTT

7. Risk factors for prediabetes and diabetes include all of the following except

a. white ethnicity.

b. BMI 25 kg/m2.

c. women with a history of polycystic ovarian syndrome.

d. previous IFG or IGT.

8. According to ADA criteria, which test result identifies a patient with prediabetes?

a. A1C 6%

b. FPG 80 to 90 mg/dL

c. IFG 100 to 125 mg/dL

d. IGT 2-hour plasma glucose 100 to 130 mg/dL

9. According to the ADA, prediabetic patients with important risk factors should be treated with

a. acarbose.

b. metformin.

c. orlistat.

d. rosiglitazone.

10. Which medication has an FDA warning against its use in patients with congestive heart failure?

a. acarbose

b. metformin

c. orlistat

d. rosiglitazone

11. MNT for diabetes

a. includes a fiber intake of 14 g/1,000 kcal.

b. includes trans-fat and saturated fat intake of 10% of total calories.

c. is usually provided by the patient's primary care provider.

d. focuses on increasing carbohydrates but limiting calories.

12. Physical activity for patients with diabetes should include

a. resistance training once a week.

b. maintaining 50% to 70% maximum heart rate.

c. 30 minutes of moderate activity twice a week.

d. limited aerobic activity and no resistance training if the patient is obese.

13. Which is not a self-care behavior recommended by the American Association of Diabetic Educators?

a. psychosocial adaptation

b. blood glucose monitoring

c. problem-solving on sick days

d. low-protein and high-carbohydrate diet

14. Which of the following decreases A1C levels?

a. renal failure

b. aspirin toxicity

c. iron-deficiency anemia

d. presence of hemoglobin S

15. In comparing various therapies, the UKPDS found that

a. insulin was the superior monotherapy.

b. metformin was the superior monotherapy.

c. sulfonylureas were the superior monotherapy.

d. they were unable to establish a superior monotherapy treatment.

16. Diabetic patients taking multiple daily insulin injections or on an insulin pump should self monitor blood glucose levels no less than

a. once daily.

b. twice daily.

c. three times daily.

d. four times daily.

17. Postabsorptive self blood glucose monitoring is defined as

a. 1 to 2 hours after the beginning of a meal.

b. 3 to 5 hours after the beginning of a meal.

c. 1 to 2 hours after completion of a meal.

d. 3 to 5 hours after completion of a meal.

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