MN 568 MIDTERM EXAM QUESTIONS AND ANSWERS GRADED A

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1. A patient is 66 inches in height, weighing 200 pounds, and newly diagnosed with type 2 diabetes mellitus (DM). Her fasting plasma glucose level is 215 mg/dL. What is the best initial treatment?

a. No treatment at this time

b. Diet and exercise for 6-week trial

c. Diet, exercise, and oral medication

d. Diet, exercise, and exogenous insulin

____ 2. The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following tests should the clinician order on the initial visit?

a. High sensitivity thyroid-stimulating hormone (TSH) and free T4

b. Free T4 and serum calcium

c. Free T3 and T4

d. TSH and thyroxin antibodies

____ 3. A patient with type 2 diabetes asks the clinician why she needs to exercise. In order to answer her, the clinician must understand that exercise has what effect on the patient with type 2 diabetes?

a. Reduces postprandial blood glucose

b. Reduces triglycerides and increases high-density lipoprotein (HDL)

c. Reduces total cholesterol

d. All of the above

____ 4. A patient with type 1 diabetes comes to the clinic complaining of feeling nervous and clammy. He states that he took his insulin this morning but was late for work and did not eat breakfast. Which action should the clinician take first?

a. Check his blood sugar.

b. Have him drink 4 ounces of juice.

c. Call 911.

d. Ask him about his usual eating habits.

____ 5. A patient with type 2 diabetes comes to the clinic after reading about metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking metformin?

a. Ketoacidosis

b. Cirrhosis

c. Hypoglycemic episodes

d. All of the above

____ 6. A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next?

a. Serum calcium

b. TSH

c. Electrolytes

d. Urine specific gravity

____ 7. The clinician has been doing diabetic teaching for a patient with type 1 diabetes. Which of the following statements by the patient would indicate that teaching has been effective?

a. “As long as I don’t need glasses, I don’t have to worry about going blind.”

b. “I know I need to have my eyes checked every year.”

c. “My optometrist checks my eyes.”

d. “I will see my eye doctor when my vision gets blurry.”

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