What is the recommended interval for monitoring John’s HgbA1C?

I understand the value of doing my own work and learning this skill to support my future independent practice as a nurse practitioner.  I understand that while there may be opportunities beyond my faculty’s control to collaborate or share answers with peers, that it would not benefit my own personal and professional growth to do so.  I agree to do my own work and take personal responsibility for my learning. 

 

 I do not.

 

 I do.

 

Question 2 Use the John Jones case study to answer the following question.

 

What is the recommended interval for monitoring John’s HgbA1C?

 

3-months

 

 1-month

 

 6-months

 

 6-weeks

 

Question 3 Use the John Jones case study to answer the following question.

 

Which of the following statements best describes John’s status?

 

He has diabetes and requires pharmacological intervention.

 

 He does not have diabetes.

 

 He has diabetes but does not require pharmacological intervention.

 

 He has pre-diabetes.

 

Question 4 Use the John Jones case study to answer the following question.

 

John calls the office and reports that he is scheduled for diagnostic testing that requires IV contrast for imaging. He inquires if there are concerns with undergoing this procedure while taking his medications. What instructions should be given to John regarding his metformin regimen? 

 

 Don’t take the metformin the day of the procedure and for 48 hours afterward.

 

 Take the metformin the morning of the procedure but don’t take it for 48 hours afterward.

 

 Don’t take the metformin the day of the procedure but resume the following day.

 

 No special instructions are needed.

 

Question 5 Use the John Jones case study to answer the following question.

 

Using the ADA Standards of Medical Care in Diabetes-2020, which of the following medications should be prescribed for John?

 

Dulaglutide

 

 Metformin

 

 Glyburide

 

 Canagliflozin

 

Question 6 Use the John Jones case study to answer the following question.

 

John’s triglycerides are 260 mg/dl and his HDL is 35mg/dl.  Referring to the ADA Standards of Medical Care in Diabetes-2020, what is the correct action to take at this time?

 

Increase John’s atorvastatin to 40 mg per day.

 

 Stop John’s atorvastatin since he is now being treated for diabetes.

 

 Leave John’s atorvastatin as is and re-check lipids when A1C is re-checked.

 

 Increase John’s atorvastatin to 20mg per day.

 

Question 7 Use the John Jones case study to answer the following question.

 

Which behavior in John’s social history poses a potential concern with initiating metformin?

 

 His diet largely consists of fast-food meals. He drinks sweet tea with every?meal.

 

 He reports drinking “a few beers on the weekend during football season”.

 

 He drinks?3-4 cups of coffee per day.

 

 There are no concerns.

 

Question 8 Use the John Jones case study to answer the following question.

 

Which of John’s behaviors or assessment findings should be addressed to encourage lifestyle changes and decrease A1C levels? Select all that apply.

 

His diet largely consists of fast-food meals. He drinks sweet tea with every?meal.

 

 Sits at a desk several hours a day.

 

 Weight 235lbs

 

 BP 130/90

 

 Family history is significant for diabetes.

 

 He drinks 3-4 cups of coffee per day.

 

Question 9 Use the John Jones case study to answer the following question.

 

Which of the following lab test should be evaluated before prescribing metformin?

 

Urinalysis

 

 Complete metabolic profile (CMP)

 

 Lipid Panel

 

 Complete blood count (CBC)

 

Question 10 Use the John Jones case study to answer the following question.

 

Which glucose level equates with a Hgb A1C of 8.1%?

 

~204 mg/dl

 

 ~160 mg/dl

 

 ~175 mg/dl

 

 ~183 mg/dl

 

Question 11 Use the John Jones case study to answer the following question.

 

Metformin works by decreasing both ____________ and _____________.

 

 incretin secretion; insulin production

 

 glucogenesis; insulin resistance

 

 glucogenesis; incretin secretion

 

 insulin resistance; incretin secretion

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