Our October 12th Question of the week quizzed test takers on the best strategy for a 90-year-old who states “they feel hungry” all the time. 76% of respondents, chose the best answer. We are excited to share this rationale of the week, so you can advocate for people living with diabetes.
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer below: Answer Question
Question: HM is living with type 2 diabetes and is 90 years old with a BMI of 32. HM’s most recent A1c was 9.6% and their GFR is 16. The provider stopped the metformin due to the diminished kidney function and HM is currently on no diabetes medications. To manage HM’s blood sugar, the provider ordered a low-calorie restrictive meal plan for HM. HM was a chef for 40 years and tells you, “they feel hungry” all the time. Based on this assessment, you decide to contact the provider.
Which of the following would be the best suggestion?
Answer Choices:
As shown above, the most common choice was option 4, the second most common answer was option 1, then option 2, and finally option 3.
If you are thinking about taking the certification exam, it is helpful to know the goals of care and considerations for people with diabetes across the lifespan. This practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” that seem so familiar to you, right under your nose. Your job is to weed through the to choose the BEST answer.
Answer 1 is incorrect. 11.13% chose this answer, “Ask provider to add a bedtime snack to reduce hunger.” While it is true that HM is hungry, a bedtime snack is not the best solution since it might contribute to already elevated blood sugars. We need to figure out a way to get blood glucose levels to goal while providing adequate nutrition.
Answer 2 is incorrect. 8.40% of you chose this answer, “Encourage HM to take a short walk after meals to reduce post prandial hyperglycemia.” Post meal walks are an excellent way to decrease post meal blood sugars, but they most likely won’t be enough to get HM out of glucose toxicity. Given that HM’s A1c is 9.6%, the average blood sugars are around 230 mg/dl. HM will need more than post meal jaunts to get blood glucose to target.
Answer 3 is incorrect. 4.30% of respondents chose this answer, “Reassure HM that limiting calories is the best plan to keep blood glucose on target.” In this situation, we need to consider quality of life issues. Given that HM is 90 years old and they were a chef, limiting calories to the point of hunger is not a strategy that considers HM’s needs, values and wants. A better approach would be to create a person-centered solution.
Finally, Answer 4 is correct. 76.17% chose this answer, “Contact provider with suggestion to start HM on once daily basal insulin.” YES, GREAT JOB. In this situation we requested that the provider start HM on 10 units of 70/30 insulin in the morning. This simple intervention will help HM in numerous ways:
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Want to learn about this question and more as you’re studying for the CDCES Exam?
This bundle includes our CDCES Online Prep Bundle (featured above) plus the ADCES Review Guide – 5th Edition-Revised. The online bundle includes Level 1, Level 2, and Level 3 (Boot Camp), plus two bonus courses. The ADCES Review Guide offers over 480+ practice questions and is a fantastic independent study tool and comprehensive resource for the Diabetes Care and Education Specialist Exam.
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Our September 21st Question of the week quizzed test takers on Intensive Insulin Therapy with A1c 6.2%. Three quarters (74%) of respondents, chose the best answer. We are excited to share info so you can pass on correct info to people living with diabetes and your colleagues.
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer below: Answer Question
Question: HR is a 78-year-old with a stroke and limited cognition with diabetes for 8 years and is on intensive insulin therapy: HR takes bolus insulin at meals and basaglar at night. HR has an A1c is 6.2% and employs a part time caretaker.
What is the best response in this situation?
Answer Choices:
As shown above, the most common choice was option 2, the second most common answer was option 4, then option 1, and finally option 3.
If you are thinking about taking the certification exam, it is helpful to know the goals of care and considerations for people with diabetes across the lifespan. This practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” that seem so familiar to you, right under your nose. Your job is to weed through the to choose the BEST answer.
Answer 1 is incorrect. 8.20% chose this answer, “Start HR on an insulin pump and CGM to prevent hypoglycemia.” This is not the best answer because we want to provide person-centered care based on the unique situation of this individual. HR has a history of a stroke, limited cognition and relies on a part time caregiver. It doesn’t seem realistic to provide pump and CGM training to HR given the cognitive limitations and the caregiver is only part-time. It is unlikely that the two of them would be comfortable enough or have the skill level to help oversee this complex technology and changing insertion sites.
Answer 2 is correct. 74.17% of you chose this answer, “Discuss de-intensifying insulin regimen.” YES. This is the best answer. Since HR is on multiple daily injections and has an A1c in the low 6% range, we know they are most likely experiencing episodes of hypoglycemia. To address this, we would need to discuss goals of care with HR and their caregivers and share our concerns about the risk and danger of hypoglycemia. We need to de-intensify this management plan. Based on the outcome of the discussion with HR, this could be accomplished by: reducing the overall insulin dose, switching to twice a day 70/30 insulin, or evaluating if oral medications could be trialed to reduce the need for insulin.
Answer 3 is incorrect. 6.46% of respondents chose this answer, “Using a strength-based approach, reinforce the importance of keeping the A1c less than 7%.” Using a strength-based approach is always a good idea, but the main issue in this question is that HR’s A1c is only 6.2%. According to the ADA Standards of Care, the A1c target in this situation would be individualized based on safety considerations, quality of life, and the goals and values of the person living with diabetes. For older, frail individuals at risk of hypoglycemia, a safer A1c target would be 7% – 8%.
Finally, Answer 4 is incorrect. 11.17% chose this answer, “Evaluate for diabetes-related distress.” Even though it is always important to consider people’s emotional response to diabetes, this answer does not address the key issue presented in this question. The first priority would be to make sure HR is safe, with a reduced risk of hypoglycemia and a realistic insulin regimen.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Did you miss the live conference? No worries! You can register now to watch on-demand
Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.
If you are seeking a state-of-the-art review of current diabetes care, this course is for you. Our team has been fine-tuning this course for over fifteen years, and we know what you need. This program can also be a great addition to your CDCES or BC-ADM exam study plan.
Team of expert faculty includes:
In addition to informative lectures, we also use group activities and case studies to highlight the essential knowledge, skills, and strategies needed to succeed in diabetes education today!
CEs: Includes over 30 CEs
Program Info: 2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Speakers: View Conference Faculty.
Dates: Your registration fee includes access to FREE podcast and all recorded webinars for one year.
Two Registration Options
Virtual DiabetesEd Specialist Conference Deluxe | Oct. 6-8 | 30+ CEs
Deluxe Virtual Program for $459 includes:
+Plus Syllabus, Standards and Swag:
2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Virtual DiabetesEd Specialist Conference Basic | Oct. 6-8 | 30+ CEs
Basic virtual program for $359 includes:
2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Team of Experts: Our team of expert faculty has been fine-tuning this course for over fifteen years and we know what you need to succeed! In addition to informative lectures, we also use group activities and case studies to highlight the essential knowledge, skills, and strategies needed to succeed in diabetes education today!
When you register for our Virtual Course, you have immediate access to these Bonus DiabetesEd University Online Courses – for FREE!
2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Our September 14th Question of the week quizzed test takers on a new med. Less than half, 47% of respondents, chose the correct answer. This was a hard question since this finerenone was only recently FDA approved. We are excited to share info about this med along to you, so you can pass on correct info to people living with diabetes and kidney disease.
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer below: Answer Question
Question: JR has a GFR of 43 and lives with type 2 diabetes. JR excitedly brings you an article that talks about finerenone (Kerendia), a newly approved non-steroidal mineralocorticoid receptor antagonist which is indicated for people with chronic kidney disease (CKD) associated with Type 2 diabetes.
If JR is started on this medication, what instruction would you provide?
Answer Choices:
As shown above, the most common choice was option 3, the second most common answer was option 1, then option 4, and finally option 2.
If you are thinking about taking the certification exam, it is helpful to know about newly approved diabetes medications, although it may take at least a year to appear in exams. However, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” that seem so familiar to you, right under your nose. Your job is to weed through the to choose the BEST answer.
Answer 1 is incorrect. 12.5% chose this answer, “Make sure to take this medication on an empty stomach.” If you don’t know anything about a particular medication and are forced to guess, this answer is pretty unlikely to be the best answer, for one reason. Most meds don’t need to be taken on an empty stomach. Two diabetes related meds, levothyroxine and oral semaglutide DO need to be taken on an empty stomach, but an empty stomach is not required for most other meds. Finerenone can be taken with or without food.
Answer 2 is incorrect. 27.8% of you chose this answer, “Contact the provider if you notice ankle swelling.” This was another juicy answer that we purposefully included. There is a class of diabetes medications, the TZDs (pioglitazone and rosiglitazone) that can cause ankle swelling, so this answer might have seemed familiar to you. Also when trying to find false answers, you may want to consider that it seems unlikely that a medication that slows kidney failure would have edema as a side effect.
Answer 3 is incorrect. 12.2% chose this answer, “Notify your provider if you experience a non-productive cough.” This juicy answer goes with a common blood pressure medication class, ACE Inhibitors, that people with diabetes are often prescribed to manage hypertension. With finerenone, the major consideration is monitoring the potassium in the first month of initiation.
Answer 4 is correct. 47.5% of respondents chose this answer, “Avoid taking medication with grapefruit or grapefruit juice.” GREAT JOB, this is the best answer. Since finerenone is a CYP3A4 substrate, the package insert recommends to avoid taking finerenone with other strong cype3A4 inhibitors. It also advises to avoid taking finerenone with grapefruit or grapefruit juice. Great job!
Check out our New Updated Med Cheat Sheets 2021 (page 2) and consider attending our Virtual Conference with Dr. Diana Isaacs, who will speak more to this topic. You can also check out our Blog Post on New Meds for Diabetes.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Did you miss the live conference? No worries! You can register now to watch on-demand
Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.
If you are seeking a state-of-the-art review of current diabetes care, this course is for you. Our team has been fine-tuning this course for over fifteen years, and we know what you need. This program can also be a great addition to your CDCES or BC-ADM exam study plan.
Team of expert faculty includes:
In addition to informative lectures, we also use group activities and case studies to highlight the essential knowledge, skills, and strategies needed to succeed in diabetes education today!
CEs: Includes over 30 CEs
Program Info: 2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Speakers: View Conference Faculty.
Dates: Your registration fee includes access to FREE podcast and all recorded webinars for one year.
Two Registration Options
Virtual DiabetesEd Specialist Conference Deluxe | Oct. 6-8 | 30+ CEs
Deluxe Virtual Program for $459 includes:
+Plus Syllabus, Standards and Swag:
2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Virtual DiabetesEd Specialist Conference Basic | Oct. 6-8 | 30+ CEs
Basic virtual program for $359 includes:
2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Team of Experts: Our team of expert faculty has been fine-tuning this course for over fifteen years and we know what you need to succeed! In addition to informative lectures, we also use group activities and case studies to highlight the essential knowledge, skills, and strategies needed to succeed in diabetes education today!
When you register for our Virtual Course, you have immediate access to these Bonus DiabetesEd University Online Courses – for FREE!
2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Our September 7th Question of the week quizzed test takers on carb counting. 55% of respondents chose the correct answer. This was a hard question. Figuring out how much insulin to cover carbs is an important topic to review, so we can pass on correct info to people living with diabetes.
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer below: Answer Question
Question: LS uses an insulin pump and CGM. Most recent report reveals LS is running 56% time in range and 44% above target range. LS asks for help with carb counting. A typical breakfast includes: ½ cup of milk, 2 tablespoons peanut butter and 1 piece whole grain bread, 3 oz’s of grapes and one cup of black coffee with Splenda. LS’s insulin to carb ratio for breakfast is 1:12, for lunch and dinner is 1:15.
Based on this, how much insulin does LS need for breakfast?
Answer Choices:
As shown above, the most common choice was option 3, the second most common answer was option 1, then option 4, and finally option 2.
If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, do careful math, be familiar with the exchange list and choose the BEST answer.
Diabetes Exchange List – a brief summary of serving size and carbohydrate counts for common foods. Excellent study tool for the exam.
Here are the carb counts of the foods listed:
LS’s insulin to carb ratio:
Answer 1 is incorrect. 23.97% chose this answer, “3.1 units.” If you chose this answer you are so close. For the exam, remember that one cup of milk has 12gms of carbohydrate (not 15gms). Please see the link to the exchange list for the carb counts of common foods.
Answer 2 is incorrect. 9.98% of you chose this answer, “2.4 units.” If you chose this answer, you may have used the lunch/dinner insulin to carb ratio of 1:15 instead of the breakfast ratio of 1:12. This is an easy mistake to make, so make sure to read the question carefully and take your time doing the math. You got this.
Answer 3 is correct. 55.32% of respondents chose this answer, “3.0 units.” GREAT JOB. This is the best answer. The total carb intake for LS is 36 gms. Since the Insulin to Carb (I:CR) ratio for breakfast is 1:12, to find out how much insulin LS needs for breakfast, just divide gms of carb by the I:CR or 36 / 12 = 3 units.
Finally, Answer 4 is incorrect. 10.73% chose this answer, “2.5 units.” If you chose this answer. there are 2 things to be aware of: one cup of milk has 12gms of carbohydrate (not 15gms) and you may have used the lunch/dinner insulin to carb ratio of 1:15 instead of the breakfast ratio of 1:12. These are easy mistakes to make, so make sure to read the question carefully, be familiar with common carbs and take your time doing the math. You got this.
Diabetes Exchange List – a brief summary of serving size and carbohydrate counts for common foods. Excellent study tool for the exam.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Want to learn more about carb counting and more?
We address this topic from many different angles during our Virtual Course!
Did you miss the live conference? No worries! You can register now to watch on-demand
Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.
If you are seeking a state-of-the-art review of current diabetes care, this course is for you. Our team has been fine-tuning this course for over fifteen years, and we know what you need. This program can also be a great addition to your CDCES or BC-ADM exam study plan.
Team of expert faculty includes:
In addition to informative lectures, we also use group activities and case studies to highlight the essential knowledge, skills, and strategies needed to succeed in diabetes education today!
CEs: Includes over 30 CEs
Program Info: 2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Speakers: View Conference Faculty.
Dates: Your registration fee includes access to FREE podcast and all recorded webinars for one year.
Two Registration Options
Virtual DiabetesEd Specialist Conference Deluxe | Oct. 6-8 | 30+ CEs
Deluxe Virtual Program for $459 includes:
+Plus Syllabus, Standards and Swag:
2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Virtual DiabetesEd Specialist Conference Basic | Oct. 6-8 | 30+ CEs
Basic virtual program for $359 includes:
2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Team of Experts: Our team of expert faculty has been fine-tuning this course for over fifteen years and we know what you need to succeed! In addition to informative lectures, we also use group activities and case studies to highlight the essential knowledge, skills, and strategies needed to succeed in diabetes education today!
When you register for our Virtual Course, you have immediate access to these Bonus DiabetesEd University Online Courses – for FREE!
2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Our August 31st Question of the week quizzed test takers on interventions. Over 90% of respondents chose the correct answer. Great job! We thought that this was an important topic to review, so we can pass on correct info to people living with diabetes.
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer below: Answer Question
Question: JR is 43 with type 2 diabetes who shows up for their usual visit and happens to mention that they have had moments of feeling dizzy over the past few months. A few times, they have checked their blood sugars during these spells, and they were 121 and 136. JRs medications include glipizide 10mg BID, metformin 1000mg BID, lisinopril 20mg, atorvastatin 20mg. JR has lost about 10 lbs since their last visit by eating more whole foods and grains and less fast foods.
Based on this assessment, what is the next best action?
Answer Choices:
As shown above, the most common choice was option 3, the second most common answer was option 1, then option 2, and finally option 4.
If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer.
Answer 1 is incorrect. 2.93% chose this answer, “Suggest that JR starts on aspirin given their cardiovascular risk profile.” Aspirin therapy is recommended for those 50 and older with existing or at risk for a cardiovascular event. Since JR is younger than 50, this is not the best answer.
Answer 2 is correct. 90.79% of you chose this answer, “Recommend JR get a home blood pressure monitor.” Yes, GREAT JOB. Most of you chose this best answer. Most likely, the dizziness is a result of lower blood pressure secondary to weight loss and treatment with an ACE Inhibitor (lisinopril). The ADA Standards recommend that people on blood pressure medications self-monitor their blood pressure at home to detect changes in pressure that warrant a reduction or intensification of anti-hypertensive therapy.
Answer 3 is incorrect. 2.51% of respondents chose this answer, “Assess if JR might need a sleep study to evaluate for sleep disorders.” While it is true that many people with diabetes have sleep disorders, in this case study there is not enough supporting clinical symptoms to support a sleep study. For example if JR was complaining of waking up tired or waking up gasping for air, plus they exhibit other risk factors, then further sleep evaluation might be warranted.
Finally, Answer 4 is incorrect. 3.77% chose this answer, “Encourage JR to increase activity level, to decrease cardiovascular risk.” Encouraging activity to improve health is an important part of self-care coaching. However, in this case, since JR is complaining of “dizziness”, for safety, we might even back off a little from recommending activity until we determine the cause of JRs dizziness.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Want to learn more about this topic and more?
Did you miss the live conference? No worries! You can register now to watch on-demand
Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.
If you are seeking a state-of-the-art review of current diabetes care, this course is for you. Our team has been fine-tuning this course for over fifteen years, and we know what you need. This program can also be a great addition to your CDCES or BC-ADM exam study plan.
Team of expert faculty includes:
In addition to informative lectures, we also use group activities and case studies to highlight the essential knowledge, skills, and strategies needed to succeed in diabetes education today!
CEs: Includes over 30 CEs
Program Info: 2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Speakers: View Conference Faculty.
Dates: Your registration fee includes access to FREE podcast and all recorded webinars for one year.
Two Registration Options
Virtual DiabetesEd Specialist Conference Deluxe | Oct. 6-8 | 30+ CEs
Deluxe Virtual Program for $459 includes:
+Plus Syllabus, Standards and Swag:
2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Virtual DiabetesEd Specialist Conference Basic | Oct. 6-8 | 30+ CEs
Basic virtual program for $359 includes:
2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Team of Experts: Our team of expert faculty has been fine-tuning this course for over fifteen years and we know what you need to succeed! In addition to informative lectures, we also use group activities and case studies to highlight the essential knowledge, skills, and strategies needed to succeed in diabetes education today!
When you register for our Virtual Course, you have immediate access to these Bonus DiabetesEd University Online Courses – for FREE!
2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Our August 24th Question of the week quizzed test takers on thick calluses coupled with leg pain. 61% of respondents chose the correct answer. We thought that this was an important topic to discuss further, so we can pass on correct info to people living with diabetes.
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer below: Answer Question
Question: JR has lived with type 1 diabetes for over twenty years. JR arrived in the clinic with thick calluses on both feet and complaints of calf pain when walking for more than 10 minutes. JR’s pulses are difficult to palpate.
What diagnosis best matches JR’s presentation?
Answer Choices:
As shown above, the most common choice was option 3, the second most common answer was option 1, then option 2, and finally option 4.
If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer. If you want to learn more about lower extremities, we invite you to join our Virtual Course or check out our Level 2 Online Courses.
Answer 1 is incorrect. 15.33% chose this answer, “Peripheral polyneuropathy.” This juicy answer is tempting, however it does not match the symptoms detailed by JR. A person with peripheral polyneuropathy will typically complain of numbness, tingling and leg pain at night. They may also have thick calluses. However, there are two clues that indicate a mismatch between question and answer. JR is “complaining of calf pain when walking for more than 10 minutes with difficulty locating pulses.” These chief complaints indicate a different pathology. Keep reading to find out more.
Answer 2 is incorrect. 14.50% of you chose this answer, “Diabetes venous stasis syndrome.” This is another juicy answer with a made up condition that is designed to sound familiar. In general, with venous disease, pulses are still palpable since there is adequate blood flow to lower extremities. There are two clues that indicate a mismatch between question and answer. “JR is complaining of calf pain when walking for more than 10 minutes with difficulty locating pulses.” These chief complaints indicate a different pathology. Keep reading to find out more.
Answer 3 is correct. 60.64% of respondents chose this answer, “Peripheral arterial disease.” YES, this is the BEST answer. Great job. JR is exhibiting the classic signs of inadequate arterial blood flow to the lower extremities, or peripheral arterial disease. JR’s complaints of “calf pain when walking for more than 10 minutes with difficulty locating pulses” indicate poor arterial circulation and warrant referral to a provider for complete CV risk assessment.
Finally, Answer 4 is incorrect. 9.53% chose this answer, “Charcot foot.” This answer is tempting. Charcot foot is characterized by severe foot inflammation and structural collapse. Since JR is “complaining of calf pain when walking for more than 10 minutes with difficulty locating pulses”, these symptoms do not match the usual complaints associated with Charcot foot. Good try, see answer 3 for more info.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Want to learn more about this topic and more?
Did you miss the live conference? No worries! You can register now to watch on-demand
Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.
If you are seeking a state-of-the-art review of current diabetes care, this course is for you. Our team has been fine-tuning this course for over fifteen years, and we know what you need. This program can also be a great addition to your CDCES or BC-ADM exam study plan.
Team of expert faculty includes:
In addition to informative lectures, we also use group activities and case studies to highlight the essential knowledge, skills, and strategies needed to succeed in diabetes education today!
CEs: Includes over 30 CEs
Program Info: 2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Speakers: View Conference Faculty.
Dates: Your registration fee includes access to FREE podcast and all recorded webinars for one year.
Two Registration Options
Virtual DiabetesEd Specialist Conference Deluxe | Oct. 6-8 | 30+ CEs
Deluxe Virtual Program for $459 includes:
+Plus Syllabus, Standards and Swag:
2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Virtual DiabetesEd Specialist Conference Basic | Oct. 6-8 | 30+ CEs
Basic virtual program for $359 includes:
2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Team of Experts: Our team of expert faculty has been fine-tuning this course for over fifteen years and we know what you need to succeed! In addition to informative lectures, we also use group activities and case studies to highlight the essential knowledge, skills, and strategies needed to succeed in diabetes education today!
When you register for our Virtual Course, you have immediate access to these Bonus DiabetesEd University Online Courses – for FREE!
2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
For our August 17th Question of the Week, 39% of respondents chose the best answer. This is due in part to our error. We mis-keyed the best answer for the first 96 respondents (we quickly fixed it as soon as we discovered the error). So, you may want to retake this question before you read on to discover the answer. Coach Bev sincerely apologizes if this caused any of you distress! But today, we are making it right. Thanks for your patience and ongoing participation!
Before we start, if you don’t want any spoilers and you tried the question on Tuesday morning, you can answer below: Answer Question
Question 1: Which of the following are considered diabetes autonomic neuropathies?
As shown above, the most common choice was option 3, the second most common answer was option 4, then option 1, and finally option 2.
If you are thinking about taking the certification exam, the content of this practice test question will set you up for success. Don’t forget to leverage your common sense and vast health care knowledge to get the best answer for specialty topics like microvascular disease. Be familiar with nerve disease presentation and screening as listed in the ADA Standards of Care on Microvascular health and treatment options. We also invite you to join our webinar (see below). Also, the tests will often provide a 2 part answer, one part being correct and the other part incorrect. Of course, if any part of the answer is incorrect, it is not the best answer. A great test taking tip to hold onto to when your sympathetic nervous system is in full gear. You got this, Coach Beverly
A note on Autonomic Neuropathy. This condition causes nerve damage to the autonomic nervous system which is in charge of digestion, sexual function, heart rate, and the adrenergic flight or fight response. The autonomic nervous system also “oversees” the energy-conserving parasympathetic response including bladder control, heart rate slowing, eye pupil constriction, and more.
Answer 1 is incorrect, 19.49% chose this answer, “Decreased sexual arousal, pins and needles sensations in lower extremities.” This is a juicy answer. Autonomic dysfunction can affect sexual function, but it doesn’t affect libido or sexual desire. In addition, the pins and needles sensation is due to the nerve damage associated with peripheral neuropathy. Since both parts of this answer aren’t correct, this answer is false.
Answer 2 is incorrect, 16.61% of you chose this answer, “Loss of protective sensation and urinary incontinence.” Loss of protective sensation is associated with peripheral neuropathy. However, urinary incontinence is often a result of autonomic neuropathy. Since both parts of this answer aren’t correct, this answer is false.
Answer 3 is correct, 39.62% of you chose this answer, GREAT JOB! “Resting tachycardia and esophageal dysmotility.” Elevated heart rate while resting is a concerning sign and is often associated with cardiac autonomic neuropathy and increased risk of a cardiac event. Autonomic neuropathy can affect the motility of the entire GI track, including the esophagus. The more commonly recognized GI autonomic neuropathy is gastroparesis. Since both conditions, resting tachycardia and esophageal dysmotility, are associated with autonomic neuropathy, this is the best answer.
Answer 4 is incorrect, 24.28% of you chose this juicy answer “Hypoglycemia unawareness and insensate feet.” Since hypoglycemia unawareness is associated with a diminished adrenergic response to low blood glucose levels, it is considered an autonomic neuropathy. However, insensate feet are due to peripheral nerve damage associated with ongoing hyperglycemia. Since both parts aren’t correct, this answer is false.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Want to learn more about this topic?
Join us for our
This course provides you with the need-to-know information regarding the microvascular complications of diabetes. We start with a brief overview of the pathophysiology and clinical manifestations then sum up with prevention strategies and screening guidelines. This straight-forward program will provide you with information you can use in your clinical setting and also provides critical content for the diabetes educator exam.
Objectives:
Can’t make it live? All paid registrants are guaranteed access to the video presentation, handouts and podcasts.
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
For our August 10th Question of the Week, 37% of respondents chose the best answer. We want to “take a closer look” at this question and determine strategies to choose the best response.
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer below: Answer Question
Question 1: AL is 24 with newly diagnosed type 1 diabetes. AL is very worried about going blind because an Aunt with Type 1 diabetes lost her vision due to living with type 1 diabetes.
Which of the following matches the ADA guidelines for diabetes eye care?
As shown above, the most common choice was option 1, the second most common answer was option 2, then option 4, and finally option 3.
If you are thinking about taking the certification exam, the content of this practice test question will set you up for success. Don’t forget to leverage your common sense and vast health care knowledge to get the best answer for specialty topics like microvascular disease. Be familiar with screening guidelines for eye disease as listed in the ADA Standards of Care on Microvascular health and treatment options. We also invite you to join our webinar (see below). You got this, Coach Beverly
Answer 1 is correct, 37.31% chose this answer, “An eye examination is recommended before pregnancy.” Great Job! Yes, this is the best answer. All people living with diabetes considering pregnancy need to get a baseline eye exam to evaluate retinal health. In addition, the ADA Standards recommend eye exams each trimester of pregnancy and after birth to monitor retinal changes.
Answer 2 is incorrect, 27.68% of you chose this answer, “Get eye exam immediately at type 1 diabetes diagnosis, then yearly thereafter.” This is the juicy answer. According to the ADA Standards for people with type 1 diabetes, they need an eye exam within in 5 years of diagnosis, then an eye exam every 1-2 years. The reason they don’t require an immediate eye exam is because type 1 diabetes is quickly identified and this short span of hyperglycemia does not increase risk of retinopathy. The reason we check people with type 2 eyes immediately, is because they could have had diabetes for an average of 6 years before diagnosis, allowing for the possibility of undetected eye damage.
Answer 3 is incorrect, 16.06% of you chose this answer, “If no retinopathy found on initial exam, refer to trained retinal expert for thorough exam.” ‘All people with diabetes do not need to be referred to a retinal expert. An ophthalmologist or optometrist can screen for type 1 diabetes eye disease. If retinopathy is discovered, depending on the severity, they may advise referral to a retinal specialist as needed.
Answer 4 is incorrect, 18.96% of you chose this answer “Only a trained ophthalmologists can screen for type 1 diabetes eye disease.” An ophthalmologist or optometrist can screen for type 1 diabetes eye disease. Programs that use retinal photography (with remote reading or use of a validated assessment tool) are also appropriate screening strategies for diabetes retinopathy. Such programs need to provide pathways for timely referral for a comprehensive eye examination when indicated.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Want to learn more about this topic?
Join us for our
This course provides you with the need-to-know information regarding the microvascular complications of diabetes. We start with a brief overview of the pathophysiology and clinical manifestations then sum up with prevention strategies and screening guidelines. This straight-forward program will provide you with information you can use in your clinical setting and also provides critical content for the diabetes educator exam.
Objectives:
Level 2 | Setting up a Successful DSME Program Standards | 1.5 CEs
This course provides you with a succinct overview of the latest standards for Diabetes Self-Management Education (DSME) and Support Programs. If you are taking the CDCES Exam or considering setting up a DSME program, this program is designed for you. We review the 10 standards and provide strategies on implementation. In addition, we discuss Medicare Reimbursement and covered benefits. This course provides insights into the exam philosophy and also highlights critical content areas.
Objectives:
Can’t make it live? All paid registrants are guaranteed access to the video presentation, handouts and podcasts.
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.