Rationale of the Week | Best intervention for JR?

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:

  1. Suggest that JR starts on aspirin given their cardiovascular risk profile.
  2. Recommend JR get a home blood pressure monitor.
  3. Assess if JR might need a sleep study to evaluate for sleep disorders.
  4. Encourage JR to increase activity level, to decrease cardiovascular risk.

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.

Getting to the Best Answer

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 question and more?

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  • Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES – Educator of the Year, 2020
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  • Ashley LaBrier, MS, RD, CDCES, Diabetes Program Coordinator

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: October 6-8. Don’t worry if you can’t make it live, your registration fee includes access to FREE podcast and all recorded webinars for one year.

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2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Virtual DiabetesEd Specialist Conference Basic | Oct. 6-8 | 30+ CEs

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  • Presentations by our team of experts
  • Q & A Session with the instructor after each webinar
  • State-of-the-art review of current diabetes care and technology.
  • Resources for each session
  • Access to FREE podcast and recorded webinars within a week of each live session for one full year.

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!


Bonus Courses worth 12 + CEs, FREE

When you register for our Virtual Course, you have immediate access to these Bonus DiabetesEd University Online Courses – for FREE!

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  • Level 2 – Hyperglycemic Crisis, DKA and HHS Standards 1.0 CEs
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  • Level 2 – Setting up a Successful Diabetes Program 1.5 CEs
  • Level 2 – Pregnancy and Diabetes 1.5 CEs
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2021 Diabetes Educator Course Flyer & Schedule (subject to change)


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