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1. The American Association of Diabetes Educators (AADE) reports that patients with diabetes see their pharmacist _____ times more frequently than they see their primary care physician.

A. 2 B. 5 C. 10 D. 7

2. The earliest insulin needles were ___ mm in length.

A. 16 B. 12.7 C. 6 D. 27

3. The number of adults with diabetes using insulin in the United States is placed at approximately ____%.

A. 10 % B. 75 % C. 59 % D. 29 %

4. When compared with the 5 mm and 8 mm needles, the 4 mm needle demonstrated _______ glycemic control for patients.

A. Greater control than both the 5 and the 8 mm needles B. The same amount of glycemic control as both the 5 and the 8 mm needles C. Poorer control than the 8 mm needle, but equal to that of the 5 mm needle D. Poorer control than both the 5 and the 8 mm needles

5. Longer insulin needles may result in inadvertent intramuscular (IM) injection, which may cause which of the following:

A. Faster absorption of insulin B. Potential decrease in insulin duration of action C. Increased injection pain D. All of the above

6. According to the consensus panel (Scientific Advisory Board for the Third Injection Technique Workshop), which needle lengths may be used by any adult, including obese patients, and should not require the lifting of a skinfold to administer the injection.

A. 4 mm B. 5 mm C. 6 mm D. All the above

7. To ensure air has not accumulated in an insulin pen prior to injection, the following procedure should be performed:

A. Rolling the pen gently between the palms B. A 2-unit air shot C. Holding the pen upright and shaking gently D. All the above

8. As opposed to pen devices, patients using insulin syringes

A. May administer the injection and not have to count to 6 before removing the needle B. Are encouraged to reuse the needle several times before replacing it C. May inject more accurately D. Should swab all used syringe needles with alcohol before reusing

9. For greater comfort upon injection, the patient could

A. Inject an insulin formulation kept at room temperature B. Let all alcohol used at the injection site to dry before administering the injection C. Both answers A and B are correct D. None of the above will make injections more comfortable

10. Recommendations for injection into the stomach include staying away from the umbilicus by _____.

A. 2 inches B. 6 inches C. 4 inches D. ½ inch

11. A lumpy or thickened lesion attributed to repeated injections into the same area is known as

A. Lipohypertrophy B. Lipoatrophy C. Lipolysis D. Atrophic lipemia

12. A term used to identify the avoidance of insulin or the avoidance of intensification of insulin by patients and clinicians alike is known as

A. Personal insulin reticence (PIR) B. Psychotrophic insulin resistance (PIR) C. Psychological insulin resistance (PIR) D. Patient impaired resistance (PIR)

13. PIR can be caused by which of the following:

A. Social stigma B. Fear of needles C. Fear of hypoglycemia D. All of the above

14. Results from the Diabetes Control and Complications Trial (DCCT), the Kumamoto study, and the United Kingdom Prospective Diabetes Study (UKPDS) showed that each 1% decrease in the glycated hemoglobin (A1C) level results in a _____ risk reduction in microvascular complications.

A. 10% to 12% B. 20% to 30% C. 70% to 80% D. 50% to 60%

15. Which of the following statements is TRUE regarding needle phobia:

A. Few patients have true needle phobia B. Needle phobia is common among all patients with diabetes C. Needle phobia does not really exist at all D. Needle phobia occurs only in children

16. _____ is the most recognized adverse effect of insulin therapy.

A. Retinopathy B. Hypoglycemia C. Lipohypertrophy D. Insulin resistance

17. Compared with type 1 diabetes, severe hypoglycemia in patients with type 2 diabetes occurs

A. More often B. Less often C. About the same D. More often and is more severe

18. Resistance from physicians to initiate insulin therapy includes which of the following factors:

A. Belief that insulin is not effective for lowering A1C B. Not enough time to effectively manage insulin treatment C. Fear of causing hypoglycemia in patients D. Both answers B and C are correct

19. Which of the following refers to motivational interviewing:

A. Is not an effective method to counsel patients with diabetes B. Is one method to learn how each patient feels about starting insulin therapy C. Is effective, but should be reserved for psychologists D. None of the above is true