A male client with type 1 diabetes mellitus with a hemoglobin A1c test result of 12.7%. In discussing the result with the client, the nurse would be most accurate in stating:

"The test needs to be repeated following a 12-hour fast."

"It tells us about your sugar control for the last 3 months."

"It looks like you aren't following the prescribed diabetic diet."

"Your insulin regimen needs to be altered significantly."

Answer and Explanation

The Correct Answer is B

A. "The test needs to be repeated following a 12-hour fast."
This statement is not accurate. The hemoglobin A1c test does not require fasting. It reflects the average blood glucose levels over the past two to three months and is not affected by short-term changes in diet or fasting.

B. "It tells us about your sugar control for the last 3 months."
This statement is accurate. The hemoglobin A1c test provides information about the average blood glucose levels over the past two to three months. It's a valuable tool for assessing long-term glycemic control.

C. "It looks like you aren't following the prescribed diabetic diet."
The hemoglobin A1c test reflects overall glycemic control over several months and is not solely influenced by recent dietary habits. While diet plays a role in diabetes management, this statement oversimplifies the interpretation of the A1c result.

D. "Your insulin regimen needs to be altered significantly."
While a high A1c may indicate a need for adjustments in the treatment plan, the decision to alter the insulin regimen should be based on a comprehensive assessment of the patient's overall diabetes management, including lifestyle, diet, and other factors. It may not solely be determined by the A1c result.

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Correct Answer is C

Explanation

A. 15 to 20 g of a fast-acting carbohydrate such as orange juice:
This is a standard and initial treatment for hypoglycemia. Fast-acting carbohydrates, like orange juice or glucose tablets, can quickly raise blood sugar levels. However, in the scenario described, the client is still conscious, and glucagon may be a more appropriate choice.

B. I.V. bolus of dextrose 50%:
Intravenous (IV) dextrose is a more aggressive intervention and is typically reserved for severe cases of hypoglycemia or for unconscious patients. It is not the first-line treatment for conscious patients.

C. I.M. or subcutaneous glucagon:
Glucagon is a hormone that raises blood sugar levels by promoting the conversion of stored glycogen in the liver to glucose. It is administered either intramuscularly (I.M.) or subcutaneously. In a conscious patient with hypoglycemia who cannot take oral carbohydrates, glucagon can be an effective and rapid way to raise blood sugar levels.

D. 10 U of fast-acting insulin:
Administering more insulin in a situation of hypoglycemia would worsen the condition. The goal in hypoglycemia is to raise blood sugar, and giving more insulin would have the opposite effect.

A. "If a vial of insulin will be used up within 21 days, it may be kept at room temperature." B. "If a vial of insulin will be used up within 2 weeks, it may be kept at room temperature." C. "If you are going to use up the vial within 1 month, it can be kept at room temperature." D. "If a vial of insulin will be used up within 1 week, it may be kept at room temperature."

Correct Answer is A

Explanation

A. "If a vial of insulin will be used up within 21 days, it may be kept at room temperature."
This statement suggests a duration of up to 21 days for room temperature storage after the vial is in use. However, most insulins can typically be stored at room temperature for up to 28 days after initial use. This recommendation might be more conservative than necessary for many types of insulin.

B. "If a vial of insulin will be used up within 2 weeks, it may be kept at room temperature."
This choice suggests a timeframe of 14 days for room temperature storage after opening the vial. However, for many insulins, the recommended duration for room temperature storage after opening is up to 28 days.

C. "If you are going to use up the vial within 1 month, it can be kept at room temperature."
This option extends the timeframe to 1 month for room temperature storage after the vial is in use. However, the generally recommended duration for many insulins is up to 28 days after opening.

D. "If a vial of insulin will be used up within 1 week, it may be kept at room temperature."
This choice suggests a very short duration of 7 days for room temperature storage after opening the vial. Most insulins can typically be stored at room temperature for a longer duration after initial use.

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A male client with type 1 diabetes mellitus with a hemoglobin A1c test result of 12.7%. In discussing the result with the client, the nurse would be most accurate in stating:

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