A nurse is assessing a client who has diabetes mellitus type 2 and presents for a follow-up visit. Which of the following lab values is most indicative of inadequate control of their diabetes since their last primary care visit and requires further teaching?

HbA1c level of 7.5% (nl. 4.4-6.4%)

2-hour post-prandial blood glucose level of 122 mg/dL (nl. <120 mg/dL)

Random blood glucose level of 300 mg/dL (nl. <200 mg/dL)

Fasting blood glucose level of 48 mg/dL (nl. 60-110 mg/dL)

Answer and Explanation

The Correct Answer is C

A. An HbA1c level of 7.5% indicates suboptimal long-term glucose control. The target for many diabetic patients is usually below 7%, but it may not require immediate action compared to more acute indicators.
B. A 2-hour post-prandial blood glucose level of 122 mg/dL is slightly above the normal range but not significantly high. This result alone is not as indicative of inadequate control as other values.
C. A random blood glucose level of 300 mg/dL is significantly elevated and indicates poor glucose control. This value is much higher than the normal range and suggests a need for further teaching and adjustment of diabetes management.
D. A fasting blood glucose level of 48 mg/dL is low and could indicate hypoglycemia rather than inadequate control. This level requires immediate attention but does not reflect poor long-term diabetes management.

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Correct Answer is B

Explanation

A. Assessing for sources of bleeding is important in clients with neutropenia, but the highest priority is preventing infection, as the client’s absolute neutrophil count is zero, indicating an extremely high risk for infection.
B. Limiting contact with infected visitors and placing the client in positive pressure isolation is crucial for preventing infections. With a neutrophil count of zero, the client is highly immunocompromised and at a significant risk of infection, making this the highest priority action.
C. Administering antiemetics and assessing nutrition and hydration are important for managing symptoms, but they do not address the immediate risk of infection associated with severe neutropenia.
D. Monitoring energy levels and implementing energy-conserving techniques are important for overall care but do not address the urgent need to protect the client from infections due to their neutropenic status.

A. "I should have my thyroid function tested frequently." B. "My diet should include foods with a high glycemic index." C. "I will need to use at least two forms of birth control due to increased fertility." D. "I should focus on weight loss to help improve my symptoms."

Correct Answer is D

Explanation

D. Weight loss can help improve symptoms of polycystic ovarian syndrome (PCOS) by reducing insulin resistance and androgen levels, which are common issues in PCOS.
A. Thyroid function testing is not specifically related to PCOS management, though thyroid function should be monitored if there are symptoms of thyroid dysfunction.
B. A diet with a low glycemic index is generally recommended for managing PCOS, not a high glycemic index.
C. PCOS is associated with decreased fertility rather than increased fertility. Contraception might be recommended for menstrual regulation, but not necessarily two forms due to increased fertility.

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A nurse is assessing a client who has diabetes mellitus type 2 and presents for a follow-up visit. Which of the following lab values is most indicative of inadequate control of their diabetes since their last primary care visit and requires further teaching?

Nursing Test Bank

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