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)
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Malnutrition and acute pancreatitis are not primary causes of chronic pancreatitis. While acute pancreatitis can lead to chronic conditions, malnutrition is not a common direct cause.
B. Heavy alcohol consumption and smoking are well-established risk factors for chronic pancreatitis. These lifestyle factors can cause inflammation and damage to the pancreas over time.
C. Caffeine consumption does not have a direct correlation with chronic pancreatitis. Cigarette smoking is a risk factor, but caffeine is not.
D. Acute hepatitis is not a common cause of chronic pancreatitis. While alcohol consumption is a risk factor, the presence of acute hepatitis is not typically a direct cause.
Correct Answer is A
Explanation
A. The first priority in this situation is to open the client's airway using the jaw-thrust maneuver. This technique is preferred for clients with suspected spinal injuries to avoid further spinal cord damage. Ensuring the airway is open and providing oxygenation are immediate life-saving actions.
B. Checking cranial nerve function, including assessing pupils, is important for evaluating neurological status but is not the first action when the client is not breathing. Ensuring the airway is open and providing oxygenation is the priority.
C. While placing the client in a rigid cervical collar is important for stabilizing the spine and preventing further injury, it should be done after ensuring the airway is clear. The immediate concern is to address the client's non-breathing status.
D. Evaluating the client for brain injury is important for overall assessment but is secondary to addressing the immediate life threat of not breathing. Ensuring the airway is open and then stabilizing the spine is the priority.
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