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 A
Explanation
A. Keeping a body map of skin lesions is a key strategy for monitoring changes in the skin over time. This helps individuals track any new or changing lesions, which is crucial for early detection of skin cancer.
B. Reducing tanning bed use is important because tanning beds are a significant risk factor for skin cancer. However, the instruction should emphasize complete avoidance rather than just reduction, as tanning beds dramatically increase the risk of melanoma.
C. Examining your body every 2 months is not frequent enough for effective skin cancer monitoring. Monthly self-examinations are generally recommended to catch potential changes early.
D. Avoiding the sun after 3 p.m. is incorrect; the most dangerous sun exposure typically occurs between 10 a.m. and 4 p.m. The instruction should advise avoiding the sun during peak hours or wearing protective clothing and sunscreen.
Correct Answer is A
Explanation
A. Performing hand hygiene before, during, and after direct contact with the client is the most effective strategy for preventing the transmission of infections. Hand hygiene interrupts the transmission of pathogens and is a cornerstone of infection control practices.
B. Changing the client's bed linens each day is a standard practice for maintaining cleanliness but does not specifically prevent infection transmission. The primary goal of infection control is to reduce pathogen transmission rather than just maintaining general cleanliness.
C. Controlling the client's blood glucose level is important for overall health and wound healing but does not directly prevent infection transmission. It is not an infection control strategy.
D. Placing the client in a room with positive-pressure airflow is used to protect immunocompromised patients from infections by preventing outside air from entering the room. However, it is not appropriate for preventing the transmission of an infection from a client to others.
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