A nurse is assessing an adolescent who has type 1 diabetes mellitus. Which of the following findings is the nurse's priority?
Cholesterol 189 mg/dL
HbA1c 11.5%
Glycosuria
Preprandial blood glucose 124 mg/dL
The Correct Answer is B
A. While an elevated cholesterol level is a concern in diabetes, it is not the priority in this case. The elevated HbA1c level indicates a more pressing issue that requires immediate attention.
B. The correct answer is B. HbA1c 11.5%. HbA1c is a measure of the average blood glucose level over the past 2 to 3 months. A high HbA1c indicates poor glycemic control and increased risk of complications from diabetes. The nurse's priority is to address the factors that are contributing to the high HbA1c and provide education and support to improve the adolescent's self-management.
C. Glycosuria, while important to monitor, is a common finding in uncontrolled diabetes.
It indicates elevated blood glucose levels and may require adjustments in the treatment plan. However, it is not as critical as addressing the elevated HbA1c level.
D. A preprandial blood glucose level of 124 mg/dL is within a reasonable range for an adolescent with diabetes. It is important to monitor blood glucose levels, but the elevated HbA1c level takes precedence in this situation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. A blood pressure of 132/82 mm Hg in an adolescent is within the normal range for their age group. It does not require immediate reporting to the provider.
B. A respiratory rate of 30 breaths per minute in a 3-month-old infant is within the expected (typically 25-40 breaths per minute).
C. A heart rate of 68 beats per minute in an 18-month-old toddler is below the normal range (typically 70-110 beats per minute) and should be reported g to the provider.
D. A rectal body temperature of 37.3° C (99.1° F) in a school-age child is within the normal range (typically 36.5-37.5° C or 97.7-99.5° F). It does not require immediate reporting to the provider.
Correct Answer is B
Explanation
A. Starting the IV in the infant's foot is not the preferred site for a 12-month-old who is ambulatory or beginning to walk, as it can interfere with mobility. The hand, forearm, or scalp (if necessary) are preferred sites.
B. Using a 24-gauge catheter is the correct choice, as smaller-gauge catheters (24- to 26-gauge) are appropriate for infants to minimize trauma and facilitate proper IV access.
C. Changing the IV site every 3 days is a general guideline for adults, but in infants, the site should be assessed frequently and changed as needed based on signs of infiltration or complications.
D. Covering the insertion site with an opaque dressing is incorrect because a transparent dressing is preferred to allow for continuous assessment of the site for complications such as infiltration or phlebitis.
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