A nurse is caring for a client who was diagnosed with type 2 diabetes mellitus 2 years ago. The client reports following the recommended diet and exercising four times per week. Which of the following findings indicates that the client's beta cells are restoring normal function?

HbA1c = 5.6%

Client reports smoking cessation

Weight gain of 5 lb

Fasting blood glucose of 140 mg/Dl

Answer and Explanation

The Correct Answer is A

A. HbA1c = 5.6%. HbA1c measures the average blood glucose levels over the past 2-3 months. A level of 5.6% is within the normal range (below 5.7%), indicating good glycemic control. This suggests that the client’s diabetes is well managed, potentially indicating that the beta cells are functioning well and insulin sensitivity has improved.

B. Client reports smoking cessation: While smoking cessation is very beneficial for overall health and can improve diabetes management, it does not directly indicate beta cell function restoration. It is more related to reducing cardiovascular risks and improving long-term health outcomes.

C. Weight gain of 5 lb: Weight gain is not typically a sign of improving beta cell function. In fact, weight gain can sometimes indicate poor control of diabetes, as insulin resistance can worsen with increased weight. It is not a direct measure of beta cell activity.

D. Fasting blood glucose of 140 mg/dL: A fasting blood glucose of 140 mg/dL is above the normal range and suggests poor glycemic control, indicating that beta cells are not functioning adequately to maintain normal glucose levels. This value points to ongoing issues with insulin resistance or secretion.

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Correct Answer is C

Explanation

A. Increased pulmonary artery wedge pressure (PAWP): PAWP measures left atrial pressure, which is typically increased in left-sided heart failure, not right-sided. Right-sided heart failure leads to systemic congestion rather than pulmonary congestion.

B. Decreased specific gravity: Specific gravity measures urine concentration. It is not a primary indicator of heart failure. Heart failure usually affects fluid balance rather than specific urine concentration.

C. Elevated central venous pressure (CVP): CVP reflects the pressure in the right atrium and central veins, which is elevated in right-sided heart failure due to the backup of blood in the systemic circulation. This results in increased venous pressure.

D. Decreased brain natriuretic peptide (BNP): BNP levels are typically elevated in heart failure, as they reflect the degree of ventricular stretching and fluid overload. A decrease would not be expected in acute heart failure.

A. Maintain oxygen saturations greater than or equal to 92%. B. Obtain an EKG. C. Administer enteric-coated acetaminophen. D. Administer ibuprofen.

Correct Answer is B

Explanation

A. Maintain oxygen saturations greater than or equal to 92%: Maintaining oxygen saturation is important but is not the immediate priority. The symptoms suggest a possible myocardial infarction (heart attack), and the primary focus should be on immediate diagnostic assessment and treatment.

B. Obtain an EKG: The symptoms described (pain in the jaw, back, and shoulder, along with shortness of breath and nausea) are classic signs of a myocardial infarction. An EKG is essential to quickly diagnose this potentially life-threatening condition and guide further treatment.

C. Administer enteric-coated acetaminophen: Acetaminophen is typically used for pain relief or fever reduction, not for the treatment of symptoms that may indicate a heart attack. It does not address the potential underlying cause, which is more serious.

D. Administer ibuprofen: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that may provide pain relief but is not appropriate for a suspected myocardial infarction. NSAIDs can also potentially increase the risk of cardiovascular events and would not be suitable in this context.

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A nurse is caring for a client who was diagnosed with type 2 diabetes mellitus 2 years ago. The client reports following the recommended diet and exercising four times per week. Which of the following findings indicates that the client's beta cells are restoring normal function?

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