A nurse is reviewing a client's laboratory results and sees that their hemoglobin A1C is 9%. Which of the following statements from the nurse is appropriate?

"Your blood sugar is very unstable."

"Your blood sugar is too high after meals."

"Your average blood sugar is high."

"You have many dangerously low blood sugar levels."

Answer and Explanation

The Correct Answer is C

A. "Your blood sugar is very unstable." While high HbA1C levels can indicate poor glucose control, they do not specifically indicate instability in blood sugar levels (i.e., frequent fluctuations between high and low levels). HbA1C does not capture short-term variations in blood glucose; it only provides an average over a few months.

B. "Your blood sugar is too high after meals." Although postprandial (after-meal) glucose levels contribute to overall blood glucose levels, HbA1C measures the average blood glucose level over several months and is not specific to postprandial glucose levels. A high HbA1C suggests elevated glucose levels overall, not just after meals.

C. "Your average blood sugar is high." HbA1C measures the average blood sugar level over an extended period, typically 2-3 months. A result of 9% indicates that the client's average blood glucose levels have been consistently high, suggesting poor long-term glucose control. This is a precise and appropriate statement reflecting the meaning of the HbA1C result.

D. "You have many dangerously low blood sugar levels." A high HbA1C indicates elevated blood glucose levels over time, not low levels. Low blood sugar levels (hypoglycemia) would not contribute to a high HbA1C. In fact, frequent hypoglycemia would more likely result in a lower HbA1C, not a higher one.

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Correct Answer is D

Explanation

A. Purple striations: Purple striations are characteristic of Cushing's syndrome due to prolonged exposure to high levels of cortisol. They are not associated with Addison's disease, which involves adrenal insufficiency and low cortisol levels.

B. Hirsutism: Hirsutism, or excessive hair growth, is not a feature of Addison's disease. It is more commonly associated with conditions involving high androgen levels, such as polycystic ovary syndrome or Cushing's syndrome.

C. Intention tremors: Intention tremors are associated with neurological conditions like multiple sclerosis or essential tremor, not Addison's disease. Addison's primarily affects hormone levels and fluid balance.

D. Hyperpigmentation: Hyperpigmentation, particularly in areas like the skin creases, gums, and around scars, is a hallmark sign of Addison's disease. It is due to increased production of melanocyte-stimulating hormone (MSH) as a result of elevated levels of adrenocorticotropic hormone (ACTH).

A. Dry skin B. Heat intolerance C. Drowsiness D. Bradycardia

Correct Answer is B

Explanation

A. Dry skin: Dry skin is typically a symptom of hypothyroidism, where there is insufficient thyroid hormone. In thyrotoxicosis, skin changes would more likely include warm, moist skin due to increased metabolism.

B. Heat intolerance: Heat intolerance is a common symptom of thyrotoxicosis because the increased metabolic rate leads to higher body temperatures and intolerance to heat.

C. Drowsiness: Drowsiness is usually associated with hypothyroidism, where low thyroid levels slow down metabolism, leading to fatigue and lethargy. Thyrotoxicosis typically causes hyperactivity and insomnia rather than drowsiness.

D. Bradycardia: Bradycardia, or slow heart rate, is associated with hypothyroidism. In thyrotoxicosis, increased thyroid hormone levels lead to an elevated heart rate (tachycardia), not a decreased one.

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