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 A

Explanation

A. Hepatomegaly: Hepatomegaly, or enlargement of the liver, is a common finding in right-sided heart failure due to congestion of the liver from impaired venous return. It indicates systemic venous congestion.

B. Crackles in the lungs: Crackles in the lungs are more commonly associated with left-sided heart failure, which leads to pulmonary congestion. Right-sided heart failure primarily causes systemic venous congestion rather than pulmonary issues.

C. Dry, hacking cough: A dry, hacking cough is not typically associated with right-sided heart failure. It is more related to left-sided heart failure or other pulmonary conditions.

D. Dizziness: Dizziness can occur in various conditions, including heart failure, but it is not a specific finding for right-sided heart failure. It is often due to decreased cardiac output or orthostatic hypotension.

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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