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A nurse is reviewing the laboratory results of a client who has been diagnosed with diabetes mellitus.

Which value should the nurse recognize as an indicator of poor glycemic control?

A.

Fasting blood glucose of 126 mg/dL

B.

Glycosylated hemoglobin (HbA1c) of 8%

C.

Random blood glucose of 180 mg/dL

D.

Urine ketones of negative

Answer and Explanation

The Correct Answer is B

Glycosylated hemoglobin (HbA1c) of 8%

Rationale: Glycosylated hemoglobin (HbA1c) reflects the average blood glucose level over the past two to three months. A normal HbA1c level is less than 5.7%, while a level above 6.5% indicates diabetes. A level of 8% or higher indicates poor glycemic control and increased risk of complications.

Incorrect options:

A) Fasting blood glucose of 126 mg/dL - This is a borderline value that may indicate prediabetes, but not necessarily poor glycemic control. A fasting blood glucose of 126 mg/dL or higher on two separate occasions is diagnostic of diabetes.

C) Random blood glucose of 180 mg/dL - This is an elevated value that may indicate hyperglycemia, but not necessarily poor glycemic control. A random blood glucose of 200 mg/dL or higher with symptoms of diabetes is diagnostic of diabetes.

D) Urine ketones of negative - This is a normal finding that indicates the absence of ketones in the urine. Ketones are produced when the body breaks down fat for energy due to insufficient insulin. The presence of ketones in the urine indicates diabetic ketoacidosis, a life-threatening complication of diabetes.


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Related Questions

Correct Answer is C

Explanation

A black nodule with an irregular border and asymmetrical shape

Rationale: A black nodule with an irregular border and asymmetrical shape is consistent with the ABCDE criteria for melanoma, which are: Asymmetry, Border irregularity, Color variation, Diameter greater than 6 mm, and Evolving or changing appearance.

Incorrect options:

A) A brown mole with a smooth border and symmetrical shape - This is a normal finding that does not indicate malignancy.

B) A red macule with a flat surface and well-defined edges - This is likely a benign vascular lesion, such as a cherry angioma or petechiae.

D) A yellow papule with a raised surface and round edges - This is likely a benign sebaceous lesion, such as a sebaceous cyst or milia.

Correct Answer is B

Explanation

"The client has crackles in the lower lobes bilaterally."

Rationale: Objective data are observable and measurable facts that can be verified by the nurse or another health care provider. Crackles are an abnormal lung sound that can be heard with a stethoscope and indicate fluid accumulation in the alveoli.

Incorrect options:

A) "The client reports feeling short of breath and fatigued." - This is an example of subjective data, which are information that only the client can perceive and describe, such as feelings, sensations, and beliefs.

C) "The client states that he has been coughing up green sputum." - This is also an example of subjective data, as it is based on the client's verbal report.

D) "The client rates his pain as 4 out of 10 on a numeric scale." - This is another example of subjective data, as pain is a personal experience that cannot be directly measured by the nurse.

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