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?
Fasting blood glucose of 126 mg/dL
Glycosylated hemoglobin (HbA1c) of 8%
Random blood glucose of 180 mg/dL
Urine ketones of negative
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Blood pressure of 90/60 mmHg
Rationale: A blood pressure of 90/60 mmHg indicates hypotension, which is a sign of septic shock and requires immediate intervention. Hypotension results from vasodilation and fluid loss due to the systemic inflammatory response to infection.
Incorrect options:
A) Temperature of 38.5°C (101.3°F) - This is a sign of fever, which is a common symptom of sepsis, but not as urgent as hypotension.
B) Heart rate of 110 beats per minute - This is a sign of tachycardia, which is a compensatory mechanism to maintain cardiac output in sepsis, but not as urgent as hypotension.
D) Respiratory rate of 22 breaths per minute - This is within the normal range for adults and does not indicate respiratory distress.
Correct Answer is B
Explanation
Use a non-latex glove to palpate the injection site
Rationale: The nurse should use a non-latex glove to palpate the injection site, as latex gloves can cause skin irritation, rash, or anaphylaxis in clients who have a latex allergy.
Incorrect options:
A) Use a filter needle to draw up the medication from the vial - This action is not related to preventing an allergic reaction, but rather to preventing contamination or injury from glass particles that may be present in some vials.
C) Use an alcohol swab to cleanse the injection site - This action is not related to preventing an allergic reaction, but rather to preventing infection by reducing the number of microorganisms on the skin.
D) Use a Z-track technique to inject the medication - This action is not related to preventing an allergic reaction, but rather to preventing leakage or irritation of the medication into the subcutaneous tissue by creating a zigzag path with the needle.
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