A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?
Urine dipstick for glucose
Fasting blood glucose
Oral glucose tolerance
Glycosylated hemoglobin (Hemoglobin A1C)
The Correct Answer is D
Choice A reason: Urine dipstick for glucose is not a reliable test to evaluate the effectiveness of treatment for type 2 diabetes. Urine glucose testing can only detect glucose in the urine when the blood glucose level is very high, above the renal threshold of 180 mg/dL. Urine glucose testing does not reflect the average blood glucose level over time, and can be affected by factors such as hydration, medication, and urinary tract infections.
Choice B reason: Fasting blood glucose is a test that measures the blood glucose level after an overnight fast of at least 8 hours. Fasting blood glucose is a useful test to diagnose diabetes, but it is not the best test to evaluate the effectiveness of treatment for type 2 diabetes. Fasting blood glucose only reflects the blood glucose level at one point in time, and can vary depending on the time of day, the amount and type of food eaten, and the activity level.
Choice C reason: Oral glucose tolerance is a test that measures the blood glucose level before and after drinking a solution containing 75 g of glucose. Oral glucose tolerance is another test that can diagnose diabetes, but it is not the most convenient or accurate test to evaluate the effectiveness of treatment for type 2 diabetes. Oral glucose tolerance requires the patient to fast for at least 8 hours, drink the glucose solution, and have blood samples taken at 0, 30, 60, 90, and 120 minutes. Oral glucose tolerance can also be influenced by factors such as stress, illness, medication, and menstrual cycle.
Choice D reason: Glycosylated hemoglobin (Hemoglobin A1C) is a test that measures the percentage of hemoglobin that has glucose attached to it. Hemoglobin is a protein in the red blood cells that carries oxygen. Red blood cells have a lifespan of about 120 days, so the hemoglobin A1C test reflects the average blood glucose level over the past 2 to 3 months. Hemoglobin A1C is the best test to evaluate the effectiveness of treatment for type 2 diabetes, as it shows how well the blood glucose level has been controlled over time, and is not affected by factors such as fasting, food intake, or daily fluctuations.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: This statement is false. Drinking more fluids in the late evening can cause nocturia, which is the need to urinate frequently at night. This can disrupt the sleep cycle and increase the risk of falls.
Choice B reason: This statement is true. Dry mouth is a sign of dehydration and indicates the need for more fluid intake. Older adults may have reduced thirst sensation and may not drink enough fluids throughout the day.
Choice C reason: This statement is false. Caffeine is a diuretic, which means it increases urine output and can worsen dehydration. Confusion is a symptom of dehydration and requires immediate medical attention.
Choice D reason: This statement is false. Feeling full is not a reliable indicator of hydration status. Older adults may have decreased appetite and gastric motility, which can make them feel full even when they are dehydrated.
Correct Answer is A
Explanation
Choice A reason: Weight loss is a common clinical manifestation of type 1 diabetes mellitus in children. Type 1 diabetes mellitus is a condition where the pancreas does not produce enough insulin, a hormone that helps the cells use glucose for energy. Without insulin, the glucose stays in the blood and causes high blood sugar levels. The body then breaks down fat and muscle for energy, resulting in weight loss.
Choice B reason: Low urine output is not a typical clinical manifestation of type 1 diabetes mellitus in children. In fact, the opposite is true: high urine output is a sign of type 1 diabetes mellitus. This is because the excess glucose in the blood draws water from the cells and tissues, causing dehydration and increased thirst. The kidneys then try to flush out the glucose and water through urine, leading to frequent urination.
Choice C reason: Weight gain is not a usual clinical manifestation of type 1 diabetes mellitus in children. As explained in choice A, type 1 diabetes mellitus causes weight loss due to the lack of insulin and the breakdown of fat and muscle. Weight gain can be a sign of type 2 diabetes mellitus, which is a condition where the cells become resistant to insulin and the pancreas cannot produce enough insulin to overcome the resistance. Weight gain can also be a side effect of insulin therapy, which is used to treat both types of diabetes mellitus.
Choice D reason: Hand tremors are not a specific clinical manifestation of type 1 diabetes mellitus in children. Hand tremors can be caused by many factors, such as anxiety, stress, caffeine, medication, or neurological disorders. Hand tremors can also be a symptom of hypoglycemia, which is a condition of low blood sugar that can occur in people with diabetes mellitus. However, hypoglycemia is not exclusive to diabetes mellitus, and can affect anyone who has a low intake of food, a high expenditure of energy, or a high dose of insulin or oral hypoglycemic agents.
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