Aron comes into the clinic after 6 months for a follow-up visit. He indicates that his blood sugars have been around 100 to 120 mg/dL, and he has been fully participating in the other aspects of his diabetes management plan. Which would lead you to believe that he has not been in tight control of his diabetes?
A reduced glycosylated hemoglobin level (Hemoglobin A1C).
An elevated glycosylated hemoglobin level.
A random blood sugar of 150 mg/dL performed in the clinic.
There is no method to determine whether the patient is in tight glucose control.
The Correct Answer is B
Choice A reason: A reduced glycosylated hemoglobin level (Hemoglobin A1C) indicates that blood sugar levels have been well-controlled over the past three months. Hemoglobin A1C is a measure of the average blood glucose levels over this period. A lower A1C level suggests that the patient has been maintaining good control of their blood sugar levels, making it an unlikely indicator of poor diabetes management. The normal range for Hemoglobin A1C is below 5.7%, while levels between 5.7% and 6.4% indicate prediabetes, and levels above 6.5% indicate diabetes.
Choice B reason: An elevated glycosylated hemoglobin level is a clear indicator that the patient has not been maintaining tight control of their blood sugar levels. Hemoglobin A1C reflects the average blood glucose levels over the past three months. If the A1C level is high, it suggests that the patient's blood sugar levels have been elevated consistently over this period. This can occur despite the patient reporting blood sugar levels within the target range during clinic visits. An elevated A1C level (greater than 6.5%) is a strong sign of inadequate diabetes management and suggests the need for adjustments in the treatment plan.
Choice C reason: A random blood sugar level of 150 mg/dL performed in the clinic provides a snapshot of the patient's blood sugar level at a single point in time. While this level is above the normal range (typically below 140 mg/dL for non-diabetics), it does not provide a comprehensive picture of the patient's overall blood sugar control. Blood sugar levels can fluctuate due to various factors, including recent meals, stress, and physical activity. Therefore, a single random blood sugar reading is not a reliable indicator of tight diabetes control.
Choice D reason: The statement that there is no method to determine whether the patient is in tight glucose control is incorrect. There are several methods to assess diabetes control, with the Hemoglobin A1C test being one of the most reliable. Additionally, frequent monitoring of blood sugar levels through self-testing and continuous glucose monitoring systems can provide valuable information about how well the patient is managing their diabetes. These methods allow healthcare providers to make informed decisions about treatment adjustments and overall diabetes management strategies.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Gestational diabetes is a form of diabetes that occurs during pregnancy and typically resolves after childbirth. It is not typically associated with Hyperglycemic Hyperosmolar Nonketoic (HHNK) Syndrome, which is a specific complication of type 2 diabetes.
Choice B reason: Type 2 diabetes is characterized by insulin resistance and high blood glucose levels. HHNK is a serious acute complication of type 2 diabetes, occurring when blood glucose levels become extremely high, leading to severe dehydration and hyperosmolarity without significant ketoacidosis. This condition requires immediate medical attention.
Choice C reason: While both type 1 and type 2 diabetes involve issues with blood glucose regulation, HHNK is specifically associated with type 2 diabetes. Type 1 diabetes complications more commonly include Diabetic Ketoacidosis (DKA), rather than HHNK.
Choice D reason: Type 1 diabetes is characterized by the body's inability to produce insulin, leading to high blood glucose levels. However, the primary acute complication of type 1 diabetes is Diabetic Ketoacidosis (DKA), not HHNK. HHNK is distinct to type 2 diabetes, where insulin resistance leads to extremely high blood glucose levels and severe dehydration.
Correct Answer is D
Explanation
Choice A reason: Increased lipid breakdown does not directly cause the release of insulin. Insulin is a hormone that facilitates glucose uptake by cells and helps regulate blood sugar levels. Lipid metabolism is primarily regulated by other mechanisms and hormones, such as glucagon and epinephrine.
Choice B reason: Decreased blood glucose level would not stimulate insulin release. In fact, low blood glucose levels would signal the pancreas to reduce insulin secretion. Instead, glucagon would be released to increase blood glucose levels by stimulating the conversion of glycogen to glucose in the liver.
Choice C reason: Increased protein breakdown does not directly trigger the release of insulin. Protein metabolism involves amino acids and other metabolic pathways, but insulin release is primarily regulated by blood glucose levels.
Choice D reason: The release of insulin is caused by increased blood glucose levels. When blood glucose levels rise, such as after eating a meal, the beta cells in the pancreas secrete insulin to help cells absorb glucose from the bloodstream, thereby lowering blood glucose levels and maintaining homeostasis.
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