The nurse in a clinic reviewing laboratory results for a patient suspected of having undiagnosed diabetes mellitus. Which of the following results would be diagnostic for diabetes

Fasting plasma glucose of 98mg/dl

Hemoglobin A1C (glycosylated hemoglobin) of 7.2%

Random plasma glucose of 110 mg/dl

Two hour plasma glucose of 140mg/dl

Answer and Explanation

The Correct Answer is B

A) Fasting plasma glucose of 98 mg/dl:
A fasting plasma glucose level of 98 mg/dl is within the normal range (70–99 mg/dl). According to diagnostic criteria, a fasting plasma glucose level of 100–125 mg/dl is considered prediabetes, and 126 mg/dl or higher on two separate occasions is diagnostic for diabetes. Therefore, a fasting plasma glucose of 98 mg/dl is not diagnostic for diabetes.

B) Hemoglobin A1C (glycosylated hemoglobin) of 7.2%:
An HbA1C level of 7.2% is diagnostic for diabetes. The American Diabetes Association (ADA) defines diabetes as an HbA1C of 6.5% or higher. The HbA1C test reflects the average blood glucose level over the past 2–3 months, and a level of 7.2% indicates that the patient's blood glucose levels have been elevated over time, consistent with diabetes. This is a key diagnostic criterion.

C) Random plasma glucose of 110 mg/dl:
Although a random glucose value greater than 200 mg/dl with symptoms of hyperglycemia can be diagnostic of diabetes, 110 mg/dl is within the normal range and does not meet the criteria for a diabetes diagnosis. For diagnostic purposes, a random plasma glucose must be 200 mg/dl or higher.

D) Two hour plasma glucose of 140 mg/dl:
For the test to be diagnostic of diabetes, the plasma glucose must be 200 mg/dl or higher after two hours. A level of 140 mg/dl suggests normal glucose tolerance or prediabetes, but it is not diagnostic for diabetes.

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Correct Answer is D

Explanation

A. 2+ pedal edema bilaterally:
While 2+ pedal edema (a mild level of swelling in the feet and ankles) is concerning, it is not an immediate emergency in the context of hyponatremia. Edema can be seen in various conditions, including fluid retention associated with hyponatremia, but it does not require urgent intervention unless it is severe or worsening. This finding would warrant monitoring but does not require immediate action.

B. Blood pressure at 107/82:
A blood pressure reading of 107/82 mmHg is within normal limits, although on the lower end of the spectrum. This is not a concerning finding in this case and does not suggest a need for immediate intervention. The nurse should continue to monitor the client, but this blood pressure reading alone is not an emergency.
C. Urine output of 460 mL in 24 hours:
A urine output of 460 mL in 24 hours is low, indicating oliguria (decreased urine output), which can occur in cases of hyponatremia due to fluid retention. However, unless the urine output is worsening or associated with other signs of acute kidney injury or severe fluid overload, this finding alone does not require immediate intervention. It is something that should be monitored and further investigated.

D. Disorientation:
Disorientation in the elderly client with hyponatremia is a critical finding that requires immediate intervention. Hyponatremia can lead to cerebral edema (brain swelling), which results in altered mental status, including confusion, disorientation, or seizures. These symptoms indicate that the hyponatremia may be severe enough to affect neurological function and requires prompt correction to avoid further complications, such as coma or permanent brain damage. Immediate intervention to address the underlying cause of the hyponatremia and restore sodium balance is crucial.

A. Encourage strict bed rest with tuning and repositioning every 2 hours. B. Have the client dangle" their legs several times per day and when pain occurs, C. Have the client elevate their legs above heart level when pain occurs D. Have the client use ice packs to relieve lower extremity pain.

Correct Answer is B

Explanation

A) "Encourage strict bed rest with turning and repositioning every 2 hours":
. For clients with peripheral arterial disease (PAD), strict bed rest is not recommended unless the client is in severe pain or experiencing complications like ulcers or gangrene. In PAD, exercise and mobility are essential for improving blood flow and reducing symptoms. Prolonged immobility could worsen circulation and lead to complications like muscle atrophy. Therefore, encouraging gentle movement and activity, like walking or repositioning, is typically more beneficial than prolonged bed rest.

B) "Have the client 'dangle' their legs several times per day and when pain occurs":
. For clients with PAD, dangling the legs can be helpful in alleviating pain and discomfort. When the client dangles their legs, gravity helps to increase blood flow to the lower extremities, which can provide temporary relief from symptoms like intermittent claudication (pain caused by insufficient blood flow). It is important to balance this with the advice to avoid elevating the legs, as elevating them above the heart level may decrease arterial perfusion, worsening symptoms.

C) "Have the client elevate their legs above heart level when pain occurs":
. Elevating the legs above the heart level in clients with PAD may worsen symptoms. In PAD, blood flow to the legs is already compromised, and elevating the legs above the heart can further reduce arterial blood flow to the lower extremities, increasing pain and discomfort. Instead, dangling the legs or lying flat with the legs at heart level is generally better for improving circulation.

D) "Have the client use ice packs to relieve lower extremity pain":
. Applying ice packs is not recommended for clients with PAD, as cold can cause vasoconstriction, further reducing blood flow to already compromised tissues. Cold therapy may increase pain and lead to tissue damage in individuals with reduced circulation. The nurse should instead focus on strategies that promote blood flow, such as encouraging gentle exercise, dangling the legs, or using warmth (in some cases) to improve circulation.

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The nurse in a clinic reviewing laboratory results for a patient suspected of having undiagnosed diabetes mellitus. Which of the following results would be diagnostic for diabetes

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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