The nurse is assessing clients in an outpatient diabetic clinic. Which entry provides the best indication that the client is adhering to the prescribed diabetic regimen?
Haemoglobin A1C of 6.2%.
Fasting plasma glucose of 189 mg/dL (10.49 mmol/L).
Postprandial plasma glucose of 225 mg/dL (12.49 mmol/L).
High-density lipoprotein of 40 mg/dL (1.03 mmol/L).
The Correct Answer is A
Choice A reason: Haemoglobin A1C of 6.2% is the best indication of long-term adherence to the prescribed diabetic regimen. The A1C test measures the average blood glucose levels over the past two to three months. A result of 6.2% indicates that the client has been maintaining good blood glucose control over this period, which reflects adherence to the regimen.
Choice B reason: Fasting plasma glucose of 189 mg/dL (10.49 mmol/L) is higher than the normal range. This result indicates poor short-term blood glucose control and suggests that the client may not be adhering to the prescribed regimen effectively.
Choice C reason: Postprandial plasma glucose of 225 mg/dL (12.49 mmol/L) is also higher than the recommended level for post-meal glucose. This result points to poor post-meal glucose control and suggests that the client may not be following their dietary or medication plan properly.
Choice D reason: High-density lipoprotein (HDL) of 40 mg/dL (1.03 mmol/L) is slightly below the recommended level for HDL cholesterol. While HDL is important for cardiovascular health, it is not a direct measure of blood glucose control or adherence to a diabetic regimen.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Alopecia, or hair loss, is a common symptom of systemic lupus erythematosus but does not require immediate follow-up. It is not life-threatening and can be managed as part of the overall treatment plan.
Choice B reason: Haematuria, or blood in the urine, requires immediate follow-up because it can indicate serious renal involvement or a possible flare-up of lupus nephritis. Kidney complications in lupus can lead to severe outcomes if not addressed promptly.
Choice C reason: Fatigue is a common symptom of lupus and while it can significantly impact the client's quality of life, it does not usually require urgent intervention. It is managed through ongoing treatment and lifestyle adjustments.
Choice D reason: Joint pain is another common symptom of lupus. Although it can be debilitating, it is not an emergency and can be managed through standard treatments for lupus.
Correct Answer is A
Explanation
Choice A reason: Determining if the client has a sliding scale insulin prescription is crucial. A sliding scale insulin regimen can help manage elevated blood glucose levels effectively. In the case of a capillary glucose of 365 mg/dL, prompt intervention is needed to prevent hyperglycaemia-related complications, and insulin administration is the most appropriate immediate action.
Choice B reason: Stopping the infusion until the healthcare provider is notified may not be the best immediate action. While it is essential to address the hyperglycaemia, halting the parenteral nutrition infusion can affect the client's overall nutritional and fluid balance. The focus should be on managing the glucose levels promptly.
Choice C reason: Assessing the client's urinary output for the previous 24 hours is important for monitoring overall fluid status and kidney function, but it does not directly address the immediate need to manage the elevated glucose levels.
Choice D reason: Reviewing the client's record for a history of diabetes mellitus can provide valuable information for long-term management and understanding the client's baseline glucose control. However, it is not the most urgent action in response to an acutely elevated capillary glucose level. Immediate intervention with insulin is needed to address the hyperglycaemia.
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