A client in the community is taking regular and NPH insulin to manage type 1 diabetes. What laboratory finding best demonstrates that the client's diabetes management is adequate?

The client's random blood glucose is 120 mg/dL (6.7 mmol/L).

The client's creatinine clearance of 1.75 mL/s/m2 is within reference ranges.

The client's glycosylated hemoglobin (HbA1c) level is 6.1% (0.06).

The client's fasting blood glucose level is 80 mg/dL (4.4 mmol/L).

Answer and Explanation

The Correct Answer is C

A. The client's random blood glucose is 120 mg/dL (6.7 mmol/L): A normal random glucose is encouraging, but it reflects only a momentary snapshot. Glucose levels can fluctuate throughout the day, so this test does not provide a reliable indicator of long-term diabetes control.

B. The client's creatinine clearance of 1.75 mL/s/m² is within reference ranges: While renal function is important in diabetic clients, especially due to the risk of nephropathy, creatinine clearance does not assess how well blood glucose levels are being managed specifically.

C. The client's glycosylated hemoglobin (HbA1c) level is 6.1% (0.06): HbA1c reflects the client’s average blood glucose control over the past 2 to 3 months. A value of 6.1% suggests effective long-term management of type 1 diabetes and is the best indicator of glucose control.

D. The client's fasting blood glucose level is 80 mg/dL (4.4 mmol/L): This is a normal fasting value and suggests good short-term control. However, like random glucose, it only represents glucose levels at one point in time and does not assess cumulative management.

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Correct Answer is C

Explanation

A. antipeptic agent: Antipeptic agents, such as sucralfate, protect the ulcer site by forming a barrier over the lesion but do not reduce hydrochloric acid secretion. They provide symptomatic relief by shielding the stomach lining rather than altering acid production levels.

B. histamine-2 antagonist: H2-receptor antagonists like ranitidine or famotidine reduce acid secretion by blocking histamine receptors in the stomach lining. While effective, they are generally less potent than proton pump inhibitors in suppressing hydrochloric acid production

C. proton pump inhibitor: PPIs such as omeprazole or pantoprazole directly inhibit the H+/K+ ATPase enzyme system at the secretory surface of gastric parietal cells. This action effectively blocks the final step in acid production, making them the most effective class for suppressing hydrochloric acid secretion.

D. prostaglandin: Prostaglandin analogs, like misoprostol, help protect the gastric mucosa by increasing mucus and bicarbonate production. They also mildly reduce acid secretion but are primarily used to prevent ulcers caused by NSAIDs rather than to suppress acid.

A. the stomach B. the brain C. the intestines D. the esophagus

Correct Answer is B

Explanation

A. the stomach: While some antiemetics may have peripheral effects on gastric motility (e.g., metoclopramide), the primary mechanism of most antiemetics does not occur in the stomach. Gastric involvement is secondary and not the main site of action.

B. the brain: Most antiemetics act on the central nervous system, specifically the chemoreceptor trigger zone (CTZ) and the vomiting center in the medulla. These brain regions coordinate the vomiting reflex and are the main targets for medications like ondansetron, promethazine, and prochlorperazine.

C. the intestines: The intestines play a role in triggering nausea via vagal afferents, especially when irritated. However, antiemetics primarily work centrally, and only a few agents (like serotonin antagonists) have partial peripheral activity in the gut.

D. the esophagus: The esophagus is involved in the act of vomiting but not in its regulation or control. It is not a therapeutic target for antiemetics and does not contain the receptors typically affected by these drugs.

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A client in the community is taking regular and NPH insulin to manage type 1 diabetes. What laboratory finding best demonstrates that the client's diabetes management is adequate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client diagnosed with peptic ulcer disease is experiencing fewer symptoms because of suppression of hydrochloric acid secretion into the lumen of the stomach. The nurse expects the client is most likely receiving which category of medication?

Correct Answer is C

Explanation

Antiemetics mostly work at which site of action?

Correct Answer is B

Explanation

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