A male client with type 1 diabetes mellitus with a hemoglobin A1c test result of 12.7%. In discussing the result with the client, the nurse would be most accurate in stating:
"The test needs to be repeated following a 12-hour fast."
"It tells us about your sugar control for the last 3 months."
"It looks like you aren't following the prescribed diabetic diet."
"Your insulin regimen needs to be altered significantly."
The Correct Answer is B
A. "The test needs to be repeated following a 12-hour fast."
This statement is not accurate. The hemoglobin A1c test does not require fasting. It reflects the average blood glucose levels over the past two to three months and is not affected by short-term changes in diet or fasting.
B. "It tells us about your sugar control for the last 3 months."
This statement is accurate. The hemoglobin A1c test provides information about the average blood glucose levels over the past two to three months. It's a valuable tool for assessing long-term glycemic control.
C. "It looks like you aren't following the prescribed diabetic diet."
The hemoglobin A1c test reflects overall glycemic control over several months and is not solely influenced by recent dietary habits. While diet plays a role in diabetes management, this statement oversimplifies the interpretation of the A1c result.
D. "Your insulin regimen needs to be altered significantly."
While a high A1c may indicate a need for adjustments in the treatment plan, the decision to alter the insulin regimen should be based on a comprehensive assessment of the patient's overall diabetes management, including lifestyle, diet, and other factors. It may not solely be determined by the A1c result.
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Related Questions
Correct Answer is C
Explanation
A. 15 to 20 g of a fast-acting carbohydrate such as orange juice:
This is a standard and initial treatment for hypoglycemia. Fast-acting carbohydrates, like orange juice or glucose tablets, can quickly raise blood sugar levels. However, in the scenario described, the client is still conscious, and glucagon may be a more appropriate choice.
B. I.V. bolus of dextrose 50%:
Intravenous (IV) dextrose is a more aggressive intervention and is typically reserved for severe cases of hypoglycemia or for unconscious patients. It is not the first-line treatment for conscious patients.
C. I.M. or subcutaneous glucagon:
Glucagon is a hormone that raises blood sugar levels by promoting the conversion of stored glycogen in the liver to glucose. It is administered either intramuscularly (I.M.) or subcutaneously. In a conscious patient with hypoglycemia who cannot take oral carbohydrates, glucagon can be an effective and rapid way to raise blood sugar levels.
D. 10 U of fast-acting insulin:
Administering more insulin in a situation of hypoglycemia would worsen the condition. The goal in hypoglycemia is to raise blood sugar, and giving more insulin would have the opposite effect.
Correct Answer is C
Explanation
A. The need to match the daily steroid dose to immediate symptoms:
Explanation: Adjusting the steroid dose based on immediate symptoms is not a recommended approach. Patients should follow the prescribed regimen provided by their healthcare provider.
B. The importance of monitoring liver function:
Explanation: While monitoring liver function is important for some medications, it is not the primary focus when teaching about hormone replacement therapy in Addison's disease. The emphasis is on the need for life-long steroid replacement.
C. The need for life-long steroid replacement:
Explanation: Patients with Addison's disease require life-long steroid replacement therapy to compensate for the deficiency in adrenal hormones. It's important for the patient to understand that adherence to the prescribed steroid regimen is essential for maintaining health and preventing adrenal crisis.
D. The possibility extreme weight loss from the use of corticosteroids:
Explanation: While corticosteroids can have various side effects, extreme weight loss is not a typical or desired outcome of steroid therapy for Addison's disease. Weight changes and potential side effects should be discussed, but the emphasis should be on the importance of long-term steroid replacement.

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