A nurse is assessing a client who has diabetes mellitus type 2 and presents for a follow-up visit. Which of the following lab values is most indicative of inadequate control of their diabetes since their last primary care visit and requires further teaching?

HbA1c level of 7.5% (nl. 4.4-6.4%)

2-hour post-prandial blood glucose level of 122 mg/dL (nl. <120 mg/dL)

Random blood glucose level of 300 mg/dL (nl. <200 mg/dL)

Fasting blood glucose level of 48 mg/dL (nl. 60-110 mg/dL)

Answer and Explanation

The Correct Answer is C

A. An HbA1c level of 7.5% indicates suboptimal long-term glucose control. The target for many diabetic patients is usually below 7%, but it may not require immediate action compared to more acute indicators.
B. A 2-hour post-prandial blood glucose level of 122 mg/dL is slightly above the normal range but not significantly high. This result alone is not as indicative of inadequate control as other values.
C. A random blood glucose level of 300 mg/dL is significantly elevated and indicates poor glucose control. This value is much higher than the normal range and suggests a need for further teaching and adjustment of diabetes management.
D. A fasting blood glucose level of 48 mg/dL is low and could indicate hypoglycemia rather than inadequate control. This level requires immediate attention but does not reflect poor long-term diabetes management.

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Correct Answer is A

Explanation

A. Petechiae are small, red or purple spots on the skin that indicate bleeding under the skin and are a classic sign of thrombocytopenia, a condition characterized by a low platelet count.
B. A decreased white blood cell count is more indicative of leukopenia, not thrombocytopenia. Thrombocytopenia specifically affects platelet counts.
C. Increased fatigue can be a symptom of many conditions but is not specific to thrombocytopenia. It may occur due to anemia or other side effects of chemotherapy.
D. Unexplained bone pain is not a typical symptom of thrombocytopenia. It might be related to other conditions or side effects but is not specific to low platelet counts.

A. Clay-colored stools B. Tenderness in the left upper abdomen C. Ecchymosis of the extremities D. Straw-colored urine

Correct Answer is A

Explanation

A. Clay-colored stools are indicative of a bile duct obstruction because bile is not reaching the intestines, leading to pale or clay-colored stools.
B. Tenderness in the left upper abdomen is more commonly associated with issues such as splenic or gastric problems rather than a bile duct obstruction.
C. Ecchymosis of the extremities is not typically associated with bile duct obstruction. It might indicate other issues such as bleeding disorders.
D. Straw-colored urine is not indicative of bile duct obstruction; typically, the urine would appear darker due to elevated bilirubin levels from bile duct obstruction.

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A nurse is assessing a client who has diabetes mellitus type 2 and presents for a follow-up visit. Which of the following lab values is most indicative of inadequate control of their diabetes since their last primary care visit and requires further teaching?

Nursing Test Bank

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