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)
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. The treatment for vancomycin-resistant enterococcus (VRE) in a previous admission is not directly related to the development of CLABSI in the current situation. The infection is more likely caused by improper handling or maintenance of the central line.
B. Drawing blood cultures from the central line, while not ideal, is not the most likely cause of CLABSI. Proper technique can mitigate the risk of introducing infection during this procedure.
C. Changing the central line dressing using clean technique instead of sterile technique increases the risk of introducing pathogens to the central line site, leading to a central line-associated bloodstream infection (CLABSI).
D. Receiving antibiotics and intravenous fluids through the same line does not typically cause CLABSI if the line is properly maintained and sterile techniques are observed during administration.
Correct Answer is B
Explanation
B. Postmenopausal vaginal bleeding is a common symptom of endometrial cancer. It is one of the most significant warning signs for this condition in older women, as it may indicate abnormal growth in the endometrial lining.
A. Bloating is more commonly associated with ovarian cancer and gastrointestinal issues rather than endometrial cancer specifically.
C. Feeling full quickly after eating is more indicative of ovarian cancer or other gastrointestinal problems.
D. Unexplained weight gain is not a typical primary symptom of endometrial cancer; it is less specific and can be associated with various other conditions.
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