A nurse is caring for a client who was diagnosed with type 2 diabetes mellitus 2 years ago. The client reports following the recommended diet and exercising four times per week. Which of the following findings indicates that the client's beta cells are restoring normal function?

HbA1c = 5.6%

Client reports smoking cessation

Weight gain of 5 lb

Fasting blood glucose of 140 mg/Dl

Answer and Explanation

The Correct Answer is A

A. HbA1c = 5.6%. HbA1c measures the average blood glucose levels over the past 2-3 months. A level of 5.6% is within the normal range (below 5.7%), indicating good glycemic control. This suggests that the client’s diabetes is well managed, potentially indicating that the beta cells are functioning well and insulin sensitivity has improved.

B. Client reports smoking cessation: While smoking cessation is very beneficial for overall health and can improve diabetes management, it does not directly indicate beta cell function restoration. It is more related to reducing cardiovascular risks and improving long-term health outcomes.

C. Weight gain of 5 lb: Weight gain is not typically a sign of improving beta cell function. In fact, weight gain can sometimes indicate poor control of diabetes, as insulin resistance can worsen with increased weight. It is not a direct measure of beta cell activity.

D. Fasting blood glucose of 140 mg/dL: A fasting blood glucose of 140 mg/dL is above the normal range and suggests poor glycemic control, indicating that beta cells are not functioning adequately to maintain normal glucose levels. This value points to ongoing issues with insulin resistance or secretion.

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Correct Answer is D

Explanation

A. Blood glucose level below 40 mg/dL: Diabetic ketoacidosis (DKA) is characterized by hyperglycemia, typically with blood glucose levels significantly elevated above normal, often exceeding 250 mg/dL. A glucose level below 40 mg/dL would indicate hypoglycemia, which is not a feature of DKA.

B. Malignant hypertension: Malignant hypertension is a condition characterized by extremely high blood pressure and is not directly associated with DKA. DKA primarily involves issues with glucose and acid-base balance rather than hypertension.

C. Cheyne-Stokes breathing: Cheyne-Stokes breathing is a specific pattern of periodic breathing typically seen in severe neurologic conditions or heart failure, not in DKA. DKA is associated with Kussmaul breathing, which is deep and rapid breathing as the body attempts to compensate for metabolic acidosis.

D. Acetone odor to breath: An acetone (fruity) odor to the breath is a classic sign of DKA due to the presence of ketones in the blood and urine. This occurs because the body is breaking down fatty acids for energy, leading to the production of ketones, which are then excreted through the breath and urine.

A. Hepatomegaly B. Crackles in the lungs C. Dry, hacking cough D. Dizziness

Correct Answer is A

Explanation

A. Hepatomegaly: Hepatomegaly, or enlargement of the liver, is a common finding in right-sided heart failure due to congestion of the liver from impaired venous return. It indicates systemic venous congestion.

B. Crackles in the lungs: Crackles in the lungs are more commonly associated with left-sided heart failure, which leads to pulmonary congestion. Right-sided heart failure primarily causes systemic venous congestion rather than pulmonary issues.

C. Dry, hacking cough: A dry, hacking cough is not typically associated with right-sided heart failure. It is more related to left-sided heart failure or other pulmonary conditions.

D. Dizziness: Dizziness can occur in various conditions, including heart failure, but it is not a specific finding for right-sided heart failure. It is often due to decreased cardiac output or orthostatic hypotension.

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A nurse is caring for a client who was diagnosed with type 2 diabetes mellitus 2 years ago. The client reports following the recommended diet and exercising four times per week. Which of the following findings indicates that the client's beta cells are restoring normal function?

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