A nurse is reviewing a client's laboratory results and sees that their hemoglobin A1C is 9%. Which of the following statements from the nurse is appropriate?

"Your blood sugar is very unstable."

"Your blood sugar is too high after meals."

"Your average blood sugar is high."

"You have many dangerously low blood sugar levels."

Answer and Explanation

The Correct Answer is C

A. "Your blood sugar is very unstable." While high HbA1C levels can indicate poor glucose control, they do not specifically indicate instability in blood sugar levels (i.e., frequent fluctuations between high and low levels). HbA1C does not capture short-term variations in blood glucose; it only provides an average over a few months.

B. "Your blood sugar is too high after meals." Although postprandial (after-meal) glucose levels contribute to overall blood glucose levels, HbA1C measures the average blood glucose level over several months and is not specific to postprandial glucose levels. A high HbA1C suggests elevated glucose levels overall, not just after meals.

C. "Your average blood sugar is high." HbA1C measures the average blood sugar level over an extended period, typically 2-3 months. A result of 9% indicates that the client's average blood glucose levels have been consistently high, suggesting poor long-term glucose control. This is a precise and appropriate statement reflecting the meaning of the HbA1C result.

D. "You have many dangerously low blood sugar levels." A high HbA1C indicates elevated blood glucose levels over time, not low levels. Low blood sugar levels (hypoglycemia) would not contribute to a high HbA1C. In fact, frequent hypoglycemia would more likely result in a lower HbA1C, not a higher one.

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Correct Answer is C

Explanation

A. Percuss each lung segment for 15 min.: Percussing each lung segment for 15 minutes is excessive and could be uncomfortable or even harmful to the child. CPT sessions are typically shorter and are rotated among different lung segments to effectively clear secretions without causing discomfort or damage.

B. Perform vibration during the client's inspirations. Vibration is usually performed during the client's expirations, not inspirations. This helps to dislodge mucus and facilitate its removal during the exhalation phase when the airways are narrowing and pushing mucus out.

C. Administer albuterol prior to CPT: Administering a bronchodilator like albuterol before CPT helps to open the airways, making it easier to clear mucus. This is a recommended practice to enhance the effectiveness of CPT and improve airway clearance.

D. Perform CPT immediately after the child eats. Performing CPT immediately after eating is not advisable because it can lead to discomfort, nausea, or vomiting. It is typically recommended to wait at least 1-2 hours after meals to perform CPT.

A. "This type of diabetes means that the cells in your pancreas do not produce any insulin." B. "This can be a reversible condition, so we will discuss ways to improve your health." C. "Your HbA1c level of 5.7% or below indicates you have impaired glucose tolerance." D. "Since you still have working beta cells, you can try a diet to lower your blood sugar."

Correct Answer is A

Explanation

A. "This type of diabetes means that the cells in your pancreas do not produce any insulin.": Type 1 diabetes mellitus is characterized by the autoimmune destruction of beta cells in the pancreas, which results in an absolute deficiency of insulin. Patients require insulin therapy for management.

B. "This can be a reversible condition, so we will discuss ways to improve your health.": Type 1 diabetes is not reversible. It is a lifelong condition that requires continuous insulin therapy.

C. "Your HbA1c level of 5.7% or below indicates you have impaired glucose tolerance.": An HbA1c level of 5.7% or below is considered normal or indicative of well-controlled blood glucose levels, not impaired glucose tolerance. Impaired glucose tolerance is typically identified with HbA1c levels from 5.7% to 6.4%.

D. "Since you still have working beta cells, you can try a diet to lower your blood sugar.": In type 1 diabetes, the beta cells are mostly or completely non-functional, meaning dietary changes alone are insufficient. Insulin replacement is necessary.

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