A nurse is reviewing the laboratory results of an adolescent who has diabetes mellitus. For which of the following values should the nurse notify the provider?
Hematocrit 36%.
Hemoglobin 12 g/dL.
Glucose 120 mg/dL.
HbA1c 10.7%.
The Correct Answer is D
Choice A rationale:
Hematocrit 36%. A hematocrit level of 36% falls within the normal range for adolescents. Hematocrit measures the proportion of blood volume occupied by red blood cells and is used to assess for anemia or polycythemia. A level of 36% is not a cause for concern in this case.
Choice B rationale:
Hemoglobin 12 g/dL. A hemoglobin level of 12 g/dL is within the normal range for adolescents. Hemoglobin is a protein in red blood cells that carries oxygen. This level indicates that the adolescent is not significantly anemic.
Choice C rationale:
Glucose 120 mg/dL. A glucose level of 120 mg/dL is within the normal range for a random blood glucose test. However, in the context of diabetes mellitus, the nurse should be more concerned about the HbA1c level, which reflects the average blood glucose level over the past few months.
Choice D rationale:
HbA1c 10.7%. HbA1c, or glycated hemoglobin, reflects the average blood glucose concentration over a span of approximately 2 to 3 months. An HbA1c level of 10.7% is significantly elevated and indicates poor long-term glucose control. This value suggests that the adolescent's diabetes management has not been effective, which can lead to an increased risk of diabetes-related complications over time. The nurse should notify the healthcare provider so that appropriate adjustments can be made to the treatment plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
"I should start by feeding my baby 3 tablespoons of solid food." At 6 months of age, infants are typically just beginning to transition to solid foods. Starting with 3 tablespoons of solid food might be overwhelming and inappropriate for the infant's digestive system. Introducing small amounts and gradually increasing the volume allows the infant to adapt to the new textures and flavors.
Choice B rationale:
"I should limit my baby to 8 ounces of juice per day." Juice consumption should be limited for infants. Juice offers little nutritional value and can contribute to excessive calorie intake, leading to potential weight gain and tooth decay. At 6 months, the primary source of nutrition should still be breast milk or formula, and the introduction of solid foods is meant to complement, not replace these sources.
Choice C rationale:
"I should introduce a new solid food to my baby every five to seven days." This statement indicates an understanding of the recommended approach for introducing solid foods to an infant. Introducing a new food every five to seven days allows the parent to monitor for any potential allergic reactions or sensitivities. This gradual approach helps identify specific foods that the infant may not tolerate well.
Choice D rationale:
"I should sweeten my baby's food with a teaspoon of honey." This statement is incorrect and potentially dangerous. Honey should not be given to infants under 12 months of age due to the risk of infant botulism, a serious and potentially fatal illness. Honey can contain spores of Clostridium botulinum bacteria, which can multiply and produce toxins in an infant's immature digestive system. It's important to avoid honey until the child is older to ensure their safety.
Correct Answer is B
Explanation
Choice A rationale:
A 15-year-old client who requests testing for a sexually transmitted infection (STI) is seeking healthcare related to sexual health, which is often considered confidential. In many jurisdictions, minors of a certain age (often 12 or older) have the legal right to consent to STI testing and treatment without parental consent. While education on sexual health and responsible decision-making is important, in this case, the nurse may not need to involve the parent if the legal requirements are met.
Choice B rationale:
This is the correct answer. Minors generally require parental consent for medical procedures, including biopsies. A biopsy involves a medical intervention that can carry risks, and it is important to have informed parental consent for procedures on underage clients.
Choice C rationale:
A 16-year-old client who requires prenatal care for pregnancy is not applicable in this scenario. Prenatal care is focused on managing the health and well-being of a pregnant individual and their developing fetus. The question does not provide information that suggests this situation.
Choice D rationale:
A 13-year-old client who requests contraception advice may have the right to access contraception services without parental consent, depending on local laws and regulations. Many places allow minors to access contraception services confidentially, recognizing the importance of sexual health and preventing unintended pregnancies. However, it's always important for healthcare providers to assess each situation and the applicable legal framework to determine whether parental involvement is required.
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