A patient asks why the doctor ordered an HbA1C test instead of just checking fasting blood sugar. The nurse's best response is:

Rationale:

A. Type 2 diabetes is a chronic, lifelong condition. Education cannot cure the disease, but it empowers the client to manage blood glucose, adopt healthy behaviors, and prevent complications. Believing diabetes can “go away” may lead to poor adherence and unrealistic expectations.

B. Medications help control blood glucose but cannot replace self-management behaviors such as monitoring glucose, maintaining a healthy diet, exercising, and understanding hypoglycemia or hyperglycemia. Education is essential for safe and effective diabetes management.

C. This statement reflects accurate understanding. Diabetes education promotes: Glycemic control through lifestyle and medication adherence, prevention of acute complications like hypoglycemia or hyperglycemia, Reduction of long-term complications such as neuropathy, retinopathy, nephropathy, and cardiovascular disease and empowerment and self-efficacy in disease management

D. Education is necessary for all patients with Type 2 diabetes, regardless of treatment modality. Even those managed with diet, exercise, or oral medications need to understand nutrition, glucose monitoring, physical activity, and complication prevention. Limiting education to insulin therapy overlooks critical self-management skills.

Rationale:
A. When mixing NPH (intermediate-acting) and Regular (short-acting) insulin, air must first be injected into the NPH vial, then into the Regular vial, before drawing up the insulin. Drawing up the Regular insulin first ensures the short-acting insulin remains uncontaminated by NPH, which could alter its onset and peak. After the Regular insulin is drawn, the NPH dose is drawn, maintaining proper concentrations and ensuring safe, accurate administration.

B. Injecting air into Regular first and drawing Regular before NPH can result in contamination of the short-acting insulin with intermediate-acting insulin. This could affect the insulin’s onset, peak, and duration. Using the wrong sequence increases the risk of improper glucose control.

C. Drawing NPH before Regular increases the risk of contaminating the Regular insulin. Contamination can alter the pharmacokinetics of the short-acting insulin, making blood glucose management unpredictable. This sequence does not follow safe mixing guidelines.

D. Not injecting air into both vials before drawing the insulin can create a vacuum, making it difficult to withdraw the correct doses. This increases the chance of dosing errors and reduces the accuracy of the insulin administered.