A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?
Urine dipstick for glucose
Fasting blood glucose
Oral glucose tolerance
Glycosylated hemoglobin (Hemoglobin A1C)
The Correct Answer is D
Choice A reason: Urine dipstick for glucose is not a reliable test to evaluate the effectiveness of treatment for type 2 diabetes. Urine glucose testing can only detect glucose in the urine when the blood glucose level is very high, above the renal threshold of 180 mg/dL. Urine glucose testing does not reflect the average blood glucose level over time, and can be affected by factors such as hydration, medication, and urinary tract infections.
Choice B reason: Fasting blood glucose is a test that measures the blood glucose level after an overnight fast of at least 8 hours. Fasting blood glucose is a useful test to diagnose diabetes, but it is not the best test to evaluate the effectiveness of treatment for type 2 diabetes. Fasting blood glucose only reflects the blood glucose level at one point in time, and can vary depending on the time of day, the amount and type of food eaten, and the activity level.
Choice C reason: Oral glucose tolerance is a test that measures the blood glucose level before and after drinking a solution containing 75 g of glucose. Oral glucose tolerance is another test that can diagnose diabetes, but it is not the most convenient or accurate test to evaluate the effectiveness of treatment for type 2 diabetes. Oral glucose tolerance requires the patient to fast for at least 8 hours, drink the glucose solution, and have blood samples taken at 0, 30, 60, 90, and 120 minutes. Oral glucose tolerance can also be influenced by factors such as stress, illness, medication, and menstrual cycle.
Choice D reason: Glycosylated hemoglobin (Hemoglobin A1C) is a test that measures the percentage of hemoglobin that has glucose attached to it. Hemoglobin is a protein in the red blood cells that carries oxygen. Red blood cells have a lifespan of about 120 days, so the hemoglobin A1C test reflects the average blood glucose level over the past 2 to 3 months. Hemoglobin A1C is the best test to evaluate the effectiveness of treatment for type 2 diabetes, as it shows how well the blood glucose level has been controlled over time, and is not affected by factors such as fasting, food intake, or daily fluctuations.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This statement is false. IV morphine sulfate is a pain medication that can be given as needed to the postoperative patient. It does not affect the serum sodium level.
Choice B reason: This statement is false. Dextrose 5% in 0.9% sodium chloride is a hypertonic solution that can be used to treat hyponatremia, or low serum sodium level. It provides both glucose and sodium to the patient.
Choice C reason: This statement is true. 5% dextrose in water is a hypotonic solution that can cause further dilution of the serum sodium level. It can worsen the hyponatremia and increase the risk of cerebral edema and seizures.
Choice D reason: This statement is false. Neurologic assessment Q2 hours is a necessary intervention for a patient with hyponatremia, as it can monitor for signs of neurologic deterioration such as confusion, lethargy, or coma.
Correct Answer is C
Explanation
Choice A reason: 363 is not the correct answer. This is the daily maintenance fluid requirement for an infant who weighs 3.5 kg, not 16 kg. The formula for calculating the daily maintenance fluid requirement for infants who weigh between 3.5 and 10 kg is 100 mL/kg¹.
Choice B reason: 727 is not the correct answer. This is the daily maintenance fluid requirement for an infant who weighs 10 kg, not 16 kg. The formula for calculating the daily maintenance fluid requirement for infants who weigh between 10 and 20 kg is 1000 mL plus 50 mL for every kg over 10¹.
Choice C reason: 1300 is the correct answer. This is the daily maintenance fluid requirement for an infant who weighs 16 kg. The formula for calculating the daily maintenance fluid requirement for infants who weigh between 10 and 20 kg is 1000 mL plus 50 mL for every kg over 10¹. Therefore, for an infant who weighs 16 kg, the daily maintenance fluid requirement is 1000 mL plus 50 mL times 6, which equals 1300 mL.
Choice D reason: 1600 is not the correct answer. This is the daily maintenance fluid requirement for an infant who weighs 20 kg, not 16 kg. The formula for calculating the daily maintenance fluid requirement for infants who weigh between 10 and 20 kg is 1000 mL plus 50 mL for every kg over 10¹. For infants who weigh more than 20 kg, the formula is 1500 mL plus 20 mL for every kg over 20¹.
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