After 6 months a patient came for a follow-up visit. He indicates that his blood sugars have been around 100 to 120 mg/dL, and he has been fully participating in the other aspects of his diabetes management plan. Which would lead you to believe that he has not been in tight control of his diabetes?
A random blood sugar of 150 mg/dL performed in the clinic
There is no method to determine whether or not he is in tight control
A reduced glycosylated hemoglobin level
An elevated glycosylated hemoglobin level
The Correct Answer is D
A. A random blood sugar of 150 mg/dL is within an acceptable range for someone with diabetes, though it may suggest some fluctuation in blood glucose levels. It does not definitively indicate poor control of diabetes.
B. There are multiple methods to determine if diabetes is under tight control, including blood glucose monitoring and glycosylated hemoglobin (HbA1c) testing.
C. A reduced glycosylated hemoglobin level would indicate that blood glucose levels have been well-controlled over the past few months, suggesting that the patient is in tight control.
D. An elevated glycosylated hemoglobin level indicates that the patient's average blood glucose levels have been higher than recommended over the past 2-3 months, suggesting poor control of diabetes despite the patient's reported blood sugar levels. HbA1c is a key indicator of long-term glucose control.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Weakness, vomiting, hypotension, and mental confusion may occur in cases of diabetic ketoacidosis (DKA), but these are more acute signs of severe complications rather than early symptoms of type 1 diabetes.
B. Vomiting, abdominal pain, sweet fruity breath, dehydration, and Kussmaul breathing are signs of diabetic ketoacidosis (DKA), a serious complication that typically develops after the onset of type 1 diabetes, not early symptoms.
C. Polydipsia (excessive thirst), polyuria (frequent urination), polyphagia (excessive hunger), weight loss, and fatigue are classic early signs and symptoms of type 1 diabetes due to the body's inability to regulate blood glucose levels properly.
D. Recurrent infections, visual changes, and paresthesia (numbness or tingling) are typically associated with long-term, poorly controlled diabetes, not early signs of type 1 diabetes.
Correct Answer is A
Explanation
A. In chronic obstructive pulmonary disease (COPD), airflow obstruction leads to ventilation-perfusion (V/Q) mismatching. This means that some parts of the lungs may receive air but not enough blood flow, or vice versa, resulting in inefficient gas exchange and reduced oxygenation. This is a hallmark of COPD.
B. While COPD can eventually affect the heart, particularly leading to right heart failure (cor pulmonale), it does not directly impair cardiac output in the early stages. The primary issue in COPD is with lung function.
C. COPD does not directly impair circulation but can lead to pulmonary hypertension and strain on the circulatory system over time. However, impaired circulation is not the primary issue triggered by COPD.
D. COPD may lead to increased work of breathing, but it does not directly cause excessive cardiac demand in the same way that conditions like anemia or sepsis might.
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