Aron comes into the clinic after 6 months 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 reduced glycosylated hemoglobin level (Hemoglobin A1C).
An elevated glycosylated hemoglobin level.
A random blood sugar of 150 mg/dL performed in the clinic.
There is no method to determine whether the patient is in tight glucose control.
The Correct Answer is B
Choice A reason: A reduced glycosylated hemoglobin level (Hemoglobin A1C) indicates that blood sugar levels have been well-controlled over the past three months. Hemoglobin A1C is a measure of the average blood glucose levels over this period. A lower A1C level suggests that the patient has been maintaining good control of their blood sugar levels, making it an unlikely indicator of poor diabetes management. The normal range for Hemoglobin A1C is below 5.7%, while levels between 5.7% and 6.4% indicate prediabetes, and levels above 6.5% indicate diabetes.
Choice B reason: An elevated glycosylated hemoglobin level is a clear indicator that the patient has not been maintaining tight control of their blood sugar levels. Hemoglobin A1C reflects the average blood glucose levels over the past three months. If the A1C level is high, it suggests that the patient's blood sugar levels have been elevated consistently over this period. This can occur despite the patient reporting blood sugar levels within the target range during clinic visits. An elevated A1C level (greater than 6.5%) is a strong sign of inadequate diabetes management and suggests the need for adjustments in the treatment plan.
Choice C reason: A random blood sugar level of 150 mg/dL performed in the clinic provides a snapshot of the patient's blood sugar level at a single point in time. While this level is above the normal range (typically below 140 mg/dL for non-diabetics), it does not provide a comprehensive picture of the patient's overall blood sugar control. Blood sugar levels can fluctuate due to various factors, including recent meals, stress, and physical activity. Therefore, a single random blood sugar reading is not a reliable indicator of tight diabetes control.
Choice D reason: The statement that there is no method to determine whether the patient is in tight glucose control is incorrect. There are several methods to assess diabetes control, with the Hemoglobin A1C test being one of the most reliable. Additionally, frequent monitoring of blood sugar levels through self-testing and continuous glucose monitoring systems can provide valuable information about how well the patient is managing their diabetes. These methods allow healthcare providers to make informed decisions about treatment adjustments and overall diabetes management strategies.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Swelling of the feet, or peripheral edema, can be associated with ascites, but it is not a primary measurement used to diagnose ascites. Peripheral edema can occur due to various conditions, including heart failure, kidney disease, and venous insufficiency. It does not specifically indicate the presence of ascites, which is the accumulation of fluid in the abdominal cavity.
Choice B reason: Urine output is an important measure of renal function and fluid balance but is not directly used to diagnose ascites. Changes in urine output can indicate kidney function and fluid status but do not specifically assess fluid accumulation in the abdomen.
Choice C reason: Abdominal girth measurement is a key method used to assess and monitor ascites. Measuring the circumference of the abdomen can help quantify the amount of fluid accumulation. An increase in abdominal girth over time is a strong indicator of ascites and can be used to track the progression or resolution of the condition. This method is simple, non-invasive, and effective in evaluating the severity of ascites.
Choice D reason: Chest circumference is not used to diagnose ascites. While changes in chest circumference can indicate respiratory or thoracic conditions, they do not provide information about fluid accumulation in the abdominal cavity. Ascites is specifically related to the abdomen, and measurements of abdominal girth are more relevant and informative in this context.
Correct Answer is A
Explanation
Choice A reason: Type 1 diabetes is characterized by the destruction of pancreatic islet cells (also known as beta cells) that produce insulin. This autoimmune process leads to a severe lack of insulin in the body. Insulin is essential for regulating blood glucose levels, and without it, glucose cannot enter the cells and remains in the bloodstream, leading to hyperglycemia. This destruction of insulin-producing cells is the fundamental defect in type 1 diabetes.
Choice B reason: Resistance of insulin-sensitive tissues to insulin is a characteristic of type 2 diabetes, not type 1 diabetes. In type 2 diabetes, the body's cells become resistant to insulin, and the pancreas may eventually fail to produce enough insulin to overcome this resistance. This leads to elevated blood glucose levels, but the underlying mechanism is different from the autoimmune destruction seen in type 1 diabetes.
Choice C reason: Stimulation by food intake of glucose production resulting in increased insulin production is not a defining feature of type 1 diabetes. While the intake of food does lead to glucose production and a subsequent need for insulin, this mechanism is part of normal physiology and is not specific to any type of diabetes. Type 1 diabetes specifically involves the lack of insulin production due to the destruction of the pancreatic beta cells.
Choice D reason: Decreased production of releasing hormones by the hypothalamus is not related to the pathophysiology of type 1 diabetes. The hypothalamus plays a role in regulating various hormonal processes, but type 1 diabetes is primarily an autoimmune disorder affecting the pancreas. The destruction of insulin-producing beta cells in the pancreas is the key issue in type 1 diabetes.
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