The nurse is assessing clients in an outpatient diabetic clinic. Which entry provides the best indication that the client is adhering to the prescribed diabetic regimen?

Haemoglobin A1C of 6.2%.

Fasting plasma glucose of 189 mg/dL (10.49 mmol/L).

Postprandial plasma glucose of 225 mg/dL (12.49 mmol/L).

High-density lipoprotein of 40 mg/dL (1.03 mmol/L).

Answer and Explanation

The Correct Answer is A

Choice A reason: Haemoglobin A1C of 6.2% is the best indication of long-term adherence to the prescribed diabetic regimen. The A1C test measures the average blood glucose levels over the past two to three months. A result of 6.2% indicates that the client has been maintaining good blood glucose control over this period, which reflects adherence to the regimen.

Choice B reason: Fasting plasma glucose of 189 mg/dL (10.49 mmol/L) is higher than the normal range. This result indicates poor short-term blood glucose control and suggests that the client may not be adhering to the prescribed regimen effectively.

Choice C reason: Postprandial plasma glucose of 225 mg/dL (12.49 mmol/L) is also higher than the recommended level for post-meal glucose. This result points to poor post-meal glucose control and suggests that the client may not be following their dietary or medication plan properly.

Choice D reason: High-density lipoprotein (HDL) of 40 mg/dL (1.03 mmol/L) is slightly below the recommended level for HDL cholesterol. While HDL is important for cardiovascular health, it is not a direct measure of blood glucose control or adherence to a diabetic regimen.

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Correct Answer is C

Explanation

Choice A reason: Pain in the lower legs when walking, also known as intermittent claudication, is a common symptom of PAD but does not indicate an immediate threat to limb viability.

Choice B reason: Black eschar over the ankle ulcer indicates necrotic tissue, which is concerning but not as immediately critical as absent pulses. It does need to be monitored and treated to prevent infection and further complications.

Choice C reason: Absent pedal pulses by Doppler indicate a significant reduction in blood flow to the lower extremities, which can lead to critical limb ischemia and requires immediate intervention to restore perfusion and prevent tissue loss.

Choice D reason: Dependent rubor (redness when the leg is in a dependent position) is a sign of poor arterial circulation but does not require as urgent intervention as absent pedal pulses.

A. Client denies urinary frequency, urgency, or dysuria. B. Stone fragments are collected when straining the client's urine. C. Urine is pale pink with no observable blood clots. D. Serum creatinine and blood urea nitrogen (BUN) levels are within normal limits.

Correct Answer is B

Explanation

Choice A reason: Denial of urinary frequency, urgency, or dysuria is a good sign of symptom relief but does not directly confirm the success of the lithotripsy in terms of stone removal.

Choice B reason: The presence of stone fragments in the urine after lithotripsy indicates that the procedure successfully broke up the kidney stones, allowing them to be excreted. This is a direct and specific measure of the procedure's effectiveness.

Choice C reason: Pale pink urine with no observable blood clots is a positive sign and suggests that there is no significant bleeding, but it does not directly confirm the removal of the kidney stones.

Choice D reason: Normal serum creatinine and blood urea nitrogen (BUN) levels indicate good kidney function but do not specifically reflect the success of the lithotripsy in breaking up and removing the stones.

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The nurse is assessing clients in an outpatient diabetic clinic. Which entry provides the best indication that the client is adhering to the prescribed diabetic regimen?

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