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 B

Explanation

Choice A reason: Placing the client in a darkened room may help alleviate symptoms if the headache is related to migraine or sensitivity to light, but it does not address the potential underlying cause of the severe headache and blurred vision in a client with a history of diabetes and hypertension.

Choice B reason: Obtaining a blood pressure reading is the most critical first step. Severe headache and blurred vision can be symptoms of hypertensive crisis, which is a medical emergency that requires immediate attention to prevent complications such as stroke or organ damage. Checking the blood pressure will help determine if the client's symptoms are due to elevated blood pressure.

Choice C reason: Administering an oral analgesic may provide temporary relief for the headache, but it does not address the potential underlying causes of the symptoms. The priority is to assess and manage any potentially life-threatening conditions.

Choice D reason: Performing a finger stick glucose test is important for monitoring blood glucose levels in a client with diabetes. However, in the context of the severe headache and blurred vision, the immediate concern should be to rule out hypertensive crisis by checking the blood pressure first. Blood glucose can be checked after ensuring the client's blood pressure is not critically high.

A. Administer IV furosemide. B. Insert an indwelling urinary catheter. C. Monitor for telemetry ST segment changes. D. Give a bronchodilator per inhaler.

Correct Answer is A

Explanation

Choice A reason: Administering IV furosemide (a diuretic) is crucial for managing the client's symptoms of fluid overload, as indicated by enema and elevated brain natriuretic peptide (BNP) levels. Furosemide helps reduce the volume of fluid in the body, relieving symptoms of heart failure and improving breathing. It addresses the most urgent need for the client.

Choice B reason: Inserting an indwelling urinary catheter might be necessary for accurate measurement of urine output, especially in a client receiving diuretic therapy. However, it is not the most immediate intervention needed to stabilize the client's condition.

Choice C reason: Monitoring for telemetry ST segment changes is important for clients with cardiac conditions. While it is necessary for ongoing assessment, it does not address the immediate need to relieve fluid overload and improve the client's respiratory status.

Choice D reason: Giving a bronchodilator per inhaler can help with respiratory symptoms related to emphysema. However, in this scenario, the primary issue is fluid overload due to heart failure, which needs to be addressed first with diuretic therapy.

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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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Naxlex Comprehensive Predictor Exams

A client with a history of diabetes mellitus and hypertension received new medication prescriptions three days ago. Today the client returns to the clinic reporting a severe headache and blurred vision. Which intervention should the nurse implement first?

Correct Answer is B

Explanation

A client with a history of emphysema and heart failure is admitted to the emergency department with enema, coughing, and shortness of breath. The client's laboratory value for brain natriuretic peptide is elevated. Which prescription is most important for the nurse to implement?

Correct Answer is A

Explanation

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