The nurse reviews the laboratory reports of a client and concludes that the client has diabetes. Which finding helped the nurse to reach this conclusion?

A glycated hemoglobin (HbA1c) value of 6.9

A postprandial blood glucose level of 170 mg/dL.

A confirmed fasting plasma glucose level of 100 mg/dL and a postprandial blood glucose level of 200 mg/dL

A fasting plasma glucose level of 90 mg/dL

Answer and Explanation

The Correct Answer is C

Choice A rationale: A glycated hemoglobin (HbA1c) value of 6.9 indicates that the client has prediabetes, which is a risk factor for developing diabetes.

Choice B rationale: A postprandial blood glucose level of 170 mg/dL is within the normal range.

Choice C rationale: This indicates that the client has diabetes mellitus. According to the American Diabetes Association, a diagnosis of diabetes can be made if one of the

following criteria is met: a fasting plasma glucose level of 126 mg/dL or higher, a postprandial blood glucose level of 200 mg/dL or higher, or an HbA1c value of 6.5% or higher.

Choice D rationale: A fasting plasma glucose level of 90 mg/dL is within the normal range.

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Correct Answer is A

Explanation

Choice A rationale: These lab findings, particularly concentrated urine (high specific gravity) and hyponatremia, are consistent with SIADH, where excessive ADH secretion leads to water retention and dilutional hyponatremia.

Choice B rationale: While it can affect sodium levels, Cushing's syndrome typically results in hypernatremia or normal sodium levels rather than hyponatremia.

Choice C rationale: Usually presents with hyponatremia but not specifically with high urine specific gravity or hematocrit.

Choice D rationale: DI is associated with high serum sodium and low urine specific gravity due to excessive excretion of dilute urine.

A. Low blood pressure sensed by baroreceptors in the kidneys. B. Low osmolality sensed by osmoreceptors in the kidneys. C. High plasma osmolarity sensed by osmoreceptors in the hypothalamus. D. High concentration of potassium sensed by chemoreceptors in the carotid body.

Correct Answer is C

Explanation

Choice A rationale: Low blood pressure sensed by baroreceptors in the kidneys would stimulate the renin-angiotensin-aldosterone system, which regulates blood pressure and sodium balance.

Choice B rationale: Low osmolality sensed by osmoreceptors in the kidneys would

indicate that the body has excess water and needs to excrete it, which would inhibit ADH release.

Choice C rationale: ADH, or antidiuretic hormone, is a peptide hormone that regulates the water balance in the body. It is released from the posterior pituitary gland in response to signals from the hypothalamus. When the plasma osmolarity, or the concentration of solutes in the blood, is high, it means that the body is dehydrated and needs to conserve water. The osmoreceptors in the hypothalamus detect this change and stimulate the release of ADH, which acts on the kidneys to increase water

reabsorption and decrease urine output. This helps to lower the plasma osmolarity and restore the water balance.

Choice D rationale: High concentration of potassium sensed by chemoreceptors in the carotid body would affect the acid-base balance and respiratory rate, but not ADH

release.

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