Which question during the assessment of a patient who has diabetes will help the nurse identify autonomic neuropathy?

"Do you need to increase your insulin dosage when you are stressed?"

"Have you noticed any painful new ulcerations or sores on your feet?"

"Have you seen any skin changes?"

"Do you feel bloated after eating?"

Answer and Explanation

The Correct Answer is D

A. This question assesses for glucose management under stress but does not specifically target autonomic neuropathy.
B. Painful ulcerations relate more to peripheral neuropathy rather than autonomic neuropathy.
C. Skin changes could be a result of diabetes but do not directly assess autonomic neuropathy.
D. Autonomic neuropathy can affect digestion, leading to symptoms such as bloating due to delayed gastric emptying (gastroparesis).

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Correct Answer is A

Explanation

A. A fasting blood glucose level of 126 mg/dL or higher on two separate occasions meets the diagnostic criteria for diabetes.
B. A casual blood glucose level of 200 mg/dL or higher, along with symptoms of hyperglycemia, is required for diagnosis.
C. An HbA1c of 6.5% or higher can indicate diabetes, but it should be confirmed on a second test.
D. A 2-hour blood glucose of 200 mg/dL or higher during an oral glucose tolerance test is used to diagnose diabetes; 170 mg/dL does not meet this threshold.

A. Urine-specific gravity B. Blood urea nitrogen (BUN) C. Serum sodium D. Serum creatinine

Correct Answer is D

Explanation

A. Urine-specific gravity provides information on the kidney's ability to concentrate urine but is not the most direct measure of renal function.
B. Blood urea nitrogen (BUN) can indicate kidney function but is influenced by factors other than kidney health, such as hydration status and protein intake.
C. Serum sodium levels are not a specific indicator of renal function and can vary based on many factors unrelated to kidney health.
D. Serum creatinine is the best indicator of renal function, as it is produced from muscle metabolism and cleared by the kidneys; elevated levels indicate decreased renal function.

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Which question during the assessment of a patient who has diabetes will help the nurse identify autonomic neuropathy?

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