Nokea
A client with diabetes comes to the clinic for a follow-up visit. The nurse reviews the client's glycosylated hemoglobin test results. Which result would indicate to the nurse that the client's blood glucose level has been well controlled?
- A. 5.50%
- B. 6.50%
- C. 8.80%
- D. 7.80%
Correct Answer: A
Rationale: A glycosylated hemoglobin level below 7% (e.g., 5.5%) indicates good blood glucose control over the past 2-3 months. Levels of 7.5% or higher (e.g., 7.8%, 8.8%) suggest suboptimal control, with 7% correlating to an average blood glucose of 150 mg/dL.
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The nurse is admitting a client with the diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNKS) following steroid therapy. Which sign(s) and symptom(s) would the nurse likely note? Select all that apply.
- A. High blood pressure
- B. Extreme thirst
- C. Bradycardia
- D. Poor skin turgor
- E. Acidosis
- F. Hypoglycemia
Correct Answer: B,D
Rationale: HHNKS presents with extreme thirst and dehydration (poor skin turgor) due to severe hyperglycemia and fluid shifts. High blood pressure is unlikely (hypotension is more common), bradycardia is incorrect (tachycardia occurs), acidosis is not typical (unlike DKA), and hypoglycemia is not associated with HHNKS.
The client who is managing diabetes through diet and insulin control asks the nurse why exercise is important. Which is the best response by the nurse to support adding exercise to the daily routine?
- A. Increases ability for glucose to get into the cell and lowers blood sugar
- B. Creates an overall feeling of well-being and lowers risk of depression
- C. Decreases need for pancreas to produce more cells
- D. Decreases risk of developing insulin resistance and hyperglycemia
Correct Answer: A
Rationale: Exercise enhances glucose uptake by increasing transmembrane glucose transporters in muscles, lowering blood sugar levels. While it may improve well-being and reduce insulin resistance, the primary benefit for diabetes management is improved glucose transport into cells.
Which is the best nursing explanation for the symptom of polyuria in a client with diabetes mellitus?
- A. With diabetes, drinking more results in more urine production.
- B. Increased ketones in the urine promote the manufacturing of more urine.
- C. High sugar pulls fluid into the bloodstream, which results in more urine production.
- D. The body's requirement for fuel drives the production of urine.
Correct Answer: C
Rationale: High blood glucose levels increase blood osmolality, pulling fluid into the vascular system, which leads to increased urine production (polyuria) as the kidneys attempt to excrete excess glucose. This triggers thirst (polydipsia), not vice versa. Ketones and fuel requirements do not directly cause polyuria.
The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action?
- A. It carries glucose into body cells
- B. It aids in the process of gluconeogenesis.
- C. It stimulates the pancreatic hormone cells.
- D. It decreases the intestinal absorption of glucose.
Correct Answer: A
Rationale: Insulin's primary role is to facilitate glucose transport into cells for energy use and promote glycogen storage in the liver, inhibiting glycogen breakdown. It does not promote gluconeogenesis, stimulate pancreatic hormone cells, or affect intestinal glucose absorption.
The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which characteristic would the nurse inform the group is associated with type 2 diabetes?
- A. Onset most common during adolescence
- B. Insulin resistance or insufficient insulin production
- C. Absence of insulin production by beta cells in the islets of Langerhans
- D. Little relation to prediabetes
Correct Answer: B
Rationale: Type 2 diabetes is characterized by insulin resistance or inadequate insulin production, typically seen in adults, not adolescents. Absence of insulin production is specific to type 1 diabetes, and prediabetes is a precursor to type 2 diabetes.