Nokea
The nurse is explaining glycosylated hemoglobin testing to a diabetic client. Which of the following provides the best reason for this order?
- A. Provides best information on the body's ability to maintain normal blood functioning
- B. Best indicator for the nutritional state of the client.
- C. Is less costly than performing daily blood sugar test
- D. Reflects the amount of glucose stored in hemoglobin over past several months
Correct Answer: D
Rationale: Glycosylated hemoglobin (HbA1c) measures glucose bound to hemoglobin over its 120-day lifespan, reflecting long-term glucose control. It does not assess overall blood functioning, nutritional status, or cost relative to daily testing, which is still necessary for insulin-dependent clients.
You may also like to solve these questions
A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously?
- A. Glargine
- B. Regular
- C. NPH
- D. Lente
Correct Answer: B
Rationale: Regular insulin is used intravenously for DKA due to its rapid onset and ability to be infused continuously. Glargine, NPH, and Lente are long- or intermediate-acting insulins administered subcutaneously, unsuitable for acute DKA management.
A diabetic client maintains glucose control with the use of long-acting and short-acting insulin. Which nursing instruction would be considered a priority instruction for this client?
- A. Mix short-acting and long-acting insulin.
- B. Monitor blood glucose levels immediately following injection.
- C. Use stomach for nighttime injections.
- D. If using Lantus or Levemir, give in separate syringe.
Correct Answer: D
Rationale: Lantus and Levemir (long-acting insulins) must be administered in separate syringes, as mixing with other insulins can alter their action. Monitoring should occur before injections, and the stomach is not specifically preferred for nighttime doses; thighs are often used for slower absorption.
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 client asks the nurse if dipstick of urine can be used for monitoring glucose levels. Which is the best response by the nurse?
- A. Yes, it is a cheaper method of monitoring glucose and ketones in the urine.
- B. This test can detect ketones but not glucose levels.
- C. The most accurate way to monitor glucose levels is by blood testing.
- D. Dipstick of urine will only indicate lower levels of glucose and ketones.
Correct Answer: C
Rationale: Blood testing via glucometer is the most accurate method for monitoring glucose levels, as urine dipsticks only detect glucose above the renal threshold, which is less precise. Urine dipsticks can detect both glucose and ketones but are not the preferred method for ongoing management.
The nurse is taking the history of a client with diabetes who is experiencing autonomic neuropathy. Which would the nurse expect the client to report?
- A. Skeletal deformities
- B. Paresthesias
- C. Erectile dysfunction
- D. Soft tissue ulceration
Correct Answer: C
Rationale: Autonomic neuropathy affects organ function, including sexual function. Up to 50% of men with diabetes may develop erectile dysfunction due to impaired nerve function. Skeletal deformities and soft tissue ulceration are associated with motor neuropathy, while paresthesias are linked to sensory neuropathy.