For a 55-year-old female patient with type 2 diabetes and a nursing diagnosis of imbalanced nutrition: more than body requirements, which goal is most important?
- A. The patient will reach a glycosylated hemoglobin level of less than 7%.
- B. The patient will follow a diet and exercise plan that results in weight loss.
- C. The patient will choose a diet that distributes calories throughout the day.
- D. The patient will state the reasons for eliminating simple sugars in the diet.
Correct Answer: A
Rationale: The correct answer is A: The patient will reach a glycosylated hemoglobin level of less than 7%. This goal is most important because it directly addresses the patient's diabetes management by aiming to achieve good glycemic control. Lowering the HbA1c level to less than 7% is a key indicator of reduced risk for diabetes-related complications. Options B, C, and D are not as critical in addressing the specific nursing diagnosis of imbalanced nutrition. Option B focuses on weight loss, which may not necessarily address the underlying issue of imbalanced nutrition. Option C addresses meal distribution but does not directly target improved glycemic control. Option D emphasizes eliminating simple sugars but does not encompass the comprehensive management of diabetes.
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An active 28-year-old male with type 1 diabetes is being seen in the endocrine clinic. Which finding may indicate the need for a change in therapy?
- A. Hemoglobin A1C level 6.2%
- B. Blood pressure 146/88 mmHg
- C. Heart rate at rest 58 beats/minute
- D. High-density lipoprotein (HDL) level 65 mg/dL
Correct Answer: B
Rationale: The correct answer is B because a blood pressure of 146/88 mmHg indicates hypertension, which is a common complication of diabetes. High blood pressure can lead to cardiovascular complications and may warrant a change in therapy. A: Hemoglobin A1C level 6.2% is within the target range for diabetes control. C: Resting heart rate of 58 beats/minute is within the normal range for an active individual. D: HDL level of 65 mg/dL is considered high and is actually beneficial for cardiovascular health.
After discussing alternatives to dressing change procedures to minimize discomfort, the nursing staff accepted a new procedure. This is an example of which stage of Havelock's model of change?
- A. Moving
- B. Self-renewal
- C. Refreezing
- D. Unfreezing
Correct Answer: A
Rationale: The correct answer is A: Moving. In Havelock's model of change, the Moving stage involves implementing the chosen change after considering alternatives. In this scenario, the nursing staff accepted a new procedure, indicating they are moving forward with the change. This stage focuses on putting the change into action.
Summary of other choices:
B: Self-renewal - This choice is not applicable as self-renewal refers to personal growth and development, not organizational change stages.
C: Refreezing - This choice is incorrect as refreezing involves stabilizing the change and ensuring it becomes the new norm, which comes after the Moving stage.
D: Unfreezing - This choice is incorrect as unfreezing refers to preparing for change by overcoming resistance and creating readiness, which precedes the Moving stage.
A diabetic patient who has reported burning foot pain at night receives a new prescription. Which information should the nurse teach the patient about amitriptyline (Elavil)?
- A. Amitriptyline decreases the depression caused by your foot pain.
- B. Amitriptyline helps prevent transmission of pain impulses to the brain.
- C. Amitriptyline corrects some of the blood vessel changes that cause pain.
- D. Amitriptyline improves sleep and reduces awareness of nighttime pain.
Correct Answer: B
Rationale: The correct answer is B because amitriptyline is a tricyclic antidepressant that works by inhibiting the reuptake of serotonin and norepinephrine, thus helping to prevent the transmission of pain impulses to the brain. This mechanism of action is effective in managing neuropathic pain, such as burning foot pain in diabetic patients. Choices A, C, and D are incorrect because amitriptyline's primary mechanism of action is related to its effects on neurotransmitter reuptake, not directly related to mood improvement, blood vessel changes, or sleep improvement.
What is the primary role of a nurse in palliative care?
- A. To provide emotional support to patients and families
- B. To coordinate patient care and provide pain management
- C. To administer medications and treatments
- D. To conduct research on end-of-life care
Correct Answer: B
Rationale: The correct answer is B because in palliative care, nurses play a crucial role in coordinating patient care and providing effective pain management. This involves working closely with patients, families, and other healthcare professionals to ensure holistic care and comfort for the patient. Nurses are responsible for assessing and addressing the physical, emotional, and psychological needs of patients in palliative care. Providing pain relief and symptom management is a key aspect of improving the quality of life for patients. Emotional support (choice A) is important but not the primary role. Administering medications (choice C) is a task within the role but not the primary focus. Conducting research (choice D) is valuable but not the primary responsibility of a nurse in palliative care.
A client discharges AMA (against medical advice). This is an example of the _________ type of risk category?
- A. nurse-focused
- B. physician-focused
- C. medical-legal incident
- D. Patient-focused
Correct Answer: C
Rationale: The correct answer is C: medical-legal incident. When a client discharges AMA, it poses medical-legal risks for healthcare providers. This includes potential liability if the client experiences adverse outcomes post-discharge. Other choices are incorrect because discharging AMA is not solely focused on nurses (A) or physicians (B), but involves legal implications. It is also not purely patient-focused (D) as it impacts the healthcare team's legal responsibilities.