A home health nurse is visiting a client who has a new diagnosis of diabetes mellitus. Which of the following actions should the nurse take first?
Teach the client about appropriate food choices.
Refer the client to a diabetes mellitus support group.
Identify the client's dietary preferences.
Develop a nutritional program.
The Correct Answer is C
Choice A reason: Teaching the client about appropriate food choices is an important intervention for diabetes mellitus, but it is not the first action the nurse should take. The nurse needs to assess the client's current dietary habits and preferences before providing education.
Choice B reason: Referring the client to a diabetes mellitus support group is a helpful strategy to promote coping and self-management, but it is not the first action the nurse should take. The nurse needs to address the client's immediate needs and priorities before making referrals.
Choice C reason: Identifying the client's dietary preferences is the first action the nurse should take. This is an assessment step that will help the nurse tailor the nutritional program to the client's individual needs and preferences. It will also help the nurse establish rapport and trust with the client.
Choice D reason: Developing a nutritional program is a planning step that requires assessment data. The nurse should not develop a nutritional program without first identifying the client's dietary preferences and needs.
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Correct Answer is C
Explanation
Choice A reason: Initiating topics of conversation that avoid the client's health status is not an appropriate intervention. The nurse should respect the client's wishes and preferences regarding the communication of their condition. The nurse should also provide emotional support and information as needed.
Choice B reason: Recommending the client seek out hospice services rather than seek treatment is not an appropriate intervention. The nurse should not impose their own values or beliefs on the client's decision-making process. The nurse should also respect the client's autonomy and right to self-determination.
Choice C reason: Providing quiet time during visits for prayer or meditation is an appropriate intervention. The nurse should acknowledge and support the client's spiritual needs and practices. The nurse should also facilitate the client's access to spiritual resources and counselors.
Choice D reason: Placing the client's name and medical condition on an online prayer chain is not an appropriate intervention. The nurse should protect the client's privacy and confidentiality and obtain their consent before sharing any personal information. The nurse should also respect the client's cultural and religious diversity and avoid any assumptions or stereotypes.
Correct Answer is B
Explanation
Choice A reason: Nodding and smiling are positive reactions, but they do not necessarily indicate understanding, as they can be polite responses or reflexive actions.
Choice B reason: Demonstration of learned content is a clear indication of understanding. When a client can replicate the teaching, it shows they have comprehended the information and are able to apply it.
Choice C reason: While wearing glasses and hearing aids can help a client see and hear the teaching better, it does not confirm that the client has understood the material presented.
Choice D reason: Frequent eye contact might suggest attentiveness, but like nodding and smiling, it is not a reliable indicator of comprehension.
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