A nurse is assessing the health literacy of an older adult client who has type 2 diabetes mellitus. Which of the following actions should the nurse take?

Ask the client how she feels about her understanding of diabetes.

Ask the client how often she reads food labels.

Ask the client to explain what she read from a brief handout about diabetes management.

Ask the client when she last had her HbA1c checked.

Answer and Explanation

The Correct Answer is C

A) Asking the client how she feels about her understanding of diabetes can provide some insight into her confidence and perceived knowledge. However, it does not objectively measure her actual understanding or ability to apply diabetes management information.

B) Asking the client how often she reads food labels assesses a specific behavior related to diabetes management but does not fully evaluate the client's overall health literacy. The frequency of reading food labels may indicate some level of engagement, but it does not necessarily reflect comprehensive understanding or effective diabetes self-management.

C) Requesting the client to explain what she read from a brief handout about diabetes management provides a direct assessment of her comprehension and retention of diabetes management information. This approach effectively measures her ability to understand and apply critical health information, which is a core component of health literacy.

D) Inquiring about the timing of her last HbA1c test assesses adherence to diabetes monitoring but does not gauge the client's understanding of diabetes management. While important, this question does not provide a clear picture of her health literacy or ability to manage her condition effectively.

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Correct Answer is B

Explanation

A) Maintain the client on bed rest for 48 hr following surgery: While some bed rest is recommended initially post-surgery, maintaining bed rest for 48 hours is excessive and can increase the risk of complications like deep vein thrombosis. Early mobilization is generally encouraged to enhance recovery.

B) Check the tubing for kinks and blood clots at least every 2 hr: Regularly checking the catheter tubing for kinks and blood clots is essential to ensure the continuous flow of urine and prevent catheter blockage. This can help in reducing the risk of complications such as bladder distension and urinary retention.

C) Irrigate the client's bladder continuously using 5% dextrose in Ringer's lactate: Continuous bladder irrigation is often done post-TURP to prevent clot formation, but 5% dextrose in Ringer's lactate is not the recommended solution. Typically, normal saline is used to minimize the risk of electrolyte imbalance and maintain the correct osmolarity.

D) Remove the catheter if the client reports severe bladder spasms: Severe bladder spasms can occur post-TURP, but removing the catheter is not the immediate solution. The catheter is necessary for drainage and should be managed with antispasmodic medications or adjusting the irrigation flow rather than removal.

A. "Drink whole milk instead of skim milk." B. "Limit saturated fat to 15 percent of total daily fat intake." C. "Select trans fats for daily fat intake." D. "Replace red meat with fish three times per week."

Correct Answer is D

Explanation

A) "Drink whole milk instead of skim milk": Whole milk contains higher levels of saturated fats compared to skim milk. For individuals with hyperlipidemia, it is advisable to reduce intake of saturated fats to help lower cholesterol levels and improve heart health. Drinking skim or low-fat milk is a healthier option to manage lipid levels.

B) "Limit saturated fat to 15 percent of total daily fat intake": The American Heart Association recommends that saturated fat intake should be limited to less than 7% of total daily calories for those managing hyperlipidemia. Limiting saturated fat to 15% is too high and can contribute to increased cholesterol levels, negatively impacting cardiovascular health.

C) "Select trans fats for daily fat intake": Trans fats are known to significantly raise LDL (bad) cholesterol levels and lower HDL (good) cholesterol, increasing the risk of heart disease. It is essential to avoid trans fats altogether in the diet, as they are detrimental to cardiovascular health.

D) "Replace red meat with fish three times per week": Replacing red meat with fish, especially fatty fish like salmon, mackerel, and sardines, can be beneficial for individuals with hyperlipidemia. Fish is a good source of omega-3 fatty acids, which can help lower triglyceride levels, reduce inflammation, and improve overall heart health. This dietary change supports better lipid management and reduces the risk of cardiovascular diseases.

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