A nurse is working with a client who has type 2 diabetes and requires assistance with reaching goals and outcomes of care. Which of the following actions should the nurse take?
Contact a provider to admit the client for inpatient care.
Contact a nurse navigator for a referral to a diabetes support group.
Contact a case manager to enroll the client in a disease management program.
Contact a social worker for financial assistance with medications.
The Correct Answer is C
A. Contacting a provider to admit the client for inpatient care is not appropriate because there is no indication of acute complications or unstable blood glucose requiring hospitalization. Type 2 diabetes management goals are typically achieved in the outpatient setting unless there is an emergency such as diabetic ketoacidosis or severe hyperglycemia.
B. Contacting a nurse navigator for a referral to a diabetes support group may be helpful for emotional support and education, but it does not directly address structured goal-setting, ongoing monitoring, and coordinated long-term disease management needed for achieving clinical outcomes in type 2 diabetes.
C. Contacting a case manager to enroll the client in a disease management program is the correct action. Disease management programs provide coordinated, evidence-based care that includes monitoring, education, medication adherence support, and follow-up. This approach directly helps clients with chronic conditions like type 2 diabetes meet individualized goals such as glycemic control, lifestyle modification, and complication prevention.
D. Contacting a social worker for financial assistance with medications may be beneficial if cost is a barrier to care; however, it addresses only one aspect of care and does not provide comprehensive support for achieving clinical outcomes and long-term diabetes management goals.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Thrombocytopenia places the client at high risk for bleeding due to a decreased platelet count. Straining during bowel movements can lead to rectal bleeding or hemorrhoids. Stool softeners help prevent constipation and reduce the need for straining, thereby decreasing the risk of bleeding complications.
B. Flossing can cause trauma to the gums and lead to bleeding in a client with thrombocytopenia. Oral care should be gentle, using a soft-bristled toothbrush and avoiding flossing unless specifically approved based on platelet levels.
C. Avoiding raw vegetables is generally a precaution for immunocompromised clients to reduce infection risk, not specifically for thrombocytopenia. While some oncology clients may have both risks, thrombocytopenia alone does not require dietary restrictions related to raw foods.
D. Removing fresh flowers is a precaution for immunocompromised clients to reduce exposure to fungal spores and bacteria. It is not a specific intervention for thrombocytopenia, which is primarily concerned with bleeding risk rather than infection risk.
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"A"}}
Explanation
- Apply warm compresses to eyes (Unanticipated): This intervention has no role in managing a pituitary adenoma or increased intracranial pressure (ICP). Eye compresses may be used for localized ocular conditions (e.g., stye, conjunctivitis), not neurological or intracranial pathology.
- Implement seizure precautions (Anticipated): A pituitary adenoma with neurologic symptoms (confusion, restlessness, headache, vomiting) suggests possible increased ICP or brain irritation. These conditions increase seizure risk, so seizure precautions (padding side rails, suction setup, airway protection) are appropriate.
- Administer furosemide (Anticipated): Furosemide is a loop diuretic that can help reduce intracranial pressure by decreasing cerebral edema and fluid volume. It is appropriate in suspected ICP elevation.
- Administer 0.9% sodium chloride 1000 mL IV at 150 mL/hr (Unanticipated): Large-volume isotonic fluid administration may worsen cerebral edema and increase ICP. In patients with suspected elevated ICP, fluid management must be cautious to avoid exacerbation of brain swelling.
- Administer dexamethasone (Anticipated): Dexamethasone is a corticosteroid that reduces cerebral edema and is commonly used in pituitary tumors or brain masses to decrease inflammation and ICP-related symptoms.
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