The home health nurse is returning to visit a client with type 2 diabetes mellitus (DM) who lives alone and receives treatment for diabetic retinopathy. Which data is most important for the nurse to review in the assessment?

Weight.

Hemoglobin A1C.

Fasting blood glucose.

Blood lipid level.

Answer and Explanation

The Correct Answer is B

Rationale:
A. Weight: Monitoring weight is important for assessing overall health, fluid status, and nutrition, but it does not directly reflect long-term glycemic control. Weight alone cannot guide management of diabetic complications such as retinopathy.

B. Hemoglobin A1C: Hemoglobin A1C provides an average blood glucose level over the past 2–3 months and is the most reliable indicator of long-term glycemic control. In a client with diabetic retinopathy, maintaining target A1C is critical to slow disease progression and prevent further vision loss.

C. Fasting blood glucose: Fasting glucose provides a snapshot of glycemia at a single point in time. While useful for daily management, it does not reflect chronic control or predict progression of microvascular complications like retinopathy.

D. Blood lipid level: Lipid levels are important for cardiovascular risk assessment in diabetes, but they are not the primary factor in monitoring the progression of diabetic retinopathy. Glycemic control has a more direct impact on ocular complications.

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Correct Answer is B

Explanation

Rationale:
A. Acknowledge that the PN has positioned the client safely and correctly: The flat prone position is not optimal for a sigmoidoscopy, as it may limit access to the rectum and visualization of the sigmoid colon. Simply acknowledging the position would not ensure procedural effectiveness.

B. Demonstrate to the PN how to position the client more effectively for the procedure: The proper position for a sigmoidoscopy is typically the left lateral (Sims’) position with knees flexed, which facilitates scope insertion and visualization. Demonstrating correct positioning promotes safe and effective care while supporting the PN’s learning.

C. Arrange for unlicensed assistive personnel to assist the PN during the procedure: Additional personnel may help with support, but correct client positioning is the priority for procedure success. Extra staff cannot compensate for improper positioning.

D. Assume care of the client and assign the PN to the care of a different client: While the nurse can take over if necessary, a collaborative teaching approach is preferred. Demonstrating proper technique improves team competence and maintains safe delegation.

Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}

Explanation

Rationale:

• Being familiar with stroke symptoms: Recognizing early stroke symptoms such as facial droop, arm weakness, and speech difficulty allows for rapid activation of emergency services. Early recognition is critical because timely treatment with thrombolytic therapy significantly improves outcomes. Education on symptom recognition empowers both the client and spouse to act quickly if symptoms recur.

• Help prevent reoccurrence: Prompt recognition and rapid response to stroke symptoms reduce delays in treatment during future events. Early intervention can limit brain injury and decrease long-term disability. Knowing when to seek immediate care helps prevent complications associated with prolonged ischemia.

• Anticoagulant medication: While anticoagulants may be prescribed due to atrial fibrillation, understanding medication use alone does not fully demonstrate stroke education comprehension. Anticoagulation reduces embolic risk but does not replace the need for symptom recognition.

• Accepting help: Accepting help relates more to coping and rehabilitation rather than prevention of recurrent stroke. Although support is important for recovery, it does not directly reduce the likelihood of another ischemic event. This option does not address early detection or risk mitigation.

• Using assistive devices: Assistive devices support mobility and safety during recovery but do not prevent stroke recurrence. Their use is more relevant to functional adaptation after neurological deficits. This reflects rehabilitation planning rather than stroke prevention knowledge. It does not demonstrate understanding of warning signs or risk reduction.

• Lower serum cholesterol: Lowering cholesterol is part of long-term cardiovascular risk management but is not directly linked to the education focus in this statement. Cholesterol control is typically achieved through medication and lifestyle changes, not symptom recognition. This narrows prevention to a single risk factor rather than comprehensive stroke awareness. It does not capture the urgency of recognizing acute symptoms.

• Prevent all falls: Falls prevention is important after stroke due to weakness and balance issues, but it is unrelated to preventing stroke recurrence. Education on falls focuses on safety rather than vascular risk reduction.

• Decrease independence: Stroke education aims to preserve function and independence, not reduce it. While some assistance may be necessary during recovery, the goal is maximizing autonomy. This option contradicts rehabilitation and recovery principles.

• Increase risk factors: Education is designed to reduce, not increase, stroke risk factors. Awareness and lifestyle modification are intended to mitigate future events. It does not demonstrate correct understanding by the client or spouse.

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The home health nurse is returning to visit a client with type 2 diabetes mellitus (DM) who lives alone and receives treatment for diabetic retinopathy. Which data is most important for the nurse to review in the assessment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is setting up the equipment to assist with a sigmoidoscopy while the practical nurse (PN) positions the client in a flat prone position. Which action should the nurse implement?

Correct Answer is B

Explanation

Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided. The nurse determines the client and spouse understand the stroke education when they verbalize that dropdown will dropdown.

Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}

Explanation

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