The nurse implements a tertiary prevention program for type 2 diabetes mellitus in a rural health clinic. Which outcome indicates that the program was effective?

Only 30% of clients did not attend self-management education sessions.

Average client scores improved on specific risk factor knowledge tests.

Clients who developed disease complications promptly received rehabilitation.

More than 50% of at-risk clients were diagnosed early in their disease process.

Answer and Explanation

The Correct Answer is C

A. Only 30% of clients did not attend self-management education sessions: This outcome does not directly indicate the effectiveness of a tertiary prevention program, which focuses on managing disease complications and improving quality of life after diagnosis.

B. Average client scores improved on specific risk factor knowledge tests: Improved knowledge is important, but tertiary prevention aims more at managing and reducing the impact of complications in individuals who already have the disease.

C. Clients who developed disease complications promptly received rehabilitation: Tertiary prevention focuses on minimizing the impact of established disease and preventing further disability. Effective rehabilitation for clients with complications demonstrates successful tertiary prevention.

D. More than 50% of at-risk clients were diagnosed early in their disease process: Early diagnosis falls under secondary prevention, not tertiary. Secondary prevention aims to identify and treat disease early to prevent complications, not managing existing complications.

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Correct Answer is A

Explanation

A. Maintain strict intake and output: Maintaining strict intake and output is essential in septic shock to monitor renal function and ensure adequate perfusion. Decreased urine output can indicate worsening shock or kidney failure, which requires prompt intervention.

B. Assess warmth of extremities: Early signs of septic shock often include cool or mottled extremities due to poor circulation, which should be addressed more through perfusion monitoring than by focusing solely on warmth.

C. Keep head of bed raised 45 degrees: Elevating the head of the bed may be helpful in certain situations, but it is not the most critical intervention for septic shock. The priority is to ensure proper hemodynamic monitoring, fluid resuscitation, and organ perfusion.

D. Monitor blood glucose level: While monitoring blood glucose is important in critically ill clients, it is not the immediate priority in septic shock. Sepsis often causes hyperglycemia, but managing fluid resuscitation and organ perfusion is the most urgent intervention.

A. Encourage the client's family to visit more often. B. Encourage the client to participate in group activities. C. Engage the client in non-threatening conversations. D. Schedule a daily conference with the social worker.

Correct Answer is C

Explanation

A. Encourage the client's family to visit more often: The client is withdrawn, increased visits may feel overwhelming. This approach assumes the client is ready for interaction, which may not be the case, and does not directly address communication barriers.

B. Encourage the client to participate in group activities: This may be premature for a client who is severely withdrawn. Pushing participation too soon may increase distress or resistance, making rapport-building through simpler interactions more effective initially.

C. Engage the client in non-threatening conversations: Starting with gentle, non-intrusive conversations helps build trust and re-establish communication. It meets the client where they are emotionally and lays a foundation for further therapeutic engagement without increasing anxiety or pressure.

D. Schedule a daily conference with the social worker: Daily meetings may not be feasible or welcomed by a withdrawn client. Interventions should first aim to re-establish connection through nurse-client interaction.

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The nurse implements a tertiary prevention program for type 2 diabetes mellitus in a rural health clinic. Which outcome indicates that the program was effective?

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