Which of the following statements is true about diabetes mellitus?

Choice A reason: This is incorrect because using smooth muscle relaxants is not the most important aspect of care for the nurse to maintain when assisting an older client with urinary incontinence. Smooth muscle relaxants are medications that can relax the bladder and reduce the urge to urinate, but they can also cause side effects such as dry mouth, constipation, or blurred vision. They are not suitable for all types of urinary incontinence, and they should be used with caution and under medical supervision.

Choice B reason: This is incorrect because availability of protective rubber garments is not the most important aspect of care for the nurse to maintain when assisting an older client with urinary incontinence. Protective rubber garments are devices that can prevent urine leakage and protect the skin and clothing, but they can also cause skin irritation, infection, or odor. They are not a cure for urinary incontinence, and they should be used as a last resort or in combination with other interventions.

Choice C reason: This is incorrect because using indwelling urinary catheters is not the most important aspect of care for the nurse to maintain when assisting an older client with urinary incontinence. Indwelling urinary catheters are tubes that can drain urine from the bladder and collect it in a bag, but they can also cause complications such as urinary tract infections, bladder spasms, or trauma. They are not recommended for long-term use, and they should be used only when other methods have failed or are contraindicated.

Choice D reason: This is correct because maintaining an attitude that is respectful and positive about resolving the problem is the most important aspect of care for the nurse to maintain when assisting an older client with urinary incontinence. Urinary incontinence can cause embarrassment, shame, isolation, or depression in older clients, and they may be reluctant to seek help or comply with treatment. The nurse should respect the client's dignity, privacy, and preferences, and provide education, support, and encouragement. The nurse should also assess the underlying causes and contributing factors of urinary incontinence, and implement individualized and evidence-based interventions.

Choice A reason: Altering modifiable risk factors is a good goal for anyone who wants to improve their health and wellness, but it is not specific to the case of the African American man who already has a normal blood pressure and no apparent health problems. Modifiable risk factors are those that can be changed by lifestyle choices, such as smoking, diet, exercise, stress, or alcohol consumption.

Choice B reason: Maintaining tight glycemic control is a relevant goal for people who have diabetes or prediabetes, as it can help prevent or delay the complications of high blood sugar, such as nerve damage, kidney damage, or eye damage. However, there is no indication that the African American man has diabetes or prediabetes, so this goal is not applicable to him.

Choice C reason: Recognizing disease in its early stages is a general goal for everyone who wants to prevent or treat health problems, but it is not specific to the case of the African American man who has no signs or symptoms of any disease. Moreover, this goal is more reactive than proactive, as it implies waiting for disease to occur rather than preventing it.

Choice D reason: Preventing cardiovascular disease is the best goal for the nurse to use to assist the African American man in maintaining his health and wellness into older age, as it is specific, proactive, and evidence-based. According to the American Heart Association, high blood pressure is a major risk factor for cardiovascular disease, and it is more prevalent and severe among African Americans than other racial groups. Therefore, the nurse would advise the African American man to monitor his blood pressure regularly, follow a healthy diet, exercise moderately, avoid smoking, and take medication if needed to prevent cardiovascular disease.