A nurse is caring for a client who has a new diagnosis of type 2 diabetes mellitus and has a referral for a dietary consult. The client tells the nurse, "I will have to eat whatever the dietitian tells me." Which of the following statements by the nurse encourages the client's involvement in their plan of care?

"I can assist you with making a list of foods you like for the dietitian."

"I understand that the dietary choices can seem overwhelming."

"Managing your diabetes will require you to make accommodations."

"The dietitian will provide you with the best food choices to manage your diabetes."

Answer and Explanation

The Correct Answer is A

Choice A reason: This statement encourages the client's involvement by offering assistance in creating a personalized list of preferred foods, which can then be discussed with the dietitian. It promotes a collaborative approach to the dietary plan, allowing the client to have a say in their food choices, which is essential for long-term adherence and management of type 2 diabetes.

Choice B reason: While this statement shows empathy, it does not actively encourage the client's involvement in their care. Understanding the challenges is important, but it is more beneficial to empower the client to take an active role in managing their dietary choices.

Choice C reason: This statement is factual, as managing diabetes does require accommodations. However, it does not directly encourage the client's involvement. Instead, it could be more encouraging by suggesting ways the client can participate in making those accommodations.

Choice D reason: Informing the client that the dietitian will provide the best food choices is reassuring but does not facilitate the client's involvement. It positions the dietitian as the sole decision-maker rather than including the client as an active participant in their dietary planning.

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Correct Answer is B

Explanation

Choice A reason: Changing the ostomy pouch daily is not typically necessary. Most pouches can be worn comfortably for several days before needing to be changed. Frequent changes are not only unnecessary but can also irritate the skin around the stoma.

Choice B reason: Emptying the ostomy pouch when it is 2/3 full is recommended to prevent leaks and overfilling, which can lead to discomfort and potential skin irritation. It is important to monitor the fullness of the pouch and empty it regularly to maintain hygiene and comfort.

Choice C reason: Trimming the opening of the ostomy seal to be 1/2 inch wider than the stoma is incorrect. The opening should be cut to match the size of the stoma to ensure a snug fit that prevents leakage and protects the skin around the stoma.

Choice D reason: Applying lotion to the peristomal skin when changing the ostomy pouch is not advised. Lotions or creams can interfere with the adhesive of the ostomy appliance and should be avoided. The peristomal skin should be clean and dry to ensure proper adhesion of the ostomy appliance.

A. Anticonvulsant B. Diuretic C. Antithrombotic D. Opioid analgesic

Correct Answer is C

Explanation

Choice A reason: Anticonvulsants are medications used to prevent seizures. While seizures can occur after a stroke, anticonvulsants are not routinely prescribed unless the patient has a history of seizures or has experienced seizures post-stroke. Therefore, anticonvulsants would not be the standard pharmacologic therapy for all patients being discharged after an ischemic stroke.

Choice B reason: Diuretics are used to remove excess fluid from the body and are commonly prescribed for conditions such as heart failure or high blood pressure. They are not typically used as a standard treatment for ischemic stroke unless the patient has a specific condition that requires fluid management.

Choice C reason: Antithrombotic agents, such as aspirin or clopidogrel, are commonly prescribed to patients after an ischemic stroke to prevent further clot formation and reduce the risk of recurrent strokes. These medications work by inhibiting platelet aggregation and are a key part of secondary prevention in stroke management.

Choice D reason: Opioid analgesics are strong painkillers that are used to treat severe pain. They are not typically prescribed upon discharge for ischemic stroke patients unless there is a specific indication for pain management that cannot be managed with other medications.

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