A nurse is caring for a client who was prescribed metformin 6 months ago. Which of the following findings indicates a positive response to the medication?
The client's frequency of incontinence has decreased.
The client's iron level has increased.
The client's high-density lipoprotein level has increased.
The client's HbA1c has decreased.
The Correct Answer is D
Rationale:
A. The client's frequency of incontinence has decreased: Incontinence is not a direct measure of blood glucose control or the effectiveness of metformin. Changes in urinary frequency may be influenced by other conditions, such as urinary tract infections or prostate issues, and do not indicate the medication’s success.
B. The client's iron level has increased: Metformin does not affect iron metabolism. An increase in iron levels would be unrelated to metformin therapy and could reflect dietary changes, supplementation, or other underlying conditions.
C. The client's high-density lipoprotein level has increased: While metformin may have mild beneficial effects on lipid profiles, its primary purpose is to improve glycemic control. Changes in HDL are not the main indicator of therapeutic success for this medication.
D. The client's HbA1c has decreased: HbA1c reflects average blood glucose levels over the past 2–3 months. A decrease indicates improved glycemic control, which is the primary goal of metformin therapy. Monitoring HbA1c is the most reliable measure to evaluate the effectiveness of the medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Restrict daily exercise: Clients with heart failure benefit from regular, moderate activity as tolerated to improve cardiac efficiency and prevent deconditioning. Restricting all exercise can worsen functional status and is not recommended unless specifically limited by the healthcare provider.
B. Encourage 3 large meals per day: Large meals can increase cardiac workload and exacerbate heart failure symptoms due to increased blood flow demands during digestion. Smaller, more frequent meals are preferable to reduce strain on the heart.
C. Limit dietary salt intake: Reducing sodium intake helps prevent fluid retention and edema, which can exacerbate heart failure and increase cardiac workload. Teaching clients to limit salt is a key intervention to manage decreased cardiac output and maintain stable fluid balance.
D. Obtain weight once per week: Daily weight monitoring is recommended for clients with heart failure to detect fluid retention early. Weekly weights may delay recognition of sudden fluid accumulation, increasing the risk of decompensation.
Correct Answer is C
Explanation
Rationale:
A. Decide which clients should be transported for a higher level of care: Determining transport priorities is usually the responsibility of the incident command or emergency response team, not individual unit nurses. Unit nurses provide patient assessments and recommendations but do not independently make these critical decisions.
B. Act as a spokesperson to provide information to the media: Communication with the media is handled by designated hospital public relations or administration personnel to ensure consistent and accurate information. Unit nurses are not responsible for media interactions during a disaster.
C. Recommend to the provider a list of clients for early discharge: Unit nurses are familiar with clients’ conditions, stability, and care needs, making them well-suited to recommend which clients can be safely discharged early. This helps prioritize resources and bed availability during a disaster while maintaining patient safety.
D. Determine the need for additional providers: Assessing staffing needs is the responsibility of the nurse manager or disaster coordinator. Unit nurses provide information about patient care demands but do not make staffing deployment decisions during an emergency.
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