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 {"dropdown-group-1":"A","dropdown-group-2":"B"}
Explanation
Rationale for correct choices
• Compartment syndrome: The child has a nondisplaced fracture of the radius and ulna, which can lead to swelling and increased pressure within the forearm compartments. Compartment syndrome is a serious complication that can compromise circulation and nerve function if not identified and treated promptly. Early recognition is critical to prevent permanent muscle and nerve damage.
• Paresthesia: The child reports mild tingling in the fingers, indicating early sensory nerve involvement. Paresthesia is a key early sign of neurovascular compromise in compartment syndrome. Monitoring for worsening tingling, numbness, or pain is essential for timely intervention, such as fasciotomy if needed.
Rationale for incorrect choices
• Deep vein thrombosis: DVT is uncommon in pediatric patients, especially in the absence of immobility, central lines, or hypercoagulable conditions. While fractures increase risk in adults, it is not the highest-priority risk in this 9-year-old child with an acute upper extremity fracture.
• Malunion: Malunion refers to healing of a fracture in an abnormal position. While possible, this risk develops over time and is not the immediate concern in the acute phase. Neurovascular compromise and compartment syndrome are more urgent.
• Type of fracture: While the fracture type (nondisplaced radius and ulna) informs management, it does not by itself represent the complication risk. The clinical symptoms of tingling are more directly indicative of acute neurovascular compromise.
• Ecchymosis: Bruising reflects local tissue trauma but is not a definitive indicator of compartment syndrome. Ecchymosis should be monitored but does not provide the highest-priority evidence of risk.
• Location of fracture: The midshaft location guides treatment, such as splinting, but the presence of paresthesia is more directly associated with risk for compartment syndrome. Location alone does not indicate imminent neurovascular compromise.
Correct Answer is D,C,A,B
Explanation
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