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":"C","dropdown-group-2":"C"}
Explanation
Rationale for correct choices
• Osteomyelitis: The client has an open fracture, which increases the risk of infection in the bone due to direct exposure to pathogens. The rising temperature (36.8 → 38.9°C) and elevated heart rate indicate a possible inflammatory response, making monitoring for osteomyelitis essential. Early detection allows prompt initiation of antibiotics and prevents chronic bone infection.
• Fat embolism syndrome: The client sustained a long-bone fracture (right femur), which is a known risk factor for fat embolism syndrome. Signs such as tachycardia, tachypnea, and decreased oxygen saturation (96% → 94%) may indicate early fat emboli. Prompt recognition and supportive interventions, including oxygen therapy and monitoring respiratory status, are critical.
Rationale for incorrect choices
• Deep vein thrombosis (DVT): While immobility and trauma increase the risk of DVT, there is no evidence of unilateral leg swelling, redness, or pain reported in this client. Although preventive measures are important, current findings suggest infection and respiratory complications are more immediate risks.
• Compartment syndrome: Compartment syndrome typically presents with severe pain unrelieved by medication, tense swelling, and neurovascular compromise in the affected limb. The client’s report and vital signs do not indicate these specific signs, so it is not the most immediate concern at this time.
Correct Answer is D
Explanation
Rationale:
A. Arrange for a meeting with the child's guardians tomorrow: Meeting with the guardians may be appropriate later, but initially, the nurse must follow mandatory reporting laws. Waiting to meet could delay protection for the child and place them at further risk.
B. Notify the president of the school board: Reporting to school administration does not replace legal obligations to report suspected child abuse. The school board president is not the appropriate authority for immediate child protection.
C. Ask the child's peers about the bruises: Questioning peers is inappropriate and could violate privacy or compromise the investigation. The nurse should not attempt to investigate the situation personally.
D. Report the findings to child protective services: As a mandated reporter, the nurse is legally required to report any suspected child abuse immediately to child protective services. This action ensures the child’s safety and initiates an official investigation.
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