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 ["A","C","D"]
Explanation
Rationale:
A. Reinforce orientation to time, place, and person: Regularly providing cues about the current time, location, and people helps reduce confusion and anxiety in clients with dementia. Orientation reinforcement supports cognitive functioning and promotes a sense of safety.
B. Refute the client’s delusions using logic: Arguing or attempting to correct delusions can increase agitation and distress. Therapeutic communication focuses on validation and redirection rather than confrontation, making this approach inappropriate for dementia care.
C. Establish eye contact when communicating with the client: Maintaining eye contact helps ensure the client’s attention and conveys engagement and respect. It enhances understanding and supports effective communication, especially when verbal comprehension may be impaired.
D. Give the client one simple direction at a time: Breaking tasks into single, clear instructions reduces cognitive overload and frustration. This approach increases the likelihood that the client can follow directions and participate successfully in activities of daily living.
E. Allow the client to choose among a variety of activities each day: While offering choices promotes autonomy, offering a large variety can be overwhelming for a client with dementia, leading to confusion, anxiety, and decision paralysis. The nurse should offer limited choices
Correct Answer is C
Explanation
Rationale:
A. Forearm: The forearm is not a recommended site for subcutaneous injections because it has limited subcutaneous tissue and is typically reserved for intradermal injections, such as allergy testing or tuberculosis screening.
B. Ventrogluteal: The ventrogluteal site is preferred for intramuscular injections due to the large muscle mass and low risk of nerve injury. It is not suitable for subcutaneous injections, which require fatty tissue rather than muscle.
C. Outer posterior aspect of upper arm: This site contains adequate subcutaneous tissue, is easily accessible, and is commonly used for subcutaneous injections such as insulin or heparin. It allows for proper absorption and minimizes the risk of intramuscular administration.
D. Vastus lateralis: The vastus lateralis is part of the thigh and is primarily used for intramuscular injections, especially in infants or adults needing large-volume IM medications. It is not a typical site for subcutaneous injections.
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