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
Explanation
Rationale:
A. "You have the right to decide who receives information.": Clients have the legal and ethical right to confidentiality regarding their medical care under HIPAA and patient privacy regulations. Respecting the client’s decision about who can receive health information reinforces autonomy and ensures that the nurse supports the client’s rights in healthcare decision-making.
B. "Your partner can be a great source of support for you at this time.": While acknowledging the potential benefits of support is empathetic, this statement does not address the client’s request for privacy. It may inadvertently pressure the client to share information, which could violate confidentiality and autonomy.
C. "Is there a reason you don't want your partner to know about your procedure?": Asking for justification may make the client feel challenged or judged. The client is not required to explain their choice, and pressing for reasons can undermine trust and respect for their privacy.
D. "The provider will be tactful when talking to your partner.": This statement assumes the provider will communicate with the partner and disregards the client’s expressed wishes. It could lead to disclosure against the client’s consent, violating confidentiality and patient rights.
Correct Answer is A
Explanation
Rationale:
A. Cheese: Aged and fermented cheeses contain high levels of tyramine, which can interact with MAOIs and cause a hypertensive crisis. Clients taking MAOIs must avoid foods rich in tyramine to prevent sudden and dangerous increases in blood pressure. This dietary restriction is a critical safety consideration when prescribing these medications.
B. Eggs: Eggs are low in tyramine and do not interact with MAOIs. They are safe to consume and provide a good source of protein for clients on this medication. No dietary restrictions are required regarding eggs.
C. Potatoes: Potatoes are low in tyramine and do not pose a risk for hypertensive crisis when taken with MAOIs. They can be included safely in the diet of clients receiving this medication.
D. Grapefruit: Grapefruit interacts with certain medications by affecting CYP450 metabolism, but it does not contain significant tyramine and is not contraindicated with MAOIs. While clients may need to avoid grapefruit with other drugs, it is not a concern specifically for MAOI therapy.
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