A nurse is providing discharge teaching about circumcision care to a parent of a newborn. Which of the following statements by the parent indicates an understanding of the teaching?

Rationale:

A. A client who has alcoholic pancreatitis: Alcoholic pancreatitis does not pose a risk of teratogenicity or infectious transmission to a pregnant nurse. Standard precautions are sufficient, making this assignment safe for a pregnant nurse.

B. A client who has latent tuberculosis: Latent TB is not contagious, as the bacteria are inactive and the client cannot transmit the infection. A pregnant nurse can safely care for this client with standard precautions without increased risk.

C. A client who is recovering from shingles: Shingles (herpes zoster) is caused by reactivation of the varicella-zoster virus and can be transmitted via direct contact with lesions. Pregnant nurses who have not had chickenpox or the varicella vaccine are at risk for serious complications, so this client should be assigned to a non-pregnant nurse.

D. A client who has HIV: HIV is transmitted through blood and body fluids, and standard precautions effectively protect healthcare workers. There is no contraindication for a pregnant nurse to care for a client with HIV using proper infection control measures.

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.