A nurse is providing discharge teaching about disease management for a client who has a new diagnosis of type 1 diabetes mellitus. Which of the following activities is the nurse's priority?

Instruct the client about the importance of regular medical appointments.

Encourage the client to participate in daily exercise.

Explain proper foot care techniques to the client.

Ensure that the client understands the medication regimen.

Answer and Explanation

The Correct Answer is D

- A. Instructing the client about the importance of regular medical appointments is important but not the priority because it is a secondary prevention strategy that aims to detect and treat any complications or changes in the client's condition early. The client should have regular follow-up visits with an endocrinologist, a diabetes educator, an ophthalmologist, a podiatrist, a dentist, and other health care providers as needed.

- B. Encouraging the client to participate in daily exercise is important but not the priority because it is a tertiary prevention strategy that aims to reduce disability and improve quality of life for clients with chronic conditions. Exercise can help lower blood glucose levels, improve insulin sensitivity, reduce cardiovascular risk factors, enhance mood, and promote weight management for clients with type 1 diabetes mellitus. The client should consult with their health care provider before starting an exercise program and follow safety guidelines such as checking blood glucose levels before and after exercise, wearing appropriate footwear and clothing, carrying a source of fast-acting carbohydrate, and staying hydrated.

- C. Explaining proper foot care techniques to the client is important but not the priority because it is a tertiary prevention strategy that aims to prevent or minimize complications such as foot ulcers, infections, and amputations for clients with type 1 diabetes mellitus. Foot care includes inspecting feet daily for any injuries or abnormalities, washing feet with mild soap and warm water, drying feet thoroughly especially between toes, applying moisturizer to prevent dryness and cracking, trimming toenails straight across and filing edges smooth, wearing clean cotton socks and well-fitting shoes, avoiding walking barefoot or exposing feet to extreme temperatures or pressure, and seeking medical attention for any foot problems.

- D. Ensuring that the client understands the medication regimen is the nurse's priority because type 1 diabetes mellitus requires lifelong insulin therapy to maintain blood glucose levels within normal range and prevent complications such as ketoacidosis, hypoglycemia, and organ damage. The client needs to know how to administer insulin injections, monitor blood glucose levels, adjust insulin doses according to carbohydrate intake and physical activity, recognize and treat signs and symptoms of hypo- and hyperglycemia, and store insulin properly.

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Correct Answer is A

Explanation

A is correct because facilitating an interdisciplinary conference at the new facility for the family can help address their concerns, provide information about the client's plan of care, and promote continuity of care.
B is incorrect because referring the client and family to a social worker for assistance and a follow-up meeting is not enough to address their immediate concerns and does not involve other members of the health care team.
C is incorrect because reassuring the client's family that the same provider will provide care at the new facility may not be true and does not address their specific concerns about the level of care.
D is incorrect because telling the family that the rehabilitation facility has an excellent client care record is not enough to address their specific concerns and may sound dismissive.

A. Fidelity. B. Beneficence. C. Veracity. D. Autonomy.

Correct Answer is C

Explanation

Choice A rationale:

Fidelity refers to the principle of being loyal, faithful, and keeping promises. It does not specifically relate to providing accurate information about treatment effects. In this scenario, the nurse is discussing the potential adverse effects of a treatment, which falls under the domain of providing accurate and truthful information to the client.

Choice B rationale:

Beneficence is the ethical principle of doing good and promoting the well-being of the patient. While educating the client about potential adverse effects is a form of beneficence, the specific principle demonstrated in this scenario is veracity, which is the duty to tell the truth. The nurse is being truthful about the potential side effect (lightheadedness) while clarifying that it should not affect memory.

Choice C rationale:

Veracity is the ethical principle of truth-telling. In this scenario, the nurse is demonstrating veracity by providing honest and accurate information to the client about the potential adverse effects of transcranial magnetic stimulation. By being truthful, the nurse upholds the ethical principle of veracity.

Choice D rationale:

Autonomy refers to the principle of respecting the patient's right to make decisions about their own healthcare. While respecting autonomy is important, the nurse's action in this scenario specifically pertains to providing accurate information (veracity) rather than solely focusing on the client's decision-making autonomy.

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A nurse is providing discharge teaching about disease management for a client who has a new diagnosis of type 1 diabetes mellitus. Which of the following activities is the nurse's priority?

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