A nurse is reinforcing teaching with an adolescent who has type 1 diabetes mellitus. Which of the following statements by the adolescent indicates an understanding of the teaching?

Choice A reason: The nurse should plan to ask the client to empty their bladder before performing Leopold maneuvers. The rationale behind this is to ensure that the client's bladder is empty to allow for better palpation of the uterus and fetal position. A full bladder can interfere with accurate assessment and may lead to incorrect findings during the examination.

Choice B reason:

The nurse should assist the client into a left-lateral position. This position is ideal for performing Leopold maneuvers because it helps to displace the uterus away from the vena cava, reducing the risk of supine hypotension syndrome. Moreover, the left-lateral position promotes optimal blood flow to the placenta, which is essential for the well-being of the fetus during the examination.

Choice C reason:

The nurse should apply an external fetal monitor to the client's abdomen after completing the Leopold maneuvers. The purpose of Leopold maneuvers is to determine the fetal position and presentation manually. Once this information is obtained, applying the external fetal monitor allows continuous monitoring of the fetal heart rate and uterine contractions to assess the baby's well-being and the progression of labor.

Choice D reason:

The nurse should not instruct the client to perform nipple stimulation when planning to assist with Leopold maneuvers. Nipple stimulation is a method to induce or augment labor, and it is not related to the process of assessing fetal position and presentation using Leopold maneuvers. It may lead to unnecessary contractions and confusion during the examination.

Choice A reason:

The nurse should inform the adolescent of their right to refuse treatment because respecting the patient's autonomy and right to make their own decisions about their healthcare is essential. This is especially true for an adolescent who is living on their own, as they have the legal capacity to make their medical decisions independently.

Choice B reason:

This statement is incorrect because, in most jurisdictions, adolescents who live on their own are considered emancipated minors, meaning they have the legal right to make their medical decisions without involving a parent or guardian. Requiring a parent or guardian's consent would not be applicable in this situation.

Choice C reason:

This statement is incorrect and irrelevant to the situation. Marriage status does not determine an individual's ability to make their own health care decisions. Regardless of marital status, an adolescent living on their own has the right to make their medical choices.

Choice D reason:

This is the correct choice. The nurse should emphasize the adolescent's right to refuse treatment if they wish to do so. It is crucial to respect their autonomy and ensure that they are fully informed about the potential consequences of their decision. However, the nurse should also provide relevant information about the treatment's benefits and risks to help the patient make an informed decision.