An older adult male client arrives at the clinic reporting that his bladder always feels full. The client also reports a weak urine flow, frequent dribbling after voiding, and increasing nocturia with difficulty initiating the urine stream. Which action should the nurse implement?

Choice A reason: Telling the charge nurse and refusing to administer the placebo could be seen as insubordination and does not address the ethical concerns associated with placebo use.

Choice B reason: Discussing ethical concerns with the healthcare provider is the most appropriate action as it addresses the potential breach of patient trust and informed consent associated with placebo use.

Choice C reason: Administering the placebo as prescribed without addressing the ethical implications could compromise the nurse's professional integrity and the patient's trust.

Choice D reason: Informing the client that a placebo was prescribed could undermine the treatment plan and the provider-patient relationship, potentially causing harm to the client.

Choice A Reason: Hypoglycemia refers to low blood sugar levels, typically below 70 mg/dL (3.9 mmol/L). The client’s fasting blood glucose level is 122 mg/dL (6.8 mmol/L), which is above the normal range, thus ruling out hypoglycemia.

Choice B Reason: Diabetes mellitus is diagnosed when the fasting blood glucose level is 126 mg/dL (7 mmol/L) or higher on two separate tests1. The client’s level is slightly below this threshold, suggesting that he does not currently have diabetes mellitus but is at risk.

Choice C Reason: Prediabetes is indicated by a fasting blood glucose level of 100 to 125 mg/dL (5.6 to 6.9 mmol/L)1. The client’s level falls within this range, indicating that he has higher than normal blood glucose levels but not high enough to be classified as diabetes, hence prediabetes.

Choice D Reason: Gestational diabetes occurs during pregnancy and is not applicable to this male client.

Option i Reason: Fatty liver disease is not directly indicated by the laboratory results provided and is typically associated with elevated liver enzymes and imaging findings.

Option ii Reason: Occupational factors are not directly related to the fasting blood glucose levels.

Option iii Reason: Lack of insulin production is a characteristic of type 1 diabetes, which is not indicated by the client’s fasting blood glucose level alone.

Option iv Reason: Impaired glucose tolerance is a condition where blood glucose levels are higher than normal but not high enough to be classified as diabetes. It is a characteristic of prediabetes and is indicated by the client’s fasting blood glucose level.