The nurse implements a tertiary prevention program for type 2 diabetes mellitus in a rural health clinic. Which outcome indicates that the program was effective?

Only 30% of clients did not attend self-management education sessions.

Average client scores improved on specific risk factor knowledge tests.

Clients who developed disease complications promptly received rehabilitation.

More than 50% of at-risk clients were diagnosed early in their disease process.

Answer and Explanation

The Correct Answer is C

A. Only 30% of clients did not attend self-management education sessions: This outcome does not directly indicate the effectiveness of a tertiary prevention program, which focuses on managing disease complications and improving quality of life after diagnosis.

B. Average client scores improved on specific risk factor knowledge tests: Improved knowledge is important, but tertiary prevention aims more at managing and reducing the impact of complications in individuals who already have the disease.

C. Clients who developed disease complications promptly received rehabilitation: Tertiary prevention focuses on minimizing the impact of established disease and preventing further disability. Effective rehabilitation for clients with complications demonstrates successful tertiary prevention.

D. More than 50% of at-risk clients were diagnosed early in their disease process: Early diagnosis falls under secondary prevention, not tertiary. Secondary prevention aims to identify and treat disease early to prevent complications, not managing existing complications.

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Correct Answer is A

Explanation

A. Urinate at a specified time, discard this urine, and collect all subsequent urine during the next 24 hours: Discarding the first void ensures the collection begins with an empty bladder, and all urine afterward is included for accurate measurement.

B. Urinate immediately into a urinal, and the lab will collect the specimen every 6 hours, for the next 24 hours: This describes timed urine sampling, not a continuous 24-hour collection required for creatinine clearance.

C. For the next 24 hours, notify nurse when the bladder is full, and the nurse will collect catheterized specimens: Routine creatinine clearance testing does not require catheterization unless the client is already catheterized.

D. Cleanse around the meatus, discard first portion of voiding, and collect the rest in a sterile bottle: This describes a midstream or clean-catch technique, typically used for urine cultures, not 24-hour collections.

A. Monitor ETT markings between 22 and 26 cm at teeth line. B. Check for capillary refill of 3 seconds or less. C. Auscultate for presence of bilateral breath sounds. D. Obtain a portable chest x-ray to verify ETT location. E. Assess for symmetrical chest movement.

Correct Answer is ["C","D","E"]

Explanation

A. Monitor ETT markings between 22 and 26 cm at teeth line: While the placement marking on the ETT can be useful for initial placement, it is not the most reliable way to confirm correct positioning. ETT placement should always be verified by clinical assessment rather than relying solely on measurements.

B. Check for capillary refill of 3 seconds or less: Capillary refill is a general indicator of peripheral circulation and does not directly assess whether the ETT is properly placed in the trachea. It is not useful for confirming ETT placement.

C. Auscultate for presence of bilateral breath sounds: This is a key assessment to confirm that the ETT is properly placed. Bilateral breath sounds indicate that air is entering both lungs, suggesting that the tube is correctly positioned in the trachea and not in the esophagus.

D. Obtain a portable chest x-ray to verify ETT location: A chest x-ray is the gold standard for confirming the correct placement of the ETT. It provides an accurate visual confirmation of the tube’s position relative to the carina and the lungs.

E. Assess for symmetrical chest movement: Symmetrical chest movement is another important assessment to confirm proper ETT placement. If the ETT is correctly placed in the trachea, both sides of the chest will rise and fall equally with each breath, indicating effective ventilation.

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The nurse implements a tertiary prevention program for type 2 diabetes mellitus in a rural health clinic. Which outcome indicates that the program was effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse plans to collect a 24 hour urine specimen for a creatinine clearance test. Which instruction should the nurse provide to the adult male client?

Correct Answer is A

Explanation

A young adult is brought to the emergency department after taking a handful of drugs. The client is unresponsive, so an endotracheal tube (ETT) is inserted. How should the nurse determine if the ETT is correctly placed? Select all that apply.

Correct Answer is ["C","D","E"]

Explanation

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