A nurse is providing teaching to a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer: B

Rationale: The correct answer is B) "I will keep my HbA1c at five percent." This response indicates an understanding of the teaching for a client with type 1 diabetes mellitus. HbA1c, also known as glycated hemoglobin, reflects average blood sugar levels over the past 2-3 months. Maintaining HbA1c around five percent is a target for individuals with diabetes to manage their condition effectively and reduce the risk of complications. Option A is incorrect because the presence of albumin in urine, known as albuminuria, indicates kidney damage in diabetes, not normal kidney function. Option C is incorrect as ketones in urine are a sign of inadequate insulin and can occur when blood glucose levels are high, not at 190 mg/dL specifically. Option D is wrong as blood glucose levels between 200 and 212 mg/dL are elevated and not within the target range for diabetes management. In an educational context, understanding the rationale behind each answer choice helps reinforce key concepts in diabetes management and empowers clients to make informed decisions about their health. Educating clients on the significance of HbA1c, urine ketones, and blood glucose levels is crucial for effective self-management of type 1 diabetes mellitus.

Correct Answer: B

Rationale: In this scenario, the correct action for the nurse to perform first is to determine the client's daily caloric intake (Option B). This is crucial because understanding the client's current caloric intake provides a baseline for creating an effective weight loss plan. By assessing the client's current intake, the nurse can identify areas for modification and tailor dietary recommendations to the individual's needs. Option A, educating the client about daily caloric requirements, may be important later in the teaching process, but without knowing the client's current intake, it is challenging to provide personalized guidance. Option C, providing meal planning information, would be premature without first understanding the client's baseline intake. Option D, showing the client how to identify the fat content of packaged foods, is relevant but not as critical as determining the starting point of the client's caloric intake. In an educational context, it is essential for nurses to prioritize assessment and individualization when teaching clients about dietary changes. This ensures that interventions are tailored to the client's specific needs and increases the likelihood of successful outcomes in weight management. By starting with a thorough assessment of the client's caloric intake, the nurse can develop a more targeted and effective plan for supporting the client's weight loss goals.

Correct Answer: B

Rationale: In the context of medical-surgical education, understanding the physiological effects of stress on metabolism is crucial for nurses to provide comprehensive care to their patients. The correct answer, option B, states that acute stress causes an increase in metabolism. This is important to note because during times of stress, the body releases hormones like cortisol and adrenaline, which can lead to an increase in metabolic rate to provide the body with the energy needed to respond to the stressor. Option A, stating that protein requirements decrease in times of stress, is incorrect. In reality, protein requirements may actually increase during stress as the body may need additional amino acids for tissue repair and to support the immune system. Option C, suggesting that stress causes a positive nitrogen balance in the body, is also incorrect. Stress typically leads to a negative nitrogen balance due to increased catabolism of protein stores in the body. Option D, claiming that glucose is broken down more slowly during times of stress, is incorrect as well. In fact, glucose is broken down more rapidly during stress to provide immediate energy for the body's fight-or-flight response. By understanding these physiological responses to stress, nurses can better assess and support patients experiencing stress-related health issues, thereby improving patient outcomes and overall quality of care.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Prednisone. Prednisone is a corticosteroid that can impair wound healing by suppressing the immune response and reducing collagen synthesis. This places the client at risk for wound dehiscence, which is the separation of the surgical incision before it has fully healed. Option A) Omeprazole is a proton pump inhibitor used to reduce stomach acid production and does not directly impact wound healing or increase the risk of dehiscence in this context. Option B) Zolmitriptan is a medication used to treat migraines and does not have a direct effect on wound healing or dehiscence risk postoperatively. Option D) Verapamil is a calcium channel blocker used to treat hypertension and cardiac conditions. It does not interfere with wound healing or increase the risk of wound dehiscence. In an educational context, understanding the effects of different medications on wound healing is crucial for nurses caring for postoperative patients. Knowledge of which medications can impair wound healing helps nurses identify and prevent complications such as wound dehiscence, ultimately improving patient outcomes. It highlights the importance of medication review and assessment in postoperative care to ensure optimal recovery for surgical patients.

Correct Answer: C

Rationale: In this scenario, the correct answer is option C) Tuna fish. The nurse should recommend this food for the older adult client with difficulty chewing due to ill-fitting dentures because tuna fish is a soft and easily chewable protein source. It requires minimal chewing effort, making it suitable for individuals with dental issues. Option A) Dried fruit is not recommended as it can be tough to chew and may exacerbate the client's chewing difficulties. Option B) Roast beef is a tough and fibrous meat that requires significant chewing, which would not be suitable for someone with chewing problems. Option D) Apple slices, while healthy, can be hard and crunchy, posing a challenge for someone with ill-fitting dentures. Educationally, understanding the importance of recommending soft and easy-to-chew foods for individuals with dental issues is crucial for nurses caring for older adult clients. Providing appropriate dietary recommendations can improve the client's nutritional intake and overall well-being, addressing specific challenges they may face due to age-related changes in oral health.