A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?

Correct Answer: D

Rationale: The correct answer is D: Glycosylated hemoglobin level. This test provides an average blood glucose level over the past 2-3 months, reflecting long-term glycemic control. It is preferred for monitoring treatment effectiveness in diabetes. Urine dipstick for glucose (A) only detects current glucose levels in urine, not overall control. Oral glucose tolerance test (B) evaluates how the body processes glucose, not long-term control. Fasting blood glucose level (C) provides a snapshot of blood glucose at a specific moment, not long-term control.

Correct Answer: D

Rationale: The correct answer is D because an elevated BUN level of 52 mg/dL indicates potential kidney dysfunction, which is a contraindication for metformin due to the risk of lactic acidosis. A: Blood glucose level of 174 mg/dL is slightly high but not a contraindication for metformin. B: Weight gain is unrelated to metformin administration. C: Chest x-ray does not directly impact metformin administration.

Correct Answer: C

Rationale: The correct answer is C: Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery. Rationale: 1. Administering insulin falls under the scope of practice for an LPN/LVN. 2. Administering lispro insulin before surgery helps maintain the patient's blood glucose within a safe range during the procedure. 3. LPN/LVNs are trained to administer medications safely and accurately. Summary: A: Communication with the circulating nurse requires critical thinking and interpretation, which may be beyond the scope of an LPN/LVN. B: Discussing the reason for insulin therapy involves patient education and interpretation, which are typically responsibilities of a registered nurse. D: Planning strategies to prevent hypoglycemia or hyperglycemia requires higher-level critical thinking and assessment skills, usually performed by a registered nurse.

Correct Answer: D

Rationale: The correct answer is D: Decrease in capillary refill time. Administering 0.9% sodium chloride helps to increase blood volume and improve tissue perfusion, leading to a decrease in capillary refill time. This improvement indicates that the treatment was successful in addressing the fluid volume deficit. A: Increase in hematocrit would not be an immediate indication of the success of fluid resuscitation as it may take time for the hematocrit levels to reflect changes in blood volume. B: Increase in respiratory rate could indicate respiratory distress or other issues not related to the effectiveness of fluid resuscitation. C: Decrease in heart rate could be due to various factors and may not directly correlate with the success of fluid replacement therapy. In summary, the most immediate and direct indicator of successful fluid resuscitation in this scenario is a decrease in capillary refill time.

Correct Answer: B

Rationale: The correct answer is B: Wipe the top of the formula can with alcohol. This is the first action the nurse should take because it ensures the cleanliness and sterility of the formula before administering it to the client through the NG tube, reducing the risk of contamination and infection. A: Making sure the enteral formula is at room temperature is important but not the first action to take. C: Rinsing the feeding bag with water between feedings is not necessary for every feeding and does not address the immediate need to ensure the cleanliness of the formula. D: Instructing the client to keep the head of the bed elevated is important for preventing aspiration but is not the first action to take in this scenario.