A client presents to the clinic for a postoperative follow-up following surgical repair of a fractured radius.

The client reports their adult child prepares two meals a day for them to eat.

The client's weight is 55.9 kg (123 Ib) and height is 175 cm (69 in). What is the client's BMI?

Choice A rationale

Increasing the rate of formula delivery would worsen hyperosmolar dehydration. A faster rate delivers more solute-rich formula to the gastrointestinal tract in a shorter time, pulling more free water from the body's vascular space into the gut lumen via osmosis. This fluid shift further depletes the body's free water, intensifying the dehydration and increasing serum osmolality.

Choice B rationale

Hyperosmolar dehydration occurs when the body's free water is drawn into the gastrointestinal tract due to a high solute concentration in the enteral formula. By adding free water to the formula, the nurse dilutes the solution, lowering its osmolarity. This action helps to balance the osmotic gradient, reducing the fluid shift and preventing further dehydration.

Choice C rationale

Switching to a lactose-free formula is indicated for clients with lactose intolerance, which causes symptoms like diarrhea and bloating, but it does not directly address hyperosmolar dehydration. Hyperosmolar dehydration is related to the overall solute load and concentration of the formula, not specifically the presence or absence of lactose.

Choice D rationale

Repositioning the NG tube is an action to ensure proper placement and prevent complications like aspiration, but it does not resolve hyperosmolar dehydration. This type of dehydration is a systemic problem related to fluid and electrolyte balance, not a local issue with the tube's position within the gastrointestinal tract. *.

Choice A rationale

Varying a child's scheduled activities each day is counterproductive for a child with ADHD. Children with this condition benefit significantly from structured routines and predictable schedules. A consistent daily structure minimizes the need for the child to process new information and adapt to changes, which can be overwhelming and lead to decreased concentration and increased impulsivity.

Choice B rationale

Encouraging a child with ADHD to read a book during an outdoor school activity period is not a suitable strategy. This situation places the child in an environment filled with external stimuli, such as other children playing, sounds, and visual distractions. This highly stimulating setting is precisely the opposite of what is needed to improve focus and attention in a child with ADHD.

Choice C rationale

Children with ADHD have difficulty filtering out irrelevant stimuli from their environment. Providing a designated, quiet space with minimal distractions directly addresses this core challenge. This environment reduces the number of competing sensory inputs, allowing the child to direct their limited attention resources more effectively toward a single task, such as homework, thereby improving concentration.

Choice D rationale

The mode of completing homework, whether by hand or using a computer, is less critical than the environmental context. While a computer might offer some interactive benefits, it also presents numerous potential distractions, such as internet access, games, and notifications. Having a child write by hand in a distracting environment would not be as effective as using a computer in a distraction-free zone. *.