A male client with coronary heart disease is informed by the healthcare provider that his cholesterol levels are significantly elevated and he needs to change his diet and lifestyle. The client emphatically states that he is not going to change his eating habits. What action should the nurse implement in response to the client's unwillingness to comply with the recommendations?

Provide pamphlets about heart healthy diet selections.

Refer the client to a dietitian for nutrition education.

Discuss client's concerns about the change in diet.

Suggest exercise as an alternative to increase HDL levels.

Answer and Explanation

The Correct Answer is C

Choice A

Providing pamphlets about heart-healthy diet selections should not be implemented. Providing information is important, but it might not be as effective if the client is strongly resistant. Engaging in a conversation first can help tailor the information to the client's needs.

Choice B

Referring the client to a dietitian for nutrition education should not be implemented. A dietitian can provide valuable education, but it might be more beneficial to address the client's concerns and resistance before making the referral.

Choice C

Discussing client's concerns about the change in diet should be implemented. When a client is resistant or unwilling to make changes to their diet and lifestyle, it's important for the nurse to engage in open and empathetic communication. Option C, discussing the client's concerns about the change in diet, is the most appropriate initial response.

By engaging in a conversation with the client, the nurse can better understand the client's perspective, reasons for resistance, and potential barriers to making dietary changes. This approach allows the nurse to address the client's concerns, provide information, and work collaboratively to find solutions that might be more acceptable to the client.

Choice D

Suggesting exercise as an alternative to increase HDL levels should not be implemented. Exercise is important for heart health, but it's important to address the client's resistance to dietary changes first. Additionally, dietary changes and exercise can work together to improve overall heart health.

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Correct Answer is C

Explanation

Choice A

"The bruises on my arms are all gone." This statement is incorrect. Bruising can be influenced by various factors, including platelet levels and clotting factors, but it is not a specific sign of Vitamin A deficiency.

Choice B

"My feet don't tingle like they used to. “This statement is incorrect. Tingling feet might be related to nerve function or circulation, but it is not a direct symptom of Vitamin A deficiency.

Choice C

"I can see at night when I wake up now. “This statement is correct. Vitamin A is essential for maintaining good vision, especially in low-light conditions. Deficiency of Vitamin A can lead to a condition called night blindness, where individuals have difficulty seeing in low light. Therefore, the statement "I can see at night when I wake up now" (option C) indicates that an adequate amount of Vitamin A is being provided.

Choice D

"My tummy seems so much smaller now. “This statement is incorrect. Changes in tummy size are not typically related to Vitamin A deficiency. Vitamin A deficiency is more closely associated with symptoms related to vision and immune function.

A. Demonstrate correct measurement of the tube insertion length. B. Remind the nurse to apply lubricant to the tube before insertion. C. Confirm that the nurse has auscultated the client's bowel sounds. D. Elevate the head of the bed before the nurse inserts the tube.

Correct Answer is A

Explanation

Choice A

Demonstrating correct measurement of the tube insertion length is the first priority. Inserting a nasogastric tube to the appropriate length is crucial for ensuring that the tube reaches the stomach and is not inserted too far. Incorrect insertion length can lead to complications, discomfort, or potential harm to the patient. Therefore, demonstrating and ensuring the correct measurement of the tube insertion length takes priority.:

Choice B

Reminding the nurse to apply lubricant to the tube before insertion is not first priority. Applying lubricant helps ease the insertion process, but it is not the most critical step to prioritize initially.

Choice C

Confirming that the nurse has auscultated the client's bowel sounds is not the first priority. Bowel sounds assessment is important to ensure proper placement, but this step can be done after ensuring the correct measurement of the insertion length.

Choice D

Elevating the head of the bed before the nurse inserts the tube is not the first priority: Elevating the head of the bed helps facilitate the passage of the tube into the stomach, but it is not the first priority in this context.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A malnourished child is receiving several nutritional supplements. Which statement by the child indicates to the nurse that an adequate amount of Vitamin A is being provided?

Correct Answer is C

Explanation

The charge nurse observes a newly hired nurse who is preparing to insert a nasogastric tube. Which action by the charge nurse takes priority?

Correct Answer is A

Explanation

The nurse is providing dietary education to a client newly diagnosed with Type 2 diabetes mellitus. Which information should the nurse provide?

The nurse is caring for an older client with that is exhibiting signs of confusion. Which intervention should the nurse implement?

The nurse instructs a client with Type 2 diabetes mellitus (DM) to avoid refined sugar and carbohydrates. Choosing which food indicates that the client understands the diet teaching?

The nurse is caring for an older adult who needs to limit sodium intake. Which food should the nurse encourage the client to avoid?

A client with celiac disease selects a bowl of oatmeal with fresh fruit and skim milk, grapefruit juice, and coffee from the breakfast menu. Which action is most important for the nurse to implement?

A client who is receiving antineoplastic chemotherapy has lost 25% of total body weight and is having difficulty eating because of stomatitis. In planning care for this client which diet should the nurse recommend?