A nurse is assisting in the care of a client who is malnourished and states, ‘’I refuse to eat right now. It goes against my beliefs.’’ Which of the following responses should nurse make?

If you continue to refuse to eat, I will have to insert an NG tube

Why aren't you willing to eat?

"Your nutrition is more important than your beliefs.

Let's discuss some menu options you would be interested in."

Answer and Explanation

The Correct Answer is D

A) If you continue to refuse to eat, I will have to insert an NG tube: This response is coercive and may not be respectful of the client’s autonomy. It can create a sense of fear and mistrust, which can make the client feel pressured or cornered. It is important to respect the client’s beliefs and preferences while also promoting nutrition, so alternative options should be explored in a more collaborative manner.

B) Why aren't you willing to eat?: While it’s important to understand the client’s reasons for refusing to eat, this response could come across as confrontational. It may place the client on the defensive and fail to acknowledge their beliefs and autonomy. A more open-ended and supportive approach is needed to create a dialogue that is respectful and patient-centered.

C) "Your nutrition is more important than your beliefs.": This response disregards the client's personal beliefs and could be perceived as disrespectful. While nutrition is critical, it is important to work within the framework of the client’s values and beliefs. The nurse should strive for a compassionate conversation that balances nutritional needs with cultural or personal beliefs.

D) Let's discuss some menu options you would be interested in.: This response is respectful of the client’s beliefs and autonomy while still addressing the issue of malnutrition. By offering options and engaging the client in the decision-making process, the nurse fosters a collaborative approach. This can help increase the likelihood of the client agreeing to eat while respecting their preferences and beliefs.

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Correct Answer is C

Explanation

A) Decreased hemoglobin level: A decreased hemoglobin level is not an expected or desirable outcome of taking furosemide. While furosemide can cause fluid loss, it does not directly affect red blood cell production or hemoglobin levels. A decrease in hemoglobin could indicate anemia or another underlying issue, which should be addressed separately.

B) Increased weight of 0.91 kg (2 lb): An increase in weight, especially in a client with heart failure, could indicate fluid retention rather than effective diuresis. Furosemide is a diuretic that helps reduce fluid buildup, so an increase in weight would typically suggest that the medication is not effectively managing fluid overload, which is a key issue in heart failure.

C) Increased urinary output: An increase in urinary output is a clear indicator that furosemide is working effectively. Furosemide is a loop diuretic, which promotes the excretion of sodium and water, leading to increased urine output. This helps reduce fluid volume in the body, which is beneficial for a client with heart failure.

D) Decreased BUN level: While furosemide can affect kidney function, a decrease in blood urea nitrogen (BUN) level is not a direct indicator of the medication’s effectiveness. BUN can be influenced by various factors such as hydration status, kidney function, and protein intake. A decreased BUN level does not directly correlate with furosemide's effectiveness in treating heart failure.

A. Impetigo contagiosa B. Sarcoptes scabiel C. Neisseria gonorrhoeae D. Human papillomavirus

Correct Answer is C

Explanation

A) Impetigo contagiosa: Impetigo contagiosa is a bacterial skin infection caused by either Staphylococcus aureus or Streptococcus pyogenes. While it is contagious, it is not typically required to be reported to the state health department, as it is not considered a high-priority communicable disease that mandates immediate reporting.

B) Sarcoptes scabiei: Scabies, caused by the mite Sarcoptes scabiei, is a contagious parasitic skin infection. Although scabies can be easily spread, it is generally not a reportable disease to the state health department unless there is an outbreak in a specific setting, such as a healthcare facility or school.

C) Neisseria gonorrhoeae: Neisseria gonorrhoeae, the bacterium that causes gonorrhea, is a sexually transmitted infection (STI) that is required by law to be reported to the state health department. Gonorrhea is a notifiable disease because of its potential for rapid transmission, complications, and its increasing resistance to antibiotics. Early reporting helps control the spread and provides opportunities for public health interventions.

D) Human papillomavirus (HPV): Human papillomavirus (HPV) is a viral infection that is not required to be reported to the state health department. While HPV is the most common STI and can lead to cancers such as cervical cancer, it is not mandated for reporting as an individual infection. However, certain types of HPV-related cancers may be tracked through cancer registries.

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A nurse is assisting in the care of a client who is malnourished and states, ‘’I refuse to eat right now. It goes against my beliefs.’’ Which of the following responses should nurse make?

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Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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