A nurse is caring for a client who has a new diagnosis of type 2 diabetes mellitus and has a referral for a dietary consult. The client tells the nurse, "I will have to eat whatever the dietitian tells me." Which of the following statements by the nurse encourages the client's involvement in their plan of care?

"I can assist you with making a list of foods you like for the dietitian."

"I understand that the dietary choices can seem overwhelming."

"Managing your diabetes will require you to make accommodations."

"The dietitian will provide you with the best food choices to manage your diabetes."

Answer and Explanation

The Correct Answer is A

Choice A reason: This statement encourages the client's involvement by offering assistance in creating a personalized list of preferred foods, which can then be discussed with the dietitian. It promotes a collaborative approach to the dietary plan, allowing the client to have a say in their food choices, which is essential for long-term adherence and management of type 2 diabetes.

Choice B reason: While this statement shows empathy, it does not actively encourage the client's involvement in their care. Understanding the challenges is important, but it is more beneficial to empower the client to take an active role in managing their dietary choices.

Choice C reason: This statement is factual, as managing diabetes does require accommodations. However, it does not directly encourage the client's involvement. Instead, it could be more encouraging by suggesting ways the client can participate in making those accommodations.

Choice D reason: Informing the client that the dietitian will provide the best food choices is reassuring but does not facilitate the client's involvement. It positions the dietitian as the sole decision-maker rather than including the client as an active participant in their dietary planning.

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Free Nursing Study Resources

Correct Answer is D

Explanation

Choice A reason: Taking two tablets PO every 15 minutes is not the standard protocol for nitroglycerin administration for chest pain. This method could lead to an overdose and significant hypotension (low blood pressure), which can be dangerous.

Choice B reason: One tablet SL every 15 minutes, up to 5 times, is also not the standard protocol. While sublingual administration is correct, the frequency and the total number of doses are higher than recommended, which could result in adverse effects such as headache, dizziness, or a severe drop in blood pressure.

Choice C reason: One tablet PO every one hour, up to 5 times, is not a recommended method for acute chest pain relief from angina. Oral administration does not provide the rapid onset of action required for acute angina relief.

Choice D reason: One tablet SL every 5 minutes, up to 3 times, is the correct protocol for nitroglycerin administration when experiencing chest pain due to angina. If pain persists after the first dose, the patient can take a second dose after 5 minutes, and if needed, a third dose after another 5 minutes. If chest pain continues after three doses in 15 minutes, emergency medical help should be sought immediately.

A. "Display a monthly calendar in the client's room." B. "Provide plenty of stimulation in the client's room." C. "Keep the client's room dark at night to promote sleep." D. "Provide the client with structured activities to fill their time."

Correct Answer is A

Explanation

Choice A reason : Displaying a monthly calendar can help orient a client with Alzheimer's disease to the date and assist with maintaining a sense of time, which can be beneficial in managing cognitive impairment.

Choice B reason: Providing plenty of stimulation can be overwhelming for clients with Alzheimer's disease. A calm and predictable environment is usually more beneficial.

Choice C reason: Keeping the room dark at night can promote sleep, but it is not the only consideration. A nightlight or low-level lighting can prevent falls if the client needs to get up during the night.

Choice D reason: Providing structured activities can help fill the client's time and provide a sense of purpose, but it should be tailored to the individual's abilities and preferences.

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Naxlex Comprehensive Predictor Exams

The nurse is instructing the client on the correct way to take nitroglycerin as needed for chest pain:

Correct Answer is D

Explanation

A nurse is providing teaching for the family of a client who has Alzheimer's disease. Which of the following statements should the nurse include?

Correct Answer is A

Explanation

A nurse is performing an abdominal assessment for a client. Which of the following findings should the nurse identify as the priority?

A nurse is assessing a client who sustained major full-thickness burns to their lower legs 12 hours ago. Which of the following findings should the nurse expect?

A nurse is caring for a client who has skeletal traction applied to the left leg. Which of the following actions should the nurse take?

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A nurse is caring for a client who is experiencing an increase in intracranial pressure (ICP). The nurse should expect which of the following as an early manifestation of increased ICP?

The nurse is caring for several clients on a hospital unit. Which of the following clients is most at risk for hypoglycemia?

A nurse is reinforcing teaching with a client who has osteoporosis and is prescribed (Fosamax) alendronate 70 mg PO weekly. Which of the following statements by the client indicates a need for further instruction?