A nurse is caring for a client who is newly diagnosed with diabetes mellitus and is prescribed an 1800 calorie ADA diet. The client is refusing to eat the provided meals. Which of the following actions should the nurse take?

Offer the client's meals on a different schedule.

Discuss the client's food preferences with the hospital's dietitian.

Request the provider change the client's prescribed diet.

Allow the client's family to bring food from home for the client.

Answer and Explanation

The Correct Answer is B

A. Offer the client's meals on a different schedule. Changing the schedule may not address the core issue if the meals themselves do not align with the client’s preferences or cultural needs. It is not the most effective initial approach.
B. Discuss the client's food preferences with the hospital's dietitian. Collaborating with a dietitian allows for the modification of the meal plan to better align with the client’s preferences while still meeting nutritional and medical requirements. This supports client-centered care and improves adherence.
C. Request the provider change the client's prescribed diet. The provider may be involved later if significant changes are needed, but the dietitian is the appropriate first contact for customizing a prescribed diet based on individual preferences.
D. Allow the client's family to bring food from home for the client. While this can be an option, it must first be approved by the healthcare team to ensure the food aligns with the therapeutic diet and does not compromise the client’s condition.

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Correct Answer is C

Explanation

A. "How long have you struggled with your weight?" While this may provide background information, it shifts the focus to the client's weight history rather than validating their current emotional experience and distress.
B. "Let's discuss some weight loss strategies that might work for you." This response prematurely shifts to problem-solving and weight management without first addressing the client’s emotional needs or acknowledging their feelings of embarrassment and vulnerability.
C. "It sounds like you're saying that you feel uncomfortable around others." This is a therapeutic, reflective response that validates the client’s feelings and encourages them to express more about their emotional experience, fostering trust and emotional support.
D. "Have you always felt uncomfortable being overweight?" This question may come across as judgmental and focuses too much on the client's body image history rather than their current emotional experience, potentially worsening feelings of shame.

A. Request a prescription for terbutaline from the provider. B. Obtain a culture specimen of the lochia from the client's perineal pad using a sterile swab. C. Inform the client she will need to formula feed her newborn until she has received antibiotics for 24 hr. D. Initiate contact precautions. E. Monitor the height and tone of the client's fundus. F. Instruct the client to wash her hands before and after changing her perineal pad. G. Encourage the client to maintain a semi-Fowler's position to enhance uterine drainage.

Correct Answer is ["E","F","G"]

Explanation

A. Request a prescription for terbutaline from the provider. Terbutaline is a tocolytic used to stop preterm labor, not indicated in this postpartum scenario. The client is already on uterotonic therapy (methylergonovine), which is appropriate for postpartum uterine atony.
B. Obtain a culture specimen of the lochia from the client's perineal pad using a sterile swab is inappropriate because the pad is asceptic.

C. Inform the client she will need to formula feed her newborn until she has received antibiotics for 24 hr. This is incorrect. Breastfeeding is usually safe with most antibiotics, including clindamycin, and mothers with postpartum infections can typically continue breastfeeding unless advised otherwise by the provider.
D. Initiate contact precautions. Contact precautions are not necessary unless the client has an identified or suspected infection that is transmissible by direct contact (e.g., MRSA). Standard precautions are sufficient for routine postpartum care and suspected endometritis.
E. Monitor the height and tone of the client’s fundus. The fundus is tender and was initially boggy, indicating risk for uterine atony or subinvolution. Monitoring tone and height helps detect complications such as hemorrhage or infection.
F. Instruct the client to wash her hands before and after changing her perineal pad. Hand hygiene is essential to prevent the spread of infection to the perineal area or incision and to promote general postpartum hygiene.
G. Encourage the client to maintain a semi-Fowler’s position to enhance uterine drainage. This position helps promote lochia drainage, reduce uterine pooling, and may help with comfort and resolution of infection by improving uterine drainage.

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A nurse is caring for a client who is newly diagnosed with diabetes mellitus and is prescribed an 1800 calorie ADA diet. The client is refusing to eat the provided meals. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is obese. The client is crying and states, "Everyone is staring at me because of my weight." Which of the following responses should the nurse make?

Correct Answer is C

Explanation

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Correct Answer is ["E","F","G"]

Explanation

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