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 B

Explanation

A. A client who consumes all the food from their meal tray. This is a normal finding and does not require immediate reporting to the nurse. It can be documented by the AP as part of routine care.
B. A client who has a prescription for compression stockings and did not receive them. Compression stockings are a prescribed intervention to prevent complications such as deep vein thrombosis. The nurse must be informed to ensure timely application and follow-up.
C. A client who requests to sit in the bedside chair while watching TV. This is a non-urgent and appropriate activity that does not require nursing intervention unless the client has specific mobility restrictions.
D. A client who requests assistance to use the bedside commode. Assisting with toileting is within the AP’s scope of practice and does not need to be reported unless there is an issue (e.g., change in condition, abnormal findings).

A. Respiratory rate 10/min B. 2+ deep-tendon reflexes C. 3+ pedal edema D. Urinary output 35 mL/hr

Correct Answer is A

Explanation

A. Respiratory rate 10/min. This is the priority finding because it suggests respiratory depression, a serious side effect of magnesium sulfate therapy. Magnesium acts as a CNS depressant, and a respiratory rate below 12/min is a potential sign of magnesium toxicity, which can lead to respiratory arrest if not promptly addressed.
B. 2+ deep-tendon reflexes. This indicates normal neuromuscular function and is actually a reassuring finding in a client receiving magnesium sulfate. Reflexes are typically monitored to detect early signs of toxicity, and a 2+ rating means the dose is likely therapeutic.
C. 3+ pedal edema. While significant, pedal edema is a common feature of preeclampsia and not directly related to magnesium sulfate toxicity. It should be monitored but does not require immediate action compared to respiratory compromise.
D. Urinary output 35 mL/hr. This is slightly above the minimum acceptable output of 30 mL/hr, indicating the kidneys are excreting adequately. While magnesium is excreted renally and output must be monitored, this value does not indicate an acute risk.

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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

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