A nurse is planning care for a client who wants to lose weight. Which of the following actions should the nurse take first?
Set a weight loss goal.
Identify the client's motivation.
Discuss behavior modification.
Refer the client to a dietitian.
The Correct Answer is B
Choice A reason: Setting a weight loss goal is an important step in the weight management process, but it is not the first action the nurse should take. The nurse should first assess the client's readiness and willingness to change, as well as the factors that motivate the client to lose weight.
Choice B reason: Identifying the client's motivation is the first action the nurse should take, as it helps the nurse to tailor the interventions to the client's needs and preferences. The nurse should explore the client's reasons for wanting to lose weight, such as improving health, appearance, or self-esteem, and use them as positive reinforcement.
Choice C reason: Discussing behavior modification is a key component of weight management, but it is not the first action the nurse should take. The nurse should first identify the client's motivation and then help the client to develop realistic and specific goals and strategies to change their eating and physical activity habits.
Choice D reason: Referring the client to a dietitian is a helpful action, but it is not the first action the nurse should take. The nurse should first identify the client's motivation and then collaborate with the dietitian to provide individualized and evidence-based dietary advice and education to the client.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Changing the feeding to a continuous infusion may not improve the constipation, as it does not address the fluid deficit or the fiber content of the formula. Continuous infusion may also increase the risk of aspiration, diarrhea, and bacterial contamination.
Choice B reason: Increasing the amount of free water can help prevent or treat constipation by hydrating the stool and facilitating its passage. The client's fluid intake and output indicate a fluid deficit, which can contribute to constipation. The recommended fluid intake for adults is 30 to 35 mL/kg/day.
Choice C reason: Decreasing the infusion rate of feeding may worsen the constipation, as it reduces the caloric and fluid intake of the client. The infusion rate should be based on the client's nutritional needs and tolerance.
Choice D reason: Requesting a prescription for a diuretic is not appropriate, as it would further dehydrate the client and aggravate the constipation. Diuretics are indicated for clients with fluid overload, not fluid deficit.
Correct Answer is B
Explanation
Choice A reason: Anticholinesterase medications should be taken 30 minutes before meals, not with meals. This is because they enhance the action of acetylcholine, which improves muscle strength and swallowing ability.
Choice B reason: Positioning the head of the client's bed to 40° while eating helps prevent aspiration and facilitates swallowing. This is the best action for the nurse to take for a client who has myasthenia gravis.
Choice C reason: Encouraging the client to lie down after eating is not advisable, as it increases the risk of aspiration and reflux. The client should remain upright for at least 30 minutes after eating.
Choice D reason: Providing the client with food cut into small bites is not enough to ensure safe and adequate nutrition. The client may still have difficulty swallowing and chewing. The nurse should also offer soft, moist, and easy-to-swallow foods, and avoid foods that are dry, sticky, or hard.

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