A nurse is providing calorie-count information to a client who has a BMI of 35. Which of the following instructions should the nurse include?
You should consume high-calorie foods early in the day.
You should limit carbohydrate intake to 30 grams per day.
You should consume 500 fewer calories per day.
You should follow a liquid meal plan for 4 weeks.
The Correct Answer is C
Choice A reason: Consuming high-calorie foods early in the day is not a good strategy for weight loss, as it can lead to overeating and increased fat storage. The nurse should advise the client to eat a balanced breakfast that includes protein, fiber, and healthy fats, which can help curb appetite and boost metabolism.
Choice B reason: Limiting carbohydrate intake to 30 grams per day is too restrictive and may cause nutritional deficiencies, ketosis, and adverse effects on mood and cognition. The nurse should recommend a moderate carbohydrate intake of 45 to 65 percent of total calories, with an emphasis on complex carbohydrates from whole grains, fruits, vegetables, and legumes.
Choice C reason: Consuming 500 fewer calories per day can result in a weight loss of about 1 pound per week, which is a safe and realistic goal for a client who has a BMI of 35. The nurse should help the client identify sources of excess calories in their diet and suggest ways to reduce them, such as choosing low-calorie beverages, using smaller plates, and avoiding distractions while eating.
Choice D reason: Following a liquid meal plan for 4 weeks is not a sustainable or healthy way to lose weight, as it can cause muscle loss, electrolyte imbalance, and rebound weight gain. The nurse should encourage the client to eat regular meals that include a variety of foods from all food groups, with appropriate portion sizes and nutrient density.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice D reason:A metallic taste in the mouth is not a recognized symptom of hyperglycemia. It may occur in other conditions, such as certain medication side effects, infections, or metabolic disorders, but it is not specific to diabetes or high blood glucose levels. Including this as a sign of hyperglycemia could lead to confusion or misinterpretation of symptoms.
Choice A reason: Anxiety is not a specific symptom of hyperglycemia, although it can be associated with stress or other psychological factors that can affect blood sugar levels. Anxiety can also be a symptom of hypoglycemia, or low blood sugar, which requires immediate treatment.
Choice B reason: Hyperventilation, characterized by deep and rapid breathing, is a critical manifestation of severe hyperglycemia, particularly in cases ofdiabetic ketoacidosis (DKA). When blood glucose levels are extremely high, the body may produce ketones, leading to metabolic acidosis. To compensate, the client may developKussmaul respirations, a type of hyperventilation aimed at expelling excess carbon dioxide. This is a medical emergency and requires immediate intervention. Teaching the client to recognize hyperventilation as a sign of severe hyperglycemia is essential for timely treatment and prevention of complications.
Choice C reason: Cool skin is not a symptom of hyperglycemia, but rather a sign of poor circulation, which can be a complication of diabetes. Diabetes can damage the blood vessels and nerves that supply blood and oxygen to the skin, especially in the feet and legs. This can lead to skin problems, infections, and ulcers.
Correct Answer is B
Explanation
Choice B reason: Older adults should decrease their calorie intake as their metabolic rate and physical activity tend to decline with age. Excess calories can lead to weight gain and increase the risk of chronic diseases such as diabetes, cardiovascular disease, and some cancers. Older adults should aim for a balanced diet that meets their nutritional needs without exceeding their energy requirements.
Choice A reason: Older adults should not decrease their vitamin D intake, as vitamin D is essential for bone health and immune function. Older adults are at risk of vitamin D deficiency due to reduced sun exposure, decreased skin synthesis, and impaired absorption. Vitamin D deficiency can cause osteoporosis, fractures, muscle weakness, and infections. Older adults should consume adequate amounts of vitamin D from fortified foods, supplements, or sun exposure.
Choice C reason: Older adults should not decrease their protein intake, as protein is important for maintaining muscle mass, strength, and function. Older adults are prone to sarcopenia, which is the loss of muscle mass and quality due to aging. Sarcopenia can impair mobility, balance, and independence. Older adults should consume enough protein from animal or plant sources to prevent or delay sarcopenia.
Choice D reason: Older adults should not decrease their fiber intake, as fiber is beneficial for digestive health and blood glucose control. Older adults often suffer from constipation, diverticular disease, and diabetes, which can be alleviated by increasing fiber intake. Fiber can also lower cholesterol levels and reduce the risk of heart disease and some cancers. Older adults should consume at least 25 grams of fiber per day from fruits, vegetables, whole grains, legumes, nuts, and seeds.
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