A nurse is providing dietary teaching to a client who has a body mass index of 22. Which of the following actions should the nurse take?
Recommend a total fat intake of 12 g each day.
Refer the client to a weight-loss support group.
Advise the client to add 500 calories per day to the diet.
Encourage the client to continue current daily caloric intake.
The Correct Answer is D
Choice A reason: Recommending a total fat intake of 12 g each day is not an appropriate action for the nurse to take because it is too low for most adults. The recommended dietary allowance (RDA. for fat is 20 to 35% of total calories per day, which translates to about 44 to 78 g of fat per day for an average adult who consumes 2,000 calories per day.
Choice B reason: Referring the client to a weight-loss support group is not an appropriate action for the nurse to take because the client does not need to lose weight. A body mass index (BMI) of 22 is within the normal range, which is 18.5 to 24.9. A weight-loss support group is more suitable for clients who have a BMI of 25 or higher, which indicates overweight or obesity.
Choice C reason: Advising the client to add 500 calories per day to the diet is not an appropriate action for the nurse to take because it may lead to weight gain. A client who has a BMI of 22 does not need to increase their caloric intake unless they have other medical conditions or nutritional needs that require more calories. Adding 500 calories per day to the diet can result in gaining about one pound per week, which can increase the risk of obesity and its complications.
Choice D reason: Encouraging the client to continue current daily caloric intake is an appropriate action for the nurse to take because it can help maintain a healthy weight. A client who has a BMI of 22 has a balanced energy intake and expenditure, which means that they consume enough calories to meet their metabolic needs and physical activity level. Continuing current daily caloric intake can prevent weight loss or gain and promote health and wellness.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Checking blood glucose level is an appropriate action for the nurse to take because it can help determine if the client has hypoglycemia or hyperglycemia, which are both complications of diabetes mellitus that can cause dizziness and weakness. Blood glucose level should be checked using a glucometer and compared with the normal range of 70 to 130 mg/dL before meals and less than 180 mg/dL after meals.
Choice B reason: Giving insulin injection is not an appropriate action for the nurse to take without checking blood glucose level first because it may cause hypoglycemia, which is a condition in which blood glucose level drops below 70 mg/dL and can cause dizziness, weakness, confusion, sweating, and seizures. Insulin injection should be given according to the prescribed dose, type, and schedule.
Choice C reason: Offering orange juice is not an appropriate action for the nurse to take without checking blood glucose level first because it may cause hyperglycemia, which is a condition in which blood glucose level rises above 180 mg/dL and can cause dizziness, weakness, thirst, polyuria, and ketoacidosis. Orange juice should be offered only if the client has hypoglycemia and is conscious and able to swallow.
Choice D reason: Applying cold compress is not an appropriate action for the nurse to take because it does not address the underlying cause of dizziness and weakness in a client who has diabetes mellitus. Cold compress may worsen the symptoms by reducing blood flow and oxygen delivery to the brain. Cold compress should be applied only if the client has fever, inflammation, or pain.
Correct Answer is D
Explanation
Choice A reason: Creatinine 0.8 mg/dL is within the normal range (0.6-1.2), and it does not indicate fluid volume excess. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys. High creatinine levels can indicate kidney damage or impaired renal function.
Choice B reason: Hgb 15 g/dL is within the normal range (13-17 for men, 12-16 for women), and it does not indicate fluid volume excess. Hgb stands for hemoglobin, which is a protein in red blood cells that carries oxygen to the tissues. Low hemoglobin levels can indicate anemia, bleeding, or hemolysis.
Choice C reason: BUN 18 mg/dL is within the normal range (7-20), and it does not indicate fluid volume excess. BUN stands for blood urea nitrogen, which is a waste product of protein metabolism that is filtered by the kidneys. High BUN levels can indicate dehydration, kidney damage, or high protein intake.
Choice D reason: Sodium 149 mEq/L is high and indicates fluid volume excess. Sodium is an electrolyte that helps maintain fluid balance, blood pressure, and nerve impulses. High sodium levels can cause fluid retention, edema, hypertension, and heart failure.
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