A nurse is providing teaching about a weight reduction plan to a client who is obese and has type 2 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?
I should reduce my caloric intake by 200 calories a day to lose 1 pound a week.
I need to lose 5 percent of my body weight to improve my glycemic control.
I must exercise for 30 minutes three times a week to lose 1 pound per week.
If my blood glucose level drops during exercise, I should drink 16 ounces of apple juice.
The Correct Answer is B
Choice A reason: Reducing caloric intake by 200 calories a day may not be enough to achieve significant weight loss for a client who is obese. The recommended daily calorie deficit for weight loss is 500 to 750 calories, which can result in a loss of 1 to 1.5 pounds per week¹.
Choice B reason: Losing 5 percent of body weight can improve glycemic control and reduce the need for glucose-lowering medications for a client who has type 2 diabetes. Studies have shown that weight loss of 5 to 10 percent can lower HbA1c levels by 0.5 to 1.0 percentage points².
Choice C reason: Exercising for 30 minutes three times a week may not be sufficient to lose 1 pound per week. The recommended amount of physical activity for weight loss is at least 150 minutes of moderate-intensity aerobic exercise per week, plus resistance training at least twice a week³.
Choice D reason: Drinking 16 ounces of apple juice is not advisable if the blood glucose level drops during exercise, as it can cause hyperglycemia. Apple juice contains about 48 grams of carbohydrates, which is equivalent to four servings of glucose tablets⁴. The recommended treatment for hypoglycemia is to consume 15 to 20 grams of fast-acting carbohydrates, such as glucose tablets, gel, or juice, and recheck the blood glucose level after 15 minutes⁵.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice B reason: Providing low-fat carbohydrates with meals can help reduce nausea and vomiting in clients who have equilibrium imbalance. Low-fat carbohydrates are easy to digest and can provide energy and prevent hypoglycemia. Examples of low-fat carbohydrates are crackers, toast, rice, and noodles.
Choice A reason: Serving hot foods at mealtime is not a good strategy for clients who have nausea from equilibrium imbalance. Hot foods can have strong odors and flavors that can trigger nausea and vomiting. Cold or room-temperature foods are more tolerable and less stimulating for the senses.
Choice C reason: Encouraging the client to eat even if nauseated is not a helpful strategy for clients who have nausea from equilibrium imbalance. Forcing the client to eat can worsen nausea and vomiting and cause discomfort and distress. The nurse should respect the client's preferences and appetite and offer small, frequent meals and snacks.
Choice D reason: Limiting fluid intake between meals is not a necessary strategy for clients who have nausea from equilibrium imbalance. Fluid intake is important to prevent dehydration and electrolyte imbalance, which can occur due to vomiting. The nurse should encourage the client to drink fluids between meals, but avoid drinking fluids with meals, as this can cause bloating and fullness.
Correct Answer is D
Explanation
Choice A reason: Abdominal distention is a possible complication of enteral nutrition, as it may indicate gas accumulation, constipation, or intolerance to the formula. However, it is not the greatest risk to the client, as it can be prevented or managed by adjusting the formula, rate, or volume of the feeding, or by administering medications or enemas.
Choice B reason: Fluid overload is a possible complication of enteral nutrition, as it may indicate excessive fluid intake, renal impairment, or heart failure. However, it is not the greatest risk to the client, as it can be prevented or managed by monitoring the fluid balance, electrolytes, and vital signs, or by administering diuretics or fluid restriction.
Choice C reason: Glycosuria is a possible complication of enteral nutrition, as it may indicate hyperglycemia, diabetes, or infection. However, it is not the greatest risk to the client, as it can be prevented or managed by monitoring the blood glucose, urine output, and signs of infection, or by administering insulin or antibiotics.
Choice D reason: Tube obstruction is the greatest risk to the client, as it may indicate clogging, kinking, or twisting of the tube, which can impair the delivery of the nutrition and medication, and cause aspiration, infection, or perforation. Tube obstruction can be prevented by flushing the tube with water before and after each feeding or medication, and by using a syringe or a pump to administer the formula. Tube obstruction can be managed by using warm water, carbonated beverages, or pancreatic enzymes to unclog the tube, or by replacing the tube if necessary.
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