A nurse is reinforcing dietary teaching with a client who has diabetes mellitus. Which of the following actions should the nurse take first?
Obtain sample menus from the dietitian to give to the client.
Ask the client to identify the types of foods she prefers.
Identify the recommended range for the client's blood glucose level.
Discuss long-term complications that can result from nonadherence to the dietary plan.
The Correct Answer is B
Choice A reason: This is an important action, but not the first one. The nurse should obtain sample menus from the dietitian to give to the client after assessing the client's food preferences, needs, and goals. The sample menus should be individualized and tailored to the client's lifestyle, culture, and preferences.
Choice B reason: This is the first action, because the nurse should ask the client to identify the types of foods she prefers before providing any dietary teaching. This can help the nurse to determine the client's current eating habits, knowledge, and readiness to learn. It can also help the nurse to establish rapport and trust with the client, and to involve the client in the decision-making process.
Choice C reason: This is an important action, but not the first one. The nurse should identify the recommended range for the client's blood glucose level after assessing the client's food preferences, needs, and goals. The recommended range for the blood glucose level depends on the type, dose, and timing of the medication, the frequency and intensity of the exercise, and the carbohydrate intake of the client.
Choice D reason: This is an important action, but not the first one. The nurse should discuss long-term complications that can result from nonadherence to the dietary plan after assessing the client's food preferences, needs, and goals. The long-term complications of diabetes mellitus include cardiovascular disease, kidney disease, nerve damage, eye damage, and foot problems. The nurse should explain the benefits of following the dietary plan and the risks of not following it.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This is the correct intervention, because avoiding IM injections can prevent bleeding and hematoma formation in the client who has low platelet count and impaired clotting.
Choice B reason: This is an incorrect intervention, because obtaining a rectal temperature once per shift can cause trauma and bleeding in the rectal mucosa, which is highly vascularized and sensitive.
Choice C reason: This is an unnecessary intervention, because the client who has thrombocytopenia does not have an increased risk of infection, unless they also have neutropenia or immunosuppression. The client should be allowed to have visitors, as long as they follow the infection control precautions.
Choice D reason: This is an incorrect intervention, because encouraging daily flossing between teeth can cause gingival bleeding and ulceration in the client who has low platelet count and impaired clotting. The client should use a soft toothbrush and avoid dental floss.
Correct Answer is ["A","C","D"]
Explanation
Choice A reason: Placing the client in a private room is a correct action, because it reduces the exposure of other clients and staff to the radiation source.
Choice B reason: Securing a dosimeter badge to the client's gown is an incorrect action, because the dosimeter badge is used to measure the radiation exposure of the staff, not the client. The client should wear an identification bracelet that indicates the type and location of the radiation source.
Choice C reason: Donning a cover gown before entering the client's room is a correct action, because it protects the nurse's clothing from contamination by the client's body fluids or secretions.
Choice D reason: Disposing of dislodged implants in a biohazard sharps container is a correct action, because it prevents the spread of radiation and infection. The nurse should also notify the radiation safety officer if an implant is dislodged.
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