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.

Answer and Explanation

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.

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Correct Answer is D

Explanation

Choice A reason: This is an incorrect action, because emptying the drainage container every 4 hr is not necessary and can interfere with the accurate measurement of the drainage volume. The drainage container should be emptied only when it is full or at the end of the shift.

Choice B reason: This is an incorrect action, because changing the client's insertion-site dressing each shift can increase the risk of infection and dislodgment of the chest tube. The insertion-site dressing should be changed only when it is soiled or loose.

Choice C reason: This is an incorrect action, because clamping the chest tube when the client is ambulating can cause a tension pneumothorax, which is a life-threatening complication of chest tube insertion. The chest tube should be clamped only when ordered by the provider or when changing the drainage system.

Choice D reason: This is the correct action, because placing the drainage unit below the client's chest level can facilitate the drainage of air and fluid from the pleural space by gravity. The drainage unit should be kept below the client's chest level at all times.

A. Cholesterol level 195 mg/dL B. Elevated HDL levels C. Elevated LDL levels D. Triglyceride level 135 mg/dL

Correct Answer is C

Explanation

Choice A reason: A cholesterol level of 195 mg/dL is not an increased risk for atherosclerosis, because it is within the normal range of less than 200 mg/dL. Cholesterol is a type of fat that circulates in the blood and can contribute to plaque formation in the arteries.

Choice B reason: Elevated HDL levels are not an increased risk for atherosclerosis, because HDL stands for high-density lipoprotein, which is the "good" cholesterol that helps to remove excess cholesterol from the blood and prevent plaque formation in the arteries.

Choice C reason: Elevated LDL levels are an increased risk for atherosclerosis, because LDL stands for low-density lipoprotein, which is the "bad" cholesterol that can deposit in the arterial walls and cause plaque formation and narrowing of the arteries.

Choice D reason: A triglyceride level of 135 mg/dL is not an increased risk for atherosclerosis, because it is within the normal range of less than 150 mg/dL. Triglycerides are another type of fat that circulates in the blood and can contribute to plaque formation in the arteries.

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