A nurse is reinforcing teaching about a heart-healthy diet with a group of clients who have hypertension.
Which of the following statements by the clients indicates a need for further teaching?
"Fresh fruits are good to include with meals.”.
"I will replace table salt with dried herbs.”.
"I can have a cola drink twice a day.”.
"I can eat frozen juice bars for a snack.”.
The Correct Answer is C
Choice A rationale:
"Fresh fruits are good to include with meals.”. Including fresh fruits with meals is an excellent choice for a heart-healthy diet. Fresh fruits are rich in essential vitamins, minerals, and fiber, which can help lower blood pressure and reduce the risk of heart disease.
Choice B rationale:
"I will replace table salt with dried herbs.”. This is a good choice for reducing sodium intake. Dried herbs can add flavor to food without the need for table salt, which is high in sodium. Lowering sodium intake is crucial for individuals with hypertension to manage their condition and maintain a heart-healthy diet.
Choice C rationale:
"I can have a cola drink twice a day.”. This choice is incorrect. Consuming cola drinks, which are high in sugar and caffeine, is not advisable for individuals with hypertension. High sugar intake can contribute to weight gain and high blood pressure, while caffeine can temporarily raise blood pressure. Clients with hypertension should limit or avoid soda consumption.
Choice D rationale:
"I can eat frozen juice bars for a snack.”. Frozen juice bars can be a healthier alternative to high-calorie, sugary snacks. However, the specific content of these bars should be considered. If they contain added sugars or high levels of sodium, it may not be the best choice. Clients with hypertension should focus on snacks that are low in added sugars and salt.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
The nurse should identify that an effective outcome of IV fluid replacement in a client with dehydration is an increase in urine output. Urine output of 200 mL in 4 hours indicates that the kidneys are responding to the IV fluid replacement, and the client is likely rehydrating. This suggests that the renal perfusion has improved, and the client's body is eliminating waste products properly.
Choice B rationale:
A heart rate of 104 beats per minute is not necessarily indicative of the effectiveness of IV fluid replacement. Heart rate may vary for various reasons, and it is not a specific parameter for assessing the response to hydration. Other factors, such as blood pressure, should be considered to evaluate cardiovascular status.
Choice C rationale:
Peripheral pulses of +1 are not a direct indicator of the effectiveness of IV fluid replacement. While improved hydration may lead to better peripheral perfusion, this assessment is somewhat subjective and may not accurately reflect the overall effectiveness of the treatment.
Choice D rationale:
A urine specific gravity of 1.04 is not indicative of the effectiveness of IV fluid replacement. A specific gravity of 1.004 is within the normal range (normal range: 1.005-1.030) and does not necessarily indicate hydration status. It is essential to focus on urine output and other objective parameters to assess the effectiveness of hydration therapy. .
Correct Answer is C
Explanation
The correct answer is C.
Choice A: Oxygen saturation of 95% The normal oxygen saturation level is between 95% and 100%. An oxygen saturation of 95% is within the normal range, so the nurse would not need to withhold furosemide for this reason.
Choice B: Serum sodium level of 140 mEq/L The normal serum sodium levels range from 135 to 145 mEq/L. A serum sodium level of 140 mEq/L is within the normal range, so the nurse would not need to withhold furosemide for this reason.
Choice C: Blood pressure of 80/40 mm Hg Furosemide is a potent diuretic that can lead to a significant depletion of electrolytes, which may lead to side effects such as muscle cramps and an irregular heartbeat. Low blood pressure (hypotension) is a potential side effect of furosemide. Normal blood pressure for adults is typically around 120/80 mm Hg. A blood pressure reading of 80/40 mm Hg is considerably lower than the normal range, indicating hypotension.
Choice D: Serum potassium level of 4.8 mEq/L The normal serum potassium levels range from 3.6 to 5.2 mEq/L. A serum potassium level of 4.8 mEq/L is within the normal range, so the nurse would not need to withhold furosemide for this reason.
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