A patient who is obese reports severe pain and is unable to bear weight on the right ankle after making dietary changes 3 weeks ago for weight loss.
The patient’s medical history includes hypertension, gouty arthritis, and cholecystitis.
Which instruction should the nurse include in the discharge teaching?

Substitute natural fruit juices for carbonated drinks.

Avoid the consumption of wine, beer, and coffee.

Use an electric heating pad when pain is at its worst.

Encourage active range of motion to limit stiffness.

Answer and Explanation

The Correct Answer is D

Choice A rationale

While substituting natural fruit juices for carbonated drinks can be a healthy dietary change, it is not directly related to the patient’s reported symptoms of severe pain and inability to bear weight on the right ankle.

Choice B rationale

Avoiding the consumption of wine, beer, and coffee can have various health benefits, but it is not directly related to the patient’s current symptoms. Furthermore, there is no indication in the patient’s history that these beverages are contributing to the patient’s condition.

Choice C rationale

Using an electric heating pad when pain is at its worst can provide temporary relief, but it does not address the underlying issue causing the pain. Additionally, heat therapy is not typically recommended for acute gout attacks, which could be a potential cause of the patient’s symptoms given their history of gouty arthritis.

Choice D rationale

Encouraging active range of motion can help to limit stiffness and improve joint function, which could potentially alleviate the patient’s pain and improve their ability to bear weight on the right ankle. This advice is relevant to the patient’s symptoms and medical history.

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Correct Answer is []

Explanation

Based on the information provided, the client is most likely experiencinganorexia nervosa.This is suggested by her significant weight loss, bradycardia, hypothermia, lanugo-type hair, and her expressed fear of gaining weight despite being underweight. However, this is a preliminary assessment and a definitive diagnosis should be made by a healthcare professional.

Actions the nurse should take to address this condition include:

Acknowledge anxious feelings: It’s important to validate the client’s feelings and fears about food and weight gain.This can help build trust and facilitate further discussion about her health.
Provide emotional support: Emotional support is crucial in managing eating disorders.The nurse can provide reassurance, listen empathetically, and encourage the client to express her feelings.

Parameters the nurse should monitor to assess the client’s progress include:

Nutritional intake: Monitoring the client’s food and fluid intake can help assess her nutritional status and response to treatment.
Weight and BMI: Regular monitoring of the client’s weight and BMI can provide objective measures of her nutritional status and response to treatment.

A. Ask the patient how often episodes of sundowning are experienced. B. Inquire about the frequency of falls in recent months. C. Request the patient to lie as still as possible for the assessment. D. Assist the patient with clarifying values about end-of-life care options.

Correct Answer is B

Explanation

Choice A rationale

Asking the patient how often episodes of sundowning are experienced is more relevant in assessing cognitive function, particularly in patients with dementia. It is not directly related to the patient’s weight loss or decreased energy and appetite.

Choice B rationale

Inquiring about the frequency of falls in recent months is crucial in a functional assessment of an older patient who has lost weight and reports a decrease in energy and appetite. Weight loss and decreased energy can increase the risk of falls, which can lead to serious injuries and further functional decline.

Choice C rationale

Requesting the patient to lie as still as possible for the assessment is not directly related to the patient’s weight loss or decreased energy and appetite. It might be necessary for certain physical examinations or procedures, but it is not the most relevant action in this context.

Choice D rationale

Assisting the patient with clarifying values about end-of-life care options is an important aspect of geriatric care, especially in patients with serious illnesses. However, it is not directly related to the patient’s weight loss or decreased energy and appetite.

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Naxlex Comprehensive Predictor Exams

Correct Answer is []

Explanation

The nurse is conducting a functional assessment on an older patient who has lost five pounds (2.27 Kg) since the last visit 12 weeks ago and reports a decrease in energy and appetite.Which action should the nurse include during the assessment?

Correct Answer is B

Explanation

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