Nursing assessment of a client with type 2 diabetes reveals that the client is 5' 6" tall (167.6 cm), weighs 238 pounds (108.2 Kg), works behind a desk all day, does not exercise, and smokes 2 packs of cigarettes daily. In planning care for this client, which intervention is most important for the nurse to implement?
Instruct the client to decrease number of cigarettes smoked daily.
Discuss changing eating habits with a goal of losing 2 pounds (1 kg) per week.
Encourage other family members to be tested for diabetes mellitus.
Determine the client's feelings about being diagnosed with a chronic disease.
The Correct Answer is B
Choice A: This is important for the client's overall health but is not the most immediate priority in managing diabetes.
Choice B: The most important intervention for this client is to address lifestyle factors that contribute to diabetes and overall health. Weight loss and dietary changes are key components of managing type 2 diabetes. The client's weight is significantly above a healthy range, and losing 2 pounds (1 kg) per week is a reasonable and safe goal.
Choice C: Encouraging family members to be tested for diabetes is relevant but does not directly address the client's own management of the condition.
Choice D: Determining the client's feelings about the diagnosis is important for emotional support but does not directly address the client's physical health and diabetes management.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A: A complete blood count (CBC) is important for monitoring various aspects of the blood, including the number of red blood cells, white blood cells, and platelets. While important for assessing overall health, a CBC is not the primary laboratory finding used to assess the effectiveness of warfarin in managing atrial fibrillation.
Choice B: Serum troponin levels are typically measured to assess cardiac muscle damage, such as in myocardial infarction (heart attack). They are not the primary indicator for assessing the effectiveness of warfarin in atrial fibrillation.
Choice C: Creatinine clearance is a measure of kidney function and is not the primary laboratory finding used to evaluate the effectiveness of warfarin.
Choice D: Prothrombin time (PT) is the most relevant laboratory finding for monitoring the effectiveness of warfarin in clients with atrial fibrillation. Warfarin's therapeutic effect is primarily assessed through PT measurements, with the goal of maintaining the client's international normalized ratio (INR) within a specific target range to prevent excessive bleeding or clotting.
Correct Answer is A
Explanation
Choice A: The nurse should determine the pH value of the aspirated fluid to confirm the placement of the NGT. Gastric aspirate typically has an acidic pH (usually below 5), which indicates that the tube is correctly placed in the stomach.
Choice B: Withdrawing the NGT and reinserting it is not necessary if the pH of the aspirate confirms gastric placement.
Choice C: Connecting the NGT to wall suction is not appropriate until placement has been confirmed with a pH test.
Choice D: Sending the fluid specimen to the lab is not the first step in verifying NGT placement. Checking the pH is a more immediate and reliable method.
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