A male client with coronary heart disease is informed by the healthcare provider that his cholesterol levels are significantly elevated and he needs to change his diet and lifestyle. The client emphatically states that he is not going to change his eating habits. What action should the nurse implement in response to the client's unwillingness to comply with the recommendations?

Provide pamphlets about heart healthy diet selections.

Refer the client to a dietitian for nutrition education.

Discuss client's concerns about the change in diet.

Suggest exercise as an alternative to increase HDL levels.

Answer and Explanation

The Correct Answer is C

Choice A

Providing pamphlets about heart-healthy diet selections should not be implemented. Providing information is important, but it might not be as effective if the client is strongly resistant. Engaging in a conversation first can help tailor the information to the client's needs.

Choice B

Referring the client to a dietitian for nutrition education should not be implemented. A dietitian can provide valuable education, but it might be more beneficial to address the client's concerns and resistance before making the referral.

Choice C

Discussing client's concerns about the change in diet should be implemented. When a client is resistant or unwilling to make changes to their diet and lifestyle, it's important for the nurse to engage in open and empathetic communication. Option C, discussing the client's concerns about the change in diet, is the most appropriate initial response.

By engaging in a conversation with the client, the nurse can better understand the client's perspective, reasons for resistance, and potential barriers to making dietary changes. This approach allows the nurse to address the client's concerns, provide information, and work collaboratively to find solutions that might be more acceptable to the client.

Choice D

Suggesting exercise as an alternative to increase HDL levels should not be implemented. Exercise is important for heart health, but it's important to address the client's resistance to dietary changes first. Additionally, dietary changes and exercise can work together to improve overall heart health.

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Correct Answer is ["455"]

Explanation

Intake:
- 8 oz of orange juice = 240 mL
- 1 cup of soup = 240 mL
- 1/2 cup of apple juice = 120 mL
- 12 oz can of soft drink = 355 mL
- Total intake = 240 + 240 + 120 + 355 = 955 mL
Output:
- Voided 150 mL
- Vomitus 100 mL
- Voided 250 mL
- Total output = 150 + 100 + 250 = 500 mL
Fluid Balance:
- Fluid balance = Intake - Output = 955 - 500 = 455 mL

A. Observe for abdominal distention, B. Calculate 24-hour caloric intake. C. Measure the urinary output. D. Check for body weight changes.

Correct Answer is A

Explanation

Choice A

Observing for abdominal distention is recommended. Gastric residual volume (GRV) is the amount of formula or food remaining in the stomach after a feeding through a gastric tube. A GRV of 325 mL is relatively high, and it's important to assess the client for signs of potential complications before contacting the healthcare provider. Observe for signs of abdominal distention, which could indicate that the stomach is not adequately emptying or that the feeding is not being tolerated well.

Choice B

Calculating 24-hour caloric intake is not recommended: While monitoring caloric intake is important for overall nutritional assessment, it does not address the immediate concern of a high GRV and the potential need for adjustment of the feeding rate or management.

Choice C

Measuring urinary output is not recommended: Urinary output is important to monitor for fluid balance, but it may not be directly related to the elevated GRV.

Choice D

Checking for body weight changes is not recommended: Monitoring body weight is essential for assessing nutritional status, but it may not provide immediate insights into the impact of the elevated GRV.

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Naxlex Comprehensive Predictor Exams

Correct Answer is ["455"]

Explanation

A client is receiving a continuous gastric tube feeding at 80 mL/hour. The nurse records the client's gastric residual volume as 325 mL during each of two consecutive hourly measurements. What assessment should the nurse complete before contacting the healthcare provider?

Correct Answer is A

Explanation

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