A nurse is caring for a client who is newly diagnosed with diabetes mellitus and is prescribed an 1800 calorie ADA diet. The client is refusing to eat the provided meals. Which of the following actions should the nurse take?

Offer the client's meals on a different schedule.

Discuss the client's food preferences with the hospital's dietitian.

Request the provider change the client's prescribed diet.

Allow the client's family to bring food from home for the client.

Answer and Explanation

The Correct Answer is B

A. Offer the client's meals on a different schedule. Changing the schedule may not address the core issue if the meals themselves do not align with the client’s preferences or cultural needs. It is not the most effective initial approach.
B. Discuss the client's food preferences with the hospital's dietitian. Collaborating with a dietitian allows for the modification of the meal plan to better align with the client’s preferences while still meeting nutritional and medical requirements. This supports client-centered care and improves adherence.
C. Request the provider change the client's prescribed diet. The provider may be involved later if significant changes are needed, but the dietitian is the appropriate first contact for customizing a prescribed diet based on individual preferences.
D. Allow the client's family to bring food from home for the client. While this can be an option, it must first be approved by the healthcare team to ensure the food aligns with the therapeutic diet and does not compromise the client’s condition.

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Correct Answer is A

Explanation

A. Arrange for an ethics committee meeting to address the family's concerns. An ethics committee can provide guidance in situations where there is conflict between advance directives and family wishes. This supports ethical decision-making while honoring the client’s autonomy and legal rights.
B. Complete an incident report. An incident report is used for errors or unusual events, not ethical dilemmas or conflicts over advance directives. It is not appropriate in this scenario.
C. Support the family's decision and initiate life-sustaining measures. The nurse is legally and ethically bound to follow the client’s advance directives, not the family’s wishes, especially when the client’s decisions are documented and clear.
D. Encourage the family to contact an attorney. While families have legal rights, referring them directly to an attorney does not address the immediate ethical issue or facilitate collaborative resolution in the care setting.

A. Determine if the stockings are binding. B. Fold the top of the stocking over neatly. C. Apply the stockings after the client is in a chair. D. Massage the client's legs once every 8 hr while the stockings are in place.

Correct Answer is A

Explanation

A. Determine if the stockings are binding. It is important to assess that antiembolic stockings are not too tight, especially around the top, as this can impair circulation. Proper fit ensures they function effectively to promote venous return and prevent deep vein thrombosis.
B. Fold the top of the stocking over neatly. Folding or rolling the tops can cause constriction and act like a tourniquet, reducing circulation and increasing the risk of complications such as venous stasis or skin breakdown.
C. Apply the stockings after the client is in a chair. Antiembolic stockings should be applied while the client is lying down, before getting up, to prevent blood pooling in the legs. Applying them after the client is upright may reduce their effectiveness.
D. Massage the client's legs once every 8 hr while the stockings are in place. Massaging the legs, especially in clients at risk for thrombosis, is not recommended as it could dislodge a clot and lead to embolism. Passive or active leg movement is safer and more effective.

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A nurse is caring for a client who is newly diagnosed with diabetes mellitus and is prescribed an 1800 calorie ADA diet. The client is refusing to eat the provided meals. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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