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","C","D","E"]

Explanation

A. Heart rate. The client has a heart rate of 120/min, which is tachycardia and may indicate dehydration, mania-related hyperactivity, or a response to poor nutritional status. This requires immediate follow-up to assess for cardiovascular strain or fluid imbalance.
B. Sleep pattern. While lack of sleep is concerning and a clear symptom of mania, it is a behavioral health issue that typically does not require immediate physiological intervention unless it leads to severe exhaustion or psychosis. It should be addressed, but is not the top priority.
C. Hallucinations. The client is responding to internal stimuli, indicating active psychosis, which poses a safety risk to the client and others. Hallucinations require immediate intervention to stabilize mental health and prevent harm.
D. Skin turgor. Poor skin turgor suggests dehydration, which is a priority physiological concern, especially when paired with tachycardia and failure to recall last food intake. This finding indicates the need for fluid and electrolyte evaluation and possible replacement.
E. Hygiene. The client's unclean appearance reflects self-neglect, a common feature of psychiatric decompensation, and may indicate inability to meet basic needs. This requires prompt attention to prevent complications like infection and assess for functional impairment, though it is secondary to life-threatening physiological or safety concerns.

Correct Answer is {"dropdown-group-1":"E","dropdown-group-2":"C"}

Explanation

The client presents with symptoms suggestive of severe preeclampsia, including headache, nausea, right upper quadrant pain, facial and dependent edema, rapid weight gain, and 3+ deep tendon reflexes (hyperreflexia). Hyperreflexia is a sign of central nervous system irritability, which can precede seizures (eclampsia) and increase the risk for placental abruption—a premature separation of the placenta from the uterine wall. This is a medical emergency that can result in fetal and maternal complications.

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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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Correct Answer is ["A","C","D","E"]

Explanation

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Correct Answer is {"dropdown-group-1":"E","dropdown-group-2":"C"}

Explanation

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