A nurse is planning care for a client who wants to lose weight. Which of the following actions should the nurse take first?

Set a weight loss goal.

Identify the client's motivation.

Discuss behavior modification.

Refer the client to a dietitian.

Answer and Explanation

The Correct Answer is B

Choice A reason: Setting a weight loss goal is an important step in the weight management process, but it is not the first action the nurse should take. The nurse should first assess the client's readiness and willingness to change, as well as the factors that motivate the client to lose weight.

Choice B reason: Identifying the client's motivation is the first action the nurse should take, as it helps the nurse to tailor the interventions to the client's needs and preferences. The nurse should explore the client's reasons for wanting to lose weight, such as improving health, appearance, or self-esteem, and use them as positive reinforcement.

Choice C reason: Discussing behavior modification is a key component of weight management, but it is not the first action the nurse should take. The nurse should first identify the client's motivation and then help the client to develop realistic and specific goals and strategies to change their eating and physical activity habits.

Choice D reason: Referring the client to a dietitian is a helpful action, but it is not the first action the nurse should take. The nurse should first identify the client's motivation and then collaborate with the dietitian to provide individualized and evidence-based dietary advice and education to the client.

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Correct Answer is D

Explanation

Choice A reason: Fever is not an indication of an allergic reaction, as it is a sign of infection or inflammation. The nurse should assess the infant for other causes of fever, such as ear infection, urinary tract infection, or viral illness.

Choice B reason: Jaundice is not an indication of an allergic reaction, as it is a sign of liver dysfunction or hemolysis. The nurse should evaluate the infant for other causes of jaundice, such as hepatitis, biliary atresia, or hemolytic anemia.

Choice C reason: Bruising is not an indication of an allergic reaction, as it is a sign of trauma or bleeding disorder. The nurse should examine the infant for other causes of bruising, such as injury, coagulopathy, or leukemia.

Choice D reason: Diarrhea is an indication of an allergic reaction, as it is a sign of gastrointestinal hypersensitivity or intolerance. The nurse should ask the parents about the infant's food intake, history of allergies, and symptoms of anaphylaxis, such as hives, swelling, or difficulty breathing.

A. "I should use butter for cooking vegetables." B. "I will choose whole grain bread." C. "I should decrease my sodium intake to 3.2 grams per day." D. "I will eat chicken with the skin."

Correct Answer is B

Explanation

Choice A reason: "I should use butter for cooking vegetables." is not a correct statement, as butter is high in saturated fat and cholesterol, which can increase the risk of heart disease. The nurse should advise the client to use unsaturated oils, such as olive or canola oil, for cooking vegetables.

Choice B reason: "I will choose whole grain bread." is a correct statement, as whole grains are rich in fiber, antioxidants, and phytochemicals, which can lower the risk of heart disease. The nurse should encourage the client to choose whole grain bread over refined bread, and to consume at least three servings of whole grains per day.

Choice C reason: "I should decrease my sodium intake to 3.2 grams per day." is not a correct statement, as 3.2 grams of sodium is equivalent to 8 grams of salt, which is above the recommended limit of 6 grams of salt per day for adults. The nurse should instruct the client to reduce their sodium intake to less than 2.3 grams per day, or 1.5 grams per day if they have high blood pressure, and to avoid processed foods, canned foods, and table salt.

Choice D reason: "I will eat chicken with the skin." is not a correct statement, as chicken skin is high in saturated fat and cholesterol, which can increase the risk of heart disease. The nurse should suggest the client to remove the skin from chicken before eating, and to choose lean cuts of poultry, fish, or meat.

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A nurse is planning care for a client who wants to lose weight. Which of the following actions should the nurse take first?

Nursing Test Bank

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