A nurse is providing calorie-count information to a client who has a BMI of 35. Which of the following instructions should the nurse include?
You should consume high-calorie foods early in the day.
You should limit carbohydrate intake to 30 grams per day.
You should consume 500 fewer calories per day.
You should follow a liquid meal plan for 4 weeks.
The Correct Answer is C
Choice A reason: Consuming high-calorie foods early in the day is not a good strategy for weight loss, as it can lead to overeating and increased fat storage. The nurse should advise the client to eat a balanced breakfast that includes protein, fiber, and healthy fats, which can help curb appetite and boost metabolism.
Choice B reason: Limiting carbohydrate intake to 30 grams per day is too restrictive and may cause nutritional deficiencies, ketosis, and adverse effects on mood and cognition. The nurse should recommend a moderate carbohydrate intake of 45 to 65 percent of total calories, with an emphasis on complex carbohydrates from whole grains, fruits, vegetables, and legumes.
Choice C reason: Consuming 500 fewer calories per day can result in a weight loss of about 1 pound per week, which is a safe and realistic goal for a client who has a BMI of 35. The nurse should help the client identify sources of excess calories in their diet and suggest ways to reduce them, such as choosing low-calorie beverages, using smaller plates, and avoiding distractions while eating.
Choice D reason: Following a liquid meal plan for 4 weeks is not a sustainable or healthy way to lose weight, as it can cause muscle loss, electrolyte imbalance, and rebound weight gain. The nurse should encourage the client to eat regular meals that include a variety of foods from all food groups, with appropriate portion sizes and nutrient density.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Administering the feeding by gravity drip is not an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Gravity drip can cause overfeeding, aspiration, and abdominal distension. The nurse should use an infusion pump to regulate the flow rate and volume of the feeding.
Choice B reason: Flushing the tubing with 10 mL water every 6 hr is an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Flushing the tubing prevents clogging, maintains patency, and hydrates the client. The nurse should also flush the tubing before and after medication administration, and whenever the feeding is interrupted or discontinued.
Choice C reason: Replacing the bag and tubing every 24 hr is not an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Replacing the bag and tubing every 24 hr does not prevent clogging, and may increase the risk of infection and contamination. The nurse should replace the bag and tubing every 48 hr, or as per facility policy.
Choice D reason: Heating the formula prior to infusion is not an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Heating the formula can alter its composition, reduce its nutritional value, and increase the risk of bacterial growth. The nurse should use room-temperature formula and store it in a refrigerator when not in use.
Correct Answer is C
Explanation
Choice A reason:A firm bilateral hand grip indicates normal muscle strength, which is a positive sign but not directly related to hypernatremia treatment efficacy.
Choice B reason: Fatigue is not a sign of effective treatment for hypernatremia. Fatigue can be a symptom of hypernatremia, as well as dehydration, infection, or other conditions. The nurse should assess the client for other causes of fatigue and monitor their vital signs and fluid status.
Choice C reason:Deep tendon reflexes graded as 2+ are considered normal and suggest that neuromuscular function is intact. Since hypernatremia can cause neuromuscular excitability, normal reflexes may indicate effective treatment.
Choice D reason: Urine output 25 mL/hr is not a sign of effective treatment for hypernatremia. Urine output 25 mL/hr is below the normal range of 30 to 50 mL/hr and indicates oliguria, which can be a complication of hypernatremia. Oliguria can result from dehydration, kidney damage, or reduced blood flow to the kidneys due to hypernatremia. The nurse should notify the provider and administer fluids as prescribed.
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