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: Changing the feeding to a continuous infusion may not improve the constipation, as it does not address the fluid deficit or the fiber content of the formula. Continuous infusion may also increase the risk of aspiration, diarrhea, and bacterial contamination¹.
Choice B reason: Increasing the amount of free water can help prevent or treat constipation by hydrating the stool and facilitating its passage. The client's fluid intake and output indicate a fluid deficit, which can contribute to constipation. The recommended fluid intake for adults is 30 to 35 mL/kg/day².
Choice C reason: Decreasing the infusion rate of feeding may worsen the constipation, as it reduces the caloric and fluid intake of the client. The infusion rate should be based on the client's nutritional needs and tolerance¹.
Choice D reason: Requesting a prescription for a diuretic is not appropriate, as it would further dehydrate the client and aggravate the constipation. Diuretics are indicated for clients with fluid overload, not fluid deficit³.
Correct Answer is A
Explanation
Choice A reason: Positioning the newborn at a 20-degree angle after feeding can help prevent the reflux of gastric contents into the esophagus. This position allows gravity to keep the food in the stomach and reduces the pressure on the lower esophageal sphincter. The nurse should instruct the parent to keep the newborn in this position for at least 30 minutes after each feeding.
Choice B reason: Diluting formula with 1 tablespoon of water is not recommended, as it can cause water intoxication, electrolyte imbalance, and malnutrition in the newborn. Water intoxication can lead to seizures, coma, and death. The nurse should advise the parent to follow the manufacturer's instructions for preparing the formula and not to add extra water.
Choice C reason: Placing the newborn in a side-lying position if vomiting is not a safe practice, as it can increase the risk of aspiration and sudden infant death syndrome (SIDS). Aspiration is when food or liquid enters the lungs and causes pneumonia or respiratory distress. SIDS is when a healthy baby dies suddenly and unexpectedly during sleep. The nurse should instruct the parent to place the newborn on the back for sleeping and to avoid soft bedding, pillows, and stuffed animals.
Choice D reason: Providing a small feeding just before bedtime is not a good idea, as it can worsen the gastroesophageal reflux and disrupt the newborn's sleep. The nurse should suggest the parent to feed the newborn smaller and more frequent meals throughout the day and to avoid feeding the newborn within 2 to 3 hours of bedtime.
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