A nurse is providing teaching about a weight reduction plan to a client who is obese and has type 2 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?
I should reduce my caloric intake by 200 calories a day to lose 1 pound a week.
I need to lose 5 percent of my body weight to improve my glycemic control.
I must exercise for 30 minutes three times a week to lose 1 pound per week.
If my blood glucose level drops during exercise, I should drink 16 ounces of apple juice.
The Correct Answer is B
Choice A reason: Reducing caloric intake by 200 calories a day may not be enough to achieve significant weight loss for a client who is obese. The recommended daily calorie deficit for weight loss is 500 to 750 calories, which can result in a loss of 1 to 1.5 pounds per week¹.
Choice B reason: Losing 5 percent of body weight can improve glycemic control and reduce the need for glucose-lowering medications for a client who has type 2 diabetes. Studies have shown that weight loss of 5 to 10 percent can lower HbA1c levels by 0.5 to 1.0 percentage points².
Choice C reason: Exercising for 30 minutes three times a week may not be sufficient to lose 1 pound per week. The recommended amount of physical activity for weight loss is at least 150 minutes of moderate-intensity aerobic exercise per week, plus resistance training at least twice a week³.
Choice D reason: Drinking 16 ounces of apple juice is not advisable if the blood glucose level drops during exercise, as it can cause hyperglycemia. Apple juice contains about 48 grams of carbohydrates, which is equivalent to four servings of glucose tablets⁴. The recommended treatment for hypoglycemia is to consume 15 to 20 grams of fast-acting carbohydrates, such as glucose tablets, gel, or juice, and recheck the blood glucose level after 15 minutes⁵.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Offering the client a selection of beverages at each meal is not a good action to include in the plan, as it may reduce the client's appetite and intake of solid foods. The nurse should limit the client's fluid intake before and during meals, and encourage the client to consume high-calorie and high-protein drinks, such as milkshakes or smoothies, after meals.
Choice B reason: Informing the client that a weight gain of 2.3 kg (5 lb) per week is expected is not a good action to include in the plan, as it may cause anxiety and resistance in the client. The nurse should set realistic and individualized weight goals for the client, and monitor the client's weight and vital signs regularly. The nurse should also avoid focusing on the client's weight, and instead emphasize the client's health and well-being.
Choice C reason: Arranging for someone to remain with the client for 30 min after meals is a good action to include in the plan, as it can prevent the client from purging or exercising excessively. The nurse should provide a supportive and nonjudgmental environment for the client, and supervise the client's eating and toileting behaviors. The nurse should also educate the client and the family about the complications and treatment of anorexia nervosa.
Choice D reason: Encouraging the client to participate in developing dietary goals is a good action to include in the plan, as it can increase the client's sense of control and motivation. The nurse should collaborate with the client, the dietitian, and the mental health team to create a personalized and flexible meal plan that meets the client's nutritional and psychological needs. The nurse should also praise the client for any progress or achievement, and reinforce the client's positive coping skills.
Correct Answer is C
Explanation
Choice A reason: Calcium is not a dietary supplement that can help with wound healing, although it is important for bone health and muscle contraction. Calcium deficiency can cause osteoporosis, muscle cramps, and abnormal heart rhythms, but it does not affect wound healing.
Choice B reason: Potassium is not a dietary supplement that can help with wound healing, although it is essential for nerve and muscle function and fluid balance. Potassium deficiency can cause weakness, fatigue, arrhythmias, and muscle cramps, but it does not affect wound healing.
Choice C reason: Vitamin C is a dietary supplement that can help with wound healing, as it is involved in collagen synthesis, tissue repair, and immune response. Vitamin C deficiency can cause scurvy, which is characterized by bleeding gums, poor wound healing, and anemia.
Choice D reason: Vitamin D is not a dietary supplement that can help with wound healing, although it is necessary for calcium absorption, bone health, and immune function. Vitamin D deficiency can cause rickets, osteomalacia, and increased risk of infections, but it does not affect wound healing.
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