A nurse is working with an adolescent who is slightly overweight and was recently diagnosed with hypertension.
They are discussing nutritional management.
Which statement by the adolescent demonstrates understanding of the information?
"I should eat plenty of fresh fruits and vegetables.”.
"I can eat any amount at a meal as long as I don't eat between meals.”.
"I have to make sure that I drink a lot of fruit juice.”.
"If I skip breakfast, I can eat a much bigger lunch.”.
The Correct Answer is A
Choice A rationale
Fresh fruits and vegetables are essential components of the Dietary Approaches to Stop Hypertension (DASH) diet, which is effective for managing blood pressure. They are naturally low in sodium and fat while being high in potassium, calcium, and magnesium, all of which contribute to lowering blood pressure by promoting vasodilation and regulating fluid balance.
Choice B rationale
This statement demonstrates a poor understanding of nutritional management. Portion control is a key strategy for weight management and hypertension, regardless of the timing of the meal. Eating an unlimited amount at a meal, even without snacking, can lead to excessive calorie intake, contributing to weight gain and poor blood pressure control.
Choice C rationale
While some fruit juice contains nutrients, it is typically very high in natural sugars and often lacks the beneficial fiber found in whole fruits. Excessive consumption of high-sugar beverages can contribute to weight gain and increase the risk of metabolic syndrome, negatively affecting blood pressure control in an adolescent.
Choice D rationale
Skipping breakfast is an unhealthy habit that often leads to overeating later in the day, contributing to overall weight gain. A healthy pattern for managing weight and hypertension includes eating regular, balanced meals, including a nutritious breakfast, to maintain a steady metabolism and prevent overconsumption at subsequent meals.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Applying warm water to pruritic (itchy) skin, especially with a viral exanthem like varicella, can cause vasodilation and increased blood flow to the area, which may intensify the itching sensation rather than providing relief. Cool or tepid baths with oatmeal preparations are generally more soothing because they reduce skin temperature and inflammation, helping to calm the nerve endings responsible for the itch.
Choice B rationale
Salt solutions, particularly when concentrated, can be irritating and drying to delicate mucous membranes like the oral mucosa, potentially causing pain and delaying the healing of vesicular lesions caused by the varicella virus. Gentle, plain water rinses or non-irritating, topical anesthetic mouthwashes (if prescribed and appropriate for the child's age) are better alternatives for comfort and maintaining oral hygiene.
Choice C rationale
Aspirin (acetylsalicylic acid) is strictly contraindicated for fever management in children with varicella (chickenpox) or other viral illnesses due to the significant risk of developing Reye syndrome, a rare but severe illness causing acute encephalopathy and liver damage. Acetaminophen (paracetamol) or ibuprofen are the standard, safe antipyretic choices for managing fever in children with varicella.
Choice D rationale
Scratching the varicella lesions must be strictly avoided as it can break the skin barrier, leading to secondary bacterial infections like cellulitis or impetigo, which require antibiotic treatment. Furthermore, excoriation from scratching significantly increases the risk of permanent scarring (pitting) after the lesions have healed, making this a critical instruction for parents.
Correct Answer is B
Explanation
Choice A rationale
Drawing blood for a type and crossmatch is a crucial step in preparing for potential blood product administration, but it is not the first action in managing a pediatric patient presenting with signs of shock. Immediate priorities involve securing vascular access to deliver intravenous fluids and medications to reverse the state of hypoperfusion.
Choice B rationale
Establishing a suitable intravenous (IV) site is the paramount first step in managing a patient in shock, especially hypovolemic shock from a broken arm, as it allows for immediate, rapid volume replacement with isotonic crystalloid fluids. Restoring intravascular volume is the primary goal to improve perfusion, making vascular access the initial life-saving priority.
Choice C rationale
Hyperventilation, which refers to an increased rate and depth of breathing, can lead to respiratory alkalosis and is not generally indicated for managing hypovolemic shock due to trauma unless there is evidence of severe head injury with signs of cerebral herniation. The immediate treatment for hypovolemic shock is fluid resuscitation, not manipulating respiratory rate.
Choice D rationale
While providing analgesics is important for pain management, it is a secondary intervention. Administering oral analgesics to a patient who is showing signs of shock is dangerous because compromised circulation can impair absorption, and the priority must remain the stabilization of hemodynamic status through fluid resuscitation via IV access.
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