After successfully losing one pound weekly for several months, an obese client at the clinic has not lost any weight for the last month. What should the nurse do first?
Review the diet and exercise guidelines with the client.
Ask the client whether there have been any changes in diet or exercise patterns.
Recommend reducing calorie intake even more.
Instruct the client to record weights weekly.
The Correct Answer is B
Choice A reason:
Reviewing the diet and exercise guidelines with the client is an important step, but it may not address the immediate issue of the weight loss plateau. It's essential to first understand if the client has adhered to the guidelines before reviewing them.
Choice B reason:
Asking the client about any changes in diet or exercise patterns is the first step in identifying potential causes for the weight loss plateau. Changes in lifestyle, stress levels, eating habits, or physical activity can all contribute to a halt in weight loss. Understanding these factors can help the nurse tailor further advice and support.
Choice C reason:
Recommending a further reduction in calorie intake might not be the best initial approach. It's important to ensure that the client is not already consuming too few calories, which can slow metabolism and hinder weight loss. Moreover, drastic calorie reduction can be unsustainable and lead to nutritional deficiencies.
Choice D reason:
Instructing the client to record weights weekly is a useful tool for monitoring progress, but it does not address the current issue of the weight loss plateau. It's a supportive action that should follow after understanding and addressing the reasons behind the plateau.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:
Magnesium sulfate is used in the management of severe preeclampsia primarily for seizure prophylaxis. One of the key side effects of magnesium sulfate is its impact on neuromuscular transmission, leading to diminished deep-tendon reflexes as serum magnesium levels rise. The therapeutic range for anticonvulsant prophylaxis is typically between 5-8 mg/dL. Reflexes may begin to diminish when serum levels reach 8-12 mg/dL, indicating potential magnesium toxicity. Therefore, diminished reflexes are a warning sign to reassess the infusion rate and possibly reduce or discontinue the medication.
Choice B reason:
A respiratory rate of 16 breaths per minute falls within the normal adult range and suggests that the client's respiratory system is not being adversely affected by the magnesium sulfate infusion. Respiratory rate is a critical parameter to monitor during magnesium sulfate therapy, as respiratory depression is a serious side effect of magnesium toxicity. Maintaining a normal respiratory rate indicates that it is safe to continue the infusion at the current rate.
Choice C reason:
While a urine output of 50 mL/hr is on the lower end of the normal range, it is still considered adequate for most adults. In the setting of magnesium sulfate therapy for severe preeclampsia, maintaining adequate urine output is essential for ensuring that the kidneys can excrete the magnesium to prevent accumulation and toxicity. If urine output decreases significantly, it may necessitate reevaluation of the infusion rate or additional interventions to support renal function.
Choice D reason:
A heart rate of 56 beats per minute is slightly bradycardic but may not be clinically significant if the client is asymptomatic. However, magnesium has a direct effect on cardiac function, and high levels can lead to bradycardia and other cardiac conduction abnormalities. It is important to monitor the client's heart rate and rhythm during magnesium sulfate therapy to detect any early signs of cardiac involvement due to magnesium toxicity.
Correct Answer is B
Explanation
Choice a reason:
Diuretic use is not typically associated with an increased risk of developing fibromyalgia. Diuretics are commonly used to treat conditions like hypertension and edema by helping the body eliminate excess fluid, but they do not contribute to the onset of fibromyalgia¹.
Choice b reason:
Emotional or physical trauma has been identified as a risk factor for fibromyalgia. Individuals who experience significant stress or traumatic events may develop the disorder due to changes in how their central nervous system processes pain. Stress can lead to long-lasting effects on the body and may trigger fibromyalgia or worsen its symptoms²³⁴.
Choice c reason:
Being overweight is not a direct risk factor for fibromyalgia, but it can exacerbate symptoms in those who have the condition. Excess weight can increase the strain on the body and may contribute to the chronic pain and fatigue associated with fibromyalgia. However, it is not considered a causative factor¹.
Choice d reason:
Being an adolescent male is not a recognized risk factor for fibromyalgia. The disorder is more commonly diagnosed in women, and while it can occur at any age, it is most often diagnosed during middle age. Gender and age alone are not sufficient to determine the risk of developing fibromyalgia.
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