An adult woman with a body mass index (BMI) of 21 tells the nurse that she wants to lose 10 pounds (4.5 kg). Which intervention is most important for the nurse to implement?
Describe the value of eating smaller portion sizes.
Encourage a well-balanced diet and moderate exercise.
Explore the reasons the client wants to lose weight.
Determine if the client has a history of anorexia.
The Correct Answer is B
Choice A
Describing the value of eating smaller portion sizes is not appropriate. While portion control is important, this advice alone might not address the overall dietary quality and exercise component necessary for effective weight loss.
Choice B
Encouraging a well-balanced diet and moderate exercise is appropriate. This intervention focuses on promoting healthy and sustainable weight loss. A well-balanced diet helps ensure that the client is getting all the necessary nutrients while aiming for a calorie deficit for weight loss. Moderate exercise complements dietary changes and contributes to overall health and weight management.
Choice C
Exploring the reasons, the client wants to lose weight is inappropriate. While understanding the client's motivations is valuable, this doesn't directly provide guidance on how to achieve the goal of losing 10 pounds.
Choice D
Determining if the client has a history of anorexia is inappropriate. While assessing for eating disorders is important in general, assuming there's no indication of anorexia, the focus should be on providing guidance for safe and effective weight loss.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A
"The bruises on my arms are all gone." This statement is incorrect. Bruising can be influenced by various factors, including platelet levels and clotting factors, but it is not a specific sign of Vitamin A deficiency.
Choice B
"My feet don't tingle like they used to. “This statement is incorrect. Tingling feet might be related to nerve function or circulation, but it is not a direct symptom of Vitamin A deficiency.
Choice C
"I can see at night when I wake up now. “This statement is correct. Vitamin A is essential for maintaining good vision, especially in low-light conditions. Deficiency of Vitamin A can lead to a condition called night blindness, where individuals have difficulty seeing in low light. Therefore, the statement "I can see at night when I wake up now" (option C) indicates that an adequate amount of Vitamin A is being provided.
Choice D
"My tummy seems so much smaller now. “This statement is incorrect. Changes in tummy size are not typically related to Vitamin A deficiency. Vitamin A deficiency is more closely associated with symptoms related to vision and immune function.

Correct Answer is D
Explanation
Choice A
Cutting the spaghetti and meatballs into small pieces is inappropriate. This choice is not directly related to the risk of infection. It might be helpful for a client who has difficulty swallowing or chewing, but it doesn't address the compromised immune system and infection risk.
Choice B
Exchanging pasteurized whole milk with skim milk is inappropriate. The type of milk doesn't have a direct impact on infection risk. Both pasteurized whole milk and skim milk are considered safe for consumption. This choice doesn't address the specific concern of infection in a client with a low ANC.
Choice C
Substituting fried potatoes with a garden salad is inappropriate. While choosing healthier food options can be beneficial for overall health, the choice between fried potatoes and a garden salad doesn't necessarily impact the infection risk for a client with a low ANC. This choice also doesn't address the specific concern of infection in this context.
Choice D
Remove the fresh grapes from the meal tray is appropriate. The reason for this choice is that a client with an absolute neutrophil count (ANC) of 400 has a significantly compromised immune system, and they are at a high risk of infection due to their low neutrophil count. Neutrophils are a type of white blood cell that plays a crucial role in fighting off infections. A normal ANC falls within the range of 2500 to 8000 mm3 or cells/uL.
Fresh grapes, being a raw and uncooked food item, may carry a higher risk of containing bacteria or pathogens that could pose a threat to a client with such a low ANC. The nurse needs to ensure that the client's exposure to potential sources of infection is minimized.
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