Nursing assessment of a client with type 2 diabetes reveals that the client is 5' 6" tall (167.6 cm), weighs 238 pounds (108.2 Kg), works behind a desk all day, does not exercise, and smokes 2 packs of cigarettes daily. In planning care for this client, which intervention is most important for the nurse to implement?

Instruct the client to decrease number of cigarettes smoked daily.

Discuss changing eating habits with a goal of losing 2 pounds (1 kg) per week.

Encourage other family members to be tested for diabetes mellitus.

Determine the client's feelings about being diagnosed with a chronic disease.

Answer and Explanation

The Correct Answer is B

Choice A: This is important for the client's overall health but is not the most immediate priority in managing diabetes.

Choice B: The most important intervention for this client is to address lifestyle factors that contribute to diabetes and overall health. Weight loss and dietary changes are key components of managing type 2 diabetes. The client's weight is significantly above a healthy range, and losing 2 pounds (1 kg) per week is a reasonable and safe goal.

Choice C: Encouraging family members to be tested for diabetes is relevant but does not directly address the client's own management of the condition.

Choice D: Determining the client's feelings about the diagnosis is important for emotional support but does not directly address the client's physical health and diabetes management.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Choice A: This response indicates an understanding of the need to avoid high- risk activities that could worsen the condition or cause injury to the affected leg, which is appropriate after acute osteomyelitis.

Choice B: While exercise is important, it should be done under medical guidance, especially after a significant illness like acute osteomyelitis.

Choice C: Resuming normal activities may not be appropriate immediately, and the level of activity should be determined by the healthcare provider.

Choice D: Keeping the leg immobile is not typically recommended as it can lead to muscle atrophy and other complications.

A. Serum protein. B. Serum osmolarity. C. Urinary ketones. D. Capillary glucose.

Correct Answer is D

Explanation

A. Serum protein is an indicator of the client’s overall nutritional status, but it is not as immediately critical to monitor as glucose levels in clients receiving TPN. Protein levels change more slowly over time and are not an acute concern.

B. While serum osmolarity is important in evaluating hydration status and electrolyte balance, it is not the primary lab to monitor during TPN administration. Glucose fluctuations are more likely to cause immediate complications.

C. Urinary ketones are typically monitored in clients with diabetic ketoacidosis (DKA), not in clients receiving TPN. Ketones are a byproduct of fat metabolism and are not a priority in TPN management.

D. Capillary glucose is the most important lab to monitor in clients on TPN because TPN solutions contain high amounts of glucose, which can lead to hyperglycemia. Monitoring glucose levels helps prevent complications such as hyperglycemia or hypoglycemia and is critical in managing the client's metabolic response to TPN.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which statement by an adolescent client with acute osteomyelitis in the right leg indicates the best understanding of the appropriate activity level after discharge?

Correct Answer is A

Explanation

While caring for a client receiving total parenteral nutrition (TPN), it is most important for the nurse to monitor which of the client's lab values?

Correct Answer is D

Explanation

Before administering a parenteral nutrition solution through a central vein, the nurse should confirm information from which sources? (Select all that apply)

A client tells the nurse about taking a variety of herbal products, including milk thistle, and has lost about thirty pounds over the last month. Which action should the nurse implement?

A 37-year-old client diagnosed with chronic kidney disease (CKD) is being treated for renal osteodystrophy. Which nursing diagnosis is most likely to be included in this client's plan of care?

The practical nurse (PN) is caring for a 3-month-old male infant two days after a pylorotomy and notices that the infant is restless, grimacing, and drawing his knees to his chest. What action should the PN implement?

The practical nurse (PN) is caring for an older client who is receiving chemotherapy for lung cancer. Which finding is the highest priority for the PN to report to the charge nurse? Reference ranges: Blood urea nitrogen (BUN): [Adult: 10 to 20 mg/dL or 3.6 to 7.1 mmol/L] Platelets:

When assessing both lower extremities (BLE) of a client who has chronic venous insufficiency, the nurse identifies bilateral stasis dermatitis and an ulcer on the medial surface of the left ankle. To promote effective self-care, which client teaching should the nurse provide?