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.

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Correct Answer is ["591"]

Explanation

One ounce is equivalent to 29.57 mL, so 12 ounces of coffee is equal to 354.84 mL. The cup of milk is usually measured as 8 ounces, which is 236.59 mL.

The oatmeal may also contain some fluid, but the amount is not given, so it cannot be counted.

Therefore, the total fluid intake at breakfast is 354.84 + 236.59 = 591.43 mL.

The nurse should document this value in the client's record, rounding it to the nearest whole number, which is 591 mL.

A. Introduce non-pharmacologic strategies for pain reduction. B. Allow adequate privacy and time for the client's phone call. C. Document the concern of incongruent pain rating and behavior. D. Administer pain medication per the healthcare provider's orders.

Correct Answer is B

Explanation

Choice A: Introducing non-pharmacologic strategies for pain reduction is a valid intervention for managing pain in a client with sickle cell anemia. However, in this scenario, the client's laughter on the phone call may not necessarily indicate that the pain level is accurately reflected by the numerical rating. It is essential to consider the client's overall well-being and pain management plan.

Choice B: Allowing adequate privacy and time for the client's phone call is a considerate and appropriate action. It acknowledges the client's need for communication and emotional support, which can be important in managing pain.

Choice C: Documenting the concern of incongruent pain rating and behavior is a necessary step for the nurse to record the observation. However, it should not be the only action taken in response to the situation.

Choice D: Administering pain medication should be based on a comprehensive assessment of the client's pain and the healthcare provider's orders. While pain medication may be indicated for this client, it should not be administered solely based on the numerical pain rating without further assessment and consideration of the client's overall condition.

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Naxlex Comprehensive Predictor Exams

The nurse assesses a client's fluid intake at breakfast, which consisted of oatmeal, a cup of milk, and 12 ounces of coffee. How many mL should the nurse document in the client's record? (Enter numerical value only.)

Correct Answer is ["591"]

Explanation

An adolescent hospitalized with sickle cell anemia reports to the nurse of experiencing a pain level of 10 on a 0 to 10 numerical scale. The nurse observes the adolescent on a phone call laughing. Which action should the nurse take?

Correct Answer is B

Explanation

After a successful cardioversion, a male client with a new onset of atrial fibrillation receives a prescription for an anticoagulant. What instruction should the practical nurse (PN) reinforce with the client?

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A 30-year-old male client tells the nurse that about half of his diet comes from eating meat and eggs. What instruction should the nurse provide?

The nurse is preparing a client for ultrasonography of the gallbladder. What should the nurse instruct the client to avoid consuming the night before the test?

After receiving morning report about four clients, which client should the nurse attend to first?

A client has a serum sodium level of 155 mEq/L (155 mmol/L). The nurse should encourage the client to make which selection from the lunch menu. Reference Range Sodium [Reference Range: Adult 136 to 145 mEq/L or 136 to 145 mmol/L]

An adult male client with chronic kidney disease (CKD) is receiving aluminum hydroxide (Amphojel). He tells the nurse that since he does not have indigestion there is no need for him to take the antacid with his meals. Which response is best for the nurse to provide?

A community health nurse is concerned about the incidence of asthma among preschool aged children in a metropolitan area. Which intervention reflects a primary prevention strategy the nurse might initiate to combat this chronic illness?