The charge nurse observes a practical nurse (PN) measuring the waist circumference of a client who has expressed a concern about health problems related to obesity. Which action should the nurse implement?

Advise the PN that waist circumference measurements are valuable to assess fluid retention but not obesity.

Tell the PN that this assessment technique should be performed by the nurse.

Review the measurement obtained by the PN and compare with ideal measurements for this client.

Instruct the PN to measure the client's waist circumference every 8 hours to assess for changes.

Answer and Explanation

The Correct Answer is C

A.   Advise the PN that waist circumference measurements are valuable to assess fluid retention but not obesity. This statement is incorrect. Waist circumference is a valuable measure for assessing abdominal obesity and related health risks.

B.   Tell the PN that this assessment technique should be performed by the nurse. Measuring waist circumference is within the scope of practice for a practical nurse and does not need to be performed by a registered nurse.
C.   Review the measurement obtained by the PN and compare with ideal measurements for this client. This action ensures that the measurement is accurate and provides an opportunity to educate the client about the significance of waist circumference in relation to obesity and associated health risks.
D.   Instruct the PN to measure the client's waist circumference every 8 hours to assess for changes. Waist circumference does not change significantly over such a short period and does not need to be measured this frequently.

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Correct Answer is D

Explanation

A. Urinary ketones are incorrect. Urinary ketones are more relevant in clients with diabetes or starvation states, but monitoring capillary glucose is more important in clients on TPN, as they may experience fluctuations in blood sugar levels.
B. Serum protein is incorrect. While serum protein is important for assessing nutritional status, capillary glucose is more critical for monitoring during TPN administration.
C. Serum osmolarity is incorrect. Serum osmolarity is important to assess fluid and electrolyte balance, but capillary glucose is more frequently monitored due to the risk of hyperglycemia in TPN patients.
D. Capillary glucose is correct. TPN contains high levels of glucose, and monitoring capillary glucose is critical to detect hyperglycemia and adjust the infusion rate or insulin therapy accordingly.

A. The consumption of fruit and/or vegetables should total between 4 to 6 servings. B. The consumption of dairy-based products should be eliminated from the diet. C. The consumption of protein products should come from lean meats, nuts, and dried beans. D. The consumption of bread products should be gluten-free.

Correct Answer is C

Explanation

A. The consumption of fruit and/or vegetables should total between 4 to 6 servings. The DASH diet actually recommends 4 to 5 servings each of fruits and vegetables per day, not combined. This statement indicates an incomplete understanding.
B. The consumption of dairy-based products should be eliminated from the diet. The DASH diet does not eliminate dairy products; instead, it recommends 2 to 3 servings of low-fat or fat-free dairy products daily.
C. The consumption of protein products should come from lean meats, nuts, and dried beans.

This is correct. The DASH diet emphasizes lean protein sources such as poultry, fish, nuts, and legumes, and limits red meat.
D. The consumption of bread products should be gluten-free. The DASH diet does not

specifically recommend gluten-free products unless the individual has a gluten intolerance or celiac disease. The focus is on whole grains rather than gluten-free.

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The charge nurse observes a practical nurse (PN) measuring the waist circumference of a client who has expressed a concern about health problems related to obesity. Which action should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is C

Explanation

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