The nurse is caring for a client with chronic kidney disease (CKD). Which meal selection should the nurse recommend to the client?

Chicken, yams, pinto beans and pecans.

Steak and baked potato with butter and cheese topping.

Canned ham and green beans.

Pasta with fish and an orange.

Answer and Explanation

The Correct Answer is D

A. Chicken, yams, pinto beans, and pecans: This meal is not ideal for a client with CKD because pinto beans and pecans are high in potassium and phosphorus, which can be problematic for clients with CKD. Yams are also high in potassium.

B. Steak and baked potato with butter and cheese topping: Steak is high in protein and phosphorus, which can overload the kidneys. Baked potato, especially with cheese, can be high in potassium, which should be monitored in CKD.

C. Canned ham and green beans: Canned ham is often high in sodium, which is not recommended for clients with CKD, as it can exacerbate fluid retention and high blood pressure. Green beans are a good choice, but the sodium content in the ham is a concern.

D. Pasta with fish and an orange: Pasta is low in potassium and phosphorus, and fish provides a good source of protein that is generally easier on the kidneys compared to red meat. This meal is lower in sodium, phosphorus, and potassium, making it a better choice for CKD.

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Correct Answer is C

Explanation

A. Provide handouts written at a 12th grade reading level: Educational materials should be written at an appropriate reading level for the client, typically 6th to 8th grade for older adults, to promote understanding. Handouts at a 12th-grade level might be too complex.

B. Use background music to promote relaxation: While this could potentially help reduce anxiety for some people, it may also be distracting for others during important health teaching. The priority is clear and focused communication.

C. Turn on overhead lights while giving instructions: Proper lighting is essential, especially for older adults who may have visual impairments. Bright, direct lighting can help ensure the client clearly sees instructional materials and feels more comfortable during teaching.

D. Stand behind the client to avoid intimidation: Standing behind the client can be intimidating and might make the interaction feel less personal. It's important to engage the client in a way that encourages open communication, typically by sitting or standing at eye level.

A. Ask the client if she has any alcohol in the room at this time. B. Administer an PRN prescription for an antianxiety drug. C. Inform the family that they are enabling the client. D. Observe for signs to determine if client is inebriated. E. Schedule a conference with the client and family members.

Correct Answer is ["A","D","E"]

Explanation

A. Ask the client if she has any alcohol in the room at this time: This is an essential step in assessing for immediate safety and contraband that may impact her treatment plan, especially considering her symptoms and possible withdrawal risk.

B. Administer a PRN prescription for an antianxiety drug: This could mask symptoms of alcohol withdrawal or interact negatively with alcohol. Medication should be given only after thorough assessment and consultation.

C. Inform the family that they are enabling the client: While family education is important, using accusatory language like "enabling" can damage therapeutic relationships. A nonjudgmental, supportive approach is better.

D. Observe for signs to determine if client is inebriated: Monitoring for inebriation supports accurate clinical assessment and decisions about withdrawal protocols, safety, and medication timing.

E. Schedule a conference with the client and family members: A joint meeting allows open discussion, identifies care goals, and promotes understanding and support from all parties involved.

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The nurse is caring for a client with chronic kidney disease (CKD). Which meal selection should the nurse recommend to the client?

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