The nurse is evaluating a client's understanding of diet teaching about the DASH (Dietary Approaches to Stop Hypertension) eating plan. Which behaviour indicates that the client is adhering to the eating plan?

No longer includes grains in daily diet.

Enjoys fat-free yogurt as an occasional snack food.

Uses only lactose-free dairy products.

Carefully cleans and peels all fresh fruit and vegetables.

Answer and Explanation

The Correct Answer is B

Choice A reason: The DASH eating plan does not recommend excluding grains from the daily diet. In fact, whole grains are an important part of the DASH diet.

Choice B reason: Enjoying fat-free yogurt as an occasional snack food aligns with the DASH diet's emphasis on low-fat dairy products. This behaviour indicates adherence to the dietary guidelines for reducing hypertension.

Choice C reason: Using lactose-free dairy products is not specifically related to the DASH diet. It may be relevant for individuals who are lactose intolerant, but it does not indicate adherence to the DASH diet principles.

Choice D reason: Carefully cleaning and peeling fresh fruits and vegetables is a good practice for food safety but does not specifically indicate adherence to the DASH diet. The DASH diet encourages the consumption of fruits and vegetables, but how they are cleaned and prepared is less relevant than the overall dietary choices.

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Correct Answer is C

Explanation

Choice A reason: A haemoglobin level of 12 g/dL (7.45 mmol/L) and haematocrit of 42% (0.42 volume fraction) are slightly lower than the reference range but not critically low. This finding is important and needs to be monitored, but it does not require the most immediate intervention.

Choice B reason: The vital signs provided are within normal limits and do not indicate an urgent or life-threatening condition. These should be monitored, but they do not require immediate intervention compared to other findings.

Choice C reason: Vomiting coffee-grounds emesis is a sign of gastrointestinal bleeding, specifically indicating that blood has been in the stomach long enough to be partially digested by stomach acid, giving it a coffee-grounds appearance. This is a serious and potentially life-threatening condition requiring immediate medical intervention to stop the bleeding and prevent further complications.

Choice D reason: Sharp epigastric pain is a common symptom of peptic ulcer disease and indicates inflammation or ulceration. While it is painful and concerning, it does not require the most immediate intervention compared to active gastrointestinal bleeding.

A. "I will wash my hands with warm soapy water before sticking my finger." B. "I will use a lancing device on the centre of my finger pad for a drop of blood." C. "I will inform the healthcare provider of my average haemoglobin A1C results weekly." D. "I will document my haemoglobin A1C results from the SMBG monitor every morning."

Correct Answer is A

Explanation

Choice A reason: Washing hands with warm soapy water before sticking the finger is a critical step in the process of self-monitoring blood glucose. Clean hands help prevent infections and ensure that the blood sample is not contaminated, which can affect the accuracy of glucose readings. This practice indicates that the client understands and can effectively follow the proper procedure for SMBG.

Choice B reason: Using a lancing device on the centre of the finger pad is not the correct technique. The sides of the finger pads are recommended for pricking because they are less sensitive than the centre and can provide a better sample with less discomfort. This indicates a misunderstanding of the correct procedure.

Choice C reason: Informing the healthcare provider of average haemoglobin A1C results weekly is unnecessary. Haemoglobin A1C is typically measured every 3 to 6 months to monitor long-term glucose control. Weekly reporting is not required and shows a lack of understanding about the appropriate use of A1C measurements.

Choice D reason: Documenting haemoglobin A1C results from the SMBG monitor every morning is incorrect. The SMBG monitor measures daily blood glucose levels, not haemoglobin A1C. Haemoglobin A1C provides an average blood glucose level over the past 2 to 3 months and is not obtained from daily SMBG readings.

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The nurse is evaluating a client's understanding of diet teaching about the DASH (Dietary Approaches to Stop Hypertension) eating plan. Which behaviour indicates that the client is adhering to the eating plan?

Nursing Test Bank

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