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: Lung sounds are important to assess for signs of fluid in the lungs, such as crackles, which can occur with fluid volume overload. However, they do not directly measure fluid balance.

Choice B reason: Turgor assesses skin elasticity and hydration status, but it is not the most accurate indicator of overall fluid balance in the context of fluid volume overload.

Choice C reason: Weight is the most accurate and direct measure of fluid balance. Daily weight monitoring can track changes in fluid status, as weight fluctuations can reflect gains or losses in body fluid.

Choice D reason: Blood pressure is important to monitor, especially in clients with fluid volume issues, but it is not the most direct measure of fluid balance. Weight changes provide more precise information about fluid status.

A. Obtain a fingerstick glucose every 6 hours. B. Ensure IV fluids are infusing continuously. C. Test urine for the presence of ketones. D. Teach the client how to manage sick days.

Correct Answer is C

Explanation

Choice A reason: Obtaining a fingerstick glucose every 6 hours is important for monitoring blood glucose levels and ensuring they are within the target range. However, it is not the most critical intervention for preventing diabetic ketoacidosis. Testing for ketones provides more specific information on the development of DKA.

Choice B reason: Ensuring IV fluids are infusing continuously is crucial for maintaining hydration and preventing electrolyte imbalances, particularly in a client who may be at risk for DKA. However, this intervention is supportive and not as directly related to detecting the onset of DKA as testing for ketones.

Choice C reason: Testing urine for the presence of ketones is the most important intervention. The presence of ketones indicates that the body is breaking down fat for energy instead of using glucose, which is a hallmark of diabetic ketoacidosis. Early detection of ketones allows for prompt intervention to prevent the progression of DKA.

Choice D reason: Teaching the client how to manage sick days is essential for long-term diabetes management and preventing complications during illness. However, for the immediate prevention of DKA in the hospital setting, testing for ketones is more urgent and directly related to detecting and managing the condition.

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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

Naxlex Comprehensive Predictor Exams

A client with fluid volume overload is admitted to the hospital for diuresis. Which assessment should the nurse perform to evaluate the client's fluid balance?

Correct Answer is C

Explanation

Correct Answer is C

Explanation

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