Which signs would alert the nurse to possible nutritional alterations? (Select all that apply, one, some, or all.)
Diaphoresis
Edema
Muscle atrophy
Impaired wound healing
Nail growth
Correct Answer : B,C,D
A. Diaphoresis (excessive sweating) is not typically associated with nutritional alterations but may occur with other conditions like fever or anxiety.
B. Edema can be a sign of protein deficiency or fluid imbalance, indicating a nutritional problem.
C. Muscle atrophy suggests a lack of sufficient protein or calories, a clear sign of malnutrition.
D. Impaired wound healing is often linked to nutritional deficiencies, particularly in vitamins and minerals like vitamin C and zinc.
E. Nail growth is generally not used to assess nutritional status. Although poor nutrition can impact hair and nails, changes in nail growth are not as immediately indicative of nutritional problems.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["104"]
Explanation
Convert days to hours:
- 1 day 24 hours/day = 24 hours 1
Calculate the hourly rate:
- 2500 mL / 24 hours = 104.1666... mL/hour
Round to the nearest whole number:
- 104 mL/hour
Correct Answer is D
Explanation
A. Documenting the patient's need for restraints is important but does not address the issue of restraining a competent patient against their will. This is an issue of patient rights and autonomy.
B. Not informing the patient is inappropriate, but the key issue is the lack of consent to be restrained, not just the failure to inform.
C. While failing to get a physician's order is critical for legal and safety reasons, the core issue here is the violation of the patient's autonomy and rights.
D. Restraining a competent patient against their will without consent is considered an intentional tort because it involves touching the patient in an unauthorized manner, which is a direct violation of their rights. This can result in legal action for assault or battery.
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