Nokea
A client has been prescribed lorcaserin (Belviq). What teaching is most appropriate?
- A. Increase the fiber and water in your diet.
- B. Reduce fat to less than 30% each day.
- C. Report dry mouth and increased sweating.
- D. Lorcaserin may cause loose stools in a few days.
Correct Answer: A
Rationale: This drug can cause constipation, so the client should increase fiber and water in the diet to prevent this. Reducing fat is important with orlistat, not lorcaserin. Dry mouth may occur, but loose stools are associated with orlistat.
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A client's small-bore feeding tube has become occluded after the nurse administered medications. What actions by the nurse are best? (Select all that apply.)
- A. Attempt to dislodge the clog by instilling a cola product.
- B. Determine if any of the medications come in a liquid form.
- C. Flush the tube before and after administering medications.
- D. Administer medications with a feeding pump.
- E. Try to flush the tube with 30 mL of water and gentle pressure.
Correct Answer: B,C,E
Rationale: If the tube is obstructed, use a 50-mL syringe and gentle pressure to attempt to open the tube with water. Cola products should not be used unless water is ineffective. To prevent future problems, determine if medications can be dispensed in liquid form and flush the tube with water before and after medication administration.
A client weighs 225 pounds (102.1 kg) and is 5'3"? (160.0 cm) tall. What is this client's body mass index (BMI)? (Record your answer using a decimal rounded up to the nearest tenth.)
- A. 40.4
- B. 35.2
- C. 45.8
- D. 38.6
Correct Answer: A
Rationale: Using the formula BMI = weight (kg) / [height (m)]^2: 102.1 / (1.6)^2 = 40.4, rounded to the nearest tenth.
A nurse is caring for a client receiving enteral feeding through a Dobhoff tube. What action by the nurse is best to prevent hypernatremia?
- A. Administer free-water boluses as prescribed.
- B. Change the client's formula.
- C. Dilute the client's formula.
- D. Slow the rate of the infusion.
Correct Answer: A
Rationale: Protein and sugar molecules in the enteral feeding product contribute to dehydration due to increased osmolality. The nurse can administer free-water boluses after consulting with the provider on the appropriate amount and timing, or per protocol. Changing or diluting the formula is not appropriate. Slowing the infusion rate will not address the problem.
A nurse attempted to assist a morbidly obese client back to bed and had immediate pain in the lower back. What action by the nurse is most appropriate?
- A. Ask another nurse to help next time.
- B. Request bariatric equipment for the client.
- C. Fill out and file a variance report.
- D. Refuse to care for the client again.
Correct Answer: C
Rationale: The nurse should complete a variance report per agency policy to document the injury. Asking for help and requesting equipment are good ideas, but the injury needs to be reported. Refusing care is unethical.
A nurse is caring for a morbidly obese client. What comfort measure is most important for the nurse to delegate to the unlicensed assistive personnel (UAP)?
- A. Designating quiet time so the client can rest.
- B. Ensuring side rails are not causing pressure.
- C. Providing oral care before and after meals and snacks.
- D. Relaying any reports of pain to the registered nurse.
Correct Answer: B
Rationale: When dealing with an obese client, the staff should ensure side rails are not putting pressure on the client's tissues to prevent pressure ulcers. The other options are appropriate but not the priority for comfort.