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A client wants to lose 1.5 pounds a week. After reviewing a diet history, the nurse determines the client typically eats 2450 calories a day. What should the client's calorie goal be to achieve this weight loss? (Record your answer using a whole number.) calories/day
- A. 1700
- B. 2000
- C. 1850
- D. 2200
Correct Answer: A
Rationale: To lose 1 pound a week, subtract 500 calories per day; for 2 pounds, subtract 1000 calories. For 1.5 pounds, subtract 750 calories: 2450 - 750 = 1700 calories/day.
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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 nurse is caring for four clients receiving enteral tube feedings. Which client should the nurse see first?
- A. Client with a blood glucose level of 138 mg/dL.
- B. Client with foul-smelling diarrhea.
- C. Client with a potassium level of 2.6 mEq/L.
- D. Client with a sodium level of 138 mEq/L.
Correct Answer: C
Rationale: The potassium level of 2.6 mEq/L is critically low, possibly due to hyperglycemia-induced hyperosmolality. The nurse should see this client first. The blood glucose reading is high but not extreme. The sodium level is normal. The client with diarrhea should be seen last to avoid cross-contamination.
A client is receiving total parenteral nutrition (TPN). On assessment, the nurse notes the client's pulse is 128 beats/min, blood pressure is 90/56 mm Hg, and skin turgor is dry. What action should the nurse perform next?
- A. Calculate the client's 24-hour intake, output, and fluid balance.
- B. Assess the client's oral cavity.
- C. Prepare to hang a normal saline bolus.
- D. Notify the provider immediately.
Correct Answer: A
Rationale: The client has clinical indicators of dehydration, so the nurse calculates the client's 24-hour intake, output, and fluid balance. This information is then reported to the provider. Assessing the oral cavity may or may not be consistent with dehydration. A fluid bolus may be needed, but not as an independent action. Notifying the provider is appropriate after data collection.
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.
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.