Nokea
A morbidly obese client is admitted to a community hospital that does not typically care for bariatric-sized clients. What action by the nurse is most appropriate?
- A. Assess the client's readiness to make lifestyle changes.
- B. Leave siderails down to prevent pressure ulcers.
- C. Refer the client to a bariatric center.
- D. Ensure appropriate bariatric equipment is available.
Correct Answer: D
Rationale: Many hospitals that see bariatric-sized clients have appropriate equipment for this population. Ensuring the availability of proper equipment is critical for patient and staff safety. The other options are relevant but not the priority.
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A client is in the bariatric clinic 1 month after having gastric bypass surgery. The client is crying and says,'I didn't know it would be this hard to live like this.' What response by the nurse is best?
- A. Assess the client's coping and support systems.
- B. Inform the client that things will get easier.
- C. Re-educate the client on needed dietary changes.
- D. Tell the client lifestyle changes are always hard.
Correct Answer: A
Rationale: The nurse should assess this client's coping styles and support systems to provide holistic care. The other options do not adequately address the client's emotional distress.
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 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 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.