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A nurse is reinforcing dietary teaching with a client who wants to reduce solid fat intake. Which of the following instructions should the nurse include?
- A. Replace tub margarine with stick margarine.
- B. Use safflower oil instead of butter when baking.
- C. Consume 2% or whole milk.
- D. Choose ground beef that is at least 80% lean meat.
Correct Answer: B
Rationale: The correct answer is B: Use safflower oil instead of butter when baking. Safflower oil is a healthier alternative to butter as it is a liquid fat and contains unsaturated fats, which are better for heart health and reducing solid fat intake. Butter, on the other hand, is a solid fat high in saturated fats, which can increase cholesterol levels. This substitution promotes a lower intake of solid fats while still allowing for baking needs. The other choices are incorrect because: A) Stick margarine is also a solid fat high in trans fats, not suitable for reducing solid fat intake. C) Whole milk contains solid fats, so opting for low-fat or skim milk would be better. D) Ground beef with at least 80% lean meat still contains solid fats, so choosing leaner options like 90% lean or ground turkey would be more beneficial.
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A nurse is collecting data from the daughter of an older adult client. Which of the following statements by the daughter is a priority to the nurse?
- A. My mother is unable to bathe herself.'
- B. We sit outside every afternoon.'
- C. We buy the prescriptions we can afford.'
- D. My mother seems depressed.'
Correct Answer: C
Rationale: Financial constraints affecting medication adherence pose an immediate health risk and require intervention.
A nurse is collecting data from a client about pitting edema and notes an indentation of 6 mm (0.25 in) at the point of pressure. Which of the following numbers should the nurse document to indicate the intensity of the client's edema?
- A. 4+
- B. 3+
- C. 2+
- D. 1+
Correct Answer: B
Rationale: A 6-mm indentation corresponds to 3+ pitting edema, indicating moderate to severe fluid retention.
A nurse is reinforcing preoperative teaching with a client of Chinese heritage who speaks limited English. Which of the following methods of communication by the nurse demonstrates cultural competence?
- A. Incorporate humor in the teaching with the client.
- B. Address the client by her last name.
- C. Maintain direct eye contact with the client.
- D. Place a hand on the client's head.
Correct Answer: B
Rationale: Addressing the client formally by her last name shows respect, which aligns with many cultural norms in Chinese heritage.
A nurse is collecting data about the fluid status of four clients. Which of the following clients should the nurse identify as being at risk for fluid volume deficit?
- A. A client who has NPO status since midnight for an endoscopy
- B. A client who has heart failure and is receiving diuretic therapy
- C. A client who has end-stage kidney disease who will undergo dialysis
- D. A client who has gastroenteritis and is receiving oral fluids
Correct Answer: B
Rationale: The correct answer is B: A client who has heart failure and is receiving diuretic therapy. In heart failure, the heart's ability to pump blood effectively is compromised, leading to fluid retention. Diuretics are prescribed to reduce fluid overload by increasing urine output. This process can potentially lead to fluid volume deficit if excessive fluid is removed. Clients with heart failure on diuretics are at risk for electrolyte imbalances and dehydration.
A: NPO status for an endoscopy does not necessarily indicate fluid volume deficit.
C: Clients with end-stage kidney disease undergoing dialysis are at risk for fluid volume overload due to the accumulation of waste products and fluid in the body.
D: Clients with gastroenteritis receiving oral fluids are typically at risk for fluid volume deficit, but the scenario does not provide enough information to confirm this as the correct choice.
In summary, choice B is correct because clients with heart failure on diuretics are at risk for fluid volume deficit due to the medication
A nurse is caring for an older adult client who has confusion and weakness. The client has a Hct of 53%, a BUN of 25 mg/dL, and a urine specific gravity of 1.232. Which of the following actions should the nurse contribute to the client's plan of care?
- A. Restrict the client's fluid intake.
- B. Monitor the client's intake and output.
- C. Weigh the client daily.
- D. Instruct the client to sit on the side of the bed for a few minutes before standing.
- E. Check the client's orientation to person, place, and time regularly.
Correct Answer: B,C,E
Rationale: The lab values suggest dehydration, so monitoring fluid balance and orientation is essential.