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An older adult's unexplained weight loss of about 15 pounds over the past 3 months has prompted a thorough diagnostic workup. What is the nurse's rationale for prioritizing biochemical assessment when appraising a person's nutritional status?
- A. It identifies abnormalities in the chemical structure of nutrients.
- B. It predicts abnormal utilization of nutrients.
- C. It reflects the tissue level of a given nutrient.
- D. It predicts metabolic abnormalities in nutritional intake.
Correct Answer: C
Rationale: Biochemical assessment reflects both the tissue level of a given nutrient and any abnormality of metabolism in the utilization of nutrients. It does not focus on abnormalities in the chemical structure of nutrients. Biochemical assessment is not predictive.
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An 89-year-old male patient is wheelchair bound following a hemorrhagic stroke and has been living in a nursing home since leaving the hospital. He returns to the adjacent primary care clinic by wheelchair for follow-up care of hypertension and other health problems. The nurse would modify his health history to include which question?
- A. Tell me about your medications: How do you usually get them each day?
- B. Tell me about where you live: Do you feel your needs are being met, and do you feel safe?
- C. Your wheelchair would seem to limit your ability to move around. How do you deal with that?
- D. What limitations are you dealing with related to your health and being in a wheelchair?
Correct Answer: B
Rationale: The question, Tell me about where you live: Do you feel your needs are being met and do you feel safe? seeks to explore the specific issue of the safety in the home environment. People who are older, have a disability, and live in the community setting are at a greater risk for abuse. An explicit focus on limitations may be counterproductive.
A team of community health nurses has partnered with the staff at a youth drop-in center to address some of the health promotion needs of teenagers. The nurses have identified a need to address nutritional assessment and intervention. Which of the following most often occurs during the teen years?
- A. Lifelong eating habits are acquired.
- B. Peer pressure influences growth rate.
- C. BMI is determined.
- D. Culture begins begin to influence diet.
Correct Answer: A
Rationale: Adolescence is a time period of critical growth and acquisition of lifelong eating habits, and, therefore, nutritional assessment, nutrition analysis, and intervention are critical. Peer pressure does not influence growth rate. Cultural influences tend to become less important during the teen years; they do not emerge for the first time at this age. BMI can be assessed at any age.
During your integumentary assessment of an adult female patient, you note that the patient has dry, dull, brittle hair and dry, flaky skin with poor turgor. When planning this patients nursing care, you should prioritize interventions that address what problem?
- A. Inadequate physical activity
- B. Ineffective personal hygiene
- C. Deficient nutritional status
- D. Exposure to environmental toxins
Correct Answer: C
Rationale: Signs of poor nutrition include dry, dull, brittle hair and dry, flaky skin with poor turgor. These findings do not indicate a lack of physical activity, poor personal hygiene, or damage from an environmental cause.
A nurse who provides care in a campus medical clinic is performing an assessment of a 21-year-old student who has presented for care. After assessment, the nurse determines that the patient has a BMI of 45. What does this indicate?
- A. The patient is a normal weight.
- B. The patient is extremely obese.
- C. The patient is overweight.
- D. The patient is mildly obese.
Correct Answer: B
Rationale: Individuals who have a BMI between 25 and 29.9 are considered overweight. Obesity is defined as a BMI of greater than 30 (WHO, 2011). A BMI of 45 would indicate extreme obesity.
A nurse is conducting a health assessment of an adult patient when the patient asks, Why do you need all this health information and who is going to see it? What is the nurses best response?
- A. Please do not worry. It is safe and will be used only to help us with your care. Its accessible to a wide variety of people who are invested in your health.
- B. It is good you asked and you have a right to know; your information helps us to provide you with the best possible care, and your records are in a secure place.
- C. Your health information is placed on secure Web sites to provide easy access to anyone wishing to see your medical records. This ensures continuity of care.
- D. Health information becomes the property of the hospital and we will make sure that no one sees it. Then, in 2 years, we destroy all records and the process starts over.
Correct Answer: B
Rationale: Whenever information is elicited from a person through a health history or physical examination, the person has the right to know why the information is sought and how it will be used. For this reason, it is important to explain what the history and physical examination are, how the information will be obtained, and how it will be used. Medical records allow access to health care providers who need the information to provide patients with the best possible care, and the records are always held in a secure environment. Telling the patient not to worry minimizes the patients concern regarding the safety of his or her health information and a wide variety of people should not have access to patients health information. Health information should not be placed on Web sites and health records are not destroyed every 2 years.