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The nurse is teaching the American Diabetes Association diet to a client diagnosed with diabetes mellitus type 2. Which should the nurse teach the client?
- A. Instruct the client to weigh all food before cooking it.
- B. Teach the client to eat only carbohydrates if the blood glucose is low.
- C. Demonstrate how to determine the amount of carbohydrates being eaten.
- D. Explain that proteins should be 75% of the recommended diet.
Correct Answer: C
Rationale: Determining carbohydrate amounts (e.g., carb counting) is key for glycemic control in type 2 diabetes per ADA guidelines. Weighing food, carb-only for hypoglycemia, and high protein are incorrect.
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The client is admitted with end-stage liver failure and is prescribed the laxative lactulose (Chronulac). Which statement indicates the client needs more teaching concerning this medication?
- A. I should have two to three soft stools a day.
- B. I must check my ammonia level daily.
- C. If I have diarrhea, I will call my doctor.
- D. I should check my stool for any blood.
Correct Answer: B
Rationale: Clients do not routinely check ammonia levels at home; this is done clinically if needed. The other statements reflect correct understanding of lactulose use for hepatic encephalopathy.
The client who is obese presents to the clinic before beginning a weight loss program. Which interventions should the nurse teach? Select all that apply.
- A. Walk for 30 minutes three (3) times a day.
- B. Determine situations that initiate eating behavior.
- C. Weigh at the same time every day.
- D. Limit sodium in the diet.
- E. Refer to a weight support group.
Correct Answer: A,B,C,E
Rationale: Walking, identifying eating triggers, consistent weighing, and support groups promote sustainable weight loss. Sodium restriction is less critical unless hypertension is present.
The nurse is preparing a client diagnosed with GERD for surgery. Which information warrants notifying the HCP?
- A. The client's Bernstein esophageal test was positive.
- B. The client's abdominal x-ray shows a hiatal hernia.
- C. The client's WBC count is 14,000/mm3.
- D. The client's hemoglobin is 13.8 g/dL.
Correct Answer: C
Rationale: An elevated WBC count (14,000/mm3) suggests infection or inflammation, which could complicate surgery and requires immediate attention. A positive Bernstein test and hiatal hernia are expected in GERD, and a hemoglobin of 13.8 g/dL is within normal limits.
The client diagnosed with ulcerative colitis is prescribed a low-residue diet. Which meal selection indicates the client understands the diet teaching?
- A. Grilled hamburger on a wheat bun and fried potatoes.
- B. A chicken salad sandwich and lettuce and tomato salad.
- C. Roast pork, white rice, and plain custard.
- D. Fried fish, whole grain pasta, and fruit salad.
Correct Answer: C
Rationale: A low-residue diet minimizes fiber to reduce bowel irritation, so roast pork, white rice, and plain custard (low-fiber foods) are appropriate. The other options include high-fiber foods like wheat, vegetables, and whole grains, which are contraindicated.
Which instruction should the nurse discuss with the client who is in the icteric phase of hepatitis C?
- A. Decrease alcohol intake.
- B. Encourage rest periods.
- C. Eat a large evening meal.
- D. Drink diet drinks and juices.
Correct Answer: B
Rationale: Rest periods conserve energy and support recovery during the icteric phase of hepatitis C, when jaundice and fatigue are prominent. Alcohol avoidance is general advice, and diet changes are less specific.