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When working with older adults to promote good nutrition, what actions by the nurse are most appropriate? (Select all that apply.)
- A. Allow uninterrupted time for eating.
- B. Assess dentures for appropriate fit.
- C. Ensure the client wears glasses if needed.
- D. Provide daily foods that the client can taste.
- E. Serve high-calorie, high-protein snacks.
Correct Answer: A,B,C,E
Rationale: Older adults need unhurried and uninterrupted time for eating. Dentures and glasses, if needed, should fit appropriately. High-calorie, high-protein snacks are beneficial. Salty snacks are not recommended due to sodium restrictions.
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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 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.
A client is in the family practice clinic. Today the client weighs 180.4 pounds (84.7 kg). Six months ago, the client weighed 201.8 pounds (96.2 kg). What action by the nurse is best?
- A. Ask the client if the weight loss was intentional.
- B. Determine if there are food allergies or intolerances.
- C. Determine if there are food allergies or intolerance.
- D. Perform a rapid bedside blood glucose test.
Correct Answer: A
Rationale: This client has had 12% weight loss. The nurse first determines if the weight loss was intentional. If not, then the nurse proceeds to a comprehensive nutritional assessment. Food intolerances are part of this assessment. Depending on the risk factors, a blood glucose test may be warranted.
A nurse is weighing and measuring a client with severe kyphosis. What is the best method to obtain this client's height?
- A. Add the trunk and leg measurements.
- B. Ask the client how tall he or she is.
- C. Estimate by measuring clothing.
- D. Use knee-height calipers.
Correct Answer: D
Rationale: A sliding blade knee-height caliper is used to obtain the height of a client who cannot stand upright, such as those with kyphosis or lower extremity contractures. The other methods will not yield accurate data.
A nurse is caring for a morbidly obese client. What comfort measure is most important for the nurse to delegate to the unlicensed assistive personnel (UAP)?
- A. Designating quiet time so the client can rest.
- B. Ensuring side rails are not causing pressure.
- C. Providing oral care before and after meals and snacks.
- D. Relaying any reports of pain to the registered nurse.
Correct Answer: B
Rationale: When dealing with an obese client, the staff should ensure side rails are not putting pressure on the client's tissues to prevent pressure ulcers. The other options are appropriate but not the priority for comfort.