NURSING 102 FINAL

tertiary prevention examples

-Chronic disease management programs -Retraining in another career for injured workers

Primary prevention examples

-campaign to encourage children to wear seat belts -promoting use of sunscreen

secondary prevention examples

-screen tests to detect early stage diseases -Modified physical requirements for return-to-work after back injuries

New and infant health promotion

-screenings for congenital heart disease and for hearing loss. -Health exams at 2 weeks and at 2,4,6,9 and 12 months. -immunizations -Fluoride supplements for infants over 6 months -Screenings for metabolic conditions (Phenylketonuria) -Education on infant parent attachment

Vitamin C

assist with the absorption of iron in the treatment of anemia and aids in wound healing

The nurse is performing a nutritional assessment of a client who weighs 185 lb and is 5 feet, 3 inches tall. This client's body mass index, rounded to the nearest hundredth, is ________.

Answer: 32.77 BMI Explanation: The nurse should use the formula [Weight in Pounds/(Height in inches × Height in inches)] × 703 for this calculation. The BMI is calculated by dividing weight in pounds (lb) by height in inches (in) squared and multiplying by a conversion factor of 703. The calculation would be 185 / 63 × 63 = 185 / 3969 = 0.0466112 × 703 = 32.77.

For older adults you should get a breast exam every

2 years

A nurse is caring for a 50-year-old client performing aerobic exercise in the cardiac rehabilitation office. The nurse calculates the client's target heart rate as ________-________.

102 beats per minute (BPM); 145 beats per minute (BPM) RATIONALE:Target heart rate can be obtained by an equation: (220 - client's age) × 60% and 85%. So 220 - 50 = 170. 170 × 0.60 = 102 BPM. 170 × 0.85 = 145 BPM.

The nurse is caring for an adult client with a BMI of 26.8 who complains of sleep apnea and gout. The nurse anticipates that treatment of this patient for obesity will consist of which therapies? Select all that apply. A) Pharmacotherapy B) Diet C) Exercise D) Behavior modification E) Surgery

B)Diet C)Exercise D)Behavior modification RATIONALE:Clients with a BMI of 25-26.9 with two or more comorbidities-sleep apnea and gout in this case-would be treated with the therapies of diet, exercise, and behavior modification, but likely not pharmacotherapy or surgery.

Which Assessment tool should the nurse use to determine if a client is overweight?

BMI body mass index

Iron may turn feces

Black

Lipase inhibitors

Block absorption of dietary fats in the small bowel protein

Lacto-vegetarian eats:

Milk, cheese, dairy food; avoids fish, meats, poultry, eggs

9-11 year olds get screened for blood cholesterol levels to reduce risk for

Obesity

The nurse is caring for a client who is on a strict vegan diet. In providing dietary teaching, the nurse should encourage the intake of foods that are high in which vitamin that may be lacking in a vegetarian diet? 1 Vitamin A 2 Vitamin C 3 Vitamin E 4 Vitamin B12

4 Vitamin B12

What foods would you include in a DASH diet? A.Campbells chicken noodle soup B.Canned green beans C.Isaly's chipped ham sandwich D.Shellfish E.Steamed zucchini

Steamed zucchini

Hunger

Stimulus that encourages eating/food seeking

Iron can cause staining or teeth so teach patient to use:

Straw, for children iron should be placed at the back of the child's mouth

Vitamin B6

Supplements isoniazid (INH therapy in the treatment of Tuberculosis to prevent side effects of paresthesia and other neurological discomforts.

Anorexiants

Suppress appetite increasing the availability of norepinephrine in the brain;central nervous system stimulant

Patients have undergone major surgeries, trauma, or are seriously undernourished are often candidates for:

TPN

Calcium may interfere with some antibiotics such as

Tetracycline so these medications must be taken several hours apart.

A nurse is preparing a workshop on the topics that are new to Healthy People 2020. Which of the topic areas should the nurse plan to address? Select all that apply. A) Adolescent Health B) Genomics C) Lesbian, Gay, Bisexual, and Transgender Health D) Mental Health and Mental Disorders E) Healthcare-Associated Infections

A)Adolescent Health B)Genomics C)Lesbian, Gay, Bisexual, and Transgender Health E)Healthcare-Associated infections RATIONALE:Healthy People 2020 is organized into 42 topic areas with nearly 600 objectives to improve health. Thirteen of these topics are new for Healthy People 2020. These topic areas include: Adolescent Health; Genomics; Lesbian, Gay, Bisexual, and Transgender Health; and Healthcare-Associated Infections. Mental Health and Mental Disorders is an old topic area.

The nurse is working with a morbidly obese client who is seeking help to lose weight at bariatric clinic. When planning this client's care, which nursing diagnosis is the priority? A) Activity Intolerance B) Disturbed Body Image C) Defensive Coping D) Constipation

A)Activity intolerance RATIONALE:Along with diet, exercise is an important part of a weight loss program. A client with morbid obesity has a sedentary lifestyle and will have activity intolerance. Disturbed Body Image and Constipation may both be legitimate diagnoses, but Activity Intolerance is a greater priority if the client is to lose weight. There is no evidence that this client exhibits defensive coping.

You should get a single dose of the shingles vaccine starting at the age of

6

Older adults should get a regular dental assessment every

6 months

Gluten Intolerance (Celiac Disease)

A protein found in wheat, rye, or barley, can cause inflammation and edema in the bowel, which leads to interruption in absorption of key nutrients. Symptoms include:diarrhea, weight loss, bloating, nausea, vomiting.

Which of the following statements best characterizes vitamin use? A) Clients should be careful not to exceed recommended allowances for daily vitamin intake. B) Vitamin D is dangerous if taken in large quantities, but there is no upper limit to Vitamin C intake. C) Generally, two multivitamin pills a day is recommended for all clients regardless of diet. D) Fat-soluble vitamins in general present the least risk of toxicity to clients who take them in excess.

A) Clients should be careful not to exceed recommended allowances of daily vitiman intake. RATIONALE: Excess consumption of some vitamins, especially the fat-soluble vitamins, can lead to significant toxicity. The disorder is referred to as hypervitaminosis. When taken in excess, vitamin D can cause bone destruction, rather than contributing to bone formation. Excess intake of vitamin C can lead to diarrhea, nausea, and stomach cramps. Two multivitamin pills a day is probably excessive because one such vitamin typically contains the recommended intakes of most vitamins and minerals needed on a daily basis, and determinations of vitamin intake should always consider diet.

An occupational health nurse for a large corporation is planning programs to address health problems identified in the Healthy People 2020 report. Which programs should the nurse include for the company employees at the worksite? Select all that apply. A) A blood disorder and blood safety education program B) A seminar about the components of wellness C) A cultural competence program related to LGBT health D) An informational program about genomics E) An education program about the importance of sleep health RATIONALE:Healthy People 2020 identifies a variety of programs that can be used to promote health at the worksite. Specific programs should address components that may affect work productivity, safety, and cohesion among workers, and may include blood disorders, wellness, LGBT health, and sleep health, among many others. Information about genomics is not relevant to the worksite.

A)A blood disorder and blood safety education program B)A seminar about the components of wellness C)An informational program related to LGBT health E)An education program about the importance of sleep health

A community health nurse is educating a group of clients on the difference between illness and disease. Which statements are appropriate for the nurse to include in the educational session? Select all that apply. A) "An individual can have a disease and not feel ill." B) "Illness is synonymous with disease." C) "Illness is an alteration in body function, where disease is highly subjective." D) "An individual can feel ill without disease." E) "Illness and disease are never related to one another."

A)An individual can have a disease and not feel ill D)An individual can feel ill without disease RATIONALE:Illness is a highly personal state in which the individual's physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished. It is not synonymous with disease and may or may not be related to disease. One individual can have a disease, such as a growth in the stomach, and not feel ill. Another individual can feel ill-that is, feel uncomfortable-and yet have no discernible disease. Disease can be described as an alteration in body functions that reduces the capacities or shortens the normal lifespan.

A critical nursing concept that a nurse uses with every client that allows the nurse to identify habits of health and wellness and the effects of illness and injury is A) assessment. B) collaboration. C) teaching and learning. D) advocacy.

A)Assesment RATIONALE: As the first step in the nursing process, the nurse will use assessment with every client to identify habits of health and wellness and the effects of illness and injury. Nurses will use the concepts of collaboration, teaching and learning, and advocacy for many clients, but these concepts do not help identify healthy habits or the effects of illness and injury.

The public health nurse is providing community education aimed at promoting nutritional habits that decrease an individual's modifiable risk factors for heart disease. Which topics should the nurse include in this teaching session? Select all that apply. A) Benefits of consuming fruits and vegetables B) Importance of eliminating all fats C) Selecting lean protein sources D) Preparing balanced meals E) Strategies for maintaining recommended daily caloric intake

A)Benefits of consuming fruits and vegetables C)Selecting lean proteins D)Preparing balanced meals E)Strategies for maintaining recommended daily caloric intake RATIONALE:The primary modifiable risk factors for nutrition alterations are food choice, portion size, and nutritional intake. Learning about the benefits of consuming fruits and vegetables, how to select lean protein sources, how to prepare balanced meals, and how to maintain the recommended daily caloric intake are all strategies for promoting good nutritional habits that decrease the risk for heart disease. In contrast, eliminating all fats should not be included, because some fats are considered "healthy" and need to be included in a heart-healthy diet.

A nurse is reviewing the medical record for a school-age client prior to a scheduled health maintenance visit. Which data from the record indicates that the client is overweight? A) Body mass index (BMI) >85th percentile B) BMI >95th percentile C) 25% increase in weight in a 6-month period D) 35% increase in weight in a 6-month period

A)Body mass index (BMI) >85th percentile A child with a BMI greater than the 85th percentile is considered overweight. A child with a BMI greater than the 95th percentile is considered obese. Percentage of weight gain in a 6-month period (regardless of baseline) does not determine whether a client is overweight or obese.

During a home visit, the nurse is assessing an older adult client. Which assessment findings support the nursing diagnosis Imbalanced Nutrition: Less than Body Requirements? Select all that apply. A) Client reports a problem with dentures slipping while chewing. B) Client complains of occasional dry mouth and problems with feelings of nausea. C) Client's adult children arrive to eat dinner together several times a week. D) Client is prescribed 15 medications. E) Client's Social Security payments have gone down over the last year.

A)Client reports a problem with dentures slipping while chewing B)Client complains of occasional dry mouth and problems with feeling nausea D)Client is prescribed 15 medications E)Clients social security payments have gone down over the last year RATIONALE:The improperly fitting dentures are causing a problem with chewing, which could lead to decreased protein and fruit and vegetable intake. Polypharmacy could negatively influence taste, and some medications promote nausea and vomiting, cause dry mouth, and suppress appetite, which could explain the dry mouth and nausea the client reports. Low finances could lead to decreased access to food. However, the client's adult children visiting and sharing a meal with the client would likely improve or support the older client's nutritional status.

A nurse working in a community health center is counseling an adolescent regarding a suspected eating disorder. The adolescent is of normal weight but admits to periods of overeating, especially when his parents fight. This client's eating habits best demonstrate which risk factor for obesity? A) Cultural and environmental factors B) Heredity C) Low socioeconomic status D) Physical inactivity

A)Cultural and environmental factors RATIONALE:This client most often overeats because of stress, which is an environmental risk factor for obesity. The client's stress comes from the environment, such as problems at school or at home, and not from heredity, low socioeconomic status, or physical inactivity, although these are all risk factors as well.

While teaching a class on health status, the nurse educator reviews internal variables that affect health status. Which internal variables are appropriate for the nurse to include in the class? Select all that apply. A) Gender B) Diet C) Exercise regimen D) Developmental level E)Age

A)Gender D)Developmental level E)Age RATIONALE:Internal variables are often described as non-modifiable because, for the most part, they cannot be changed. Examples of internal variables include gender, developmental level, and age. In contrast, external variables, such as diet and exercise, are easily modified for most clients.

A nurse is working with an adolescent client who is attempting to lose weight. The client admits having difficulty being compliant with the diet prescribed by the healthcare provider. Which suggestion by the nurse might assist the client in being compliant with the prescribed diet in a way that is sensitive to the client's age? A) "It can be difficult to avoid unhealthy foods if that's what your friends are eating, but try to choose healthier options when you can." B) "Write down the exact foods you eat so that you can see what and how much you are eating." C) "Watch the nutrient content and number of calories in everything you eat." D) "Eat at the kitchen table so that you eat along with the rest of the family."

A)It can be difficult to avoid unhealthy foods if that's what your friends are eating, but try to choose healthier options when you can. RATIONALE:Adolescence is a time of identity formation, and adolescents align with peers in regard to food selection. Keeping food diaries and monitoring the nutrient content and caloric values of food intake are helpful behavior modification strategies, but these don't take into account the age of the client, and studies on food consumption show that caloric information or nutrient content is not a major consideration in choice among adolescents. Parental food choices can have a strong impact on adolescents, but some adolescents rebel against these food choices, positively or negatively, and eating with the rest of the family is only beneficial if the family's habits are healthy.

A nurse identifies the seven components of wellness as a useful tool in assessing health. Which are some of the components of wellness? Select all that apply. A) Physical B) Environmental C) Emotional D) Financial E) Spiritual

A)Physical B) Environmental C) Emotional E) Spiritual RATIONALE:The physical component is the ability to carry out daily tasks, achieve fitness, and generally practice positive lifestyle habits. The environmental component includes influences such as food, water, and air. The emotional component is the ability to manage stress and to express emotions appropriately. Finances are not one of the seven components of health. The spiritual component is the belief in some force (nature, science, religion, or a higher power) that serves to unite human beings and provide meaning and purpose to life.

For a client with chronic obstructive pulmonary disease (COPD), the nurse may provide health promotion teaching about what other major health concept? A) Safety B) Elimination C) Immunity D) Development

A)Safety RATIONALE:COPD often develops as a result of years of smoking, and one common therapy is oxygen administration. The combination of smoking and oxygen increases the client's risk for safety related to fire hazards. COPD does not commonly cause changes in elimination, immunity, or development.

The pulmonary rehabilitation nurse is teaching a group of clients about both isotonic and isometric exercises. At the conclusion of the session, which client statements indicate effective teaching has occurred? Select all that apply. A) "Isotonic exercises are also called dynamic exercises." B) "Isotonic exercises are static movements." C) "Isometric exercises involve exerting pressure against a solid object." D) "Isotonic exercises produce a mild increase in heart rate and cardiac output, but no appreciable increase in blood flow to other parts of the body." E) "Isometric exercises are useful for endurance training."

A)isotonic exercises are also called dynamic exercises. C)isometric exercises are static movements E)isometric exercises are useful for endurance training RATIONALE: In isotonic exercises, which are dynamic exercises, the muscle shortens to produce muscle contraction and active movement. Isometric exercises, which are static exercises, involve exerting pressure against a solid object. Isometric exercises produce a mild increase in heart rate and cardiac output, but no appreciable increase in blood flow to other parts of the body. Isometric exercises are useful for endurance training.

What is an indication that the patient's nutrition status is improving? (select all that apply) A.Gained 1 pound this week B.Patient is alert and oriented C.Wound is well approximated after staples removed D.Electrolytes are WNL E.Prealbumin is low F.Temperature is low G.Glucose is low

A,B,C,D

Fat-soluble vitamins includes:__,__,__,__ and it is stored in the _________ tissues until needed.

A,D,E,K;Liver

What are signs of dehydration? (select all that apply) A.Poor skin turgor B.Decreased urine output C.Bradycardia D.Fatigue E.Dry mucous membranes

A. Poor skin turgor B. Decreased urine output D. Fatigue E. Dry mucous membranes Tachycardia can be a sign of dehydration Encourage patient to drink more water

Monitor _________levels throughput administration of TPN

Albumin

Iron is used to treat

Anemia due to blood loss

Examples of chronic illness includes

Arthritis, heart and lung diseases, and diabetes mellitus.

By far the most dangerous complication associated with feeding a client when the feeding tube is improperly placed.

Aspiration pneumonia

Vitamin D

Assist with the absorption of calcium, administered to those who have insufficient intake as a component of osteoporosis treatment.

water soluble vitamins include: ___,___ these vitamins are absorbed with water in the ______ ________.

B complex,C;GI tract

The nurse is providing teaching related to health promotion for a group of older adults. Several individuals describe their current health status. Which client is most in need of additional information related to health promotion? A) A client who states that her daughter takes her to all of her medical appointments B) A client who states she was recently diagnosed with Parkinson disease C) A client who states that she walks five times a week at the community center to help prevent osteoporosis D) A client who states that her husband has been suffering from hypertension for the past 12

B)A client who states she was recently diagnosed with Parkinson's disease. RATIONALE: Although all clients, regardless of age and health status, can benefit from teaching about health promotion, individuals who have recently been diagnosed with a chronic illness, such as Parkinson disease, will require additional teaching related to health promotion that is specific to their condition. The other clients appear to have positive support systems or social activities that help promote health related to their conditions, or they have considerable experience dealing with health conditions of family members.

The community health nurse reviews data collected during interviews with community members during a health fair and decides to create a brochure on how to improve iron intake. Which of the following action items might the nurse include that would help vegans and vegetarians increase their iron intake? Select all that apply. A) Take calcium supplements. B) Consume tofu. C) Consume lentils. D) Increase intake of vitamin C. E) Consume Swiss chard.

B)Consume tofu C)Consume lentils D)Increase intake of Vitamin C E)Consume Swiss chard RATIONALE:Vegan diet plans can lead to deficiencies in certain nutrients, including iron. All vegetarians should ensure that they get adequate amounts of iron, and to facilitate the absorption, vitamin C should also be plentiful in the diet. Tofu, lentils, and Swiss chard are all foods that both vegans and vegetarians might eat that can provide needed iron. However, although calcium supplements are good for vegetarians and vegans to take to ensure adequate calcium intake, they do not specifically provide iron.

The nurse is planning physical fitness and exercise recommendations for a 27-year-old pregnant woman at 16 weeks' gestation. The woman states that before becoming pregnant, she ran 3.5 to 4 miles on four days per week at a pace of 11 minutes per mile. She enjoys competing in 5K races and has a goal to complete a 10K race before the age of 30. Which exercise recommendation should the nurse include for this client at this stage of her pregnancy? A) Continue exercising the same amount of time, but decrease the intensity of the workout to a jog or walk B) Continue engaging in vigorous activity as much as possible, with a goal of at least 150 minutes of moderate to vigorous activity per week C) Decrease the amount of exercise to 30 minutes three times per week, engaging in moderate to vigorous activity D) Increase the amount of exercise to 60 minutes on most days of the week, most of it aerobic exercise

B)Continue engaging in vigorous activity as much as possible, with a goal of at least 150 minutes of moderate to vigorous activity per week RATIONALE:Pregnant women should engage in at least 150 minutes of moderate physical activity each week. They can engage in vigorous physical activity if that is already part of their routine. The intensity of the workout may need to decrease as she progresses through the pregnancy, but at 16 weeks' gestation, she should be able to continue her normal vigorous exercise routine. Decreasing the amount of exercise is not recommended. Engaging in aerobic exercise for 60 minutes on most days of the week is recommended for children ages 6 to 17 years, not pregnant women.

After conducting a physical assessment for an adult client, the nurse discusses the assessment with a coworker and states that the client's beliefs and actions regarding common health practices are unfamiliar to her. Based on this data, which action by the nurse is the most appropriate? A) Repeat the assessment later in the day. B) Determine the culture with which the client identifies. C) Write a nursing diagnosis to address the unfamiliar beliefs and actions. D) Communicate the findings to the healthcare team.

B)Determine the culture with which the patient identifies. RATIONALE:A thorough assessment that includes assessment of cultural beliefs and practices is needed before proceeding with other steps of the nursing process. Behavior that is considered uncommon in one cultural context may be considered desirable in another. Repeating the assessment will most likely result in the same incomplete data. Writing a nursing diagnosis or communicating findings before investigating the client's culture would be premature.

During a health assessment, a client states, "I only eat carbohydrates and low-fat foods. I don't understand why I am still gaining weight!" Which principles of nutrition should guide the nurse's response? Select all that apply. A) Carbohydrates should only be eaten at breakfast. B) Eating too many carbohydrates leads to excess glucose, which is converted to fat. C) Excess carbohydrates can lead to obesity. D) A carbohydrate-limited diet is the only way to not gain weight. E) Carbohydrates should be high in fiber and low in sugar.

B)Eating to many carbohydrates can lead to excess glucose, which can be converted into fat. C)Excess carbohydrates can lead to obesity E)Carbohydrates should be high in fiber and low in sugar RATIONALE:Carbohydrates should be eaten throughout the day. Carbohydrates are converted to glucose; when carbohydrates are consumed in excess, the excess glucose is converted to glycogen, or fat, and stored in adipose tissue, which can lead to weight gain and an increased risk for obesity. Carbohydrate deficiencies lead to protein tissue wasting. Carbohydrates should come from the consumption of foods high in fiber and low in added sugars. A carbohydrate-limited diet is not the only way to avoid weight gain.

The nurse is preparing educational materials for a client with hypertension. Which of the following elements should the nurse include when preparing this material? Select all that apply. A) Advising the client to avoid all sodium in the diet B) Explaining the effects of sodium on blood pressure C) Teaching the client how to read nutritional labels D) Helping the client to recognize foods that are low in sodium E) Showing the client how to follow the DASH eating plan

B)Explaining the effects of sodium on blood pressure C)Teaching the client how to read nutritional labels D)Helping the client recognize foods that are low in sodium E)Showing the client how to read the dash eating plan RATIONALE:Sodium is important in the diet, and not all sodium should be avoided; however, consumption of sodium should be according to the USDA dietary guidelines for recommended intake. In some people, an increase in sodium intake leads to fluid retention and increases blood pressure. The nurse should prepare to teach the client how to read nutritional labels, how to identify foods that are low in sodium, and the DASH eating plan.

The nurse is providing care to an older adult client who was recently diagnosed with early osteoporosis. Which intervention is most appropriate for the nurse to implement with this client? A) Providing the client with assisted range of motion exercising twice daily B) Instituting an exercise plan that includes weight-bearing activities C) Protecting the client's bones with strict bedrest D) Increasing the amount of calcium in the client's diet

B)Instituting an exercise plan that includes weight-bearing activities RATIONALE:Osteoporosis is a demineralization of the bone in which calcium leaves the bone matrix. One causative factor is lack of weight-bearing activity. Weight bearing helps to move calcium back into the bone, thereby strengthening it. A standard intervention for those attempting to prevent or reverse osteoporosis is beginning an exercise plan that includes weight- bearing activities. Additional calcium in the diet after osteoporosis has begun is not thought to be effective. Strict bedrest may well make the osteoporosis worse because there is no weight- bearing activity. Assisted range of motion exercises are not weight bearing and do not help delay or reverse osteoporosis.

Which nursing intervention exemplifies the nurse working in a health promotion role? Select all that apply. A) Administering a prescribed antibiotic B) Reinforcing desirable changes to the client's lifestyle C) Administering vaccines to a well child D) Administering an inhaler to a client with asthma E) Obtaining a blood glucose sample on a client with hypoglycemia

B)Reinforcing desirable changes to a clients lifestyle C)Administering vaccines to a well child RATIONALE: The nurse acting in a health promotion role is performing interventions to prevent disease. Reinforcing desirable changes to the client's lifestyle and administering vaccines to a well child exemplify health promotion. Administering an ordered antibiotic or inhaler to a client and obtaining a blood glucose sample from a symptomatic client exemplify nursing interventions that are in response to disease or illness.

A nurse is teaching a couples' class at a local community center about building positive relationships. Today's session is on learning skills to be open-minded and respectful to those with opposing opinions. Based on this data, on which component of wellness is the nurse focusing this session? A) Physical B) Social C) Environment D) Emotional

B)Social RATIONALE: The social component of wellness focuses on the ability to interact successfully with people and within the environment of which each person is a part, to develop and maintain intimacy with significant others, and to develop respect and tolerance for those with differing opinions and beliefs. The physical, environmental, and emotional components focus on other life skills.

For many clients, health promotion requires nursing assessment of and implementation of changes in A) culture. B) lifestyle. C) spiritual beliefs. D) socioeconomic status.

B)lifestyle RATIONALE:Health promotion involves nursing assessment of a client's lifestyle and implementation of needed changes to that lifestyle. Examples include assessing and implementing changes in habits related to smoking, diet, and exercise. The nurse is responsible for assessing culture, spiritual beliefs, and socioeconomic status and how those factors influence health promotion, but the nurse is not responsible for promoting changes to those factors.

A nurse is assessing a client and discovers the infusion pump with the client's total parenteral nutrition (TPN) solution is not infusing. The nurse should monitor the client for which of the following conditions? A. Excessive thirst and urination B. Shakiness and diaphoresis C. Fever and chills D. Hypertension and crackles

B)shakiness and diaphoresis When a sudden interruption in the infusion of TPN occurs, the client is at risk for hypoglycemia. Shakiness and diaphoresis are manifestations of hypoglycemia.

A nurse is providing wellness teaching to a client who is interested in beginning an exercise program to reduce certain health risks. The nurse determines that the client understands the teaching when the client selects which health risks that can be reduced by regular exercise? Select all that apply. A) Liver disease B) Type 2 diabetes C) Cardiovascular disease D) Falling E) Renal disease

B)type 2 diabetes C)cardiovascular disease D)falling RATIONALE:Regular physical activity results in a decreased risk of cardiovascular disease, type 2 diabetes, and falling. It does not decrease the risk of liver or renal disease.

The nurse is teaching a client scheduled for Roux-en-Y gastric bypass surgery about potential postsurgical complications and how to reduce them. Which client statement best indicates that teaching has been effective? A) "I need to eat at least one meal a day that is high in simple carbohydrates." B) "Complications of this surgery are likely to be limited to mild gastrointestinal issues for several days." C) "I need to be alert for the indications of infection or malnutrition." D) "I will not continue my exercise program following this surgery."

C)I need to be alert for the indications of infection or malnutrition RATIONALE:Possible postoperative complications for a procedure such as a gastric bypass include anastomosis leak with peritonitis, abdominal wall hernia, gallstones, wound infections, deep venous thrombosis, nutritional deficiencies, and gastrointestinal (GI) symptoms. If the client recognizes a need to be alert to the signs of infection and malnutrition, this shows awareness of some of the complications that might be expected. Mild GI issues are not the only significant complication of this surgery. The client likely should continue the exercise program. Eating meals high in simple carbohydrates can bring on dumping syndrome, a complication in which stomach contents move rapidly through the small intestine, drawing fluid into the intestine by osmosis.

Physical activity and exercise improve the functioning of many body systems. Exercise improves what normal body function of the gastrointestinal system? A) Use of fatty acids B) Insulin responsiveness C) Peristalsis D) Metabolic rate

C)Peristalsis RATIONALE: Exercise increases peristalsis in the gastrointestinal system, improving movement of substances through the GI tract and increasing elimination of fecal matter. Use of fatty acids, insulin responsiveness, and metabolic rate all also improve with exercise, but they are related to effects on the endocrine system, not the gastrointestinal system.

The nurse is assessing a 24-year-old woman who recently found out she is pregnant. Which factor would the nurse identify as the most likely source of a barrier to health promotion in this client? A) Age of the client B) Presence of the client's mother during the appointment C) Pregnancy occurred as a result of rape D) First pregnancy (primigravida)

C)Pregnancy occurred as a result of rape RATIONALE:The age of the mother, presence of the client's mother, and gravidity could all be factors that promote a desire for health or cause the client to make unhealthy choices, depending on the client's situation. However, most clients who are pregnant as a result of rape will have both physical and emotional barriers to health promotion.

The nurse is planning a teaching seminar for a group of young adult clients who are at risk for obesity. Which statement by the nurse best addresses their needs? A) There are drugs that are good to use to reduce weight. B) Obesity often leads to low self-esteem and depression. C) Proper diet and exercise programs can not only prevent obesity but also potentially improve the ability to think and the positivity of self-perception. D) Maternal obesity often leads to menstrual irregularities and higher incidences of infertility.

C)Proper diet and exercise programs can not only prevent obesity but also potentially improve the ability to think the positivity of self perception. RATIONALE:The young adults who are at risk for obesity need education about changing lifestyles and the importance of preventing obesity as opposed to treating it. Education should include tips on eating healthy and exercising, which can lead to other benefits than preventing obesity. Drugs are used to manage obesity, not prevent it. Information about maternal obesity is not necessarily relevant to all individuals and does not address health promotion. Although obesity is a risk factor for low self-esteem and depression, emphasizing these negative effects does not empower clients to address their risk factors.

A nurse is caring for a client who weighs 209 pounds and is 1.67 meters tall. The client eats a high-protein diet and lifts weights to increase muscle mass. The client presents with complications such as sleep apnea, which is often caused by obesity. Which statement regarding this client is true? A) A body mass index calculation should provide an accurate measure of the client's amount of fat. B) A body mass index calculation is the best possible means of measuring this client's fat if combined with the client's waist-to-hip ratio. C) This client's body mass index calculation might indicate a false positive for obesity. D) The client should be given a bioelectrical impedance test to most accurately measure the client's fat.

C)The client body mass index calculations might indicate a false positive for obesity. RATIONALE:This client's weight might be at least partially from body building efforts, and so a body mass index calculation, which only uses the parameters of weight and height, might not accurately indicate whether this client is actually obese. Even if combined with the client's waist-to-hip ratio, a BMI calculation is not the best possible means of measuring a client's fat, and neither is a bioelectrical impedance test. Underwater weighing is considered the most accurate way to determine body fat.

The nurse is assessing the nutritional status of an older client. Which finding is most likely to suggest xerostomia? A) The client refuses food because it is difficult to chew with missing teeth. B) The client frequently becomes dehydrated due to failure to remember to drink water. C) The client has a chronically dry mouth despite adequate intake of fluids. D) The client does not enjoy foods due to diminished taste.

C)The client has chronic dry mouth despite the adequate intake of fluids. RATIONALE:Xerostomia is decreased salivation due to decreased function of salivary glands. It may decrease the taste of food, impair chewing, and lead to avoidance of certain foods. The client with a dry mouth most clearly demonstrates xerostomia. Eating patterns may be altered in clients who are missing teeth, have impaired cognition and become dehydrated, or have diminished taste buds, but these are unrelated to xerostomia.

What is the definition of the basal metabolic rate? A) The amount of energy stored in fat each day B) The speed of triglyceride breakdown C) The cost in kilocalories of being alive D) The speed at which glucose is converted to energy

C)The cost in kilocalories of being alive RATIONALE: More than 70% of the energy expended each day goes to maintaining the basal metabolic rate (BMR)-essentially, the "cost" (in kilocalories) of being alive. It is not a measure of triglyceride breakdown, storage of energy in fat, or the conversion of glucose to energy. B) More than 70% of the energy expended each day goes to maintaining the basal metabolic rate (BMR)-essentially, the "cost" (in kilocalories) of being alive. It is not a measure of triglyceride breakdown, storage of energy in fat, or the conversion of glucose to energy.

​Which statements regarding upper body obesity are accurate? Select all that apply. A) Upper body obesity is also called peripheral obesity. B) Upper body obesity is when the waist-to-hip ratio in men is greater than 0.8 in men or greater than 1 in women. C) Upper body obesity is associated with a greater risk of hypertension. D) Young women tend to have more intra-abdominal fat than men. E) Postmenopausal women tend to have upper body obesity.

C)upper body obesity is associated with a greater risk of hypertension E)Postmenopausal women tend to have upper body obesity RATIONALE:A) Upper body obesity (also called central obesity) is identified by a waist-to-hip ratio of greater than 1 in men or 0.8 in women. Upper body obesity is associated with a greater risk of complications such as hypertension, abnormal blood lipid levels, heart disease, stroke, and elevated insulin levels. Men tend to have more intra-abdominal fat than women, although women develop a central fat distribution pattern after menopause.

A nurse at a health fair is assessing the weight status of four clients. Which of the following clients are classified as overweight? ●A. A client who has a body mass index of 24 ●B. A child's who's weight status in the 50th percentile ●C. A client who has a BMI of 28 ●D. A client who has a BMI of 35

C. A client who has a BMI of 28 ●BMI of 18.5-24.9 normal weight ●BMI of 25- 29.9 is overweight ●BMI of >30 is obese ●Normal weight status of a child is 5th to 85th percentile ●<5th percentile weight status in a child is considered underweight

What is an example of high fiber foods that can help prevent constipation? ●A. Wonder bread and Lucky charms ●B. Wedding soup with lots of cooked spinach ●C. Pear, Avocado, and chai seeds ●D. Apple dumpling, peach cobbler

C. Pear, Avocado, and chai seeds

Vitamin D absorbs

Calcium

most abundant mineral in the body

Calcium

Vegan diets can lead to deficiencies in:

Calcium,omega-3 fatty acids, iron, zinc, and vitamin B12

Heart disease

Cholesterol, sodium

Four types of situations have a universally significant-enough effect on family system to characterize them as a crisis

Chronic illness, major injuries, mental illness, pediatric illness

Clear liquid diet includes

Clear broth, apple juice and it provides hydration and simple carbs

Diethylpropion (Tenuate) May produce nervous system effects such as:

Confusion , nausea , tremors

What is one of the most common side effects of opioid use?

Constipation

A school nurse is reviewing the physical activity for adolescent high school students. Which student has met the outcome for physical activity set by the Centers for Disease Control and Prevention (CDC)? A) An 18-year-old who speed-walks 60 minutes once per week B) A 16-year-old who lifts moderately heavy weights for 15 minutes 3 times per week C) A 15-year-old who runs at a fast pace for 20 minutes 2 times per week D) A 17-year-old who alternates aerobic activities for 60 minutes daily and lifts weights 2 times per week

D) A 17-year-old who alternates aerobic activities for 60 minutes daily and lifts weights 2 times per week RATIONALE:The recommendations for physical activity for adolescents are 60 minutes of physical activity almost every day, with vigorous activity at least 3 days per week and inclusion of muscle strengthening activities. Only the adolescent who alternates aerobic activities for 60 minutes daily and lifts weights 2 times per week fits the referenced criteria.

The nurse conducts teaching for a client recently diagnosed with type 2 diabetes mellitus. At the conclusion of the session, which client statement indicates that teaching has been effective? A) "I will take medication for a week for this acute illness." B) "I will have to take insulin for this disease every day for the rest of my life." C) "This chronic disease will become worse and lead to death." D) "I will have to make dietary changes to manage this chronic disease."

D) I will have to make dietary changes to manage this chronic disease RATIONALE:The client is aware that dietary changes will be needed to manage this chronic disease, indicating that the client understands the teaching the nurse provided. Not all clients diagnosed with type 2 diabetes mellitus require medication, such as insulin, to manage the disease process. Diabetes is chronic, not acute. Depending on the client's response to the disease, the outcome may not become worse or lead to death.

The nurse is providing teaching to a female client about dietary modifications to promote weight loss. Which statement by the nurse is accurate? A) "Your diet should consist of 1200-1600 calories per day, with calorie consumption increasing toward the end of the day." B) "Your diet should consist of 750-1000 calories per day, with just one big meal and then intermittent snacking." C) "Your diet should simply cut 500 calories per day from your normal intake, with a special attention to eliminating all fats from your diet." D) "Your diet should consist of 1000-1200 calories per day and be low in fat, high in fiber, and include a variety of foods."

D) Your diet should consist of 1000-1200 calories per day and be low in fat, high in fiber, and include a variety of foods. RATIONALE:Collaboration with a nutritionist helps clients to identify healthy foods that appeal to them and that can make up a diet plan to create a daily 500- to 1000-kcal deficit. Ideally, the recommended diet should be low in kilocalories and fat, contain adequate nutrients and minerals, and be high in dietary fiber. The client should eat regular meals with small servings. A gradual, slow weight loss of no more than 1-2 lb/week is recommended. For most individuals, this means a diet of 1000- 1200 kcal/day for most women and 1200-1600 kcal/day for men. Fewer than 1200 kcal each day may lead to loss of lean tissue and nutritional deficiencies.

The nurse is caring for an adult female client who is admitted to the hospital with a possible hip fracture. Following the admission assessment, the nurse determines that the client is obese. The client's BMI is 33.2 and her waist circumference is 90 cm. How should the nurse classify her obesity and associated disease risk? A) Class I, high B) Class II, very high C) Class III, extremely high D) Class I, very high

D)Class I, very high

Bariatric surgery is an option for which category of clients? A) Overweight B) Pregnant women C) Adolescents D) Morbidly obese

D)Morbidly obese RATIONALE:For people with morbid obesity, bariatric or lap band surgery is an option. Bariatric surgery may be considered in adolescents in severe cases of obesity resistant to previous weight loss attempts, but not simply adolescents as a group regardless of their obesity. Bariatric surgery would not be considered for clients who are only overweight or for pregnant women.

A nursing diagnosis that indicates that a client wants to implement steps to promote health and wellness usually includes the word(s) A) impaired. B) ineffective. C) risk for. D) readiness for.

D)readiness for. RATIONALE:Nursing diagnoses that indicate that a client wants to implement steps to promote health and wellness usually include the words "readiness for," such as readiness for enhanced coping, readiness for enhanced health management, or readiness for enhanced parenting. Diagnoses that include the words "impaired" or "ineffective" refer to a disease process, and diagnoses that include the words "risk for" indicate that the client has an increased probability of developing complications related to their condition.

Your patient has an order for "advance diet as tolerated" after the patient has returned to the medical surgical floor following surgery. What diet would you start the patient on to progress them slowly? ●A. Rice, toast, Bananas, and Apples ●B. Milk, chocolate pudding, soup, and ice cream ●C. pancakes, eggs, ground sausage, and ensure milkshake ●D. Apple juice, popsicle, chicken broth, and lime jello

D. Apple juice, popsicle, chicken broth, and lime jello It is common to advance diet slowly after a patient has had surgery, anesthesia, or been NPO to avoid nausea, GI upset, and vomiting. You typically start with a clear diet, advance to full liquid, then soft, and then to regular or what is ordered appropriate for a patient and disease process Always ensure a patient is awake, alert, and has a good gag reflex before starting to eat. Advance diet slowly when it is obvious by appetite, lack of N/V, that the patient is tolerating the diet well. CLEAR LIQUID DIET

The nurse should recognize that under undernutrition can affect a child in what way?

Decreases immune response; under nutrition increases the risk of the development of infections in children due to a decrease in immune response. It leads to slow bone development and child be short for developmental age.

With illness protein deficiency can lead to

Delayed wound healing, lack of tissue integrity, adverse effects on blood components

Excess intake of Vitamin C can lead to

Diarrhea

Excess intake of vitamin c leads to

Diarrhea

Vegan

Eats only plant origin, some plan allow inclusion of fish also

Patients taking lipase inhibitors such as Orlistat (alli,Xenical) should restrict intake of:

Fatty foods

Satiety

Feeling of fullness

Sources of vitamins B12

Fortified cereal Fortified soy beverage Meat substitute

Vitamin K

Helps blood clot

Individuals with increased anxiety disorders have turned to

Herbal remedies

Complication of TPN includes:

Hyperglycemia

lacto-ovo-vegetarian

Includes eggs

Dietary fiber

Is a polysaccharide carbohydrate that contributes to disease prevention, especially in the GI tract and cardiovascular system.

Genetics play a role in nutritionally related disorders of:

Lactose intolerance and hylercholestremia

Replacing lost calcium is especially important for:

Postmenopausal women

Kidney diseaae

Protein

Benefits of breastfeeding

Provides positive nutritional balance, promotes GI a functioning, enchases immune function, provides psychological benefits.

Nutrition

Science of intake of nutrients

All vegetarians should make sure they get sufficient amount of calcium, iron, zinc, and vitamins D through foods such as:

Tofu Lentils Swiss chard

When referring to a nutrition label what nutrients should you limit?

Total fats, Saturated fats, cholesterol, sodium

Niacin (B3)

Treats elevated cholesterol

Folic acid

Used in the prevention of open neural cord in the fetus

To facilitate absorption (intake) of iron into the body, patients should also consume sufficient quantities of:

Vitamin C

illness behavior

Ways in which people monitor their bodies, define and interpret their symptoms, take remedial actions, and use the health care system. An example would be eating chicken noodle soup when flu like symptoms start.

Vitamin B12 replacement

Will be lifelong

Macronutrients

carbohydrates, proteins, and fats

lactose intolerance

caused by deficiency of lactase, which is produced by the cell lining the small intestines, and results in distressing GI symptoms including: nausea, abdominal pain, diarrhea.

Sick-role behavior

often includes using the healthcare system for help and may involve dependent behaviors, such as avoiding usual responsibilities. An example would be patient staying in bed for long period of time and not doing homework, going to job, or attending school.

Vitamin B12 deficiency can lead to:

pernicious anemia

The client receiving TPN is at a high risk for infection,

so temperature assessment should be completed at least every 4 hours.

Vitamin D

sunshine vitamin

What are some factors affecting food choice?

taste, smell,habits,packaging,emotion,body image,health benefits,convenience, cost,income,availability/proximity,food desert,food insecurity, dentition

Total parental nutrition TPN

the intravenous infusion of nutrients administered directly into the bloodstream, bypassing the digestive system

Micronutrients

vitamins and minerals

Remission (chronic illness)

when symptoms disappear

Exacerbation

when symptoms reappear