Unit 4 Quizzes

Until what age in years does a child need to drink whole milk for adequate neurologic development?

Toddlers need to drink whole milk until the age of 2 years to ensure adequate intake of the fatty acids necessary for brain and neurologic development.

The nurse teaches which action to the diabetic client who self-injects insulin to prevent local irritation at the injection site? Be sure to aspirate prior to injecting insulin. Massage the site after injecting insulin. Use a 1-inch needle for the injection. Allow the insulin to warm to room temperature before injecting it.

Allow the insulin to warm to room temperature before injecting it. Cold insulin from the refrigerator is the most common cause of irritation. Aspiration of insulin is not recommended; massaging the site can cause irritation; and a 1-inch needle is the improper size for insulin injections.

The nurse is assessing a group of patients to determine their risk of vitamin D deficiency. Which of the following patients has the highest risk for vitamin D deficiency? A Caucasian female who is 39 weeks gestation An African-American female who is breastfeeding An Asian female diagnosed with hypoglycemia A Hispanic female who has a BMI of 24.1

An African-American female who is breastfeeding Vitamin D deficiency is more frequently found among persons of African heritage and has increased in prevalence, especially among the infants of breastfeeding African-American mothers. Caucasian females do not share these risk factors. There is no known risk of hypoglycemia and vitamin D deficiency; however, diabetes increases the risk for vitamin D deficiency. There is no known risk of vitamin D deficiency in normal-weight females of Hispanic heritage; however, obesity is a risk factor.

A nurse in a home setting is assessing a 79-year-old male patient's risk for malnutrition. The nurse suspects malnutrition when reviewing which laboratory results? Select all that apply. Body mass index (BMI) of 17 Waist-to-hip ratio of 1.0 Weight loss of 6% since last month's visit Prealbumin level of 16 mg/dL Hematocrit level of 50% Hemoglobin level of 8.2 g/dL

Body mass index (BMI) of 17 Weight loss of 6% since last month's visit Hemoglobin level of 8.2 g/dL A BMI of 18.5 to 24.9 is normal, and this patient's BMI is below normal; a major weight loss is defined as more than a 2% weight change over 1 week; and the expected hemoglobin level for a man is 14 to 18 g/dL. The patient's values may also indicate dehydration. The expected level for prealbumin is 15 to 36 mg/dL. A hematocrit level of 50% is within normal limits.

A client who had a cesarean birth is unable to void 3 hours after the removal of an indwelling catheter. How would the nurse evaluate the client for bladder distension? By catheterizing the client for residual urine By palpating the client's suprapubic area gently By asking the client whether she still feels the urge to urinate By determining whether the client is experiencing suprapubic pain

By palpating the client's suprapubic area gently Palpation will indicate whether bladder distention is present. The increased intra-abdominal space available after birth can result in bladder distention without discomfort. Assessment should be done before interventions. Trauma to the area makes surrounding organs atonic; the client may have a full bladder and not feel the urge to void.

When planning care for a diabetic patient with microalbuminuria, it is important to include which goal to reduce the progression to renal failure? Decrease the total percentage of calories from carbohydrates Decrease the total percentage of calories from fruits Decrease the total percentage of calories from proteins Decrease the total percentage of daily caloric intake

Decrease the total percentage of calories from proteins Restriction of dietary protein to 0.8 g/kg body weight per day is recommended for clients with microalbuminuria to reduce the progression to renal failure. All other choices can increase blood glucose and total body weight but are not specific for progression to renal failure.

A patient has a tumor that secretes excessive antidiuretic hormone (ADH). He is confused and lethargic. His partner wants to know how a change in blood sodium can cause these symptoms. What should the nurse teach the patient's partner? Decreased sodium in the blood causes the blood volume to decrease so that not enough oxygen reaches the brain. Decreased sodium in the blood causes brain cells to swell so that they do not work as effectively. Increased sodium in the blood causes the blood volume to increase so that too much oxygen reaches the brain. Increased sodium in the blood causes brain cells to shrivel so that they do not work as effectively.

Decreased sodium in the blood causes brain cells to swell so that they do not work as effectively. The normal action of ADH is renal reabsorption of water, which dilutes the blood. Excessive ADH causes hyponatremia, which is manifested by a decreased level of consciousness because the osmotic shift of water into the brain cells impairs their function. Hyponatremia does not decrease the blood volume. Answers that include increased sodium in the blood are incorrect because ADH excess causes hyponatremia rather than hypernatremia.

A client presents to the emergency department with weakness and dizziness. The blood pressure is 90/60 mm Hg, pulse is 92 and weak, and body weight reflects a 3-pound (1.4 kilogram) loss in two days. The weather has been hot. Which condition should the nurse conclude is the priority for this client? Deficient fluid volume Impaired skin integrity Inadequate nutritional intake Decreased participation in activities

Deficient fluid volume The low blood pressure indicates hypovolemia, the increased pulse is an attempt to maintain adequate oxygenation of tissues, and the rapid weight loss reflects loss of body fluid. Although impaired skin integrity is a concern with dehydration, it is not the priority. The rapid weight loss reflects a loss of fluid, not a loss of body tissue. Although the client may need assistance with activities, an inadequate intake of fluid has caused the client's dehydration, which is a serious medical problem that needs to be treated immediately.

The patient talks with the nurse about bladder health. What is one of the most important recommendations the nurse can make for this patient? Eat foods high in fiber. Drink 6 to 8 glasses of noncaffeinated fluids daily. Exercise in the morning and evening. Visit the urologist once yearly.

Drink 6 to 8 glasses of noncaffeinated fluids daily. Drinking 6 to 8 glasses of noncaffeinated fluids daily helps with bladder health because urine is not stagnating in the bladder. Exercising and eating foods high in fiber help with bowel elimination but do not have an effect on urination. Visiting the urologist is good if there is a problem, but this is not the most important recommendation from the nurse.

The nurse is talking with a patient who was just diagnosed with a urinary tract infection. The patient asks the nurse how to prevent such infections in the future. The nurse should make which appropriate recommendations for the patient? Select all that apply. Drink 6 to 8 glasses of noncaffeinated fluids daily. Exercise daily. Increase fiber in the diet. Void when the urge is felt. Eat fruit twice daily.

Drink 6 to 8 glasses of noncaffeinated fluids daily. Void when the urge is felt. Drinking noncaffeinated drinks and voiding when the urge happens are the most appropriate measures for avoiding a urinary tract infection. Increasing fiber, exercising, and eating fruit do not prevent a urinary tract infection.

The home health nurse should assess a patient who has chronic diarrhea for which fluid and electrolyte imbalances? Extracellular fluid volume (ECV) excess Extracellular fluid volume (ECV) deficit Hypokalemia Hyperkalemia Hypocalcemia Hypercalcemia

Extracellular fluid volume (ECV) deficit Hypokalemia Hypocalcemia Chronic diarrhea has a high risk of causing ECV deficit, hypokalemia, and hypocalcemia because it increases the fecal output of sodium-containing fluid, potassium, and calcium. Unless the intake of these substances increases appropriately, imbalances will occur. Excesses of ECV, potassium, and calcium are not likely, because the ECV, potassium, and calcium are being removed from the body.

The nurse is admitting an older adult with left-sided heart failure. The nursing assessment reveals adventitious lung sounds, dyspnea, and orthopnea. The nurse anticipates which of the following orders? Furosemide (Lasix) 20 mg PO now Intravenous (IV) 500 mL of 0.9% NaCl at 125 mL/h IV Dextrose 5% at 125 ml/h IV D KCl 20 mEq at 125 ml/h

Furosemide (Lasix) 20 mg PO now Lasix is a diuretic, which will assist in relieving extracellular fluid volume (ECV) excess, which is the major consideration with left-sided heart failure. The remaining options are incorrect because IV fluids may place an additional load on the failing heart.

What suggestion should the nurse provide to the mother whose child has had constipation for three days? Select all that apply. Give laxatives to the child. Reduce the child's fluid intake. Include dairy products in the child's diet daily. Increase the child's physical activity. Include food with a high fiber content in the child's diet.

Give laxatives to the child. Increase the child's physical activity. Include food with a high fiber content in the child's diet. Constipation is infrequent and difficult passage of stools, and it can be managed by following certain measures. Laxatives may help with the easy passage of stools to relieve constipation. Bowel movements can also be promoted by increasing physical activity and adding fiber to the diet to add bulk to the stool to relieve constipation. Low fluid intake and consumption of dairy products can increase the risk for constipation.

A parent expresses concern that the adolescent child is not ingesting enough calcium because of an allergy to milk. What alternative foods or liquids should the nurse suggest? Select all that apply. Cottage cheese Green leafy vegetables Black or baked beans Yogurt Oranges Salmon and sardines

Green leafy vegetables Black or baked beans Oranges Salmon and sardines Green leafy vegetables, black and baked beans, oranges, and salmon and sardines are all good sources of calcium even though they do not contain milk or milk products. Cottage cheese and yogurt both contain milk and therefore must be eliminated.

It is most important for the nurse to include which risk factors in a teaching plan associated with the development of type 2 diabetes mellitus? Select all that apply. Hypertension History of pancreatic trauma Weight gain of 30 pounds during pregnancy Body mass index greater than 25 kg/m Triglyceride levels between 150 and 200 mg/dL Delivery of a 4.99-kg baby

Hypertension Body mass index greater than 25 kg/m Delivery of a 4.99-kg baby Risk factors for type 2 diabetes include habitual inactivity, hypertension, delivery of a baby weighing over 9 pounds, a history of vascular disease, a body mass index greater than 25 kg/m, and triglyceride levels over 200 mg/dL.

A patient has impaired urinary elimination: retention. Which system is at risk for alteration in addition to the renal system? Gastrointestinal Immune Skeletal Gynecologic

Immune Systems are interrelated and alterations in one system contribute to alterations in other systems. Urinary retention, if untreated, causes urine to backflow out of the urinary bladder, up the ureters and into the kidneys themselves. This pressure can cause pyelonephritis and infection, which is an immune alteration.

What effect does inadequate fluid intake have on a patient's urinary system? Decreases the presence of bladder crystals. Decreases incidence of urinary incontinence. Increases the risk for urinary infections. Increases the ability to recognize bladder cues.

Increases the risk for urinary infections. The concept of urinary elimination interrelates with the concept of fluid and electrolyte balance. Inadequate fluid intake increases the risk for urinary infections because toxins cannot be eliminated from the body without adequate fluids.

Based on the nurse's assessment of a diabetic patient, which finding indicates the need for avoidance of exercise at this time? Ketone bodies in the urine Blood glucose level of 155 mg/dL Pulse rate of 66 beats per minute Weight gain of 1 pound over the previous week's weight

Ketone bodies in the urine Exercise would lead to further elevations in blood glucose levels due to inadequate insulin to promote intracellular glucose transport and uptake. Assessing for ketones in the urine may indicate insulin deficiency.

A patient has newly diagnosed hyperparathyroidism. What should the nurse expect to find during an assessment at the beginning of the nursing shift? Lethargy and constipation from hypercalcemia Positive Trousseau's sign from hypercalcemia Lethargy and constipation from hypocalcemia Positive Trousseau's sign from hypocalcemia

Lethargy and constipation from hypercalcemia Parathyroid hormone (PTH) shifts calcium from the bones into the extracellular fluid (ECF). Excessive PTH causes hypercalcemia, which is manifested by lethargy and constipation. A positive Trousseau's sign is characteristic of hypocalcemia rather than hypercalcemia. Answers that indicate hypocalcemia are not correct, because PTH moves calcium into the ECF.

The nurse is caring for a 25-year-old woman who is requesting information to lose weight. What information will the nurse include in a weight-loss plan? Weigh yourself at the same time every morning and evening. Stick to a 600- to 800-calorie diet for the most rapid weight loss. Low carbohydrate diets lead to rapid weight loss but are difficult to maintain. Weighing all foods on a scale is necessary to choose appropriate portion sizes.

Low carbohydrate diets lead to rapid weight loss but are difficult to maintain. The restrictive nature of fad diets makes the weight loss achieved by the patient more difficult to maintain. Portion size can be estimated in other ways besides weighing. Severely calorie-restricted diets are not necessary for patients in the overweight category of obesity and need to be closely supervised. Patients should weigh weekly rather than daily.

The nurse should institute which precaution for the hypoglycemic patient receiving intramuscular glucagon due to an inability to swallow the oral form? Elevate the head of the bed. Have a padded tongue blade at the bedside. Position the client face down or in a side-lying position. Apply pressure and massage the injection site for 5 minutes.

Position the client face down or in a side-lying position. Intramuscular injection of glucagon often causes vomiting, increasing the patient's risk for aspiration. Elevating the head of the bed, instituting the use of a padded tongue blade, or applying pressure at or massaging injection site is not a safe nursing practice.

The nurse is working with a patient who has been complaining of nausea and diarrhea. The nurse suspects dehydration. Which sign does the nurse expect to see? Flat neck veins when upright Decreased patellar reflexes Positive Trousseau sign Jugular vein distension

Positive Trousseau sign Trousseau sign is likely present in patients who have diarrhea or dehydration because dehydration can cause increased neuromuscular excitability. reflexes would likely be increased or hyper in patients with diarrhea and dehydration. jugular vein distension is a sign of excess fluid volume.

Appropriate approaches used by the long-term care nurse to provide education for a 73 year old who has just been diagnosed with diabetes include which of the following? Select all that apply. Schedule a visit by another resident who is diabetic . Demonstrate food choices using food photographs. Avoid discussion of the patient's favorite foods. Remind the patient that a lot of damage has already occurred. Encourage the patient's family to participate in teaching sessions. Ask the patient about past experiences with lifestyle changes.

Schedule a visit by another resident who is diabetic. Demonstrate food choices using food photographs. Encourage the patient's family to participate in teaching sessions. Ask the patient about past experiences with lifestyle changes. Strategies to promote learning in older adults include peer teaching, visual aids, family participation, and relating new learning to past experiences. Discussion of the patient's favorite foods is needed to determine how old favorites can be adapted to the new diet. Reminders about the damage already done will indicate that the changes are not worth the effort.

A diabetic patient is receiving intravenous insulin. Which laboratory results should the nurse anticipate as a potential problem? Serum chloride level of 90 mmol/L Serum calcium level of 8 mg/dL Serum sodium level of 132 mmol/L Serum potassium level of 2.5 mmol/L

Serum potassium level of 2.5 mmol/L Insulin activates the sodium-potassium adenosine triphosphatase (ATPase) pump, which increases the movement of potassium from the extracellular fluid into the intracellular fluid, resulting in hypokalemia. The chloride, calcium, and sodium levels are in normal parameters.

A client with diabetes asks how exercise will affect insulin and dietary needs. What information does the nurse share about insulin and exercise? "Exercise increases the need for carbohydrates and decreases the need for insulin." "Exercise increases the need for insulin and increases the need for carbohydrates." "Regular physical activity decreases the need for insulin and decreases the need for carbohydrates." "Intensive physical activity decreases the need for carbohydrates but does not affect the need for insulin."

"Exercise increases the need for carbohydrates and decreases the need for insulin." Exercise increases the uptake of glucose by active muscle cells without the need for insulin; carbohydrates are needed to supply energy for the increased metabolic rate associated with exercise. The need for insulin is decreased.

The registered nurse is preparing to assess a client's renal system. Which statement by the nurse indicates effective technique? "I must first palpate the client if a tumor is suspected." "I must first listen for normal pulse at the client's wrist region." "I must first auscultate the client and then proceed to percussion and palpation." "I must first examine tender abdominal areas and then proceed to nontender areas."

"I must first auscultate the client and then proceed to percussion and palpation." Palpation and percussion can cause an increase in normal bowel sounds and hide abdominal vascular sounds. Therefore it is wise to perform auscultation prior to percussion and palpation during clinical assessment of the renal system. Palpation should be avoided if a client is suspected of having a tumor because it could harm the client. It is more important as part of clinical assessment of the renal system to listen for bruit by auscultating over the renal artery. Bruit indicates renal artery stenosis. The nontender areas should be examined prior to tender areas to avoid confusion regarding radiating pain from the tender area being percussed.

A patient has acute gastroenteritis with watery diarrhea. Which statement by this patient would indicate that the nurse's teaching has been effective? "I should drink a lot of tap water today." "I need to take more calcium tablets today." "I should avoid fruits with potassium in them." "I need to drink liquids with some sodium in them."

"I need to drink liquids with some sodium in them." Sodium-containing fluids are removed from the body by acute diarrhea and must be replaced to prevent an extracellular fluid volume (ECV) deficit. Drinking tap water will not prevent ECV deficit from diarrhea, because tap water does not contain enough sodium to hold the water in the extracellular compartment. Taking calcium tablets is an incorrect answer because hypocalcemia is characteristic of chronic diarrhea rather than acute diarrhea. Restricting fruits is an incorrect answer because diarrhea increases the potassium output and the potassium intake should be increased to balance it.

What are the indicators of nutritional risk in pregnancy in a client who is of normal weight? Select all that apply. Smoker Twin gestation Hemoglobin of 12 g/dL (120 mmol/L) Term delivery 2 years ago Caffeine intake of 180 mg/day Fasting blood sugar of 80 mg/dL (4.4 mmol/L)

Smoker, Twin gestation Smokers generally have a nutrient-poor diet and are at risk for continuing the same diet through pregnancy. Multifetal pregnancies require nutrition above the normal requirements for pregnancy. A hemoglobin reading of 12 g/dL (120 mmol/L) and fasting blood sugar of 80 mg/dL (4.4 mmol/L) are normal values. Caffeine intake of 180 mg/day is less than the daily recommended intake.

If a patient has a colostomy in the area known as the "ascending colon," what would the nurse expect of the stool in the colostomy device? Stool would be dark. Stool would be formed. Stool would be loose. Stool would have flecks of blood.

Stool would be loose. The correct answer is C because stool in the ascending colon is loose or watery. Stool should not be dark or have flecks of blood. This would be an abnormal finding. Stool would not be loose, because the colon has not reabsorbed the water yet.

Which clinical manifestation of decreased renal function in the diabetic clinic should the nurse anticipate as a potential problem? Elevated specific gravity Ketone bodies in the urine Glucose in the urine Sustained increase in blood pressure from 130/82 mm Hg to 150/110 mm Hg

Sustained increase in blood pressure from 130/82 mm Hg to 150/110 mm Hg Hypertension is both a cause and a result of renal dysfunction in the diabetic client. Although ketones and glucose in the urine are findings in diabetes mellitus, they are not specific for renal function. Specific gravity is elevated with dehydration.

A nurse is educating the mother of a one-year-old baby about an adequate child's diet plan. Which statement made by the mother indicates the need for further education? "I should limit the intake of milk to two to three cups per day." "I should serve finger foods in small and reasonable amounts." "I can start supplementing milk with solid food items such as vegetables and fruits." "I should give low-fat or skimmed milk to the child until he or she is two years old."

"I should give low-fat or skimmed milk to the child until he or she is two years old." Children under two years of age should not be given low-fat or skimmed milk because fat is important for physical and intellectual growth. Milk intake should be limited to two to three cups per day because the consumption of more than a quart of milk per day will decrease a child's appetite for essential solid foods and result in inadequate iron intake. Serving finger foods to toddlers allows them to eat by themselves and to satisfy their need for independence and control. Small, reasonable servings allow toddlers to eat all of their meals. By the age of six months, the mother should start supplementing milk with solid food items, ensuring a balanced diet for an adequate growth of the child.

A diabetic patient has proliferative retinopathy, nephropathy, and peripheral neuropathy. What should the nurse teach this patient about exercise? "Jogging for 20 minutes 5 to 7 days a week would most efficiently help you to lose weight." "One hour of vigorous exercise daily is needed to prevent progression of disease." "Avoid all forms of exercise because of your diabetic complications." "Swimming or water aerobics 30 minutes each day would be the safest exercise routine for you."

"Swimming or water aerobics 30 minutes each day would be the safest exercise routine for you." Exercise is not contraindicated for this client, but modifications are necessary to prevent further injury. Swimming or water aerobics provides support for the joints and muscles while increasing the uptake of glucose and promoting cardiovascular health. Jogging, vigorous exercise, or no exercise would increase the pathologies of this patient.

The nurse is caring for a confused patient who is wearing a vest restraint in bed. The nurse speaks with an unlicensed assistant about toileting the patient. The nurse knows the unlicensed assistant understands the toileting procedure when making which statement? The patient must remain in the restraints all day. The patient needs to be toileted to maintain a regular toileting schedule. The patient needs to be provided with adult briefs for incontinence. The patient will use the call bell when he or she feels the urge to void.

The patient needs to be toileted to maintain a regular toileting schedule. The correct answer is toileting the patient so he or she can maintain a normal toileting schedule. Leaving the patient in restraints all day is against the standard of care. Providing the patient with briefs when he or she is not incontinent does not meet the patient's toileting needs. If the patient is confused, he or she will not be able to use the call bell.

A patient with a history of cardiac problems talks with the nurse about bowel elimination. The nurse stresses to the patient not to strain during bowel movements. Straining can put pressure on the vagas nerve and cause bradycardia. The nurse is explaining which physiological action? First-degree heart block Eupnea Valsalva maneuver Tachypnea

Valsalva maneuver The Valsalva maneuver happens when the cardiac patient strains to have a bowel movement. First-degree heart block is not brought on by straining. Eupnea means normal respirations and tachypnea means fast respirations; neither has any connection to straining during a bowel movement.

The nurse is caring for a patient diagnosed with peptic ulcer disease (PUD). The patient was prescribed the proton pump inhibitor Prevacid (lansoprazole). Which of the following supplements may be prescribed to prevent deficiency? Vitamin B12 Vitamin C Vitamin D Omega-3 fatty acids

Vitamin B12 Vitamin B12 deficiency can occur as a result of the reduced gastric acidity associated with use of proton pump inhibitors, and supplementation is often warranted. Vitamin C deficiency is not a known deficiency associated with medications. Vitamin D deficiency may occur in patients who take cholesterol medication, and this link is currently being investigated. Omega-3 fatty acids may be used as monotherapy or in conjunction with cholesterol medication for patients with hyperlipidemia.

A client begins therapy with a new medication. One month later the client notices blood in the urine. Which drug does the nurse anticipate as the cause? Warfarin Nifedipine Nitrofurantoin Phenazopyridine

Warfarin Warfarin is an anticoagulant medication and could result in blood in urine, a condition known as hematuria. Nifedipine is a calcium channel blocker that could affect the ability of the urinary bladder or sphincter to contract and relax normally. Nitrofurantoin is used to treat urinary tract infections but can cause alteration in urine color to a dark yellowish-brown. Phenazopyridine, a bladder analgesic used to treat pain associated with urinary tract conditions, changes the color of urine to orange or red.

Gastrointestinal elimination serves which primary physiologic purpose? Electrolyte homeostasis Gastrointestinal integrity Peristaltic activity Waste product excretion

Waste product excretion The definition of elimination is the excretion of waste products, which is also the primary physiologic purpose of elimination. The concept of gastrointestinal elimination refers to the physiologic elimination of waste products by the bowel. Electrolyte homeostasis, maintenance of gastrointestinal integrity (intact bowel), and peristaltic activity facilitate waste product excretion

Which priority intervention will the nurse initiate for the patient having Kussmaul's respirations due to diabetic ketoacidosis? Administration of oxygen by nasal cannula at 15 L/min Intravenous infusion of 10% glucose Implementation of seizure precautions Administration of intravenous insulin

Administration of intravenous insulin The Kussmaul's respirations pattern is the body's attempt to reduce the acids produced by utilization of fat for fuel. Administration of insulin will reduce this respiration pattern by assisting glucose transport back into cells to be used for fuel instead of fat. Nasal cannula oxygen is given at 1 to 6 L per minute; intravenous glucose administration will not have the desired effect of treatment; and although seizure precautions may be implemented, they will not have any effect on glucose transport into cells.

The nurse suspects that a patient has a decreased cellular volume with a possible electrolyte imbalance. The provider has ordered blood chemistry laboratory tests. What is the most important nursing intervention for this patient until laboratory results confirm this suspicion? Raise bedside rails because of potential decreased level of consciousness and confusion. Examine sacral area and patient's heels for skin breakdown caused by potential edema. Establish seizure precautions because of potential muscle twitching, cramps, and seizures. Institute fall precautions because of potential postural hypotension and weak leg muscles.

Institute fall precautions because of potential postural hypotension and weak leg muscles. Electrolyte imbalances are abnormal plasma concentrations of electrolytes such as K+, Ca++, and Mg++. Hypokalemia can cause postural hypotension and bilateral muscle weakness, especially in the lower extremities. Both of these increase the risk of falls. Options A, B, and C are incorrect because decreased cellular volume does not cause edema, decreased level of consciousness, or seizures

The nurse is caring for a 50-year-old man who has a body mass index (BMI) of 31 kg/m2, a normal C-reactive protein level, and low serum transferrin and albumin levels. The nurse will plan patient teaching to increase the patient's intake of foods that is high in: Iron Protein Calories Carbohydrate

Protein These laboratory results are indicative of low protein levels. Protein intake is essential for cellular ability to manufacture other forms of proteins, such as carrier proteins, and to enable tissue growth and repair. Iron supplementation is indicated for anemia. This patient has a BMI of 31, which is obese. High calorie and high carbohydrates would lead to further weight gain.

The nurse recommends the pen-injector insulin delivery system for the client with which clinical presentation? Confusion and reliance on another person for insulin injections Requirements for intensive therapy with small, frequent insulin doses Visual impairment affecting the ability to draw up insulin accurately Frequent episodes of hypoglycemia

Requirements for intensive therapy with small, frequent insulin doses The pen injector allows greater accuracy with small doses of less than 5 units. It is not recommended for those with cognitive or visual impairments or those who suffer frequent hypoglycemic episodes.

A patient injured in an earthquake today when a wall fell on his legs received 9 units of blood an hour ago because he was hemorrhaging. Which laboratory value should the nurse check first when the report returns? Serum sodium Serum potassium Serum total calcium Serum magnesium

Serum potassium The patient has two major risk factors for hyperkalemia: massive sudden cell death from a crushing injury (potassium shift from cells into the extracellular fluid) and massive blood transfusion (rapid potassium intake).

Which clinical manifestation indicates to the nurse a patient's hyperosmolar nonketotic syndrome (HNKS) therapy needs to be adjusted? Ketone bodies in the urine have been absent for 3 hours. Blood osmolarity has decreased from 350 to 330 mOsm. Serum potassium level has increased from 2.8 to 3.2 mEq/L. The Glasgow Coma Scale is unchanged from 3 hours ago.

The Glasgow Coma Scale is unchanged from 3 hours ago. Slow but steady improvement in central nervous system functioning should be seen with effective therapy for HNKS. An unchanged level of consciousness may indicate inadequate rates of fluid replacement. Ketone bodies, blood osmolarity, and serum potassium levels are consistent with improvement.

A person of Northern heritage is at an increased risk for which of the following? Select all that apply. Vitamin C deficiency Type 1 diabetes Celiac disease Type 2 diabetes Hypertension Metabolic syndrome

Type 1 diabetes Celiac disease Type 1 diabetes and Celiac disease are more common in Northern heritage. African Americans and Hispanics are at increased risk for Type 2 diabetes, hypertension, and metabolic syndrome. Vitamin C deficiency is not a common deficiency related to heritage or ethnicity.