NURSING 245 WEEK 8 QUESTIONS AND ANSWERS STUDY
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Mrs. Lyons is a 50-year-old obese woman being seen for hypertension
management. She has high cholesterol and high triglyceride levels. She states,
"The doctor said low blood sugar can cause you to want to eat, but mine is normal.
What causes me to eat too much?" What is the nurse's best response?
1. "Blood sugar is not the only chemical stimulant of hunger. There are also many
other factors that play a role in why people eat.
"2. "You eat because of emotions, not because you are hungry.
"3. "You will need to build your willpower, or overeating will kill you."
4. "It is probably an inherited tendency. It is just the way it is going to be with
you."
Answers :1. "Blood sugar is not the only chemical stimulant of hunger. There are
also many other factors that play a role in why people eat."
There are many factors inherent in weight gain, appetite, and satiety. It is best to
convey that obesity is multifaceted. Although emotions, genetics, and such
personality traits as willpower may be issues, the nurse would not be able to say
that they are causal in such a factual manner with this client.
Mrs. Glass is a 32-year-old woman seeking advice about dieting. She states she has
tried "every fad diet in the book," and nothing works. Her BMI is 32.2 kg/m2. She
states that she has started an exercise program consisting of both aerobics and
muscle-strengthening exercises 4 days a week or more, and does not want to take
any medications. She says she does not eat much at all but can't seem to lose
weight, and she says, "I eat healthy." Which teaching would be most therapeutic?
Take antidepressants
Keep a food diary
,Stop eating out
Exercise a little more
Answers :Keep a food diary
Keeping a food diary could help Mrs. Glass understand what she actually eats and
when. It could also give her some insight into her food choices. She is already
exceeding the recommended exercise intensity, so this is not a priority
recommendation. There is nothing in the case study that reflects a need for an
antidepressant, and Mrs. Glass has already said she does not want to take
medications. Rather than stopping her from eating out, it would be appropriate to
give Mrs. Glass information about best food choices when eating out.
Ms. Stinson, a 60-year-old African American female. was diagnosed with obesity
and complications from gastric bypass surgery. The nurse evaluates Ms. Stinson's
plan of care while in the hospital. Which outcome is appropriate when determining
client support after discharge?
The client works with a dietitian for meal planning.
The client meets with a support group once per year.
The client's exercise routine is placed on indefinite hold.
The client makes appointments to attend two weigh-ins every other year.
Answers :The client works with a dietitian for meal planning.
Client goals and outcomes should be tailored to meet the client's needs. The client
should work in collaboration with a dietitian for meal planning; the health care
team for exercise routines that fit the client's situation; and support groups to help
with weight loss goals. She should develop appropriate strategies to deal with
hunger and making unhealthy food choices. The client should also attend regular
weight loss clinics and keep regular weigh-in appointments.
, A 62-year-old woman, Karen Johnson, has come into the emergency room with a
possible wrist fracture. This is the third such injury she has had in the past year,
and the nurse suspects osteoporosis. She reports no other health symptoms. Which
piece of data in Ms. Johnson's history supports the diagnosis of osteoporosis?
Answers :Administer atropine sulfate
A cholinergic crisis occurs when the parasympathetic nervous system is
overstimulated, as in the case of an AChE inhibitor overdose. Because some
symptoms-tachycardia, muscle weakness, and respiratory distress-of myasthenic
crisis are similar to those of cholinergic crisis, a careful diagnosis must be made. If
there is no symptomatic improvement after a very small dose of edrophonium
chloride (Enlon) is administered, then a cholinergic crisis will likely be diagnosed
and atropine sulfate administered as an antidote. Although the health care provider
will probably discontinue the AChE inhibitor, the most immediate action would
involve treatment of the cholinergic crisis.
A 65-year-old man has a low testosterone level, low lifetime calcium level, and has
had two bone fractures in the past 2 years. Which intervention can the nurse
suggest to prevent or slow the development of osteoporosis?
Answers :History of alcoholism
A history of alcoholism places this client at risk of osteoporosis. An inactive
lifestyle, not an active lifestyle, would place this client at risk. Being underweight,
not overweight, is a risk factor. A lack of vitamin D intake, not daily intake, would
also be a risk factor for osteoporosis.
A 65-year-old woman, Lina Chen, has recently been diagnosed with osteoporosis.
Which advice will the nurse give her?
Increase alcohol intake
Start or continue weight-bearing exercise
Eat foods low in iron
Increase caffeine intake
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