during the acute phase of burn the priority nursing intervention in caring for this client is

ATI RN

ATI RN Nutrition Online Practice 2019

1. During the acute phase of a burn, the priority nursing intervention in caring for this client is:

A. Prevention of infection
B. Pain management
C. Prevention of bleeding
D. Fluid resuscitation

Correct answer: D

Rationale: During the acute phase of a burn, fluid resuscitation is the priority nursing intervention. This phase is characterized by fluid loss and the risk of hypovolemic shock. Administering fluids is crucial to maintain perfusion and prevent complications such as organ failure. While prevention of infection, pain management, and prevention of bleeding are important aspects of burn care, fluid resuscitation takes precedence in the acute phase to stabilize the client's condition and prevent further damage.

2. What is a major feature of the therapeutic lifestyle changes (TLC) recommended for the treatment of high blood cholesterol?

A. Avoiding all foods that contain cholesterol
B. Reducing sodium intake to less than 2 g/day
C. Limiting total fat intake to less than 30% of energy intake
D. Limiting saturated fat intake to less than 7% of energy intake

Correct answer: D

Rationale: The correct answer is D, 'Limiting saturated fat intake to less than 7% of energy intake.' This is a central feature of the therapeutic lifestyle changes (TLC) recommended for treating high blood cholesterol. Saturated fats can increase low-density lipoprotein (LDL) cholesterol, a significant risk factor for heart disease. Choice A is incorrect because while it is recommended to limit cholesterol intake, it's not suggested to avoid all foods containing cholesterol entirely in the TLC. Choice B is also incorrect as although reducing sodium intake is beneficial for controlling blood pressure, it's not specifically targeted in the TLC for managing high cholesterol. Lastly, while limiting total fat intake is a healthy guideline, it's not as specific or effective as limiting saturated fat intake, making choice C also incorrect.

3. Which of the following statements is false?

A. People with a vitamin K deficiency experience increased clotting time
B. The major function of vitamin E is promoting vision
C. Vitamin D functions as a hormone
D. Rich sources of beta-carotene include carrots, sweet potatoes, and butternut squash

Correct answer: B

Rationale: The statement that the major function of vitamin E is promoting vision is incorrect. Vitamin E primarily acts as an antioxidant, protecting cells from oxidative damage. Its role is not primarily related to vision, which is a major function of vitamin A. On the other hand, the other options are true. Vitamin K deficiency does indeed lead to increased clotting time, vitamin D functions as a hormone, and carrots, sweet potatoes, and butternut squash are rich sources of beta-carotene.

4. A nurse in a long-term care facility is developing strategies to promote increased food intake for an older adult client. Which of the following interventions should the nurse implement?

A. Offer sugar substitutes to increase the clientâ€™s appetite.
B. Provide opportunities to eat three large meals per day.
C. Provide entertainment while the client is eating.
D. Offer finger foods at mealtime.

Correct answer: D

Rationale: The correct intervention for promoting increased food intake for an older adult client is to offer finger foods at mealtime. Finger foods are easier for older adults to manage, making eating less cumbersome and more enjoyable, which can help increase overall food intake. Providing sugar substitutes (Choice A) may not necessarily increase appetite and could have negative health effects. Eating three large meals per day (Choice B) may be overwhelming and not suitable for older adults who may prefer smaller, more frequent meals. While providing entertainment (Choice C) during meals can be beneficial in some cases, it may not directly contribute to increased food intake as effectively as offering finger foods.