The nurse has completed the admission assessment of a client and has determined that the client's body mass index (BMI) is 33.5 kg/m2. What health promotion advice should the nurse provide to the client?

Correct Answer: A

Rationale: Step-by-step rationale for the correct answer (A): 1. BMI of 33.5 indicates the client is in the overweight category. 2. Physical activity can help in weight management and improving overall health. 3. Integrating physical activity can help in reducing weight and lowering BMI. 4. Health promotion advice should focus on lifestyle changes rather than surgical interventions or support groups. Summary of why other choices are incorrect: B: While maintaining a healthy diet is important, focusing solely on diet may not be as effective as incorporating physical activity for weight management. C: Surgical options are typically considered for severe obesity cases, which may not be necessary at a BMI of 33.5. D: Referring to a support group for severe obesity may not be appropriate at this stage as lifestyle modifications should be the initial approach.

Correct Answer: D

Rationale: The correct answer is D: Inability of the liver to use vitamin K. Vitamin K is essential for the synthesis of clotting factors, including prothrombin. In liver failure, impaired function leads to reduced production of bile, which is necessary for the absorption of fat-soluble vitamins like vitamin K. This results in inadequate activation of clotting factors and increased risk of bleeding. Choices A, B, and C are incorrect as alterations in glucose metabolism, retention of bile salts, and inadequate albumin production do not directly impact the synthesis and activation of clotting factors like prothrombin in liver failure.

Correct Answer: C

Rationale: The correct answer is C: Daily weights and measurement of abdominal girth. Portal hypertension can lead to fluid retention and ascites, causing weight gain and abdominal distension. Monitoring these parameters helps assess fluid status and effectiveness of treatment. A: Assessment of blood pressure and evaluation for headaches and visual changes is not a priority as they are not directly related to portal hypertension. B: Assessment for signs and symptoms of venous thromboembolism is not a priority in this case unless there are specific risk factors present. D: Monitoring blood glucose every 4 hours is not directly related to portal hypertension and is not a priority in this scenario.

Correct Answer: A

Rationale: The correct answer is A: Immunization. Hepatitis B is a viral infection transmitted through exposure to infected blood or body fluids. Immunization with the hepatitis B vaccine is the most effective preventative measure, providing long-term protection against the virus. Chronic tonsillitis (B) is unrelated to hepatitis B prevention. Consumption of a vitamin-rich diet (C) and annual vitamin K injections (D) do not offer protection against hepatitis B. Immunization is the best choice due to its proven efficacy in preventing hepatitis B transmission.

Correct Answer: D

Rationale: The correct answer is D: IV administration of octreotide. Octreotide is indicated for variceal bleeding as it reduces portal venous pressure, decreases blood flow to varices, and inhibits release of vasoactive substances. It helps control bleeding and stabilize the patient. Heparin (A) is not indicated for variceal bleeding. Albumin (B) may be used for volume resuscitation but does not address the bleeding. Vitamin K (C) is used for coagulation disorders, not variceal bleeding.