Test Question

[tiffanyleigh0212]

You have a pt. with a BMI of 17. What is the first thing the nurse should do?

I forgot the other 2 answers but the ones I remember are

- Talk to pt. about increasing dietary intake.

- Assess pt. daily dietary intake.

This question has made me absolutely FURIOUS! I want to hear what a few people have to say then I'll tell my rationale behind my answer. Thanks!

[Boog'sCRRN246, RN]

Was that the entire question? If so, it's a really crappy one. It doesn't include the patient's height, age, or gender. I mean, generally, an adult with a BMI of 17 is considered underweight, but if they are 5'2 or 5'3, it's boderline between underweight and healthy.

[tiffanyleigh0212]

yes that was the entire question. i chose the assess first, and i was wrong.. all semester long they have been drilling into us ADPIE and now it's apparently wrong? and furthurmore, we don't know the height or weight or anything else so the BMI might not in fact be underweight.. and even if the pt is underweight, you first should know what they're consuming before you automatically talk to the pt about increasing their diet. there are so many people i know who are small, some even considered underweight, but they eat like pigs! i just don't understand it at all and don't think it's fair. the teacher couldn't give us a rationale for it either. if i heard a decent rationale it'd be one thing, but i haven't heard one and can't think of one either

[SRK77]

I was definitely thinking assess before implement. Sounds like the instructor forgot the nursing process. That one should have been thrown out.

[ambirrgrrl]

Why would you talk to them about increasing intake before getting an idea about what they are eating? Makes no sense and that the professor can't back it up is lame. That would really make me mad too. Keep looking in your book, you may find it and get your point back. Good luck!

[Isitpossible, LPN, LVN]

i definitely assess first too!

[tiffanyleigh0212]

Thanks everyone for your input, apparently the entire class gave her crap about it so she said she would accept both answers. Still irritates me though as to why on earth she would think that way though in the first place.

[semester1kid]

i definitely assess first too!

Add me as another who would select this answer:)

[Intern67]

yes that was the entire question. i chose the assess first, and i was wrong.. all semester long they have been drilling into us ADPIE and now it's apparently wrong?

Ask your instructor if Type I diabetics with a BMI of 17 benefit from increasing their dietary intake.

I'm with everyone else, assess first.

Some instructors simply suck at writing good "NCLEX" style questions. Instead of making a goal of writing good questions that test application of knowledge, they pride themselves on writing questions that many people get wrong because there is no good rationale for the correct answer.

Not much can be done about this. I have a theory that the true goal of this type of BS question is grade deflation.

[ghillbert, MSN, NP]

Not only is the "assess" answer correct, the other is INCORRECT. You can't tell someone to increase their food intake if you don't know what they are eating. Maybe they eat a lot but don't absorb it. Maybe they binge eat and then throw up... there are a lot of reasons for underweight and your first intervention would not be to tell them to eat more. Not to mention how it's drilled into everyone's heads in school and NCLEX that the nurse's first action is always assess.