Chp 18: Digestion & Nutrition

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A client has been asked to keep a food journal to address ongoing issues with constipation. The client brings the journal to a follow-up appointment. When reviewing the journal, the nurse notes that the client has a bagel and coffee for breakfast, macaroni and cheese for lunch, and soup and salad for supper during a typical 24-hour period. Which dietary change would the nurse most likely suggest?

"Gradually increase the amount of fiber in your daily diet."

A nurse assesses older adults at a senior center. One older adult, age 78, has a body mass index (BMI) of 15. Which response by the nurse is appropriate?

"Have you been losing weight?"

A nurse teaches older adults about nutrition. Which of the following statements shows the nurse that the older adult requires further teaching?

"My over-the-counter beta-carotene pill is appropriate for long-term use."

A nurse counsels an older adult regarding nutritional requirements. Which of the following teaching points is priority when discussing age-related changes in nutritional requirements?

"Overall, you don't need to take in as many calories as you used to."

An older adult states, "I just feel so full so fast, I can't eat any more." Which of the following responses is most appropriate?

"Slower emptying of your stomach may be the cause."

An older adult client reports that he often experiences "indigestion" after each fatty foods. He states that this never used to happen to him when he was younger and asks the nurse why this is now the case. What is the nurse's best response?

"With age, reduced pancreatic secretions can affect the digestion of fatty foods."

A nurse teaches an older adult about changes to nutritional requirements. Which of the following meal choices would give evidence that the older adult understands the teaching?

Baked chicken, carrots, and angel food cake

During a home visit, the nurse notes that an older adult client has a tray of many types of vitamins, minerals, and herbal supplements on the kitchen counter. The client was recently discharged from the hospital after having an acute myocardial infarction. Which instruction would be most appropriate for the nurse to make about the client's supplements?

Check with the health care provider to identify any supplements that may produce adverse interactions with prescribed medication

A health-conscious resident of an assisted living facility is promoting the value of fiber to a fellow resident. In addition to improving bowel activity, which additional benefit would be most appropriate for the health-conscious resident to cite?

Decreased serum cholesterol

After reviewing a client's list of medications the nurse asks if the client ever experiences a dry mouth. Which medication on the list caused the nurse to ask the client this question?

Diuretic

A nurse at a rehabilitation unit assesses an 86-year-old woman with a BMI of 30 and a history of heart failure, whose oral intake is declining. Which of the following risk factors is related to this older adult's decline in appetite?

Diuretics

A nurse plans care for a client who states that food is no longer appealing. The nurse notes a dry mouth and teeth in poor condition. Which interventions should the nurse include in the plan of care? (Select all that apply.)

Eight-ounce bottle of water between each meal Oral care before each meal

A 70-year-old client with urosepsis is admitted to a nursing unit. The labs include elevated sodium, blood urea nitrogen, hematocrit, and albumin. Which of the following nursing diagnoses is priority for this client?

Fluid volume deficit

A nurse teaches a health education class for older adults about constipation. Which of the following points should the nurse stress?

If older adults need a medication to promote bowel regularity, a bulk-forming agent is needed daily.

A nurse admits a 90-year-old client to the hospital with a diagnosis of failure to thrive. Which of the following laboratory data should the nurse expect?

Low albumin and red blood cells (anemia, malnutrition)

A nurse assesses an older adult in the assisted living facility who has presbyphagia. Which of the following systems should the nurse auscultate?

Lung sounds (swallowing difficulties, aspiration)

A nurse manager of the long-term care facility develops plans to reduce nutritional deficits. Which of the following interventions is appropriate to include in the plan?

Promote oral care for residents multiple times each day.

A nurse plans the diet for an older adult with congestive heart failure. Which of these nursing interventions would be most successful to encourage optimal nutrition?

Provide 55% of calories from complex carbohydrates.

An older adult develops diarrhea. Which of the following is the priority intervention for the nurse?

Review the client's medication list.

An 88-year-old client is prone to chronic constipation and ask the nurse why. The nurse should explain what age-related physiological change?

Slow peristalsis

The nurse observes the unlicensed assistive personnel provide mouth care to an older client. For which observation should the nurse intervene?

Swabbed the lower back molars with lemon-glycerin swabs

A nurse evaluates the plan of care for a client who experienced an ischemic stroke. Which of the following assessment findings should signal the nurse to the possibility that the client has developed dysphagia?

The client pockets food in the affected cheek during meals.

A nurse working for human services visits a long-term care facility. Which resident assessment finding indicates poor quality care?

Unintentional weight loss

The nurse suspects that an older adult's diarrhea is related to medications. Which medication should the nurse consider as causing this client's problem?

ampicillin

The nurse is concerned that an older adult client is experiencing undiagnosed malnutrition. What information may cause the nurse to make this clinical determination?

serum albumin level 2.8 g/dL (28 g/L)

An older client has esophageal dysphagia. What intervention should the nurse plan for this client?

thicken liquids


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