Nutrition

A nurse is providing dietary instructions to a client with tuberculosis. The nurse would specifically instruct the client to increase intake of which of the following food items in the daily diet?

Answer: Meats and Citrus Fruits Rationale: The nurse teaches the client with tuberculosis to increase intake of protein, iron, and vitamin C. Food sources that are rich in protein include meats and legumes. Food rich in iron include liver and other meats, from which 10% to 30% of available iron is absorbed. Foods rich in vitamin C include citrus fruits, berries, melons, pineapple, broccoli, cabbage, green peppers, tomatoes, potatoes, chard, kale, asparagus, and turnip greens. Less than 10% of iron is absorbed from eggs, and less than 5% is absorbed from grains and vegetables.

A nurse reviews a client's serum sodium level and notes that the level is 150 mEq/L. The health care provider prescribes dietary instructions for the client based on the sodium level. Which of the following food items will the nurse instruct the client to avoid?

Answer: Processed oat cereals Rationale: A serum sodium level of 150 mEq/L is indicative of hypernatremia. Based on this finding, the nurse would instruct the client to avoid foods high in sodium. Spinach and molasses are good food sources of calcium. Squash is high in phosphorus

A nurse instructs a client to increase the amount of riboflavin in the diet. The nurse tells the client to select which food item that is high in riboflavin?

Answer: Milk Rationale: Food sources of riboflavin include milk, lean meats, fish, and grains.

The nurse evaluates that further teaching is required on bowel elimination when the client states which of the following?

Answer: "I need to decrease fiber in my diet." Rationale: Adequate dietary fiber is an important factor for improving bowel function. Dietary fiber increases fecal weight and water content and accelerates the transit of the fecal mass through the gastrointestinal (GI) tract.

A nurse is instructing a client on how to decrease the intake of potassium in the diet. The nurse tells the client that which food contains the least amount of potassium?

Answer: Lettuce Rationale: Lettuce contains less than 100 mg of potassium

A nurse has completed diet teaching for a client who has been prescribed a low-sodium diet to treat hypertension. The nurse determines that further teaching is necessary when the client makes which of these statements?

Answer: "Fresh foods such as fruits and vegetables are high in sodium." Rationale: A low-sodium diet is used as an adjunct to antihypertensive medications for the treatment of hypertension. Sodium retains fluid, which leads to hypertension secondary to increased fluid volume. Fresh foods such as fruits and vegetables are low in sodium.

A nurse is instructing a client regarding how to decrease the intake of phosphorus in the diet. The nurse tells the client that which food item contains the least amount of phosphorus?

Answer: Oranges Rationale: An orange contains the least amount of phosphorus. Foods high in phosphorus include fish, pork, beef, chicken, organ meats, nuts, whole-grain breads, and cereals.

A nurse needs to increase the calcium in the diet of a client who is lactose intolerant. Which food items should the nurse encourage? Select all that apply. T

Tofu Broccoli Sardines Mustard Green Rationale: Therefore these clients need high-calcium foods from nondairy sources. Tofu, broccoli, mustard greens, and sardines are foods that are high in calcium that do not come from dairy sources.

A client with heart disease is instructed regarding a low-fat diet. The nurse determines that the client understands the diet if the client states that a food item to avoid is:

Answer: Cheese Rationale: Fruits, vegetables, and skim milk contain minimal amounts of fat. Cheese is high in fat.

A low-sodium diet has been prescribed for a client with hypertension. Which of the following foods, if selected from the menu by the client, would indicate an understanding of this diet?

Answer: Baked turkey

A client states that he has removed all dairy foods from his diet because he is lactose intolerant. The nurse plans care for the client, knowing that:

ANSWER: Calcium and protein are valuable nutrients and need to be supplemented in some form. Rationale: Calcium and protein need to be supplemented in some form in the diet of the client with lactose intolerance.

A client in a long-term care facility is being prepared to be discharged to home in 2 days. The client has been eating a regular diet for a week, yet is still receiving intermittent enteral tube feedings and will need to receive these feedings at home. The client states concern about not being able to continue the tube feedings at home. Which of the following nursing responses would be appropriate at this time?

Answer: "Tell me more about your concerns with your feedings after going home." Rationale: This client has a fear about not being able to care for himself at home and not being able to handle the tube feedings at home. An open communication statement such as, "Tell me more about..." often leads to valuable information about the client and the client's concerns.

A caregiver states that the client eats only about 25% of the food that is offered and seems to be losing weight. The caregiver asks the nurse about feeding the client by a tube into the stomach. The initial response by the nurse would be:

Answer: "Tube feedings can provide adequate amounts of required nutrients." Rationale: Weight loss and a dietary intake of only 25% indicate that alternative sources of nutritional intake should be sought. Tube feeding is an alternative for temporary or permanent nutritional maintenance. Enteral tube feedings are generally safer and significantly less costly than peripheral or parenteral nutrition.

A client has a serum sodium level of 151 mEq/L, and the nurse conducts dietary teaching about the types of foods to avoid. The nurse determines that the client needs further information if the client later states that which is a good food choice?

Answer: American cheese Rationale: The client's laboratory value reflects hypernatremia because the normal serum sodium level is 135 to 145 mEq/L.

A nurse instructs a client at risk for hypokalemia about the foods high in potassium that should be included in the daily diet. The nurse tells the client that which food provides the least amount of potassium?

Answer: Apple Rationale: An apple provides approximately 3 mEq of potassium per serving

A client has acute diverticulitis. Which principle should the nurse keep in mind while planning care for this client?

Answer: Avoid High-Fiber Foods Rationale: Diet therapy for acute diverticulitis involves allowing the bowel to rest by avoiding high-fiber foods.

A postoperative client has been placed on a clear liquid diet. Choose the items that the client is allowed to consume on this diet. Select all that apply.

Answer: Broth Coffee Gelatin Rationale: A clear liquid diet consists of foods that are relatively transparent to light and are clear and liquid at room and body temperature. These foods include water, bouillon, clear broth, carbonated beverages, gelatin, hard candy, lemonade, Popsicles, and regular or decaffeinated coffee or tea.

A clear liquid diet has been prescribed for a client with gastroenteritis. Which item would be the most appropriate to offer to the client?

Answer: Fat-free broth Rationale: A clear liquid diet consists of foods that are relatively transparent.

A nurse instructs a client at risk for hypokalemia about the foods high in potassium that should be included in the daily diet. The nurse determines that the client needs further instruction if the client states that which food is high in potassium?

Answer: Eggs Rationale: One large egg provides 66 mg of potassium. One-half cup of raisins contains 700 mg of potassium. Four ounces of beef contains 420 mg, and 4 ounces of pork contains 525 mg of potassium.

A nurse is providing dietary instructions to a client with a diagnosis of ulcerative colitis. Which of the following foods should the nurse instruct the client to avoid?

Answer: Fresh Corn on the cob

A nurse caring for a client with a neurological disorder is assisting in planning care to maintain nutritional status. The nurse is concerned about the client's swallowing ability. The nurse avoids including which food item in this client's diet?

Answer: Spinach Rationale: Raw vegetables, chunky vegetables such as diced beets, and stringy vegetables such as spinach, corn, and peas are foods commonly excluded from the diet of a client who has difficulty swallowing.

A client is a lacto vegetarian. Which food item would the nurse remove from the tray?

Answer: Eggs Rationale: Eggs are not consumed by lacto vegetarians

A client who is receiving parenteral nutrition may begin to take small amounts of clear liquids today. The nurse's priority is to collect data regarding which of the following before giving the client anything by mouth?

Answer: The presence of the swallow reflex Rationale: The nurse ensures that the client has intact gag and swallow reflexes before giving clear liquids. The nurse would also check for the presence of bowel sounds.

A nurse is teaching a client about complete/high quality protein foods. Which food choice would indicate the client understood the teaching?

Answer: Egg Rationale: Complete/high-quality proteins are found in a variety of meats and dairy products, specifically eggs. Beans are incomplete/low-quality proteins as are some cereals. Oranges contain vitamins and minerals.

A nurse is asked to assist with preparing a client who will be receiving a parenteral nutrition (PN) solution via a central line. The nurse plans to obtain which essential piece of equipment for this procedure?

Answer: Electronic infusion pump Rationale: The nurse obtains an electronic infusion pump in preparation for the administration of PN. It is necessary to use an infusion pump to ensure that the solution does not infuse too rapidly or fall too far behind.

A client is admitted to a long-term care facility with the diagnosis of weight loss secondary to anorexia. The health care provider inserts a nasogastric tube and prescribes a tube feeding of a standard formula feeding to run at 50 mL/hr. The nurse plans care, knowing that which of the following is true regarding enteral feedings?

Answer: Enteral feedings require the normal digestive capabilities of the gastrointestinal (GI) tract. Rationale: Enteral nutrition can include providing nutrients by mouth, nasogastric tube, gastrostomy tubes, or percutaneous endoscopic gastrostomy (PEG) tube.

An older postoperative client has been tolerating a full liquid diet, and the nurse plans to advance the diet to solid food as prescribed. The nurse collects data regarding which important item before advancing the diet to solids?

Answer: Fever and pruritic urticaria Answer: signs and symptoms of fat overload include fever, leukocytosis, hyperlipidemia, pruritic urticaria, and possibly focal seizures.

A client is having problems with blood clotting. Which food item would the nurse encourage the client to eat?

Answer: Green, leafy vegetables Rationale: Green, leafy vegetables are high in vitamin K, which acts as a catalyst for facilitating blood-clotting factors.

A nurse provides dietary instructions to a client at risk for hypokalemia about the foods high in potassium that should be included in the daily diet. The nurse tells the client that the fruit highest in potassium is:

Answer: Kiwifruit Rationale: Foods that are high in potassium include bananas, cantaloupe, kiwifruit, and oranges

A client who has recently been started on enteral feedings begins to complain of abdominal cramping, followed by passage of two liquid stools. A nurse notes that the client has abdominal distention as well. The nurse reviews the nutritional content on the label of the can to see if it contains which of the following ingredients?

Answer: Lactose Rationale: Several tube feeding formulas contain lactose. A client with an unreported history of lactose intolerance would develop symptoms such as these in response to nutritional therapy with these formulas. If the client is diagnosed as lactose intolerant, a lactose-free formula should be prescribed by the health care provider. This will resolve the client's symptoms and promote adequate nutrition for the client.

A client has a diagnosis of hyperphosphatemia. The nurse teaches the client to eliminate which of the following from the diet?

Answer: Fish Rationale: Foods naturally high in phosphates should be avoided by the client with hyperphosphatemia. These include fish, eggs, milk products, vegetables, whole grains, and carbonated beverages.

A newly pregnant client is asking how to prevent neural-tube birth defects. What food choice should the nurse recommend?

Answer: Grapefruit Rationale: Folic acid (folate) helps prevent neural-tube birth defects; it is found in green, leafy vegetables; liver, beef, and fish; legumes; and grapefruit and oranges.

A nurse is instructing a client on how to decrease the intake of magnesium in the diet. The nurse tells the client that which food item contains the least amount of magnesium?

Answer: Proceed Drinking water Rationale: Drinking water that has been processed through a water softener is low in magnesium.

A nurse is preparing to administer an intermittent tube feeding to a client. The nurse aspirates 90 mL of residual tube feeding. What should the nurse do with the aspirated feeding?

Answer: Re-instill the residual and administer the feeding. Rationale: It is important to return the contents to the stomach to prevent electrolyte imbalances.

A nurse is providing dietary instructions to a client with gout. The nurse tells the client to avoid which food item?

Answer: Scallops Rationale: Scallops should be omitted from the diet of a client who has gout because of the high purine content.

A nurse is developing a nutritional plan for an assigned client. Which of the following is the most critical piece of data to collect before formulating the plan?

Answer: The presence of food allergies Rationale: The presence of food allergies is critical to know before developing a nutritional plan.

A client has been diagnosed with pernicious anemia. In planning care for the client, the nurse anticipates that the client will be treated with:

Answer: Vitamin B12 Treatment consists of monthly injections of vitamin B12.

A client with a burn injury is transferred to the nursing unit, and a regular diet has been prescribed. The nurse encourages the client to eat which dietary items to promote wound healing?

Answer: Chicken breast, broccoli, strawberries, and milk Rationale: Protein and vitamin C are necessary for wound healing.