Chapter 19: Nutrition for Patients with Diabetes Mellitus, Chapter 20: Nutrition for Patients with Cardiovascular Disorders, Chapter 21: Nutrition for Patients with Kidney Disorders
The DASH diet emphasizes whole foods versus individual nutrients. The nurse recognizes which of the following is a suggested food for the grains group? A) Enriched grain B) Whole grain C) White rice D) Raw, unprocessed grain
B
The client has prepared some menus based on a 2000-calorie DASH diet. Which of the following dishes show the client understands the diet? Select all that apply. A) 1 chicken leg B) 1 medium-sized apple C) 1/2 cup of tomato juice D) 1 cup of vanilla fat-free ice cream E) 3 tablespoons of peanut butter crackers
B, C
The nurse is caring for a client with uremia that has impacted his nutritional status. The nurse is aware that this individual's appetite tends to be the best at what time of the day? A) Breakfast B) Lunch C) Dinner D) Bedtime
A
The nurse is conducting nutrition teaching with a client who just passed a kidney stone. The client asks what foods he should avoid to decrease his risk for developing more kidney stones. What foods should he be advised to avoid? A) Spinach B) Wine C) Green beans D) Grapefruit juice
A
The nurse is discussing the differences of the DASH diet and traditional Mediterranean diet with a client. The nurse explains the main difference between the two diets is which of the following? A) Amount of fat B) Amount of sodium C) Amount of fish D) Amount of calories
A
The nurse is discussing the different types of groups in the exchange list plan with a newly diagnosed diabetic. The nurse explains that there are three sublists in the fat exchange list. Which of the following would be the reason for the different sublists? A) Type of fat B) Amount of fat C) Amount of cholesterol D) Amount of calories
A
The nurse is discussing the need of some clients with type 2 diabetes to take exogenous insulin. Which of the following would be the correct reason for these clients needing exogenous insulin? A) Lifestyle interventions are not achieving glycemic control. B) The client is not exercising enough. C) The client is not following the caregiver's care plan. D) The client is not eating enough.
A
The nurse is discussing vitamin and minerals and their action in diabetes with the nutrition class. What essential mineral has been studied for its possible role in the prevention and treatment of diabetes? A) Chromium B) Manganese C) Zinc D) Potassium
A
The nurse is discussing with a group of student nurses the various foods that have the potential to provide cardiometabolic benefits. One student asks what can help lower triglyceride levels. The nurse would respond with which of the following? A) Fish B) Milk C) Whole wheat D) Fruit
A
The nurse is working with the client to help him learn the DASH diet to lower his blood pressure. Which nutrient is very effective in lowering blood pressure when someone follows the DASH diet? A) Potassium B) Sodium C) Glucose D) Phosphorus
A
The client is frustrated that she is not losing weight even though she is following the DASH plan. After reviewing her food log, the nurse recognizes which "food" might be the culprit? A) Black coffee B) Sweet iced tea C) Low-fat milk D) Fruit juice
B
The nurse cares for clients who are receiving dialysis. The nurse is aware that the clients can absorb calories from what? A) The dialysate used in hemodialysis B) The dialysate used in peritoneal dialysis C) Potassium exchange resin drugs D) Epogen
B
The nurse emphasizes that nutrition therapy is the basis of treatment for all diabetics in the nutrition class. Which of the following nutrition recommendations for diabetics is true? A) Together, total carbohydrate and monounsaturated fat should provide less than 50% of total calories. B) Glycemic control is dependent on matching carbohydrate intake with the action of insulin or other medication. C) Natural sources of fructose (fruits, vegetables) should be restricted. D) Gram for gram, sucrose cannot replace starch without causing a deleterious effect on glucose levels.
B
The nurse has been working with a client who has CKD. Recent laboratory tests indicate the client's condition is deteriorating and dietary changes need to be implemented. The nurse is preparing to teach the client how to limit his potassium intake. The nurse knows this is based on which of the following serum potassium values? A) Greater than 4 mEq/L B) Greater than 5 mEq/L C) Greater than 6 mEq/L D) Greater than 7 mEq/L
B
The nurse is assessing the pregnant client for the risk of developing gestational diabetes. When should women who are at high risk for gestational diabetes be screened for the disease? A) Between 24 and 28 weeks' gestation B) Before or shortly after conception C) At 36 weeks' gestation D) At about 40 weeks' gestation
B
The nurse is caring for a client taking iron and erythropoietin for the anemia of CKD. What type of iron will this client be receiving? A) Oral B) Intravenous C) Enteral D) Intramuscular
B
The nurse is caring for a renal client on a low-protein diet. The nurse is aware that this client needs to make major adjustments to his diet. What should he be advised regarding eating? A) Eat all the meat allowances early in the day. B) Increase intake of sugar and fat. C) Increase intake of grains and vegetables. D) Eat more vegetable sources of protein.
B
The nurse is caring for an individual with nephrotic syndrome. The client's daily laboratory results have returned from the lab and the nurse finds an elevation in which of the following results concerning? A) Sodium and potassium B) Protein and sodium C) Potassium and cholesterol D) Protein and chloride
B
The client is learning how to plan his meal using the exchange list to maintain a 2000-calorie diet. The client knows that he can choose from a variety of foods as long as he uses the correct number of choices with each meal. Which of the following are correct guidelines for his carbohydrate choices per meal in the 2000-calorie plan? Select all that apply. A) 2 servings from milk group B) 1 serving from the bread, cereal, rice, and pasta group C) 1 serving of fruit D) 3 servings of nonstarchy foods
B, C, D
The nurse is teaching a group of student nurses the importance of knowing the potassium content of foods when helping their clients who have CKD. The students are instructed to list fruits and vegetables according to their content of low-, medium-, and high-potassium. Which ones will the nurse expect to see listed as medium-potassium foods? Select all that apply. A) Brussel sprouts B) Turnips C) Peaches D) Celery E) Mangoes F) Nectarines
B, C, D, E
The client is complaining about his diet. He isn't hungry, nothing tastes good, and he can't have what he wants, are just a few of his complaints. The nurse realizes this client needs encouragement and some suggestions to improve his nutritional status. Which of the following are some suggestions the nurse can make? Select all that apply. A) Limit dairy foods to 1 cup each day. B) Try highly seasoned or strongly flavored foods. C) Add salt at the table, not during cooking. D) Spread protein allowance over the day.
B, D
The client has recently been diagnosed with prehypertensive syndrome. The nurse discusses with the client various lifestyle changes that can help lower the blood pressure. Which of the following are some of those lifestyle changes? Select all that apply. A) Bariatric surgery B) Exercise 150 minutes/week C) Start drug therapy D) Lose weight E) Decrease sodium intake to 2300 g/day
B, D, E
The nurse is helping a client prepare menus to reflect dietary changes the physician has ordered due to the recent diagnosis of CHD. The nurse recognizes whole grains are essential in this diet change. Which of the following components of whole grains have been implicated in providing benefits for clients with CHD? Select all that apply. A) Vitamin K B) B vitamins C) Vitamin C D) Fiber E) Phytochemicals
B, D, E
The nurse is teaching a class on nutrition with a group of clients who need to cut sodium from the diet. Today's topic is learning how to correctly read nutritional labels and recognize sodium. Which of the following are ingredients that might be hiding sodium in various foods that the clients need to be aware of? Select all that apply. A) Casein B) MSG C) Gelatin D) Baking soda E) Food coloring F) Baking powder
B, D, F
The nurse is working with a client who needs to lower his sodium intake, but he doesn't like to cook so he eats out a lot. He has been trying to order wisely; however, the nurse notes he should change which of the following habits? A) Requesting no added salt B) Choosing grilled versus fried C) Choosing fresh fruit for dessert D) Enjoying soup for an appetizer
D
The nursing class has been given the assignment of making a 2000-calorie menu for diabetics based on the carbohydrate counting method. What would be the best choice for a bedtime snack on this diet plan? A) 1 cup of shredded wheat and 1 cup of whole milk B) 1 cup of cubed papaya and a mocha latte C) 1 cup of chocolate ice cream and 1 cup of nonfat milk D) 3 cups of no-fat-added popcorn and 1 cup of nonfat milk
D
The physician has instructed the client to decrease her sodium intake. The client is upset because she's afraid the food will not taste good if she does. Which of the following should the nurse suggest to this client? A) Use garlic salt, onion salt, or celery salt. B) Use smoked meat. C) Use soy substitutes instead of meat. D) Use herbs and spices to flavor the food.
D
When a client is in acute renal injury (ARI), the nurse should closely monitor which of the following laboratory test values? A) Serum sodium B) Blood urea nitrogen C) Complete blood count D) Serum potassium
D
The client's CKD has progressed to the point where the physician has ordered her to limit her potassium intake. When discussing this change with the nurse, she wonders what fruit she can now safely eat. The nurse recommends which of the following fruits? Select all that apply. A) Apricots B) Oranges C) Kiwi D) Plums E) Cranberries F) Pineapple
D, E, F
The client is recovering well after a successful kidney transplant. During a follow-up visit, he mentions he is thirsty a lot and wishes he could drink more. When asked how much he is drinking, he answers 1000 mL plus his urine output. The nurse lets him know that since he is doing so well, he can now advance his fluid intake to which of the following? A) As much as he wants B) 2000 mL plus urine output C) 2000 mL D) 3000 mL
A
The nurse is assessing a client who presents with symptoms that are suspicious for type 2 diabetes. During the discussion of the past medical history, which past diagnosis should the nurse recognize as a potential risk factor? A) Gestational diabetes 7 years ago B) Hypertension C) Yo-yo dieting with weight fluctuations D) A great-grandparent with diabetes
A
The nurse is assessing a new client who is being admitted to the ICU after a motor vehicle accident. The client is in critical condition and on assessment the nurse notes there has been no urine output in the past 2 hours, but he does have active bowel sounds. Which form of nutrition does the nurse expect the client to receive? A) Standard EN formula B) AKI PN formula C) AKI EN formula D) Standard PN formula
A
A 32-year-old female is preparing for discharge from the unit after being treated for a hypertensive crisis. The physician has ordered a 2000-calorie DASH diet. The nurse is helping the client create menus to follow once she goes home. Which of the following is a good menu option for this client? A) 1/2 cup of whole wheat spaghetti, 1 oz meatballs made with lean ground beef, 1/2 cup fat-free spaghetti sauce; 1/2 cup steamed broccoli; 1/2 cup sliced fresh peaches; and 1 cup black coffee B) 3 breaded fried chicken strips, 1 small baked potato with 1 tablespoon each of butter and sour cream, 1 slice of sourdough bread with 1/2 teaspoon of butter and jelly, 1/2 cup of sweet peas, and 1/2 cup of vanilla ice cream C) 1 cup of spilt green pea soup with ham, 6 saltine crackers with American cheese slices, and hot tea with honey D) 4 oz of poached salmon with lemon juice, 1 cup of au gratin potatoes, 3/4 cup of spinach, 1 cup of tossed salad (lettuce, tomatoes, carrots, radishes, crotons, celery, grated cheese, olives) with 2 tablespoons of fat-free dressing, and 2 cups of diet soda
A
The client is a diabetic who has been following the exchange diet plan; however, his renal function appears to be deteriorating. The nurse has suggested he makes a change in exchange group to hopefully improve his proteinuria. Which of the following suggestions did the nurse make? A) Choose more animal source protein over plant source. B) Choose more plant source protein over animal source. C) Eliminate all animal source protein. D) Eliminate all plant source protein.
A
A newly diagnosed diabetic tells the nurse she is using the Exchange Lists for Meal Planning but is having difficulty remembering when a food or beverage is considered to be free. What would be the best response? A) A good guide is the "free food list." B) When the portion size is less than 1 oz C) When it is a nonfat product D) When the client has consumed the recommended number of daily servings from each exchange list
A
An intervention proven to reduce hypertension and increase weight loss is a "heart healthy" diet. What diet besides the DASH diet is recommended as "heart healthy"? A) Mediterranean diet B) Low-calorie, low-potassium diet C) Los Angeles diet D) Metabolic diet
A
Dairy products, beef, pork, poultry, and lamb, eaten so liberally in the American diet, provide the majority of which of the following substances? A) Saturated fat B) Polyunsaturated fat C) Monounsaturated fat D) Omega-3 fat
A
It is widely recognized and accepted that our diets can result in various disorders and diseases. Food is also responsible for many benefits. Some components are specifically known for their cardiometabolic benefits. Which of the following has linked fruits to possible cardiometabolic benefits? A) Antioxidant benefits B) Unsaturated fatty acids C) Sodium D) Omega-3 fatty acids
A
Research has been conducted to determine how various food types affect the body and various conditions. Which of the following food groups has been noted to lower triglyceride levels in human trials? A) Fish oil B) Whole grains C) Nuts D) Vegetable oils
A
The nurse is monitoring a dialysis client whose urine output is 400 mL in 24 hours. The nurse realizes this client is on a fluid restriction. What would the fluid allowance be for this client? A) 1400 mL B) 1900 mL C) 2600 mL D) 4000 mL
A
The nurse is providing nutrition education to a group of new diabetics. Today's topic is learning how to read nutrition labels. The nurse recognizes that more discussion is necessary when one of the participants say which of the following? A) "One cup of any canned food equals one carbohydrate exchange." B) "Some products may count in more than one group." C) "If sugar is the first ingredient, there may be too much sugar in this product." D) "It's important to note the serving size."
A
The nurse is teaching a client with CKD about necessary food changes that he must now make due to the progression of his disease. He needs to limit his potassium now and give up eating which of the following? A) Tomatoes B) Bell peppers C) Corn D) Green beans
A
The nurse is teaching a group of student nurses how to develop menu plans based on a 2000-calorie DASH eating plan. Which of the following menus best demonstrates this plan? A) 1/2 cup of brown rice; 6 oz of steamed salmon; 1/2 cup of steamed green beans; 1 cup of tossed salad with lettuce, carrots, tomatoes, celery, radishes, and onions; 1 tablespoon of fat-free salad dressing; and hot tea B) 3 oz of ground beef patty fried; 1 whole wheat hamburger bun with lettuce leaf, tomato slice, 1 slice of American cheese, 2 tablespoons of mayonnaise and mustard; and 2 cups diet soda C) 1 cup of clam chowder in medium-sized bread bowl, 4 saltine crackers, and 2 cups of skim milk D) 1 slice of pizza with cheddar cheese, pepperoni, mushroom slices, bell pepper, olives, and pizza sauce; and 2 cups of milk
A
The nurse is working with a client who needs to lose weight to try and lower his hypertension. The client wants to focus on individual nutrients and the nurse is trying to encourage him to look at eating whole "real" foods instead. Which of the following explanations can the nurse share with this client concerning this? A) It is likely several aspects of the diet lower blood pressure. B) It is easier to design menu plans. C) Focusing on individual nutrients is more time consuming. D) It enables more use of prepared foods.
A
The nurse needs to clarify information on the nutrition recommendations for managing diabetes when she hears one of the students state which of the following? A) A diabetic needs to keep the amount of carbohydrate at each meal in a given day equal. B) A diabetic needs to keep total calories to weight maintenance levels to prevent weight gain. C) A diabetic needs to adjust per-meal doses of insulin based on amount of carbohydrate to be consumed to control postprandial hyperglycemia. D) A diabetic needs to make sure their carbohydrate intake is consistent with the activities of the day and the amount of insulin taken.
A
The nurse recognizes that sometimes cultural factors will influence food choices. While working with a Mexican American client, which of the following should the nurse encourage the client to change to improve his dietary habits? A) Substitute oil for lard. B) Substitute whole wheat for corn. C) Decrease the amount of lard used. D) Increase the use of vegetables.
A
The nursing students are making a list of interventions for people who need to limit their intake of sodium to 2000 mg/day. What would be an acceptable intervention for this population? A) Limit processed cheese use. B) Limit bread to two slices per day. C) Drink and cook with distilled water. D) Use low-sodium milk.
A
Many diabetics plan their meals from the exchange lists for meal planning. According to the exchange list, a serving of milk may be exchanged for which of the following? Select all that apply. A) Fruit B) Starch C) Other carbohydrates D) Vegetables E) Meat
A, B
The client is learning to make adjustments in his diet due to his progression of CKD. He understands he needs to limit his potassium intake. He is learning he needs to eat certain vegetables. Which of the following vegetables are safe for him to eat? Select all that apply. A) Cabbage B) Lettuce C) Raw onions D) Cooked spinach E) Yams F) Cooked mushrooms
A, B, C
The nurse is teaching a client how to plan a 2000-calorie DASH menu. The nurse asks the client to list several food options. Which of the following can the client list for the nurse? Select all that apply. A) 1/2 cup of brown rice B) 1/2 cup of orange juice C) 1 egg D) 2 teaspoons of soft margarine E) 1 1/2 cups of yogurt F) 1 cup of steamed vegetables
A, B, C
The diabetic class is discussing metabolic syndrome. This can occur with individuals with type 2 diabetes. Which of the following abnormalities make up metabolic syndrome? Select all that apply. A) Hypertension B) Central obesity C) Low triglycerides D) Low high-density lipoprotein (HDL) E) Low low-density lipoprotein (LDL)
A, B, D
The nurse is helping a group of diabetics learn how to use the exchange lists. She asks them to name a food item that represents one carbohydrate choice. Which of the following correctly demonstrates one carbohydrate choice? Select all that apply. A) 1/2 cup of potatoes B) 2 tablespoons of dried apricots C) 1 cup of oatmeal D) 3/4 cup of strawberries E) 1 slice of whole wheat bread F) 1/2 cup of peas
A, B, F
The nurse is doing client education with a newly diagnosed diabetic. One thing the nurse teaches is appropriate initial treatment for a diabetic experiencing hypoglycemia. Which of the following are appropriate initial treatments for hypoglycemia? Select all that apply. A) A regular carbonated beverage B) A chocolate bar C) Life Savers D) Gum drops E) Chocolate cookies
A, C, D
The client is learning the difference of the amounts of potassium in various foods. The nurse suggests several fruit and vegetable choices that are low in potassium to the client. What did the nurse suggest? Select all that apply. A) Eggplant B) Zucchini C) Okra D) Blueberries E) Corn F) Pineapple
A, D, E, F
A "Mediterranean" type diet is higher in fat than is recommended, yet it is felt to be a heart healthy diet by the American Heart Association (AHA) because the major oil in this diet is olive oil. What is the major fat in olive oil, canola oil, and peanut oil? A) Trans fat B) Monounsaturated fat C) Polyunsaturated fat D) Omega-3 fat
B
A 19-year-old college student has come to the college health clinic for information on how to decrease his risk for developing diabetes. He is concerned because he is overweight and he just learned his mother has been diagnosed with type 2 diabetes. The nurse provides him with information and makes several suggestions he can do. Which of the following is one of those suggestions? A) Eliminate fats from his diet B) Consume low-saturated fats C) Exercise an average of 250 minutes/week D) Weight loss of at least 15% within the next 6 months
B
A client has a history of type 2 diabetes and hypertension. His renal function has slowly been deteriorating. The nurse, when reviewing his diet with him, notices his sodium intake may be too high. The nurse reminds him to limit his sodium intake to how much daily? A) 1000 mg/day B) 1500 mg/day C) 2000 mg/day D) 2500 mg/day
B
In the diabetic class on exercise, the nurse stresses that insulin users should test their blood glucose level before exercising. At what blood glucose level would the diabetic need to eat a carbohydrate snack before exercising? A) 70 mg/dL B) 100 mg/dL C) 110 mg/dL D) 130 mg/dL
B
Monounsaturated fat is considered a "heart healthy" fat. Which oil is highest in monounsaturated fat? A) Fish oil B) Olive oil C) Corn oil D) Coconut oil
B
Nutrient recommendations for the intake of fat are the same for diabetics as for people with preexisting cardiovascular disease. What is this recommendation? A) Keep trans fat as high as possible. B) Limit saturated fat to less than 7% of total calories. C) Polyunsaturated fat should provide up to 20% of total calories. D) The level of monounsaturated fat should be the total daily calorie intake.
B
Primary and secondary prevention of diabetes is consistent with the recommendations for the primary and secondary prevention of coronary heart disease. Which of the following are people with diabetes urged to limit their intake of? A) Fiber B) Saturated fat C) Sucrose D) Nonnutritive sweeteners
B
The nurse is conducting client teaching with a dialysis client who is awaiting kidney transplant. The client asks what the difference in his diet will be after he gets his new kidney. What would be the best response for this client? A) You will have to eat more protein but fewer calories each day after you get your new kidney. B) You will have to eat less protein and fewer calories each day after you get your new kidney. C) You will have to eat less protein but more calories each day after you get your new kidney. D) You will have to eat less protein and the same calories each day after you get your new kidney.
B
The nurse is helping a 58-year-old gentleman who was recently admitted to the unit with nephrotic syndrome plan his menu. This gentleman's admission vitals were blood pressure 140/90, height 6 ft 3 in, and weight 200 pounds. His labs revealed proteinuria and hyperlipidemia. He also has 2+ pitting edema. The nurse determines his daily protein intake should be which of the following? (Round to the nearest whole number) A) 54 to 63 g B) 64 to 73 g C) 74 to 83 g D) 84 to 93 g
B
The nurse is teaching a client with CKD to understand the necessary diet changes. The nurse knows that the client understands the teaching when she states which of the following? A) "I need to increase my protein intake." B) "I need to restrict my protein intake." C) "I need to restrict my sodium intake." D) "I need to restrict my potassium intake."
B
The nurse is teaching a group of student nurses about eating correctly to correct and/or prevent hypertension. After the discussion, the students were able to indicate which of the following as effective as drug monotherapy for mild hypertension? A) Low-sodium diet B) Whole foods diet C) Low-calorie diet D) Low-fat diet
B
The nurse is teaching a nutrition class with a group of student nurses. One of the students asks why the meat and meat exchange list is divided into four subgroups. Which of the following is the most appropriate answer? A) It is divided due to protein content. B) It is divided due to fat content. C) It is divided due to cholesterol content. D) It is divided due to minerals content.
B
The nurse is working with a client who has had difficulty maintaining adequate control of his type 2 diabetes. During the course of the conversation, the client mentions that he gets tired of adding up all the calories and forgets to do it sometimes. What suggestion can the nurse make to help this client? A) Download an app to his smartphone from the ADA to help count calories. B) Switch to the exchange list system. C) Concentrate on checking his glucose before each meal. D) Make a daily plan and follow it precisely.
B
A client is discussing changing to a Mediterranean diet from the DASH diet with the nurse. The client has a chronic history of hyperlipidemia, obesity, and hypertension. He has been talking with a friend who has experienced good results with the Mediterranean diet. The nurse recognizes that the Mediterranean diet has been noted in studies to do which of the following? A) Increase the risk of CHD B) Increase the risk of alcoholism C) Shown improvements in MetS components D) Maintain A1C levels
C
Alcohol consumption is encouraged to be limited to no more than one per day for women and two per day for men. How may the moderate consumption of alcohol reduce the risk of heart disease? A) Lowering LDL cholesterol B) Lowering blood pressure C) Reducing platelet aggregation D) Providing vitamin E
C
Children and adolescents with diabetes create unique problems when managing their care. What is the best meal plan for children and adolescents with diabetes? A) High glycemic index B) Carbohydrate counting C) Individualized meal plans D) Exchange lists
C
People with diabetic kidney disease have different protein requirements than someone with nephrotic syndrome. Individuals with nephrotic syndrome are encouraged to eat protein with high biologic value. Which of the following is an example of a protein with high biologic value? A) Peanut butter B) Gelatin C) Eggs D) Kidney beans
C
Recommended daily allowances for diabetics can be different than for the general population. What is the recommended intake of fiber for diabetics? A) Less fiber than currently recommended for the general population B) More fiber than currently recommended for the general population C) The same amount of fiber as currently recommended for the general population D) Most fiber in the form of insoluble fiber
C
Research has shown that as the intake of sodium increases so does the blood pressure. For the possible prevention of hypertension, it is recommended by the American Heart Association (AHA) that all Americans try to reduce their intake of sodium to which of the following? A) 1800 mg B) 2000 mg C) 2300 mg D) 3000 mg
C
The average sodium intake in the American diet is approximately 3900 mg/day. In the average American diet, where does the greatest amount of sodium come from? A) Salt added during cooking B) Salt added at the table C) Salt added to processed foods D) Natural sources of sodium
C
The client overhears the dietitian and the physician talking about the client's nutrient requirements. The client asks the nurse why the "experts" are having so much trouble deciding what the best diet should be. What is the best response? A) "You have a disease process that creates unique nutritional problems in your body. We haven't gotten the diet exactly right yet." B) "Even ëexperts' can disagree from time-to-time." C) "Clients in acute renal injury, like you, cannot use protein or calories efficiently. It is difficult to adjust your intake of these nutrients to meet your nutritional goals." D) "You are breaking down parts of your body to use as energy because right now your body isn't able to optimally use the calories and protein you are eating."
C
The nurse asks a student in the nutrition class to give an example of a medium-fat meat and meat substitute group food. Which of the following is the best response? A) 1 oz of cottage cheese B) 1 tablespoon of peanut butter C) 1 egg D) 1 small hot dog
C
The nurse has given a group of students the assignment of making a DASH menu based on 2000 heart healthy calories. What would be the best lunch on this diet? A) Cheese sandwich, 1 tablespoon of mayonnaise, 6-inch Italian roll, 1 large leaf of iceberg lettuce, 2 slices of tomato, low-sodium potato salad, and 1 medium apple B) Ham sandwich with 2 oz of low-sodium ham, 1 teaspoon of Dijon mustard, 1 slice of cheddar cheese, 6-inch Italian roll, large leaf of iceberg lettuce, 2 slices of tomato, low-sodium potato salad, and 1 medium peach C) Beef sandwich with 2 oz of low-sodium beef; 1 tablespoon of Dijon mustard; 2 slices of reduced fat cheddar cheese; sesame roll; 1 large leaf of romaine lettuce; 2 slices of tomato; 1 cup of low-fat, low-sodium potato salad; and 1 medium orange D) 1 low-fat grilled cheese sandwich on white bread, 1 large leaf of iceberg lettuce, 2 slices of tomato, 1 tablespoon of original ranch dressing, 1 individual package of corn chips, and 1 medium orange
C
The nurse is assessing a new client who is being evaluated for coronary heart disease. After reviewing his dietary habits, the nurse notes which of the following as a possible contributing factor to this client's condition? A) Monounsaturated fatty acids B) Saturated fatty acids C) Trans fatty acids D) Polyunsaturated fatty acids
C
The nurse is caring for a client who has a diagnosis of renal calculi. The client asks what he can do to keep from forming more calculi. What foods would the nurse tell him to avoid for oxalate-based calculi? A) Chocolate, strawberries, and wine B) Rhubarb, green beans, and tomatoes C) Beets, rhubarb, and tea D) Instant coffee, oranges, and potatoes
C
The nurse is caring for a client with chronic, well-controlled diabetes who is post-op for a knee replacement. The client is confused by the menu choices as he has been following the ADA diet. What diet has replaced the traditional standard "ADA diet" for hospitalized clients with diabetes? A) Carbohydrate counting diet B) Exchange lists for meals diet C) Consistent carbohydrate diet D) High glycemic index diet
C
The nurse is conducting a support group with clients who have CKD. Today's topic is concerning the various types of protein and the reasons for consuming one over the other. The nurse discusses the rationale for using high biologic proteins instead of low biologic proteins is related to which of the following reasons? A) Contain less nitrogen and therefore minimize urea production B) Contain more fat and therefore more calories to minimize body protein catabolism C) Promote reuse of circulating nonessential amino acids for protein synthesis and therefore minimize urea production D) Are the only type of protein used for protein synthesis
C
The nurse is helping the client make necessary adjustments to his diet due to his advancing CKD. The client needs to limit his potassium intake but he is having difficulties because he loves to eat fruit. Which of the following does the nurse suggest he avoid? A) Apples B) Watermelon C) Raisins D) Peaches
C
The nurse is meeting with a client who has CKD. The client has been trying to follow the prescribed diet but finds it very restrictive, and she feels punished that she cannot occasionally have some of her favorite foods. As she sits and cries complaining that she never feels good anymore and she just doesn't want to deal with it anymore, the nurse notes she may be more malnourished. Which of the following can the nurse suggest that might prove beneficial? A) Suggest she meets with a family member to talk about her frustrations. B) Give her permission to ignore the diet restrictions one day a week. C) Suggest taking a specially formulated vitamin supplement. D) Readjust her diet to include one of her favorite foods.
C
The nurse is reviewing the food log with a client. The nurse is concerned because the client's blood pressure is elevated. Which item on the log may be contributing to the elevated blood pressure? A) Watermelon B) Regular salad dressing C) Hot dogs D) Pork and beans
C
The nurse is teaching a class of newly diagnosed adolescent diabetics. The topic for tonight is hypoglycemia. The nurse asks one young man to name one thing that can cause hypoglycemia in an insulin-dependent diabetic. Which of the following would be an acceptable answer? A) Acute illness B) Stress C) Delaying meal time D) Too much food
C
Type 1 diabetics who are well-controlled can consume alcohol without adversely affecting their blood glucose, if they drink in moderation and drink with meals instead of between meals. Why are they advised to drink with meals? A) They are less likely to consume too much alcohol when it is taken with meals. B) It aids in the digestion of food when consumed at the same time. C) It increases the risk of hypoglycemia when consumed between meals. D) Taken with meals, it tends to cause people to eat less.
C
Acute episodes of illness can create problems for insulin-dependent diabetics. During these periods of acute illness, what should insulin-dependent diabetics do? A) Insulin-dependent diabetics should not take insulin. B) Insulin-dependent diabetics should not eat. C) Insulin-dependent diabetics should use regular sweetened carbonated beverages, gelatin, ice cream, and popsicles to consume the exact amount of carbohydrate normally allowed. D) Insulin-dependent diabetics should use regular sweetened carbonated beverages, gelatin, ice cream, and popsicles to consume between 45 and 50 g of carbohydrates every 3 to 4 hours.
D
Hypertension is one of the most common conditions in the United States. It is estimated that just over half the adults in the U.S. have either prehypertension or hypertension making it a serious medical condition. What is the initial treatment for stage 1 hypertension? A) Exercise B) Antihypertensives C) Vitamin supplements D) Diet
D
One of the strategies for reducing the risk of cardiovascular disease is to increase high-density lipoprotein (HDL) cholesterol. What is the best way of increasing HDL? A) Reducing saturated fat intake B) Reducing cholesterol intake C) Increasing dietary fiber intake D) Losing weight, if overweight
D
The AHA has recommended limiting sodium intake to 2300 mg/day. Which of the following foods is the best choice for the client on a restricted-sodium diet? A) 2 large graham cracker rectangles B) 1 corn bread muffin C) 2 slices of reduced fat cheese D) 1 teaspoon of soft margarine
D
The cause of the long-term complications of diabetes is poorly understood. What is known are interventions that can significantly lower the incidence of these long term complications. Which of the following is one of these interventions? A) Controlling blood lipid level, carbohydrate intake, and blood glucose level B) Controlling protein intake, blood pressure, and blood lipid level C) Controlling blood glucose levels, triglyceride level, and weight D) Controlling blood glucose levels, blood pressure, and blood lipid level
D
The client has recently started on hemodialysis after a long history of type 2 diabetes and a gradual deterioration of her renal function. She mentions that she is tired of always feeling thirsty. The nurse makes a few suggestions for her to try. Which of the following is one of those suggestions? A) Eat ice chips when feeling thirsty. B) Rinse her mouth with hot liquids. C) Eat frozen fruit juice. D) Rinse her mouth with ice cold water.
D
The client is a 19-year-old female who appears to be in a prediabetic stage. Anxious to lose weight, she wants to know which diet other diabetics follow to help her lose weight. Which of the following should the nurse recommend? A) 1200-calorie MyPlate plan B) 1400-calorie Exchange Lists plan C) Low-fat, low-carbohydrate diet D) Individualized to each individual
D
The client is status post a recent kidney transplant and is progressing well with healing, kidney function, and diet. During a follow-up visit, the nurse lets him know that he can increase his potassium intake to which of the following? A) 2 to 3 g/day B) 3 to 4 g/day C) 4 to 5 g/day D) Unrestricted
D
The clinic nurse is caring for a diabetic client who has frequent episodes of hypoglycemia. What would be the best intervention for this client? A) Encourage the client to gain weight. B) Encourage the client to eat three large meals per day. C) Counsel the client to limit total carbohydrate intake to less than 100 g/day. D) Counsel the client to encourage better compliance.
D
The diet recommendations for the treatment and prevention of all renal calculi are not effective when used alone. What is the most effective dietary intervention for renal stones? A) Altering urinary pH through an acid or a basic ash diet B) Restricting the intake of the offending substance C) Losing weight, if overweight D) Increasing fluid intake
D
The nurse has been teaching a client with type 2 diabetes menu planning using the exchange list based on a 2000-calorie diet. The nurse asked the client to plan several dinner menus. Which of the following menus demonstrates the client's understanding of the exchange diet? A) 1 cup of spaghetti noodles, 4 meatballs, 1/2 cup of spaghetti sauce; coleslaw, 1 slice of buttered garlic bread, and 1 cup of milk B) 4 oz of broiled hamburger patty, 1 cup of mashed potatoes with butter, 1 cup of green beans, and 1 cup of low-fat vanilla ice cream C) 1 1/2 cups of chicken noodle soup (1/2 cup of chicken breast, 1 cup of egg noodles, chopped carrots, onions, celery, and broth), 1 oz of saltine crackers, 1 cup of hot tea with 1 teaspoon of honey D) 1 taco shell, 3 oz of taco meat; 1 1/2 cups combined chopped lettuce, tomato, onion; 1/3 cup of rice; and 1 cup of papaya
D
The nurse is assessing a new client to the unit who is admitted for kidney stones. When asked about over-the-counter drugs, herbs, and supplement use, the client mentions that she does take several supplements. The nurse recognizes which of the following supplements may be contributing to the kidney stones? A) Coenzyme 10 B) Vitamin D C) B vitamins D) Vitamin C
D
The nurse is caring for a 21-year-old female with type 1 diabetes who is on a 2000-calorie diet. The nurse knows the client understands the diabetic teaching when she states, "I need four carbohydrate choices at breakfast." Which of the following menus indicates her understanding? A) 3/4 cup of low-fat granola, 8 oz of plain yogurt, coffee, and 2 cups of orange juice B) 1 cup of orange juice, 1 waffle topped with 1/2 cup of blueberries, and coffee C) A parfait consisting of 1 1/4 cups of strawberries, 1/2 cup of low-fat granola, 6 oz of plain yogurt, and black coffee D) Black coffee, 1/2 cup of orange juice, 1 low-fat waffle topped with 3/4 cup of blueberries, and 1 teaspoon of light margarine
D
The nurse is caring for a 71-year-old female with heart failure who is on a 1800 mg/day sodium-restricted diet. The nurse knows the client understands the nutrition teaching when she states, "I need to restrict my intake of sodium so I will choose a breakfast of . . . " which of the following? A) 1/2 cup of low-fat granola, 6 oz of plain yogurt, coffee, and 1 cup of orange juice B) 1 cup of orange juice, 1 waffle topped with 3/4 cup of blueberries, and coffee C) A parfait consisting of 1 1/4 cups of strawberries, 1/2 cup of low-fat granola, 6 oz of plain yogurt, and black coffee D) 2 cups puffed-wheat cereal; 1 slice of whole wheat bread; 1 medium banana; 1 cup of nonfat milk; 1 cup of orange juice; and 1 teaspoon of soft, unsalted margarine
D
The nurse is helping a new client on the unit who was admitted with CKD. The client is also a long time type 2 diabetic. He has recently been experiencing nausea, vomiting, and anorexia. His lab workup reveals he is malnourished. The nurse recognizes his malnourishment is likely related to which of the following? A) Dehydration B) Anuria C) Recurrent UTI's D) Increasing urinary excretion
D
The nurse is teaching a nutrition class and knows the students understand the content of the lecture on nutrition and diabetes when a student is heard to say, "Nutrition therapy is the cornerstone of treatment for" which of the following? A) Pregnant diabetics B) Type 1 diabetics C) Type 2 diabetics D) All diabetics
D
The nurse is teaching a nutrition class for nursing students. The discussion for today is about nutrition therapy for nephrotic syndrome. The goal of nutrition therapy is to reduce proteinuria and possibly slow the progression of kidney disease. According to recent studies, what is the suggested way to do this? A) Low biologic value protein always works best in clients with kidney disease. B) There is no difference among proteins as long as the client gets enough of them. C) Use biologic value protein in the client's diet. D) Use soy protein in the client's diet.
D
The nurse is teaching a nutrition class for nursing students. The topic for today is nutrition therapy for diabetic older adults. What is the most important factor impacting glycemic control in adults? A) People naturally lose weight as they age. B) Older adults eat less sugar than younger adults. C) Older adults metabolize carbohydrates differently than younger adults. D) Serum blood sugar levels rise with age.
D
The nurse is teaching clients who are on protein-restricted diets. What should the nurse teach these clients to do? A) Eat all the protein in one meal. B) Take protein supplements as needed. C) Cook all the protein in the microwave. D) Spread the protein out over the whole day.
D
