Nutrition EAQs

A client, admitted with full-thickness burns 2 weeks ago, has lost an average of 1 lb (0.5 kg) of weight each day. Which dietary adjustment would the nurse recommend? A. Increase low-sodium milk intake B. Provide high-protein drinks C. Increase foods that are low in potassium D. Provide 10% more calories in the form of fats

B. High-protein drinks have twice the calories per volume of other fluids and provide protein for wound healing. Low-sodium milk does not contain adequate calories to help meet the high metabolic rate associated with burns. Potassium is restricted during the first 48-72 hours after a burn injury, not 2 weeks after the injury. Increased calories in the form of protein and carbohydrates, not fats, are needed.

By which process would total parenteral nutrition (TPN) on an outpatient basis help a client with Crohn's disease prepare for surgery? A. Decreasing fecal bulk B. Preventing bowel infection C. Providing stimulation of secretions D. Maintaining negative nitrogen balance

A. By decreasing fecal bulk and bowel stimulation, TPN provides rest for the bowel while the client awaits surgery. TPN does not prevent a bowel infection. TPN does not stimulate gastrointestinal secretions. TPN promotes positive nitrogen balance.

Which medication is derived from a natural source and may be prescribed for the treatment of osteoporosis? A. Calcitonin B. Raloxifene C. Clomiphene D. Bisphosphonates

A. Calcitonin is derived from natural sources such as fish; this medication may be prescribed to prevent osteoporosis. Raloxifene is prescribed to prevent postmenopausal osteoporosis. Clomiphene is prescribed to induce ovulation. Bisphosphonates are prescribed to treat osteoporosis; this medication is not derived from natural sources.

Which action would the nurse take after contacting the primary health care provider of a post-surgical client complaining of nausea, fatigue, and a headache during the fourth hour of the infusion of total parenteral nutrition (TPN) instituted via a central venous infusion who has an hourly urine output that is twice the amount of the previous hour? A. Check the serum glucose level B. Obtain an oxygen saturation level C. Administer a prescribed analgesic D. Elevate the head of the bed

A. Rapid administration of glucose can cause glucose overload, leading to osmotic diuresis and dehydration. There is no indication of hypoxia. The client's headache should disappear with oral fluid replacement; analgesics are not indicated. There is no reason to elevate the head of the bed.

Which information will the nurse include when providing education to the family of an adolescent who was recently diagnosed with type 2 diabetes mellitus? A. "Your teen will need insulin injections for the rest of her life." B. "The most important interventions are good nutrition and portion control." C. "This is a condition where the body produces antibodies against its own cells." D. "This condition causes weight loss and increased appetite, thirst, and urination."

B. Most children with type 2 diabetes are overweight or at risk for becoming overweight. With nutritional intervention to promote proper weight, the condition may often be managed with diet and exercise alone. A lifelong insulin regimen, the production of antibodies against the child's own cells, and weight loss with increased appetite, thirst, and urination are all typical of type 1 diabetes.

Thick mucous gland secretions, elevated sweat electrolytes, meconium ileus, and difficulty maintaining and gaining weight are associated with autosomal recessive disorder? A. Cerebral palsy B. Cystic fibrosis C. Muscular dystrophy D. Multiple sclerosis

B. The early symptom of cystic fibrosis is meconium ileus (impacted stool in newborns). Thick mucous secretions, salty sweat, and difficulty gaining weight because of high caloric demands are characteristics of the condition. Cerebral palsy is a motor disorder caused by damage to the brain. Muscular dystrophy is a muscular disorder. Multiple sclerosis is a condition with progressive disintegration of the myelin sheath.

When teaching an adolescent with type 1 diabetes about dietary management, which instruction would the nurse include? A. Meals should be eaten at home B. Foods should be weighed on a gram scale C. A ready source of glucose should be available D. Specific foods should be cooked for the adolescent

C. An adolescent with type 1 diabetes must carry a source of simple sugar (glucose tablets, Insta-Glucose, sugar containing candy - Lifesavers) to rapidly counteract the effects of hypoglycemia. This should be followed by a complex carbohydrate and a protein. Stating that meals should be eaten at home is an unrealistic and unnatural instruction for an adolescent. Stating that foods should be weighted on a gram scale is an unnecessary and time-consuming procedure. The adolescent should be made to feel a part of the family; the recommended diet is nutritious and no different from that of the rest of the family.

Which recommendation would the nurse give when teaching a class about nutrition to a group of adolescents, taking into consideration the prevalence of overweight teenagers? A. "Join a gym." B. "Drink fewer diet sodas." C. "Decrease fast-food intake." D. "Take a multivitamin daily."

C. Eating a variety of healthful foods instead of fast-food diet that is high in fat and carbohydrates helps decrease excess weight and increase energy with which to engage in physical activities. Joining a gym is expensive and unnecessary. Physical activity can be achieved in the schoolyard or at home. Diet soft drinks do not contribute to obesity. A multivitamin will not promote weight loss. Vitamins and minerals are best obtained in a balanced diet.

Which condition would the nurse identify as the likely cause of profound weakness and nervousness in a client that became confused shortly after self-administering the morning dose of 10 units of regular insulin and 25 units of NPH insulin after a light breakfast with no additional intake in the 3 hours since that time? A. Hyperglycemia B. Hyperinsulinemia C. Hypoglycemia D. Hypoinsulinemia

C. Severe hypoglycemia is a finding in diabetic clients who take insulin and miss a meal. Signs and symptoms of hypoglycemia are nervousness, weakness, confusion, and disorientation. Hyperglycemia is rare in clients who are on insulin therapy and decrease their intake. Hyperinsulinemia is a condition where an excess of insulin is produced by the pancreas in response to conditions such as insulin resistance or insulinomas. Hypoinsulinemia refers to abnormally low levels of insulin in the blood.

Which nutrients would the nurse teach the parents of a child with celiac disease to avoid? A. Saturated oils and fats B. Milk and hard cheeses C. Corn and rice products D. Wheat and oat products

D. Wheat, oats, rye, and barley are major dietary sources of gluten; the gliadin fraction of these grains is not tolerated by individuals with celiac disease. There is no gluten in oils and fats. There is no gluten in cheeses and milk. Corn and rice are used as substitute grains because they do not contain gluten.